Factors contributing to changes in viscosity and flow rate of a dedicated gel for gel immersion endoscopy

Background and study aims  Gel immersion endoscopy is a novel technique for securing the visual field during endoscopy. Clinical application of a dedicated gel for this technique with an appropriate viscosity to prevent mixing with blood and its efficacy was reported. The aim of this study was to evaluate changes in gel viscosity and flow rate under different conditions. Methods  The viscosity of the gel after injection and flow rate were measured under various conditions changing the injection route and method. Gel viscosity was measured at 25, 10, and 4 °C. Results  A decrease in gel viscosity was found when the gel was injected via the water jet channel compared to the accessory channel. The flow rate and decrease in viscosity of the gel injected via the water jet channel were 220 mL/min and 63.2 %, while when injected via the accessory channel with a clip device inserted were 560 mL/min and 35.8 %. When the gel was kept at a low temperature, the viscosity increased. Conclusions  Gel injection via the accessory channel should be the first choice for efficient use considering the viscosity and flow rate.

Development of a gel dedicated to gel immersion endoscopy

Backgrounds and study aims  Gel immersion endoscopy is a novel technique to secure the visual field during endoscopy. The aim of this study was to develop a dedicated gel for this technique. Methods  To identify appropriate viscoelasticity and electrical conductivity, various gels were examined. Based on these results, the dedicated gel "OPF-203" was developed. Efficacy and safety of OPF-203 were evaluated in a porcine model. Results  In vitro experiments showed that a viscosity of 230 to 1900 mPa·s, loss tangent (tanδ) ≤ 0.6, and hardness of 240 to 540 N/cm ² were suitable. Ex vivo experiments showed electrical conductivity ≤ 220 μS/cm is appropriate. In vivo experiments using gastrointestinal bleeding showed that OPF-203 provided clear visualization compared to water. After electrocoagulation of gastric mucosa in OPF-203, severe coagulative necrosis was not observed in the muscularis but limited to the mucosa. Conclusions  OPF-203 is useful for gel immersion endoscopy.

Multifactorial analysis of local control and survival in patients with early glottic cancer

OBJECTIVES

The purpose of this study is to determine the effects of various prognostic factors for early glottic cancer patients who underwent radiotherapy.

METHODS

We retrospectively reviewed the all patients who were treated at our hospital for early glottic squamous cell carcinoma from 2004 to 2016. Data included patient's age, sex, T classification, tumor size, pathological grade, anterior commissure involvement, subglottic extension, laryngeal ventricle involvement, and restriction of vocal cord movement.

RESULTS

There were 74 patients with T1 tumors and 31 with T2 tumors. Recurrence was found in four patients with T1 and eight patients with T2. There were 99 males and six females enrolled, and the mean age was 67.5 ± 9.2 years for T1a, 67.3 ± 11.2 years for T1b, and 67.4 ± 7.9 years for T2. One patient with recurrence after 1 month was thought to have a residual tumor. The 5-year overall survival (OS) rate and the 5-year disease-specific survival (DSS) rate for T1-T2 patients were both 100%. The rate of larynx preservation was 94.6% for T1 and 74.2% for T2. A univariate analysis showed that the effective factors were age, T, size, SE. A multivariate logistic regression analysis showed that age influenced the recurrence status. Size is also suspected to be a prognostic factor.

CONCLUSIONS

This study revealed that the effective factors were age, T, size, and SE.

LEVEL OF EVIDENCE

4 Laryngoscope, 130:1701-1706, 2020.

Phospholipid Fatty Acid Composition and Diamine Oxidase Activity of Intestinal Mucosa From Rats Treated With Irinotecan Hydrochloride (CPT-11) under Vegetable Oil–Enriched Diets: Comparison Between Perilla Oil and Corn Oil

BACKGROUND

Irinotecan hydrochloride (CPT-11), a topoisomerase I inhibitor highly effective for various cancers, has its dosage limited by diffuse mucosal damage with increased prostaglandin (PG) E(2). However, an analysis of intestinal phospholipid fatty acid composition after CPT-11 treatment has not been reported. This study aimed to evaluate intestinal phospholipid fatty acid composition in relation to intestinal mucosal integrity and plasma and mucosal PGE(2) levels after CPT-11 treatment. The effect of dietary vegetable oil supplementation, perilla oil vs corn oil, was also evaluated.

