Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall.

BACKGROUND: We examined the findings of contrast-enhanced multidetector-row computed tomography (MD-CT) in patients with colonic perforation. METHODS: Abdominal contrast-enhanced MD-CT findings in six patients with colonic perforation were reviewed retrospectively. Patients (three men and three women) were 74 to 88 years old (mean age = 78 years). Colonic perforation was confirmed by surgery. CT findings were correlated with surgical and pathologic findings. RESULT: The site of colonic perforation was suggested by the following combination of CT findings: free air, dirty mass, dirty fat sign, extraluminal fluid collection, bowel wall thickening, and interruption of colonic wall. The ruptured colonic wall was directly visualized in four cases (67%). CONCLUSION: Abdominal contrast-enhanced MD-CT may improve the accuracy of diagnosis and localization of colonic perforation.

[Two delayed cases of traumatic diaphragmatic hernia].

This report concerns 2 cases with blunt traumatic hernia of the diaphragm. The diagnosis of these cases had been delayed by 1 month and 6 years, respectively. The former was a left sided case, which had suddenly suffered severe dyspnea. An emergency operation revealed the dislocated stomach into the left thoracic cavity. The latter was a right sided case, which was discovered by chance during the laparoscopic cholecystectomy. The right lobe of the liver dislocated into the right thoracic cavity. The delayed case of traumatic diaphragmatic hernia tends to be overlooked without suspicion. In all patients with thoracoabdominal blunt injury, a rupture of the diaphragm must be suspected.

The simple and rapid spectrophotometric determination of trace chromium(VI) after preconcentration as its colored complex on chitin.

Preconcentration method with collection of metal complexes on a chitin has been applied to the spectrophotometric determination of chromium(VI) in water. The chromium(VI) is collected as its 1,5-diphenylcarbazide(DPC) complex on a column of chitin in the presence of dodecyl sulfate as counter-ion. The Cr-DPC complex retained on the chitin is eluted with a methanol-1 M acetic acid mixture (7:3, v/v), and the absorbance of the eluent is measured at 541 nm. Beer's law is obeyed over the concentration range of 0.05-0.6 mug of chromium(VI) in 1 ml of the eluent. The apparent molar absorptivity is 3.5x10(4) dm(3) mol(-1) cm(-1). The tolerance limits for Fe(III) is low, i.e. ten times that of chromium(VI), but some metal ions and common inorganic anions do not interfere in concentration range of 100-10 000 times that of chromium(VI). The present method can be applied to the determination of chromium(VI) in natural water samples.

Steric effect of substituents on the extraction of lanthanoids(III) with N-p-(n-, iso- and tert-)butylbenzoyl-N-phenylhydroxylamine.

N-p-(n-, iso- and tert-)Butylbenzoyl-N-phenylhydroxylamine (HL) was synthesized to evaluate the steric effect of the substituent on the mutual extraction separation of representative lanthanoids(III) (Ln). Lanthanoids(III) were all found to be extracted with compounds as self-adducts of the form LnL(3)(HL)(2). It was found that the structure of the substituents in N-p-butylbenzoyl-substituted N-phenylhydroxylamine is closely related to the separation factor for the pair of Yb/Eu. The separation factors for a pair of Eu/Yb with these compounds decreased in the order of tert-butyl derivative>iso->n-, with a decreasing Taft's E(s) value, that is, with an increasing steric effect of the substituent group. The correlation between the separation factor and the stereochemical shape of the substituent was also investigated.

The spectrophotometric determination of trace molybdenum (VI) after collection and elution as molybdate ion on protonated chitin.

Collection and elution method for inorganic anion on protonated chitin has been applied to the spectrophotometric determination of molybdenum (VI). The molybdenum (VI) is collected as molybdate ion on a column of chitin in weak acidic medium which is easily eluted with a small volume of 0.1 M ammonia buffer solution (pH 10). The molybdenum (VI) in the eluent is determined by bromopyrogallol red-Zephiramine method spectrophotometrically. Beer's law is obeyed over the concentration range of 0.1-0.8 mug of molybdenum (VI) in 1 ml of eluent at 634 nm. The apparent molar absorptivity is 6x10(4) dm(3) mol(-1) cm(-1). The tolerance limits for WO(4)(2-), VO(3)(-), CrO(4)(2-) and Fe (III) is low, that is, 1-100 times that of molybdenum (VI), but some metal ions and common inorganic anions do not interfere in concentration range of 1000-5000 times that of molybdenum (VI). The present method can be applied to the determination of molybdenum (VI) in natural water samples.

Simultaneous determination of platinum(II) and palladium(II) by reversed phase high-performance liquid chromatography with spectrophotometric detection after collection on and elution from resin coated with dimethylglyoxal bis(4-phenyl-3-thisomicarbazone).

