Endoscopic band ligation for postpolypectomy gastric bleeding

We report a case of a patient in whom endoscopic band ligation was achieved for postpolypectomy gastric bleeding. A 76‐year‐old man visited our hospital because of anemia. Endoscopy revealed a gastric polyp, approximately 12 mm in diameter, on the lesser curvature in the distal gastric body. The polyp was considered to be the source of chronic anemia and was therefore removed by using standard careful snare‐cautery polypectomy technique. Four days later, follow‐up endoscopy was performed to evaluate the postpolypectomy site, and an active bleeding postpolypectomy ulcer was identified. Initial attempts to achieve hemostasis with ethanol injection were unsuccessful. Immediate hemostasis was obtained with a subsequent endoscopic band ligation device. There has been no recurrent bleeding. Endoscopic band ligation might be a good treatment modality for the treatment of a postpolypectomy gastric bleeding lesion.     

Melatonin treatment for rhythm disorder

Abstract We tried melatonin treatment in two patients with non-24 h sleep-wake syndrome, who did not respond to treatments by vitamin B₁₂, bright light therapy, or hypnotics. In one patient, melatonin 5–10 mg improved difficulty in falling asleep and in waking, although it failed to improve the sleep-wake rhythm. In another patient, melatonin 3 mg successfully changed the sleep-wake rhythm from free-running pattern to delayed sleep phase pattern. However, melatonin re-administration after a 4-month drug-free interval failed to improve his free-running sleep-wake rhythm. These results suggest that melatonin acted as a sleep inducer in one patient and as a phase setter in the other, although the effect on the latter patient was transient.     

GENOTYPES OF ALDH2 RELATED TO LIVER AND PULMONARY DISEASES AND OTHER GENETIC FACTORS RELATED TO ALCOHOLIC LIVER DISEASE

Genetic factors related to the development of alcoholic liverand pancreatic diseases (ALD and APD) and of alcohol-inducedasthma were analyzed. The development of ALD is geneticallycontrolled and is directly associated with the polymorphismsof the genes of acetaldehyde (Ac-CHO) and ethanol-metabolizingenzymes, aldehyde dehydrogenase-2 (ALDH2) and cytochrome P4502E1.The development of ALD and APD may also be genetically linkedwith the induction of gamma-glutamyl transferase (GTT) by alcohol.Alcohol-induced asthma is related to the genotypes of ALDH2and is caused by rapid elevation of blood Ac-CHO. ALDH1 playsa very important role in the oxidation of Ac CHO in blood.     

Effects of granulocyte colony-stimulating factor upon coxsackievirus B3 myocarditis in mice

Granulocyte colony-stimulating factor is a potent activatorof mature granulocytes, and subsequently enhances superoxiderelease. The purpose of this study was to investigate the effectsof granulocyte colony-stimulating factor upon murine coxsackievirusB3 myocarditis in relation to free radical-mediated cardiacdamage. Two-week-old, male, C₃H/He mice were inoculated intraperitoneallywith coxsackievirus B3. Gramulocyte colony-stimulating factor20 µg.kg^–1. day^–1, polyethylene glycol-conjugatedsuperoxide dismutase (an enzyme catalyzing the conversion ofO₂^- to H₂O₂) 1 x 10³ U.kg^–1 day^–1 and granulocytecolony-stimulating factor 20 µg. kg^–1 day^–1,plus polyethylene glycol-conjugated superoxide dismutase 1 x10³ U.kg^–1. day^–1, were injected subcutaneouslydaily on days 0 to 14. Treated groups were compared to the infected,untreated group. The survival rate in the polyethylene glycol-conjugatedsuperoxide dismutase group was higher than that of the untreatedgroup on day 14, but on day 7, cardiac pathology was not significantlydifferent among the four groups. On day 14, the scores of cellularinfiltration, myocardial necrosis and calc were lower in thepolyethylene glycol-conjugated superoxide disnuitase group andin the granulocyte colony-stimulating factor plus polyethyleneglycol-conjugated superoxide dismutase group than in the untreatedgroup. The myocardial virus titres on days 7 and 14 did notd sign y among the four groups. The number of total white bloodcell and neutrophil counts were signifIcantly greater in thegranulo cyte colony-stimulating factor group than in the untreatedgroup on day 7. Taken altogether with the previous reports andpresent evidence that the administration of granulocyte colony-stimulatingfactor did not exacerbate coxsackievirus B3 myocarditis, itmay be that oxygen-free radicals appeared to be derived notfrom leukocytes but from other components in this experimentalmodel of myocarditis, whereas the myocardium was inflamed withleukocytes.     