METHODS

Intestinal phospholipid fatty acid composition, PGE(2) level, mucosal diamine oxidase (DAO) activity, diarrhea, and blood tests were evaluated in rats injected with CPT-11 under a conventional diet. The same parameters were compared among 3 different dietary vegetable oil supplementations: perilla oil, corn oil, and a 1:3, respectively, mixture with a semisynthetic diet during 14 days.

RESULTS

CPT-11 treatment caused severe diarrhea, and intestinal mucosal fatty acid composition changed with increased PGE(2) level and decreased DAO activity. Decreases in eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and EPA/arachidonic acid (AA) ratio in colonic mucosa were observed. Perilla oil increased omega-3 polyunsaturated fatty acids, alpha-linolenic acid, EPA, and EPA/AA ratio and decreased plasma PGE(2). But the amounts used were not enough to attenuate intestinal damage from CPT-11 treatment.

CONCLUSIONS

CPT-11 induced changes of intestinal mucosal fatty acid composition with increased PGE(2) level and decreased intestinal integrity; perilla oil shows the possibility of being able to attenuate those changes.

Residual cholesteatoma revealed by endoscopy after microsurgery

Residual cholesteatoma revealed by endoscopy after microsurgery.

OBJECTIVE

To endoscopically examine common sites of residual cholesteatoma occurrence after microscopic ear surgery.

METHODS

Thirty patients (15 men and 15 women; age range: 7-81 years) who underwent treatment for middle ear cholesteatoma (20 patients with pars flaccida :holesteatoma and 10 patients with pars tensa cholesteatoma) were selected. Following the removal of the cholesteatoma matrix via microscopy, residual matrix presence was assessed using an endoscope system. Additional resection was performed if the residual matrix was detected. Sites of residual matrix and their rates of incidence were then investigated.

RESULTS

Residual matrix was observed in nine out of the 30 (30%) patients by endoscopy after microscopic surgery. Residual matrix was observed in eight out of the 20 (40%) patients with pars flaccida cholesteatoma and in one out of :he 10 (10%) patients with pars tensa cholesteatoma. Residual matrix was observed in six out of the 14 (43%) patients who underwent canal wall up (CWU) tympanomastoidectomy and in three out of the 13 (23%) patients who underwent -anal wall down (CWD) tympanomastoidectomy. Sites of residual matrix included the tegmen tympani in two patients, he medial scutal surface in three patients, the tympanic sinus in two patients and the anterior epitympanic recess in three patients. The risk of residual matrix was greater in patients with pars flaccida cholesteatoma than in those with pars tensa :holesteatoma. The attic, tympanic sinus and anterior epitympanic recess are common sites of residual cholesteatoma.

CONCLUSION

Endoscopy is advantageous for the assessment of residual cholesteatoma in hidden areas.

Features of oral, pharyngeal, and laryngeal lesions in bullous pemphigoid

Bullous pemphigoid is an autoimmune bullous disease characterized by skin lesions, with or without oral lesions. The occurrence of pharyngolaryngeal lesions is very rare in affected patients. We conducted a study to investigate the characteristics of oral and pharyngolaryngeal lesions in bullous pemphigoid. Our study population was made up of 6 consecutively presenting outpatients-2 men and 4 women, aged 40 to 83 years (mean: 68.2)-who had been referred to our department over an 11-year period. Presenting symptoms included sore throat in all 6 patients and oral pain in 3. The sites of mucosal lesions included the soft palate, epiglottis, gingiva, hypopharynx, tongue, nasal cavity, and buccal mucosa. These lesions appeared as erosions, erosions with white coating, erythematous patches, and/or blisters. Mucosal lesions preceded skin lesions in 2 patients, appeared after skin lesions in 1 patient, and appeared simultaneously with skin lesions in 3 patients. We conclude that bullous pemphigoid sometimes involves the mucosa, such as that of the laryngopharynx and the oral cavity, and it can manifest as skin lesions. In the differential diagnosis of refractory pharyngolaryngeal lesions, bullous pemphigoid should be considered.

