Quantitative real-time polymerase chain reaction analysis of the type distribution, viral load, and physical status of human papillomavirus in liquid-based cytology samples from cervical lesions

Human papillomavirus (HPV) 16 DNA can be integrated into the DNA of cells, thereby disrupting E2 gene expression, which leads to increased expression of the E6 and E7 viral oncogenes and progression to cancer. However, the relationships among HPV viral load, cytologic diagnosis, and HPV integration status remain unclear. The aim of this study was to evaluate the HPV type distribution, viral load, and HPV 16 integration status, and then investigate their relationships with precancerous and cancerous lesions among Japanese women of different age groups. Liquid-based cytology (LBC) samples were examined by quantitative real-time polymerase chain reaction (PCR). The overall mean prevalences of HPV were higher in younger women and lower in middle-aged women among the age groups. The positivity rate of HPV 16 peaked at a younger age than that of all HPV subtypes. The HPV 16 viral load per cell decreased from a low-grade squamous intraepithelial lesion (LSIL) to a cancerous lesion (257.4 for LSIL, 76.9 for high-grade squamous intraepithelial lesions, and 35.7 for cancerous lesions). The average HPV 16 DNA copy numbers for three different HPV 16 integration statuses were 64.1 for the episomal form, 465.5 for the mixed form, and 0.4 for the integrated form. Furthermore, the mean age of patients with the pure integrated form of HPV 16 was more than 10 years older than those of patients with the episomal and mixed forms. Quantitative real-time PCR appears to be a useful method for quantitative and physical status analyses of HPV in cervical cancer screening with LBC samples.

Totally implantable ventricular assist system that can increase brain blood flow

In the clinical usage of the ventricular assist device (VAD), multiple organ failure becomes an important problem. To improve the clinical record of the VAD, another organ function may be vitally important. For that reason, we have been developing a VAD system aiming at improving another organ's function. Development of the vibrating flow pump (VFP), which can generate a very unique flow pattern from 10 Hz to 50 Hz, was ongoing in our Institute. In order to evaluate brain blood flow and oxygen consumption, HbO2 was measured with a NIRO monitoring device in healthy adult goats. Four goats were anesthetized with halothane inhalation; then left thoracotomy was performed for the left heart bypass. HbO2 of the brain was measured by recording of the hemodynamic variables during left heart assistance with the VFP system. During left heart bypass with the VFP system, hemodynamic parameters stayed within normal range, and satisfactory pump output was easily obtained. Pump output stayed within 20-40% bypass to evaluate the effect of high frequency oscillated assist flow on brain blood flow during the same cardiac output. Interesting results were observed during the experiments. During 30 Hz drive of the VFP left heart assistance, HbO2 suggested that brain blood flow significantly increased compared with another drive frequency assistance during the same total cardiac output. These results suggest that we can control the brain blood flow with a totally implantable VAD system such as the VFP system.

Total vascular resistance and blood flow frequency during left ventricular assistance using a vibrating flow pump

A vibrating flow pump (VFP) can generate high frequency oscillated blood flow within 10-30 Hz by the oscillation of its central tube. A totally implantable artificial heart using a VFP is being developed as a unique type of blood pump. In this study, left ventricular (LV) assist circulation was performed using a VFP. The total vascular resistance and driving frequency of the VFP were estimated from their relationship. The effect of oscillation on the vascular system was studied by the frequency analysis method and vascular impedance. Adult goats were anesthetized by halothane using an inhaler and a left fourth thoracotomy was performed. The inflow cannula was inserted into the left ventricle, and the outflow cannula was sutured to the descending aorta. The VFP and a centrifugal pump were set in parallel for alternation and comparison. The driving frequency of the VFP was changed and included 15, 20, 25, and 30 Hz. The hemodynamic parameters were continuously recorded during experiments by a digital audio tape (DAT) data recorder. The internal pressure of the left ventricular cavity and aortic pressure were monitored by the pressure manometers continuously. One hundred percent LV assistance was judged by the separation of LV and aortic pressure. The total vascular resistance was decreased by the start of operation of each pump. The decrease during flow using the VFP was not as large as that using a centrifugal pump (CP). The arterial input impedance during oscillated blood flow by the VFP showed a slow curve appearance. It was similar to the frequency characteristics curve of natural heart beats within the lower frequencies. The study of arterial impedance may be important for the estimation of the reflection of the pulsatile wave from the arterial branch, among other things.

