[Autologous blood transfusion in surgery of urologic malignant tumor].

BACKGROUND: Autologous blood transfusion has been widely endorsed, because of the adverse effects attributed to homologous blood transfusion. So we employed autologous blood transfusion to avoid homologous blood transfusion in operation of urological malignant patients. We reviewed our experience with autologous blood transfusion in 48 patients. METHODS: A total of 48 patients underwent operation with 400 to 1,200 ml preoperative autologous blood donation, in 41 patients with administration of erythropoietin and 7 patients without erythropoietin. The details of operations are radical nephrectomy in 18 cases (2 cases were bilateral), radical nephro-ureterectomy in 2 cases, retroperitoneal lymph node dissection (RPLND) in 2 cases, radical prostatectomy in 12 cases and radical cystectomy in 14 cases. RESULTS: The volume of surgical blood loss were 381 +/- 522 ml in nephrectomy (1,158 +/- 202 ml in bilateral case), 517 +/- 5 ml in radical nephro-ureterectomy 636 +/- 574 ml in RPLND, 665 +/- 291 ml in radical prostatectomy and 1,123 +/- 417 ml in radical cystectomy. Only three cases needed homologous blood transfusion. CONCLUSION: We can avoid homologous blood transfusion in 94% of patients. Autologous blood transfusion is recommended as safe and convenient.

A comparative study of the repeat dose toxicity of grepafloxacin and a number of other fluoroquinolones in rats.

Grepafloxacin is a new oral fluoroquinolone with potent activity against community acquired respiratory pathogens, including Streptococcuspneumoniae, and pharmacokinetic properties which allow once daily dosing. As part of its safety evaluation a study of 4 weeks duration was performed to compare the toxicity of grepafloxacin with that of a number of commercially available quinolones in the rat. Groups of eight male Sprague-Dawley rats received either control material or grepafloxacin, enoxacin, lomefloxacin, ofloxacin or ciprofloxacin at an oral dosage of 300 mg/kg/day for 4 consecutive weeks. Effects related to the antibacterial activity of the drugs were seen as increased caecal weight, decreased urinary excretion of sodium, increased water consumption, decreased urine volume, increased urine osmolality, soft stools and suppressed body weight gain. It is well documented that fluoroquinolones can cause lesions in the cartilage of the major diarthrodial joints, and blister formation or erosion on the joint surface was observed in all quinolone-treated groups other than the grepafloxacin group. Some quinolones, have been found to cause crystalluria, which is often associated with secondary nephropathy in laboratory animals due to the poor solubility of quinolones under the alkaline conditions of the urine. In the present study, needle-like crystals in the urinary sediment were observed in enoxacin and ciprofloxacin treated groups only. In conclusion, grepafloxacin was well tolerated and showed a low potential for joint toxicity and crystalluria compared to other quinolones.

Microflora and tetrodotoxin-producing bacteria in a gastropod, Niotha clathrata.

Shellfish (Niotha clathrata) were collected in both July and November from three locations in Taiwan (Pingtung, Kaohsiung and Chiai Prefecture) and assayed for anatomical distribution of tetrodotoxin (TTX) and aerobic heterotrophic bacteria. Pingtung specimens showed higher toxicity than those from Kaohsiung and Chiai, and did not show much seasonal variation. At each site, the total aerobic bacterial counts in November samples were higher than in July. The predominant genera were Vibrio, Pseudomonas, Pasteurella, Aeromonas and Plesiomonas. Vibrio comprised more than 35% of the genera, with V. alginolyticus as the major species. The viable counts of Vibrio species were higher in November than in July. However, the results did not suggest any relationship between the total count or viable count and the toxicity of the shellfish. HPLC, UV and gas chromatographic-mass spectrometric analyses demonstrated that some of the bacteria isolated, such as V. alginolyticus, V. parahaemolyticus, Pseudomonas spp. Plesiomonas sp. and Aeromonas sp., produced TTX and/or related substances.

Characteristics of [125I]omega-conotoxin labeling using bifunctional cross linker DSP in crude membranes from chick brain.

Characteristic of [125I]omega-conotoxin (omega-CgTX) labeling using bifunctional cross linker (dithio bis[succinimidyl propionate]:DSP) was systematically investigated in crude membranes from chick whole brain. [125I]omega-CgTX specifically labeled 216 kDa as a main and 236 kDa as a minor bands in the crude membranes under non-reduced condition, but not labeled under reduced condition. We investigated the effect of various Ca channel antagonists on [125I]omega-CgTX labeling with DSP in detail, and found that there is a strong correlation between the effects of Ca channel antagonists on [125I]omega-CgTX labeling of the 216 kDa band and specific [125I]omega-CgTX binding. These results suggest that labeling of the 216 kDa band under non-reduced condition with [125I]omega-CgTX using DSP involves the specific binding sites of [125I]omega-CgTX, perhaps including one of the neuronal N-type Ca channel subunits in the crude membranes.

Characteristics of specific 125I-omega-conotoxin GVIA binding and 125I-omega-conotoxin GVIA labeling using bifunctional crosslinkers in crude membranes from chick whole brain.