[A Clinical Study of Acute Epiglottitis]

We carried out a retrospective review of 285 cases of acute epiglottitis (180 males, 105 females, mean age 49.6 years) that required inpatients hospital care between 1998 and 2014. All the patients complained of sore throat, and 62 patients complained of respiratory discomfort; 17 patients had severe dyspnea, and 27 patients required airway management (tracheotomy in 25, cricothyroidotomy in 2 patients). All the patients survived. As acute epiglottitis can cause rapidly progressive airway obstruction and death, emergent airway management should be undertaken in patients with dyspnea. However, it is difficult to determine the indications for prophylactic respiratory management in patients without dyspnea. Therefore, the disease severity of the epiglottitis was evaluated on a five-grade scale according to the degree of swelling of both the epiglottis and the arytenoids. Although prospective evaluation is necessary, this scoring system may be beneficial to determine the indication for airway management, because all of the patients who complained of severe dyspnea or underwent airway management had grade 4 or 5 disease, while none of the patients with grade 1-3 disease required tracheotomy or cricothyroidotomy. Moreover, we compared the white blood cell count, body temperature, serum CRP and the interval from the onset between the group that required airway management and the group that did not require airway management. The white blood-cell count and body temperature were significantly higher, and the interval from the onset was significantly shorter in the group that required airway management than in the group that did not require airway management; however, the serum CRP level did not differ between the two groups.

Potentially lethal pharyngolaryngeal edema with dyspnea in adult patients with mumps: A series of 5 cases

In this article we describe 5 rare cases of mumps-associated pharyngolaryngeal edema. To the best of our knowledge, this report includes the first case of mumps-associated pharyngolaryngeal edema in a patient who had previously received mumps vaccination, and these cases represent the sixth report of mumps-associated pharyngolaryngeal edema in the English literature. All 5 of our patients with mumps infection were adults and manifested airway stenosis due to pharyngolaryngeal edema. This edema responded favorably to steroid treatment without tracheotomy. We conclude that a pharyngolaryngeal examination is recommended for patients with mumps infection. Steroid treatment is usually effective against pharyngolaryngeal edema; however, in certain cases tracheotomy may be inevitable.

Hyperbranched hydrocarbon surfactants give fluorocarbon-like low surface energies

Two series of Aerosol-OT-analogue surfactants (sulfosuccinate-type di-BCnSS and sulfoglutarate-type di-BCnSG) with hyperbranched alkyl double tails (so-called "hedgehog" groups, carbon number n = 6, 9, 12, and 18) have been synthesized and shown to demonstrate interfacial properties comparable to those seen for related fluorocarbon (FC) systems. Critical micelle concentration (CMC), surface tension at the CMC (γCMC), and minimum area per molecule (Amin) were obtained from surface tension measurements of aqueous surfactant solutions. The results were examined for relationships between the structure of the hedgehog group and packing density at the interface. To evaluate A and B values in the Klevens equation for these hedgehog surfactants, log(CMC) was plotted as a function of the total carbon number in the surfactant double tail. A linear relationship was observed, producing B values of 0.20-0.25 for di-BCnSS and di-BCnSG, compared to a value of 0.31 for standard double-straight-tail sulfosuccinate surfactants. The lower B values of these hedgehog surfactants highlight their lower hydrophobicity compared to double-straight-tail surfactants. To clarify how hydrocarbon density in the surfactant-tail layer (ρ(layer)) affects γCMC, the ρ(layer) of each double-tail surfactant was calculated and the relationship between γCMC and ρ(layer) examined. As expected for the design of low surface energy surfactant layers, ρ(layer) was identified as an important property for controlling γCMC with higher ρ(layer), leading to a lower γCMC. Interestingly, surfactants with BC9 and BC12 tails achieved much lower γCMC, even at low ρ(layer) values of <0.55 g cm(-3). The lowest surface energy surfactant studied here was di-BC6SS, which had a γCMC of only 23.8 mN m(-1). Such a low γCMC is comparable to those obtained with short FC-tail surfactants (e.g., 22.0 mN m(-1) for the sulfosuccinate-type FC-surfactant with R = F(CF2)6CH2CH2-).