Detection of the cardiac function by fractal dimension analysis

Nonlinearity in circulation control attracts attention because nonlinearity is thought to be essential in the function of the living body. Many investigators have pointed out that the analysis of heart rate variability in particular is important in the analysis of autonomic nerve and cardiac function evaluation. Heart rate variability shows nonlinear behavior. However, until the present, many reports have been premised on linearity; linear correlation by frequency analysis has been used by many studies. However, in terms of this methodology, there is a problem applying it to the nonlinear living body. Therefore, fractal and chaos methodology has been used. The ascertainment of cardiac function has become important in allowing the clinical stage of a ventricular assist system to be successful. The purpose of this study was cardiac function evaluation by a methodology that was premised on nonlinearity. Chaos and fractal theory was used as a nonlinear dynamic theory. As a methodology of measurement, the volume of the left ventricle was used rather than an electrocardiogram, the waveform of arterial blood pressure. The volume was measured using acoustic quantification (AQ) ultrasonic echocardiography. Using these methodologies, the time series of many patients were analyzed. For example, drug administration was attempted in this study, and it was found that some drugs like ACE inhibitors showed a significant effect upon nonlinear dynamics in the cardiovascular system. The result, which attempted cardiac function evaluation by these various methodologies, is reported.

Peripheral vascular resistances during total left heart bypass with an oscillated blood flow

For development aimed at a totally implantable type ventricular assist device (VAD), the vibrating flow pump (VFP) has been developed at Tohoku University. A transcutaneous energy transmission system (TETS) using amorphous fibers was developed to power the totally implantable VAD system. The VFP works at a high frequency compared to that of a natural heart of a biological system. It is a frequency of 10-50 Hz. In this research, animal experiments with left heart bypass were carried out with healthy adult goats. For comparison between nonpulsatile flow and oscillated flow, a rotary pump (RP) and the VFP were used in the experiments. For the achievement of total left heart bypass, left ventricular approaches were carried out, and blood was pumped from the left ventricle to the descending aorta. Adequate support of the left heart was provided by both pumps. In terms of the results, the vascular resistances tended to decrease during the use of both pumps during 100% bypass driving. When we compared these pumps at the same flow rate, the resistances during RP driving were significantly smaller than those during VFP driving. These results may suggest that the influences of the VFP upon the peripheral vessels may be relatively small compared to those of the RP. This may be an important result when a stable hemodynamic condition is required during artificial circulation. The VFP was considered as a candidate for a totally implantable VAD as a result.

Left heart bypass using the oscillated blood flow with totally implantable vibrating flow pump

Aiming at a totally implantable ventricular assist device (VAD), a vibrating flow pump (VFP) was developed in Tohoku University. A transcutaneous energy transmission system (TETS) using an amorphous fiber was developed for the totally implantable VAD system. The VFP works with a higher frequency than the natural heart of a biological system, a frequency of 10-50 Hz. In this research, animal experiments on left heart bypass were performed with healthy goats. Blood from the apex of the left ventricle was received and was sent to the aorta so that an adequate supporting effect of the left heart was provided. In particular, the depression effect of the left ventricle was obvious. As a result, sufficient artificial heart flow was provided. For a totally implantable type VAD, left heart bypass of almost 100% may become necessary in some situations. Therefore, apex approaches of left heart bypass may be desirable. From an anatomical consideration, an apex of the heart is suitable for the VFP of this totally implantable type. In the left heart bypass for which the apex of the heart was used, an almost 100% bypass was possible. This is a requirement that is important when waiting for recovery of sufficient cardiac function. It is also important that left heart circulation is maintained fully by an artificial heart of the complete implantation type. The VFP was considered to be useful as a totally implantable type artificial heart from the results.

[A case of complete remission from acute myelogenous leukemia in second relapse achieved using an intermediate-dose cytosine arabinoside (ID Ara-C) regimen]

A 57-year-old-male patient with acute myelogenous leukemia in second relapse who was refractory to BHAC . AMP [behenoyl arabinosyl cytosine (BHAC), aclacinomycin, 6-mercaptopurine and prednisolone (PSL)] and BHAC . DVP [BHAC, daunomycin, vincristine and PSL] was treated with an intermediate-dose cytosine arabinoside (ID Ara-C) regimen. This schedule consisted of a 1-h infusion of Ara-C at a dose of 500 mg/m2 every 12 h for 6 d (days 3-8), in combination with doxorubicin 50 mg/m2 on day 1 and vincristine 1 mg/m2 on day 2. The patient achieved a complete remission 23 days after completion of Ara-C and was treated with ID Ara-C (Ara-C days 3-6) as a consolidation. Remission duration was only 2.5 months. Plasma Ara-C concentrations were assayed by HPLC and the peak level was 6.7 micrograms/ml. Side effects were mild nausea, vomiting, alopecia and moderate skin rash.