Clinical Evaluation of a New Type of Centrifugal Pump

Abstract: The major problems with existing centrifugal pumps are leakage, mechanical trauma, and thrombus formation. In consideration of these problems, a new compact centrifugal pump system was developed. The purpose of this study was to evaluate the new centrifugal pump system clinically. Ten patients underwent open heart surgery with a centrifugal pump or a roller pump. During surgery, hemodynamic and hematological data were obtained. A pulsatile assist device in the pump circuit was used in patients with severe heart disease. There was neither operative death nor hospital mortality, and there was no difference with regard to hemodynamic data between the two groups. The centrifugal pump group, however, had significantly lower hemolysis, especially during prolonged cardiopulmonary bypass. This centrifugal pump could also create sufficient pulsatile flow with a pulsatile assist device. Postoperative macroscopic and microscopic findings demonstrated the smooth surface of the pump without thrombus formation. This centrifugal pump system might be useful for prolonged cardiopulmonary bypass.     

温州地区近6年907例精神病司法鉴定案例分析

目的　探讨近 6年精神病司法鉴定案例的特征。方法　对浙江温州鹿城精神病医院1998～ 1999年 (A组 ) 2 0 2例 ,2 0 0 0～ 2 0 0 1年 (B组 ) 36 8例 ,2 0 0 2～ 2 0 0 3年 (C组 ) 337例进行对照研究。结果　近 6年 ,女性和无业构成比上升 (P <0 .0 1)。责任能力评定下降 ,服刑能力、民事行为能力评定上升 (P <0 .0 1)。精神损伤评定构成比上升 (P <0 .0 5 )。诊断为精神分裂症、情感性精神病逐年上升(P <0 .0 1)。无责任能力评定上升 (P <0 .0 1) ,完全责任能力评定下降 (P <0 .0 1)。法院委托鉴定上升 (P <0 .0 5 )。结论　近 6年中精神病司法学呈现不同的特点 ,并逐步向规范化、法规化迈进 ,服务范围和对象将会扩大     

Cross-sectional study of allergic disorders associated with breastfeeding in Japan: The Ryukyus Child Health Study

Uncertainties remain as to whether breastfeeding is protective against childhood allergic disorders. Positive relationships of breastfeeding with asthma and atopic eczema were observed in two previous Japanese studies. This cross-sectional study investigated the association between the feeding pattern after birth and the prevalence of allergic disorders during the past 12 months in Japanese schoolchildren. Study subjects were 24,077 children aged 6-15 yr in Okinawa. The outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Allowance was made for age, sex, number of siblings, smoking in the household, paternal and maternal history of asthma, atopic eczema, and allergic rhinitis, and paternal and maternal educational level. Breastfeeding, regardless of exclusivity, for 13 months or longer and exclusive breastfeeding for 4-11 months were independently associated with a higher prevalence of atopic eczema, particularly among children without a parental allergic history. A clear positive dose-response relationship was observed between prolonged duration of breastfeeding, regardless of exclusivity, but not exclusive breastfeeding, and the prevalence of atopic eczema. We found a significant positive trend for atopic eczema across the three categories (formula milk, partial and exclusive breastfeeding) in the first 4 months of life although the odds ratio for exclusive breastfeeding was not statistically significant. No material association was found between the feeding pattern after birth and the prevalence of wheeze or allergic rhinoconjunctivitis. Prolonged breastfeeding may be associated with a higher prevalence of atopic eczema in Japanese children.     