Butyrate and trichostatin A attenuate nuclear factor kappaB activation and tumor necrosis factor alpha secretion and increase prostaglandin E2 secretion in human peripheral blood mononuclear cells

The effects of short-chain fatty acids (butyrate, propionate, and acetate) and trichostatin A (TSA), a typical histone deacetylase inhibitor, on tumor necrosis factor (TNF)-alpha secretion and nuclear factor kappaB (NF-kappaB) activation in peripheral blood mononuclear cells induced with lipopolysaccharide were evaluated in relation to prostaglandin E(2) (PGE(2)) secretion. Treatment of cells with butyrate; tributyrin, a prodrug of butyrate; propionate; acetate; and TSA down-regulated TNF-alpha secretion but all up-regulated PGE(2) secretion. Butyrate, propionate, and TSA inhibited NF-kappaB activation. The effects of the cyclooxygenase-nonspecific inhibitor, indomethacin; the cyclooxygenase-2 selective inhibitor, N-[2-(cyclohexyloxy)-4-nitro-phenyl] methanesulfonamide; and the general lipoxygenase inhibitor, nordihydroguaiaretic acid, varied in cells treated with each short-chain fatty acids. N-[2-(cyclohexyloxy)-4-nitro-phenyl] methanesulfonamide inhibited the effect of propionate on TNF-alpha secretion, and nordihydroguaiaretic acid inhibited that of acetate. The results showed that butyrate, propionate, and TSA inhibited TNF-alpha production via PGE(2) secretion and down-regulated NF-kappaB activation by lipopolysaccharide. These data suggest that the mechanism of butyrate and propionate action is through histone deacetylation and acetate through lipoxygenase activation in the regulation of proinflammatory responses in cells.

Short-chain fatty acids and trichostatin A alter tight junction permeability in human umbilical vein endothelial cells

OBJECTIVE

The short-chain fatty acids (SCFAs), butyrate, propionate, and acetate, produced by bacterial fermentation of dietary fiber, can modulate the transcription of certain genes by inhibiting histone deacetylase in colonocytes and several other cell types in vitro. We previously reported that butyrate decreases tight junction permeability by activating lipoxygenase (LOX) in intestinal monolayer cells. In the present study, we evaluated the effects of SCFAs on tight junction permeability in an endothelial cell culture and their possible mechanisms of action via histone deacetylase inhibitor activity. We also investigated the factors modulating tight junction permeability.

METHODS

The effects of butyrate, propionate, and acetate on tight junction permeability in human umbilical vein endothelial cells were examined using Transwell chamber cultures. The contributions of inducible nitric oxide synthase (NOS), endothelial NOS, estrogen receptor, cyclo-oxygenase, and LOX to SCFAs' effects were also evaluated. The effects of SCFAs were compared with those of trichostatin A, a typical histone deacetylase inhibitor.

RESULTS

Low concentrations of butyrate and propionate decreased paracellular permeability without inducing cell damage. However, acetate decreased paracellular permeability in a concentration-dependent manner. An estrogen receptor antagonist attenuated the effects of SCFAs on tight junction permeability. The influences of inducible NOS, cyclo-oxygenase, and LOX inhibitors and the expressions of cyclo-oxygenase and LOX mRNAs were different for each SCFA. Trichostatin A slightly decreased paracellular permeability when used at lower concentrations, but higher concentrations of trichostatin A increased permeability.

CONCLUSION

The SCFAs play an important role in the assembly of tight junctions in normal vascular endothelial cells.

