Clinical experience of endotracheal intubation after administration of NC45-10 (vecuronium bromide 10 mg preparation)]

We studied the usefulness of the 10 mg presentation of vecuronium bromide (NC45-10) for endotracheal intubation. Subjects were ASA type I-II patients between 20-65 years of age scheduled for various kinds of surgery who consented to participate in this study. After the entrance of patients into the operating room, we set up monitors and intravenously injected a priming dosage of NC45-10, 0.015 mg.kg-1. Next, we administered thiopental 5 mg.kg-1 and injected initial dosage of either 0.065 mg.kg-1 or 0.1 mg.kg-1 of NC45-10 intravenously 5 minutes after the administration of priming dose. One minute later, we attempted endotracheal intubation. We evaluated the muscle relaxation by the reaction to endotracheal intubation and graded it by the score of 0-3. Satisfactory muscle relaxation on endotracheal intubation was obtained in 80% of the patients with no significant difference between the 2 groups of initial dosage. No side effect or cardiovascular action was observed. It is concluded that this preparation is clinically safe and useful.     

Detection and prognosis of alimentary tract cancers--mass screening

The limitation of detectability and curability in terms of current techniques (screening and details) were sought in otherwise healthy examinees. Not a few cancers were present in the alimentary tract, except for the stomach, in these otherwise healthy examinees who voluntarily underwent gastric cancer mass screening. The prognosis of alimentary tract cancers deteriorates in the descending, following order: colon cancer, stomach cancer, and esophageal cancer. The survival rate of primary liver cancer, cholecyst cancer, and pancreas cancer is extremely low. Unless new techniques are developed in these diagnoses, no improvement in the survival rate can be anticipated.     

In vitro analysis of the change in resistance of Chlamydia trachomatis under exposure to sub-MIC levofloxacin for a therapeutic term

BACKGROUND: While fluoroquinolone-resistant Chlamydia trachomatis strains have not been clinically isolated, they were isolated in an in vitro study recently. METHODS: To determine whether C. trachomatis strains develop resistance under sub-MIC antibacterial exposure in a clinical therapeutic term, C. trachomatis strains were exposed to sub-MIC levofloxacin (LVFX) for about 2 weeks. The MIC of LVFX was measured and DNA fingerprinting was performed every 72 h by PCR using random primers. RESULTS: There was almost no change in the MIC under exposure to 0.125 microg/ml LVFX. However, some mutational changes in DNA fingerprints developed. CONCLUSIONS: In clinical therapeutic terms, resistant strains of C. trachomatis will probably not develop, even if sub-MIC LVFX is employed.     

Oesophageal coins invisible on chest radiography: a case report

Background

Coins are made of metal, which is generally radiopaque, and so physicians often have the misconception that all coins are detectable by radiography. Here, we report a case of intentionally swallowed coins in the oesophagus of an adult; the coins could not be detected on chest radiography but were detected using computed tomography (CT).

Case presentation

A 46-year-old woman with a history of depression presented to the emergency department after an intentional medication overdose and ingestion of two Japanese 1-yen coins. She complained of persistent retrosternal discomfort. In order to confirm whether the coins were in the oesophagus or trachea, an anteroposterior chest radiograph was obtained; however, no coins were detected. Owing to her persistent symptoms, a chest CT was performed. On the initial CT scan, two 1-yen coins were observed in the oesophagus: one in the middle oesophagus and the other in the lower oesophagus. After the scanning, the patient drank water with permission, but vomited. No coins were found in her vomit, and the symptoms of retrosternal discomfort had completely disappeared. A subsequent CT scan revealed that the two 1-yen coins were in the patient’s stomach.

Conclusions

Japanese 1-yen coins are made of 100% aluminium, which is less radiopaque than the metals that make up coins (nickel, bronze, and lead), and so, they were not visible via chest radiography in our case. Detecting very small or thin radiolucent foreign bodies is not possible using a chest radiograph or contrast oesophagram, but is possible via CT. CT is both increasingly convenient and non-invasive, unlike endoscopy or bronchoscopy, and so, the use of CT scans should be considered in cases of possible radiolucent foreign body ingestion.

     

Immature granulocyte count after liver transplantation.

We evaluated the significance of immature granulocyte (IG) count during the clinical course after liver transplantation. We counted IG using the flow cytometric method with CD16, CD11b, and CD45 antibodies. Samples were obtained from 31 patients in the Department of Transplantation and Immunology, and we determined (i) the distribution of IG peak value, (ii) the distribution of IG peak time-points, (iii) the clinical background of patients with high IG, and (iv) the clinical course of high IG cases. We observed the appearance of IG (100/microl or higher) in the majority of the patients (23 out of 31 patients; 74.2%). The IG peak was detected on the 19th day after transplantation. We observed serious complications, such as melena, rejection, or severe infection, in high IG (500/microl or higher) cases. We observed instances of inflammation with low C-reactive protein (CRP) value in the presence of IG. We believe that IG is a useful marker to monitor inflammation.     

In vitro inhibitory effects of hinokitiol on proliferation of Chlamydia trachomatis

The inhibitory effects of hinokitiol (beta-thujaplicin) on Chlamydia trachomatis D/UW-3/Cx were shown by MIC, minimum lethal concentration (MLC), and preinoculation minimal microbicidal concentration assays using HeLa 229 cells. The MIC and the MLC were both 32 microg/ml. Further evaluation of hinokitiol as a topical agent against C. trachomatis is warranted.