Chronotropic and inotropic effects of histamine in developing chick heart: differential mechanisms before and after hatching

Chronotropic and inotropic effects of histamine were examined in isolated atrial and ventricular preparations from embryonic and hatched chicken hearts. Histamine produced positive chronotropic and inotropic responses both in embryonic and hatched hearts. The responses to histamine in middle embryonic myocardia, which were observed in the micromolar range, were antagonized by H₂ antagonists but not by H₁, H₃ antagonists and propranolol. Isobutylmethylxantine, an inhibitor of phosphodiesterase, produced a leftward shift of the concentration-response curve for the chronotropic effect of histamine in the embryo. The responses to histamine in myocardia from hatched chicks, which were observed in the milimolar range, appeared concurrently with the responses to tyramine during development and were antagonized by beta adrenoceptor antagonists but not by any of the histamine antagonists. The positive inotropic response to histamine in hatched ventricular preparations were greatly attenuated by reserpine pretreatment or in the presence of desipramine. Thus, we demonstrated that exogenously applied histamine produces positive chronotropic and inotropic responses in developing chicken hearts and that the mechanisms are different between embryonic and hatched chicks: direct action on H₂ receptors in the embryonic heart and release of norepinephrine from sympathetic nerve terminals in hatched hearts.     

Tibial artery autogenous in situ vein bypass with adjunctive arteriovenous fistula

A man suffering from severe intermittent claudication of the right calf and foot was successfully treated by femoro-tibio-peroneal trunk autogenous vein bypass with adjunctive arteriovenous fistula. Prior to operation, he was unable to walk more than 50 meters without resting. Preoperative arteriography revealed extensive occlusion of the popliteotibial arteries, except for indistinct visualization of the tibio-peroneal trunk, in which conventional reconstructive surgery seemed not to be feasible because of poor distal run-off. An autogenous vein bypass graft between the distal superficial femoral artery and tibio-peroneal trunk was successfully made "in-situ", creating an adjunctive arteriovenous fistula. Postoperatively, the ankle pressure index of the posterior tibial artery was considerably increased from 0 to 0.65, and Doppler flow wave could be recorded. The patient can now walk more than 1,500 meters without resting.     

Randomized controlled trial comparing oral doxifluridine plus oral cyclophosphamide with doxifluridine alone in women with node-positive breast cancer after primary surgery.

PURPOSE: We compared the therapeutic usefulness of doxifluridine (5'-DFUR) alone and a combination of 5'-DFUR plus cyclophosphamide (CPM), both of which are considered effective against advanced and recurrent breast cancer, to determine which treatment is more beneficial as postoperative adjuvant chemotherapy. PATIENTS AND METHODS: A total of 1,131 women with node-positive primary breast cancer were randomly assigned after primary surgery to receive 5'-DFUR alone or 5'-DFUR plus CPM. All patients initially received 5'-DFUR in an oral dose of 1,200 mg/d for 4 weeks, starting 4 weeks after surgery. Chemotherapy was then not given for 2 weeks. Patients in the 5'-DFUR group subsequently received five 4-week cycles of treatment consisting of oral 5'-DFUR (1,200 mg/d) for the first 2 weeks and no chemotherapy for the next 2 weeks. Those assigned to the 5'-DFUR plus CPM group also received oral CPM 100 mg/d for the first 2 weeks and no chemotherapy for the next 2 weeks. Women 50 years or older concurrently received 20 mg/d of tamoxifen for 2 years in both groups. RESULTS: Of the 1,088 eligible women, 546 were assigned to receive 5'-DFUR alone and 542 were assigned to receive 5'-DFUR plus CPM. Overall disease-free survival was significantly better in women who received 5'-DFUR plus CPM than in those who received 5'-DFUR alone (log-rank test, P =.021). Toxic effects occurred in 20.0% of patients (109 of 546) in the 5'-DFUR group and 32.3% of patients (175 of 542) in the 5'-DFUR plus CPM group (chi(2) test, P <.001). CONCLUSION: Combination therapy with 5'-DFUR plus CPM is more effective in preventing recurrence than 5'-DFUR alone.     