Establishment and evaluation of the Japanese edition of the Weekly Epidemiological Record (WER) website by the Faculty of Health Sciences of Kobe University School of Medicine

To report on the establishment of the Japanese version website of the Weekly Epidemiological Record (WER) by the faculty and to evaluate its accessibility and the educational outcome: all articles from the WER since 2000 have been translated into Japanese by graduate students with teachers' guidance, verified by the committee members, and delivered to the website. The server log files and retrieval keywords were analyzed using Analog 6.0. An on-line questionnaire survey of visitors to the website was performed. Opinion sheets reported by the students for translation were evaluated as the educational outcome. Over 6 years, there were 820,571 requests to the website and, the number of requests increased with disease outbreaks. According to domain analysis, most requests were during daytime on weekdays, and the website was utilized by users in educational institutions and the Japanese government and by overseas visitors. Among respondents to the questionnaire, 47% were laypersons and 69% found the website easy to understand. SARS and HIV/AIDS were the terms most frequently used for retrieval. The students recognized the importance of the World Health Organization (WHO) and had broadened their perspective on international health. The website is useful for Japanese. The translating process was effective for international health education.

A Clinical Study on Deep Neck Infection

Deep neck infection (DNI) remains an emergent and life-threatening otolaryngologic disease. We examined 69 patients, 52 men and 17 women, with DNI, who were treated in our hospital between January 1995 and December 2004. The mean age of the patients with DNI was 50.0 years and the peak incidence was in the sixth decade. Twenty patients suffered from diabetes mellitus (DM). The primary DNI lesion was found in the tonsils in 34 cases, the oral cavity in 16 cases, and the pharynx in 12 cases, respectivelys. Among the 69 patients with DNI, the infection remained in the suprahyoid region in 31 cases, but it extended to the infrahyoid region in 33 cases and to the mediastinum in 5 cases. The titer of C-reacting protein (CRP) and the duration of admission were considered as parameters of the severity of DNI. CRP was significantly higher in elderly patients, in patients with DM, and in patients whose infection extended to the infrahyoid region and to the mediastinum, however, significant difference was not found between men and women, or among the types of primary DNI lesions. Moreover, the duration of admission was significantly longer in elderly patients, in patients with DM, and in patients with infrahyoid and mediastinal DNI, whereas no significant differences were found between men and women or among the types of primary lesions. Therefore, age, DM, and the extension of DNI are considered to be important factors which determining the severity of DNI.

Short-chain fatty acids alter tight junction permeability in intestinal monolayer cells via lipoxygenase activation

OBJECTIVE

Involvement of lipoxygenase (LOX) and cyclo-oxygenase (COX) on cellular differentiation or apoptosis induced by butyrate has been reported recently, but the effect on tight junction (TJ) permeability has not been reported. One major activity of butyrate and, to a lesser extent, propionate is to modulate gene transcription via histone acetylation by their histone deacetylase inhibitor activity. In this study, we evaluated the activation of LOX and COX in TJ permeability changes by short-chain fatty acids, butyrate, propionate, and acetate in intestinal monolayer cells and their possible mechanism by histone acetylation.

METHODS

The effects of LOX and COX inhibitors on TJ permeability and the expression of LOX or COX mRNA induced by short-chain fatty acids were investigated in Caco-2 cells using Transwell chambers. The effects of hydroxyeicosatetraenoic acid (a product of LOX) on TJ permeability were also evaluated. The effects of short-chain fatty acids were compared with those of trichostatin A (histone deacetylase inhibitor).

RESULTS

A LOX inhibitor clearly inhibited the effect of butyrate on TJ permeability, whereas COX inhibitors did not. The LOX and COX inhibitors partly inhibited the effects of propionate but not of acetate. Butyrate increased LOX mRNA expression, and hydroxyeicosatetraenoic acid and trichostatin A mimicked its effect.

CONCLUSION

These results suggest that short-chain fatty acids, especially butyrate, induce TJ permeability changes through LOX activation through histone acetylation.