Amberlite XAD-7 resin coated with dimethylglyoxal bis(4-phenyl-3-thiosemicarbazone) (DMBS) was prepared and applied to the preconcentration of platinum(II) and palladium(II) from aqueous solution. Platinum(II) and palladium(II) were collected quantitatively on resin coated with the reagent (DMBS-XAD-7) from acidic solution in the presence of iodide ion by a bach method. The metal ions were then easily eluted from DMBS-XAD-7 as their DMBS chelates with a small volume of N,N-dimethylformamide. This collection and elution method was applied to the simultaneous determination of platinum(II) and palladium(II) by reversed-phase high-performance liquid chromatography with spectrophotometric detection using an ODS column and acetone-water as the mobile phase. The proposed method was applied to the determination of the metals in commercially available samples.

[Pulmonary embolectomy for massive pulmonary embolism].

Surgical cases of massive pulmonary embolism remain rare in Japan. To discuss the surgical problems, clinical courses of 4 patients who underwent pulmonary embolectomy under cardiopulmonary bypass at our hospital for the last six years were reviewed. There were 2 men and 2 women; ranging from 41 to 72 years (mean age, 63 years), 1 of whom had deep venous thrombosis of the lower extremity as a predisposing factor. The initial disease recurred in 2 patients. Shock occurred in 3 patients preoperatively, 2 of whom had sudden syncope. Cardiac arrest occurred before and during pulmonary arteriography (PAG) in 1 patient. The systolic pulmonary arterial pressure rose to between 60 and 80 mmHg in all patients except for 1 of whom it was not measured. The diagnosis was established in 3 patients by PAG and clinically in the remaining recurrent patient. Thrombolysis was not effective in all patients, then pulmonary embolectomy was performed between four hours and five days after the onset of the disease. One patient with preoperative cardiac arrest died of low output syndrome and severe respiratory failure, but 3 survived with clinical improvement. Development of the prompt and noninvasive diagnostic procedure, rapid cardiopulmonary support in severe cases and an early decision to operate are required to improve the operative results. Partial resection of the lung was obliged due to massive endobronchial hemorrhage after embolectomy in 1 recurred patient. Compression of the lungs and embolectomy using a balloon catheter should be performed carefully to prevent injuring pulmonary arteries. Implantation of an inferior vena cava filter may be beneficial for the selected patient to prevent recurrence of the disease.

[Antibodies to human T-cell lymphotropic virus type 1 in the aqueous humor of HTLV-I associated uveitis].

To elucidate the pathomechanism of human T-cell lymphotropic virus type 1 (HTLV-I) associated uveitis (HAU), we assessed antibodies to HTLV-I and IgG for paired samples of serum and aqueous humor. Seven of 10 samples from HAU patients showed antibodies to HTLV-I in the aqueous humor with antibody titer ranging from 16 to 128, and five of these samples showed significantly high antibody quotients as calculated by reference to the IgG levels in the serum and aqueous humor, hence suggesting local production of antibodies rather than their transfer from the serum. On the other hand, eight of 45 control samples from HTLV-I carriers with senile cataract but without uveitis had antibodies to HTLV-I in the aqueous humor with antibody titer ranging from 8 to 128, but none of these samples showed high antibody quotient. We conclude that, although antibodies to HTLV-I in aqueous humor were detected in those HAU and control cases which showed high antibody titer in the serum, intraocular synthesis of antibodies to HTLV-I may sometimes occur in HAU.

Preparation of Amberlite XAD resins coated with dithiosemicarbazone compounds and preconcentration of some metal ions.

The Amberlite XAD resins coated with dithiosemicarbazones were prepared and their collection behavior of metal ions from aqueous solution was investigated. Among the resins used, the reagent-loaded Amberlite XAD-7 was found to be superior for the collection of metal ions to other reagent-loaded resins used. The quantitative collection of mercury(II), palladium(II) and copper(II) was obtained from acidic medium, while cadmium(II) and lead(II) was obtained from neutral medium by the Amberlite XAD-7 resin coated with dimethylglyoxal bis(4-phenyl-3-thiosemicarbazone) (DMBS). These metal ions collected on the resin were easily eluted with a small volume of N,N-dimethylformamide as their DMBS chelates. This collection-elution method was applied to the determination of their metal ions by reversed-phase high performance liquid chromatography with a spectrophotometric detection.

Discrimination between different types of white matter edema with diffusion-weighted MR imaging.

Brain edema can be classified into three categories: vasogenic, cytotoxic, and interstitial. The mechanism of edema is thought to be different in each type. The authors studied the movement of water molecules in each type of white matter edema in a rat model by using diffusion-weighted magnetic resonance imaging. Conventional T2-weighted imaging did not allow distinction between the three types of white matter edema; the three types of edema were, however, distinguished by using diffusion-weighted imaging. The apparent diffusion coefficient (ADC) of water was different in each type of edema. Water molecules in cytotoxic edema induced by triethyl-tin intoxication showed a smaller and less anisotropic ADC than in normal white matter. In contrast, water in vasogenic edema induced by cold injury had a larger and more anisotropic ADC than in normal white matter. Water in interstitial edema due to kaolin-induced hydrocephalus had an anisotropic and very large ADC.