Cardiac rehabilitation and return to work after coronary artery bypass surgery

The work situation of 66 male patients who underwent elective coronary artery bypass surgery (CABS) and who had been randomly allocated to receive cardiac rehabilitation (group R) was compared with the work situation of 59 similar patients allocated to receive only standard care (group H). The follow-up time was one year. The proportions of subjects working in groups R and H were 26% and 20% (p=ns) before the CABS, 45% and 34% (p=ns) 6 months and 56% and 38% (p=ns) 12 months after the CABS, repectively. The increase in proportion of subjects who worked was significant in both groups at both 6 and 12 months after the CABS (p<0.05 for all changes). The increases were not significantly different between the whole groups, but in patients younger than 55 years of age, return to work was more frequent in group R than in group H (at 12 months 60% vs. 35%, p for the difference in change=0.02). Stepwise logistic regression analysis of the factors influencing return to work showed that a patient's judgement of his own working capacity as good 6 months after CABS (odds ratio (OR) 8.5, confidence interval (CI) 2.3–32.0), functional class 16 months after the CABS (OR 6.7, CI 1.8–24.5), his desire to work (OR 6.4, CI 1.6–26.0) and absence from work of less than 3 months before the CABS (OR 4.9, CI 1.2–20.2) were significant positive predictors of return to work 1 year after the CABS.     

Phase I Study of Paclitaxel by Three-hour Infusion: Hypotension Just after Infusion Is One of the Major Dose-limiting Toxicities

The primary objectives of this study were to determine the maximum tolerated dose (MTD) of paclitaxel administered by 3-h infusion to patients with solid tumors, and to characterize the pharmacokinetics of a 3-h infusion in comparison with those of a 24-h infusion. Twenty-seven patients each received one of six levels of paclitaxel, 105, 135, 180, 210, 240 and 270 mg/m², with premedication. Two patients given 240 mg/m² and one patient given 270 mg/m² unexpectedly had grade 3/4 hypotension just after finishing the paclitaxel infusion. Peripheral neuropathy was also dose-limiting at 270 mg/m². Although granulocytopenia was significantly less severe than with a 24-h infusion, more than half of the patients experienced grade 4 toxicity at doses of 240 or 270 mg/m². Severe hypersensitivity reactions (HSRs) were not observed. Pharmacokinetic studies using high performance liquid chromatography demonstrated proportionally greater increases in the peak plasma concentration and area under the curve, and decreases in clearance and volume of distribution with increasing dose, suggesting non-linear pharmacokinetics of paclitaxel when given by 3-h infusion. The MTD of paclitaxel given as a 3-h infusion was determined to be 240 mg/m² with dose-limiting toxicities of granulocytopenia, peripheral neuropathy and hypotension. Hypotension just after infusion, induced by 3-h infusion of paclitaxel, is a new observation which has not been reported previously. The recommended dose for phase II study is 210 mg/m². Although hypotension was observed as an unexpected toxic effect, paclitaxel could be administered safely over 3 h with premedication and proper monitoring, resulting in reduced myelotoxicity and with no increase in the incidence of HSRs as compared with a 24-h infusion.     

枳鳖胶囊抗大鼠肝纤维化形态学及肝组织Ⅲ型胶原mRNA表达的实验研究

目的:观察枳鳖胶囊抗肝纤维化形态学和Ⅲ型胶原mRNA表达的变化。方法:选择66只健康清洁级SD大鼠,雌雄各半,随机分为:正常对照组,模型组,秋水仙碱组,枳鳖胶囊大、中、小剂量组。以40%四氯化碳花生油皮下注射结合高脂饲料、酒水饮料复合因素诱导大鼠肝纤维化模型。造模结束后,除正常组不予处理外,其他组分别以蒸馏水,秋水仙碱混悬液,高、中、低浓度枳鳖胶囊溶液灌胃,疗程36d。疗程结束后,观察大鼠新鲜肝脏的表面情况、色泽、质地等大体形态,测定肝组织Ⅲ型胶原mRNA的表达,光镜观察肝组织HE染色和网状纤维染色的病理形态学改变。结果:模型组大鼠肝细胞损害、肝脏脂肪变性和胶原纤维增生的程度最显著,Ⅲ型胶原mRNA的表达最强。枳鳖胶囊组上述改变明显减轻,且可抑制Ⅲ型胶原mRNA的表达,疗效优于秋水仙碱组。结论:枳鳖胶囊可较好地保护肝细胞,并能阻止肝纤维化进程甚或逆转肝纤维化病理改变,抑制胶原基因表达,抑制胶原基因表达可能是其抗肝纤维化的作用机理之一。     