Release of (1-->3)-beta-D-glucan from depth-type membrane filters and their in vitro effects on proinflammatory cytokine production

To clarify the origin of (1-->3)-beta-D-glucan in blood products and assess the biological activity of filter extracts, we evaluated (1-->3)-beta-D-glucan extraction from depth filters used to process blood products and their in vitro effects on proinflammatory cytokine production from macrophages. Cellulose or nylon filters were analyzed for (1-->3)-beta-D-glucan using the Fungitec G test. To evaluate the biological activity of the filter extracts, Mono Mac 6 cells (a human macrophage cell line) were cultured with filter extracts with or without lipopolysaccharide, and tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1beta) concentrations in the culture media were measured. (1-->3)-beta-D-Glucan was released from seven cellulose filters but the nylon filter level was undetectable. Proinflammatory cytokine production ranged from 74.3% to 119.0% of the control for TNF-alpha and 81.2% to 115.9% for IL-1beta. TNF-alpha and IL-1beta levels were low without lipopolysaccharide. The data indicate that (1-->3)-beta-D-glucan in blood products is contaminated with the depth filters and that these filter extracts modulate proinflammatory cytokine production from macrophages.

Experimental proof of contamination of blood components by (1?3)-?-D-glucan caused by filtration with cellulose filters in the manufacturing process

The level of (1-->3)-beta-D-glucan in blood is a diagnostic index of fungal infection because it is released from the fungal cell wall. However, high levels of plasma (1-->3)-beta-D-glucan in patients administered blood components may give false positive results. High levels of (1-->3)-beta-D-glucan have been detected in blood components. We suspected that (1-->3)-beta-D-glucan from cellulose filters had been eluted into blood components by filtration in the manufacturing process. To investigate the contamination of blood components by (1-->3)-beta-D-glucan from cellulose filters, in vitro experiments were performed by using six cellulose filters and a nylon filter. Human serum albumin (HSA) solution (100 ml) was flowed through each filter after rinsing with 100 ml of distilled water, and (1-->3)-beta-D-glucan in each fraction was determined by Fungitec G test MK. The concentration of (1-->3)-beta-D-glucan eluted from cellulose filters in 100-ml distilled water fractions ranged from 6 to 207 pg/ml, and that of HSA fractions ranged from 33 to 20,784 pg/ml. These data showed that remarkably higher (1-->3)-beta-D-glucan levels were detected in HSA fractions flowed through cellulose filters in spite of advance rinsing with 100 ml of distilled water. In the case of a nylon filter, (1-->3)-beta-D-glucan was not eluted in either fraction. These results indicate that (1-->3)-beta-D-glucan contamination in blood components is caused by filtration with cellulose filters in the manufacturing process.

Effect of gamma-linolenic acid or docosahexaenoic acid on tight junction permeability in intestinal monolayer cells and their mechanism by protein kinase C activation and/or eicosanoid formation

OBJECTIVE

Polyunsaturated fatty acids have been characterized as immunonutrients, but the effect of gamma-linolenic acid (GLA) or docosahexaenoic acid (DHA) on intestinal permeability has rarely been reported.

METHODS

Confluent Caco-2 cells on porous filter were used to measure tight junction function by fluorescein sulfonic acid permeability and transepithelial electrical resistance. Treatments with 0, 10, 50, and 100 microM of GLA or DHA during 24 h were compared. Then the effects of butylated hydroxytoluene (antioxidant), 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (protein kinase C antagonist), and inhibitors of enzymatic degradation to the eicosanoids, indomethacin (cyclooxygenase inhibitor) and 2-(12-hydroxydodeca-5,10-diynyl)-3,5,6-trimethyl-p-benzoquinone (lipoxygenase inhibitor), on GLA or DHA were examined.

RESULTS

GLA and DHA enhanced fluorescein sulfonic acid permeability to 8.7- and 1.4-fold, respectively, and lowered transepithelial electrical resistance to 0.52- and 0.73-fold, respectively, versus the control in a concentration-dependent manner without cell injury (P < 0.001 to 0.05). Indomethacin and 2-(12-hydroxydodeca-5,10-diynyl)-3,5,6-trimethyl-p-benzoquinone enhanced the changes mediated by GLA but did not alter the DHA effect. Butylated hydroxytoluene was ineffective. 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine facilitated the changes mediated by GLA, DHA, and eicosapentaenoic acid. The results indicated that the mechanism to change tight junction permeability via protein kinase C regulation is common but that via eicosanoid formation differs among GLA, DHA, and eicosapentaenoic acid.