Characteristics of specific 125I-omega-conotoxin GVIA (125I-omega-CgTX) binding and 125I-omega-CgTX labeling using bifunctional crosslinkers were systematically investigated in crude membranes from chick whole brain. Aminoglycosides and dynorphine A (1-13) inhibited the specific binding of 125I-omega-CgTX, but not that of the L-type calcium ion channel antagonist [3H](+)PN200-110. It seems likely that the inhibitory effect of dynorphine A (1-13) does not involve kappa-opiate receptors, based on results with the opiate receptor antagonist naloxone and the kappa-opiate receptor agonist U50488H. Spider venom, Cd2+ and La3+ inhibited the specific binding of 125I-omega-CgTX, as well as that of [3H](+)PN200-110. Various L-type Ca2+ channel antagonists did not affect the specific binding of 125I-omega-CgTX. 125I-omega-CgTX specifically labeled 135 kDa and 215 kDa bands in crude membranes under reduced and non-reduced conditions, respectively. The crosslinker disuccinimidyl suberate (DSS) yielded better 125I-omega-CgTX labeling than the other two crosslinkers tested. We investigated the effect of various Ca2+ channel antagonists on 125I-omega-CgTX labeling with DSS in detail, and found that there is a strong correlation between the effects of Ca2+ channel antagonists on 125I-omega-CgTX labeling of the 135 kDa band and specific 125I-omega-CgTX binding. These results suggest that aminoglycosides and dynorphine A (1-13) are specific inhibitors of specific 125I-omega-CgTX binding, and that labeling of the 135 kDa band with 125I-omega-CgTX using DSS involves the specific binding sites of 125I-omega-CgTX, perhaps including one of the neuronal N-type Ca2+ channel subunits in the crude membranes.

[The present situation of the computer system for the clinical laboratory in Japan].

We report the present situation of the computer system utilization for the Clinical Laboratory in Japan. For this studies, the data were calculated to our purpose from the materials for statistics published by the Ministry of Health and Welfare, Japan Society of Medical Technologist, and so on. The results were as follows, 1) computer systems were used on the 85% of all hospitals, and the most of them were used for the medical office work included the payment office. At clinical laboratory, there was very few use the computer systems, which account for 25%. 2) In the field of the clinical laboratory, there was mostly used at clinical chemistry, next field was hematology, serology, urinalysis, and microbiology, respectively. 3) Total system for the hospital, including ordering system were used only 0.06% (208 cases) of all hospitals in Japan. We calculated the number of beds with a hundred thousand population, the spread of the computer system, the number of the out-patients, in-patients, and the utilization ratio of beds, then we compared with that data for all of the prefecture included Tokyo, Osaka and Kyoto. As a result of the calculation, the prefecture which the number of bed with a hundred thousand population was much more than another zone were the utilization ratio of beds was less than another area, and there was worth at the spread of computer system. We think there areas had the smaller hospitals than that of having highly spread of computer system.

Early mucosal gastric cancer with extra-perigastric (n2) lymph node metastasis.

During the 10 years from 1977 to 1986, a total of 314 cases of early gastric cancer were resected. Of these, 43 (14%) had lymph node metastases, with 6 cases of mucosal (m-) cancer and 37 of submucosal (sm-) cancer. Among the patients with positive lymph node metastases, 37 (86%) had metastases in the Group 1 regional lymph nodes. Eight patients had metastases in the Group 2 lymph nodes, and these involved 2 cases of m-cancer and 6 of sm-cancer. Lymph node metastasis is generally believed to occur in only about 3% of m-cancer, and then mainly in the Group 1 lymph nodes. Here, 2 rare cases of early gastric m-cancer with positive extra-gastric lymph node metastasis are reviewed in detail, with special attention to the surgical management.

Cyclic 3',5'-nucleotide phosphodiesterase in rat skin. II. Biochemical characterization.

The biochemical characteristics of cyclic 3',5'-nucleotide phosphodiesterase were studied in homogenates of male albino rat skin using preparations which were predominantly epidermal. Enzymatic activity was detected in both the particulate and soluble fractions of these skin homogenates. Two kinetically distinct phosphodiesterase (PDE) activities were detected in the soluble fraction (100,000 times g supernatant). This 100,000 times g supernatant contains at least two distinct protein bands that hydrolyze cyclic AMP as demonstrated by gel electrophoresis. Divalent cations (Mg-++ or Mn-++) and 2-mercaptoethanol were required for maximal enzymatic activity. Epinephrine, dibutyryl cyclic AMP, and methylxanthines inhibited while imidazole and histamine phosphate stimulated the cyclic AMP phosphodiesterase activity at high and low cyclic AMP concentrations. Cyclic GMP competitively inhibited hydrolysis of low, but not high, concentrations of cyclic AMP. Hydrocortisone phosphate in pharmacologic concentrations blocked PDE denaturation by heat. These studies indicate that there are complex interrelationships between cyclic nucleotides and PDE in rat skin.