Twenty-degree-tilt radiography for evaluation of lateral humeral condylar fracture in children

Objective  

To investigate the efficacy of ‘20°-tilt anteroposterior (A-P) radiography’ in the assessment of lateral condylar fractures of the distal humerus.     

Cost and effectiveness of reduced-intensity and conventional allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndrome

Goals of work  

Allogeneic stem cell transplantation with a reduced-intensity regimen (RIST) has been evaluated mostly in terms of its clinical benefit, and the pharmacoeconomic aspects of this procedure remain unclear. We compared the cost and effectiveness of RIST with those of stem cell transplantation using a conventional myeloablative regimen (CST).     

Is cyclosporine A transport inhibited by pravastatin via multidrug resistant protein 2?

Background and purpose  

Cyclosporine A (CyA) is an immunosuppressant drug used to treat various autoimmune diseases and transplantations. It has been reported that, in humans, CyA is metabolized by cytochrome P450 (CYP) 3A or excreted by P-glycoprotein/multidrug resistant protein (MRP) 2. Pravastatin, a statin, is used to treat hyperlipidemia and has also been reported to be excreted primarily by MRP2. We observed an increased blood CyA level in a patient following pravastatin administration, suggesting the possibility that CyA interacted with the pravastatin via MRP2. The aim of the study reported here was to investigate the effects of pravastation on CyA transport via MRP2 using a human colon adenocarcinoma (Caco-2) monolayer model system.     

Detection performance of a portable ion mobility spectrometer with <Superscript>63</Superscript>Ni radioactive ionization for chemical warfare agents

The detection performance of a portable ion mobility spectrometer (IMS) (SABRE 4000, Smiths Detection) with ⁶³Ni ionization, air purification, and reduced ion mobility measurements using calibrants was investigated for vapors of chemical warfare agents. In a matter of several seconds, the SABRE 4000 enabled tentative identification of sarin, soman, cyclohexylsarin, tabun, and nitrogen mustard 3, each with a limit of alarm (LOA) of 0.005–0.5 mg m⁻³ in positive ion collection mode. Hydrogen cyanide could be identified with a LOA of 0.2 mg m⁻³ in the negative mode. Mustard gas, nitrogen mustards 1, 2, and 3, phosgene, and chloropicrin showed a positive alarm of “HD/Phos” with a LOA of 0.2–2 mg m⁻³ in negative mode. Lewisite 1, cyanogen chloride, and chlorine vapors did not show any alarm, although the characteristic ion peaks appeared in negative mode. The peak areas of the respective detected ions on the second differentiation spectra were positively correlated with the corresponding vapor concentrations in low concentration ranges. Several chemical agent simulants and organic solvents were also examined for detection by the machine. The SABRE 4000 is superior to other portable IMS machines at this time, although some improvements of the system are necessary.     

Pseudoaneurysm of the subclavian artery due to Xanthomonas pneumonia in a patient with acute myeloid leukemia: its rupture treated by transcatheter coil embolization.

A 52-year-old male with acute myeloid leukemia developed pseudoaneurysm of the subclavian artery. Pneumonia due to Xanthomonas maltophilia, which was multi-drug resistant, progressed to a lung abscess even under administration of antibiotics. This lung infection contiguous to the left carotid and subclavian arteries was suggested to have caused the pseudoaneurysm of the subclavian artery. The rupture of the aneurysm by penetration to the trachea amounted to about 1,000 ml of bleeding; fortunately the bleeding ceased spontaneously. Nonetheless, an emergency transcatheter coil embolization prevented re-bleeding. Endovascular treatment should be considered especially for aneurysms which develop in patients with underlying diseases.     

Percutaneous ethanol injection therapy for patients with inoperable thyroid papillary cancer: a report of two cases

Percutaneous ethanol injection therapy (PEIT) has been proposed for the treatment of autonomously functioning thyroid nodules and cysts. We report two patients with inoperable thyroid papillary cancer treated with PEIT, which has not, to date, been used frequently for this purpose. One patient, who had a large thyroid papillary cancer, had had liver cirrhosis for more than 5 years. The other patient was elderly and had diabetes mellitus and chronic hepatitis. In both patients, there was massive adhesion between the tumor and the trachea. Because a complete resection would have been both difficult and risky for either patient, we elected to use the PEIT procedure. The tumors regressed markedly in size as a result of the repetition of PEIT. There were no severe complications in either patient, except for slight pain and transient mild dysphagia. PEIT may be a useful treatment for patients with advanced thyroid papillary cancer and/or for those patients at high risk for surgical remedies; it is a viable option for patients with inoperable disease. Received: February 12, 1999 / Accepted: May 15, 2000     

Adrenomedullin amidation enzyme activities in hypertensive patients.

Adrenomedullin (AM) is a potent vasodilating peptide secreted from the vasculature of various organs. It is biologically active when its C-terminus is amidated. Recently, an RIA method was developed for measurement of the active form of AM, or mature AM. We here employed this method to investigate the significance of amidation of AM in controlling cardiovascular function. Thirty-six patients under hemodialysis were recruited and divided into hypertensive (n = 25; 157/86 mmHg) and normotensive (n= 11; 116/66 mmHg) groups. Mature AM, immature AM and blood pressure were monitored during hemodialysis in all patients. There was a significant reduction in blood pressure during hemodialysis in both groups, although after hemodialysis blood pressure was still higher in hypertensives than in normotensives (139 +/-14.8/76 +/- 2.5 mmHg vs. 110 +/- 5.1/66.7 +/- 3.1 mmHg). Mature AM before hemodialysis were lower in hypertensives than normotensives and it decreased in both groups. Although mature AM decreased more in normotensives than in hypertensives (-27 +/- 8% vs. -17 +/- 5%), at the end point, its level was still higher in normotensives. The ratio of mature AM/immature AM decreased only in normotensives (-11.4 8.7%), whereas it remained stable in hypertensives (0.2 +/- 5.6%). Both groups showed similar changes in ANP, endothelin, catecholamines, cGMP, and NOx. The low level in mature AM level in hypertensives may have contributed to the higher blood pressure in this group. The attenuation of AM amidation in normotensives indicates that an unspecified amidative enzyme of AM was regulated in order to normalize blood pressure.