No evidence for association between the −112G/A polymorphism of UGRP1 and childhood atopic asthma

BACKGROUND: Susceptibility to asthma is known to involve genetic factors. Genome-wide screens have indicated that the chromosome 5q31-q34 region is linked to and/or associated with asthma. A new gene, named UGRP1 and reported by Niimi et al., encodes uteroglobin-related protein and is expressed in the lung and trachea. Niimi et al. showed the -112G/A polymorphism of the UGRP1 gene to be associated with asthma in a case-control study. OBJECTIVE: The objective of the present study was to replicate this association and confirm the possible role of the UGRP1-112G/A polymorphism in the aetiology of childhood asthma in a Japanese population. METHODS AND RESULTS: We conducted a transmission disequilibrium test (TDT) in 131 families identified through paediatric patients being treated for asthma. A case-control study was also carried out by comparing the probands and 137 unrelated non-atopic non-asthmatic Japanese children and 211 unrelated healthy Japanese adults. The -112G/A polymorphism was genotyped by the PCR-RFLP method. The TDT revealed that the -112A allele was not preferentially transmitted to asthma-affected children (P=0.85). Neither the presence of at least one A allele in an individual's genotype (sum of the G/A and A/A genotypes) nor the -112A allele was more prevalent among the asthma subjects than among the control subjects. CONCLUSION: Our findings indicate that the UGRP1-112G/A polymorphism does not play a substantial role in genetic predisposition to childhood asthma in this Japanese population.     

Clinical and manometric evaluation of anorectal function following low anterior resection with low anastomotic line using an EEA™ stapler for rectal cancer

Anorectal function was evaluated in eight patients who had low anterior resection of the rectum with a low anastomotic line, using an EEA^™ stapler, with determination of function based on periodic manometric studies and clinical symptoms. Immediately following surgery all patients suffered from frequent bowel actions and soiling. These symptoms improved with time and most patients could enjoy almost normal daily life by the sixth postoperative month. One month after surgery, anal canal resting pressure and maximum squeeze pressure were significantly reduced and rectoanal inhibitory reflex was absent; neither showed a distinct tendency to improve thereafter. Rectal sensation and reservoir capacity, which also were seriously impaired, recovered satisfactorily by the time of the six-month examination. This suggests that an improvement of clinical symptoms following this operation is dependent upon the recovery of reservoir capacity and sensation of the neorectum, and that this operative procedure is a functionally acceptable option for low rectal cancer.     

Factors associated with recovery and recurrence of depression in older people: A prospective study

The Liverpool Continuing Health in the Community Study has followed up 1070 elderly community subjects over 6 years. In the first year 123 subjects had case-level depression. Three years later 49 (39.8%) of the previously depressed were recovered, 33 (26.8%) were depressed, 16 (13%) were not available for interview and 25 (20.3%) were dead. This study looks at factors associated with the 3-year outcome of patients who were depressed at year 0. Two outcome groups that were compared were a recovered depression group and a recurrent/persistent depression group. The factors that were significantly associated with a recurrence of depression (or persistent depression) at year 3 were bereavement of a close figure in the 6 months before interview, loneliness and life dissatisfaction at year 3. A variety of traditional risk factors for depression (including age, marital status, physical ill-health and incapacity) failed to attain significance in predicting recurrent or persistent depression. When combined, both recovered and recurrently depressed groups at year 3 had significantly higher levels of pain and a higher number of serious upsets in the past 6 months and 6 weeks compared to a compared to a control group. The depressed at year 0 were more likely to have entered more dependent forms of accommodation by year 3.