CONCLUSIONS

GLA and DHA affect tight junction permeability in intestinal monolayer cells specifically and in a concentration-dependent manner.

Positive (1-->3)-beta-D-glucan in blood components and release of (1-->3)-beta-D-glucan from depth-type membrane filters for blood processing

BACKGROUND

The false-positive elevation of plasma (1-->3)-beta-D-glucan level, a serodiagnostic test for deep-seated mycosis, is suspected in patients administered with blood components.

STUDY DESIGN AND METHODS

(1-->3)-beta-D-Glucan and endotoxin levels in blood components consisting of 12 albumins, 8 immunoglobulins, and 3 blood coagulation factors were measured by fungal infection tests (Fungitec G-test, Seikagaku Co.; the Wako WB003 test, Wako Pure Chemical Industries; and the Endospec ES test, Seikagaku Co.). In vitro release of (1-->3)-beta-D-glucan from the depth-type filters made by cellulose membrane to process blood components was analyzed through an in vitro filtration process as a source of (1-->3)-beta-D-glucan in blood components.

RESULTS

The amounts of (1-->3)-beta-D-glucan in blood components ranged from 0 to 7510 pg per mL in the Fungitec G-test, with wide variations among brands. The positive rates over 20 pg per mL were 75 percent in albumin solutions, 40 percent in blood coagulation factors, and 63 percent in immunoglobulin solutions. (1-->3)-beta-D-Glucan levels released from the five depth filters ranged from 5 to 2516 pg per mL. The (1-->3)-beta-D-glucan level in filtration fluid was decreased by rinsing with distilled water, but rebounded again during the albumin filtration process.

CONCLUSION

Depth filters are considered the source of (1-->3)-beta-D-glucan content in some blood components.

Functional organisation of anterior thoracic stretch receptors in the deep-sea isopod Bathynomus doederleini: behavioural, morphological and physiological studies

The relationship between segmental mobility and the organisation of thoracic stretch receptors was examined in the deep-sea isopod Bathynomus doederleini, which shows a developed adaptive behaviour during digging. The movements of segments during digging were analysed from video recordings, which showed that a large excursion occurred in the anterior thoracic segments. Dye-fills of axons revealed four types of thoracic stretch receptor (TSR): an N-cell type (TSR-1), a differentiated N-cell type (TSR-2), a muscle receptor organ (MRO)-type with a long, single receptor muscle (TSR-3) and an MRO-type with a short, single receptor muscle (TSR-4 to TSR-7). Physiologically, TSR-1 and TSR-2 are tonic-type stretch receptors. TSR-3 to TSR-7 show two kinds of stretch-activated responses, a tonic response and a phasico-tonic response in which responses are maintained as long as the stretch stimulus is delivered. Both TSR-2, with a long muscle strand, and TSR-3, with a single, long receptor muscle, have a wide dynamic range in their stretch-activated response. In addition, TSR-2 is controlled by an intersegmental inhibitory reflex from TSR-3. These results suggest that, although TSR-1 has no receptor muscle and TSR-2 has a less-differentiated receptor-like muscle, they are fully functional position detectors of segmental movements, as are the MRO-type receptors TSR-3 to TSR-7.

Effect of eicosapentaenoic acid (EPA) on tight junction permeability in intestinal monolayer cells

The purpose of this study is to evaluate the effect of C18 and C20 long chain fatty acids on tight junction permeability in a model of intestinal epithelium.

METHODS

Confluent Caco-2 cells on porous filters with double chamber system were used to measure fluorescein sulfonic acid (FS) permeability and transepithelial electrical resistance (TEER). Lactate dehydrogenase release and ultrastructure were evaluated. Effect of 200 microM eicosapentaenoic acid (EPA, C20:5 n-3), arachidonic acid (AA, C20: 4 n-6), alpha-linoleic acid (ALA, C18: 3 n-3), linoleic acid (LA, C18: 2 n-6), or oleic acid (OA, C18: 1 n-9) enrichment in the culture medium during 24 hours were compared. The effect of the cyclooxygenase inhibitor, indomethacin, lipoxygenase inhibitors, NDGA or AA861, and antioxidant, BHT, was evaluated as a mechanism to change tight junction permeability.