MgH2–CoO: a conversion-type composite electrode for LiBH4-based all-solid-state lithium ion batteries

Several studies have demonstrated that MgH₂ is a promising conversion-type anode toward Li. A major obstacle is the reversible capacity during cycling. Electrochemical co-existence of a mixed metal hydride-oxide conversion type anode is demonstrated for lithium ion batteries using a solid-state electrolyte. 75MgH₂·25CoO anodes are obtained from optimized mixing conditions avoiding reactions occurring during high-energy ball-milling. Electrochemical tests are carried out to investigate the cycling capability and reversibility of the on-going conversion reactions. The cycling led to formation of a single-plateau nanocomposite electrode with higher reversibility yield, lowered discharge–charge hysteresis and mitigated kinetic effect at high C-rate compared to MgH₂ anodes. It is believed that reduced diffusion pathways and less polarized electrodes are the origin of the improved properties. The designed composite-electrode shows good preservation and suitability with LiBH₄ solid electrolyte as revealed from electron microscopy analyses and X-ray photoelectron spectroscopy.

The findings point to a means of guided formation of MgH₂–CoO conversion-type nanocomposite electrode for all-solid-state Li-ion batteries.     

Predictor of respiratory disturbances during gastric endoscopic submucosal dissection under deep sedation

BACKGROUND Sedation is commonly performed for the endoscopic submucosal dissection(ESD) of early gastric cancer. Severe hypoxemia occasionally occurs due to the respiratory depression during sedation.AIM To establish predictive models for respiratory depression during sedation for ESD.METHODS Thirty-five adult patients undergoing sedation using propofol and pentazocine for gastric ESDs participated in this prospective observational study. Preoperatively, a portable sleep monitor and STOP questionnaires, which are the established screening tools for sleep apnea syndrome, were utilized. Respiration during sedation was assessed by a standard polysomnography technique including the pulse oximeter, nasal pressure sensor, nasal thermistor sensor, and chest and abdominal respiratory motion sensors. The apnea-hypopnea index(AHI) was obtained using a preoperative portable sleep monitor and polysomnography during ESD. A predictive model for the AHI during sedationwas developed using either the preoperative AHI or STOP questionnaire score.RESULTS All ESDs were completed successfully and without complications. Seventeen patients(49%) had a preoperative AHI greater than 5/h. The intraoperative AHI was significantly greater than the preoperative AHI(12.8 ± 7.6 events/h vs 9.35 ± 11.0 events/h, P = 0.049). Among the potential predictive variables, age, body mass index, STOP questionnaire score, and preoperative AHI were significantly correlated with AHI during sedation. Multiple linear regression analysis determined either STOP questionnaire score or preoperative AHI as independent predictors for intraoperative AHI ≥ 30/h(area under the curve [AUC]: 0.707 and 0.833, respectively) and AHI between 15 and 30/h(AUC: 0.761 and 0.778, respectively).CONCLUSION The cost-effective STOP questionnaire shows performance for predicting abnormal breathing during sedation for ESD that was equivalent to that of preoperative portable sleep monitoring.     

Ulcerative colitis followed by the development of Behçet's disease

A 34-year-old man who had a history of ulcerative colitis (UC) was admitted to our hospital with complaints of arthralgia, erythema nodosum, recurrent oral aphthous ulcers and bloody stools. A colonoscopy revealed multiple aphthous ulcers on his cecum and colon and also revealed a transmural ulcer on his rectum consistent with a diagnosis of UC. The patient was HLA-B51 positive. Based on clinical evidence [recurrent oral ulcers, skin lesions (erythema nodosum), positivity for pathergy test] this patient was diagnosed as having Beh?et's disease with gastrointestinal involvement. We describe this rare case of Beh?et's disease with colitis and discuss the difficulties in making a differential diagnosis between Beh?et's disease and the inflammatory bowel diseases.     

乳腺癌广泛导管内癌成分与组织蛋白酶D Ki-67及单链DNA表达的关系及临床意义

目的 探讨乳腺癌广泛导管内癌成分（extensive intraductal component，EIC）、粉刺状坏死（comedo necrosls）、组织学分级与组织蛋白酶D（eathepsin D）、Kiab7、单链DNA（ssDNA）及c-erbB-2表达的关系。方法检测日本德岛乳腺门诊与东德岛医院1996年1月至1997年4月连续手术切除的59例乳腺浸润性导管癌标本。用免疫组化方法，检测59例乳腺浸润性导管癌中组织蛋白酶D（eathepsin D）、Ki-67、单链DNA及c-erbB-2的表达。结果EIC阳性组，肿瘤上皮细胞中的组织蛋白酶D为高表达（P=0．021），肿瘤间质细胞中的组织蛋白酶D表达差异无显著性意义。粉刺状坏死的出现，与c-erbB-2癌基因、肿瘤上皮细胞中的组织蛋白酶D和细胞增殖指数相关（P分别为0．042，0．006及0．013）。结论肿瘤上皮细胞中的组织蛋白酶D可能参与了EIC与粉刺状坏死的形成。EIC与粉刺状坏死的检测有临床应用价值。