Difficulty in removing a percutaneous central venous catheter inserted from a peripheral vein

Two girls with acute lymphocytic leukemia (ALL) are reported. There were difficulties in removing their central venous catheters inserted from a peripheral vein. One girl required surgery under general anesthesia for the removal. The other patient received continuous infusion of low dose urokinase from a distal peripheral vein. The residual catheter was then removed successfully.     

Polysomnography and body temperature changes by phototherapy in a delayed sleep phase syndrome case

Abstract We examined polysomnography (PSG) and body temperature in a patient with delayed sleep phase syndrome who responded to phototherapy. The patient was a 31-year-old woman whose condition had slightly improved by a vitamin B₁₂ administration. Phototherapy was administered to her in combination with the vitamin B₁₂ medication, and this combined treatment successfully advanced her delayed sleep phase. On PSG, the regimen showed shortened sleep latency, decreased total sleep time and stages 1 and 2 sleep, and increased slow wave sleep. Phototherapy also improved temporal distribution of delta half-waves (0.5-2.0 Hz, 31 µV) as well as phase relationship between sleep and body temperature.     

Influence of gum-chewing on the haemodynamics in female masseter muscle

Summary  Blood flow in active skeletal muscles provides energy substrate, oxygen and reduction of excessive heat and metabolic by-products. Although cyclic jaw motions such as those during mastication and speech articulation are the primitive oro-facial functions, possible effects of the cyclic muscle contractions on the intramuscular haemodynamics of the jaw muscles remains scarcely known. We investigated the masseteric haemodynamics during and after gum-chewing. Ten healthy female adults participated in the study. Electromyography, kinetics of masseter muscle oxygenation, electrocardiogram and blood pressure were recorded simultaneously. The subjects were asked to perform gum-chewing and cyclic jaw motion without gum bolus (empty-chewing task). The haemodynamics parameters were compared between the two experimental conditions. During gum-chewing task, deoxygenated haemoglobin and sympathetic nerve activity increased, while tissue blood oxygen saturation decreased. Blood pressure and parasympathetic nerve activity did not change. The overall behaviour of haemodynamic parameters during empty-chewing task was similar to that observed during gum-chewing task. However, the latency periods from the end of chewing until significant changes in the haemodynamic parameters were notably shorter ( P  < 0·05) in gum-chewing task as compared with those associated with empty-chewing task. The duration of the changes was shorter with empty-chewing than with gum-chewing. Fluctuations in masseter muscle haemodynamics associated with chewing jaw movement differed depending on the level of muscle contraction during movement. The differences became statistically significant immediately after the commencement of chewing and after the cessation movement. During the chewing movement, automatic nerve activities increased in response to the level of muscle contraction during movement.     

Alternating Non-Cross Resistant Chemotherapy for Small Cell Lung Cancer

After stratification for the extent of disease, previously untreatedpatients .with small cell lung cancer randomized to receivetherapy with the four-drug combination of cyclophosphamide,oncovin, nimustine hydrochloride (ACNU), and procarbazine (CONP)every four weeks (continuous regimen) or to receive CONP alternatingwith the three-drug combination of etoposide (VP-16), adriamycinand cisplatin (VAD) at four-week intervals (alternating regimen).Sixty-nine patients were entered in the study. Of 34 evaluablepatients receiving the continuous regimen, six (17.6%) achievedcomplete response (CR) and 16 (47.1%) achieved partial response(PR). Of 31 evaluable patients receiving the alternating regimen,10 (32.3%) achieved CR, and 16 (51.6%) achieved PR. There wasa tendency in favor of the alternating regimen in CR and overall response rates (0.05 < p < 0.1). There were no significantdifferences be tween the regimens in response duration or survival.The projected median survival times were 9.2 months and 9.4months for the continuous and alternating regimens, respectively.One patient receiving the continuous regimen and three receivingthe alternating regimen have been living for more than two years.The major toxicity was myelosuppression in both regimens. Onepatient died of hemorrhage due to thrombocytopenia during inductionwith CONP, and one patient died of cisplatin-induced renal failure.We conclude that alternating non-cross resistant chemotherapyleads to improved CR and response rates, but does not improvesurvival.