RESULTS

Caco-2 cells formed polarized columnar epithelial cells with densely packed microvilli and well developed junctional complexes. Addition of EPA enhanced FS permeability to 3.0+/-1.6-fold and lowered TEER to 0.59+/-1.2-fold vs. control with concentration dependency without cell injury (P<0.01-0.05). OA, AA or LA did not change, but ALA enhanced tight junction permeability. Indomethacin and AA861 normalized the changes mediated by EPA.

CONCLUSIONS

EPA affects tight junction permeability in intestinal monolayer cells specifically and concentration dependently via cyclooxygenase and lipoxygenase products.

[Changes in neuropsychological functions following cardiovascular surgery]

This study was designed to elucidate if there is a potential hazard of developing neuropsychological deterioration after major cardiovascular surgery. Neuropsychological functions were studied in 49 patients before and after cardiac (coronary artery bypass, cardiac valve replacement, etc.) and thoracic aortic surgery (aortic aneurysm). Neuropsychological examinations using 5 batteries (Mini-Mental State Examination, Cross Cultural Cognitive Examination, Miyake's Verbal Memory Test, Benton Visual Retention Test and Wisconsin Card Sorting Test) were performed before surgery and subsequently at 3 weeks and 8 months after. Twenty-five of 49 patients (51%) showed a significant deterioration at least in one of the test batteries. There was no significant relation between age or educational levels and post-surgical impairment of cognitive function. The impairment of cognitive function was found mainly in the "memory function". Follow up examinations were carried out on 31 of the 49 patients 8 months after surgery. Among these patients, 13 patients did not show any changes in cognitive function throughout the study period. Eleven of the 16 patients who developed a decrease in cognitive function for a certain period after surgery (3 weeks), recovered to the same level at the follow-up examination that it was prior to the surgery. Cognitive function in five patients did not improve and remained at the decreased level. The other two patients whose function was normal at the first post-surgical examination, were found to have developed impairment of cognitive function at the follow up. Although the patients had some deficits on their neuropsychological function, they scarcely complained about any problems in their daily life.(ABSTRACT TRUNCATED AT 250 WORDS)

Automatic determination of hydroperoxides of phosphatidylcholine and phosphatidylethanolamine in human plasma

An automatic method for the determination of hydroperoxides of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) is reported. Sample plasma was deproteinized with a fourfold volume of methanol. After centrifugation, the supernatant was injected directly into an HPLC system without further treatment. The hydroperoxides of PC and PE were concentrated and washed on an ODS column followed by introduction into two analytical columns, a silica gel and an aminopropylsilica gel column, which were connected in series, by column switching. After the separation, they were detected by postcolumn detection with diphenyl-1-pyrenylphosphine. The compounds were determined at picomole levels within 30 min with good reproducibilities. By using only a silica gel column as an analytical column, PC hydroperoxides were determined within 20 min, and samples could be injected into it at 15-min intervals. Those methods made it possible to inject a sample of up to 2 ml at one time and up to 8 ml by repeated injections and to determine phospholipid hydroperoxides in human plasma at picomole levels.

[A case report of leiomyosarcoma of the rectum]

A case of leiomyosarcoma of the rectum and a review of the relevant Japanese literature is reported. A 33-year-old man, suspected of having a rectal tumor was admitted to out hospital for though examination. The tumor was located at the anterior wall of the rectum behind the prostatic gland. A preoperative perineal biopsy was done and the pathological diameters was a leiomyosarcoma. The abdominoperineal resection was performed but the nerve was able to be preserved. The postoperative quality of life has been good. The difficulties in arriving at a histological differentiation of a simple tumors of the rectum from a malignant smooth muscle tumor of the rectum is discussed.