Na+/D-glucose cotransporter based bilayer lipid membrane sensor for D-glucose.

A new type of amperometric blosensor for glucose was fabricated using a Na+/D-glucose cotransporter as the signal-transducing sensory element that exploits the D-glucose-triggered Na+ ion current through bilayer lipid membranes (BLMs). The planar BLM was formed by the folding method across a small aperture of a thin Teflon film. The Na+/D-glucose cotransporter, isolated and purified from small intestinal brush border membrane of guinea pigs, was embedded into BLMs through proteoliposomes. The number of the protein molecules thus incorporated in the present sensing membrane was estimated to be ca. 10(7). The sensor response was measured as an ionic current through the BLM arising from cotransported Na+ ion flux under a constant applied potential and was only induced by D-glucose above 10(-9) M, but not by the other monosaccharides except for D-galactose. The effect of applied potentials, Na+ and K+ ion concentrations, and the addition of a competitive inhibitor, phlorizin, were scrutinized to characterize the sensor output. The results were briefly discussed in terms of the potential use of the Na+/D-glucose cotransporter as a sensory element for D-glucose.

Sequence homology of NADH CoQ reductase subunit IV with nucleotide-requiring enzymes.

The amino acid sequence of NADH CoQ reductase subunit IV is highly homologous with those of enzymes such as ATPase, argininosuccinate synthetase and adenylate kinase. Replacement of arginine by histidine in three enzymes was shown to result in loss of enzyme activity, causing pathologies including citrullinemia. As an analogy, we submit the hypothesis that replacement of arginine by histidine in NADH CoQ reductase subunit IV leads to its activity change, and ultimately results in Leber's hereditary optic neuropathy.

[Two cases of isolated avulsed retinal vessels].

Two cases of isolated avulsed retinal vessels without retinal breaks or any other vitreoretinal disorders are reported. Case 1: a 57-year-old woman developed acute vitreous hemorrhages in the right eye associated with an avulsed retinal artery in the superior equatorial region. Case 2: a 74-year-old man had an asymptomatic avulsed retinal vein in the superior midperiphery. Repeat argon laser photocoagulation resulted in uncomplicated occlusion of the avulsed retinal vessels and reduced the risk of recurrent vitreous hemorrhage.

Nonfamilial and unusual cases of Leber's hereditary optic neuropathy identified by mitochondrial DNA analysis.

Peripheral blood mitochondrial DNA (mtDNA) samples from 11 patients with acute optic neuritis or insidious optic atrophy were examined for the mutation at nt 11778 and nt 3460 in polymerase chain reaction products. The mtDNA mutation at nt 11778 was evident in 8 cases, which led to a definite diagnosis of Leber's hereditary optic neuropathy (LHON); 4 of the cases were familial and the remaining 4 cases were nonfamilial. None of the 11 patients showed the nt 3460 mutation. The symptoms and signs were variable among the LHON cases with nt 11778 mutation. Assessment of mtDNA provides a useful diagnostic aid for clinically undefined, seemingly nonfamilial or atypical cases of Leber's hereditary optic neuropathy, particularly in bilateral, insidious optic nerve disease in early childhood.

Bilateral retinal detachment with large breaks of pars plicata associated with coloboma lentis and ocular hypertension.

A 39-year-old man developed bilateral, insidiously progressing detachment of the retina and nonpigmented epithelium of the ciliary body because of a large break in the pars plicata. The anterior segments had multiple malformations including ectopia of the lens associated with coloboma of the lens and hypoplastic ciliary processes. The pars plicata breaks were present in areas corresponding to the anomalies of the lens-zonule-ciliary body complex and caused progressive, shallow rhegmatogenous retinal detachments with anterior chamber cells and elevation of intraocular pressure. Surgeries with scleral buckling procedure combined with vitrectomy and lensectomy brought about reattachment of the retina. This case indicates that subtle anomalies in the lens-zonule-ciliary body complex might be an indication of a break in the nonpigmented epithelium of the ciliary body which could lead to rhegmatogenous retinal detachment. The mode of inheritance of the clinical syndrome remained undefined because of negative family history.

Ion channel sensors for glutamic acid.

Coulometric biosensors using glutamate receptor (GluR) ion channel protein as a signal-amplifying sensory element that exploit the glutamate-triggered Na+ ion current through bilayer lipid membranes have been fabricated. The formation of stable planar bilayer lipid membranes was achieved by applying the folding method across a small circular aperture bored through a thin polyimide film. The multichannel type sensing membranes, formed across an aperture of ca. 120 microns diameter, contained more than 10 GluR proteins and showed L-glutamate-triggered response as a composite of individual single-channel currents. The single-channel type sensing membranes, formed across an aperture of ca. 20 microns diameter, contained a sufficiently small number of GluR proteins so that the response was observed as a series of single-channel pulse currents. Dependence of the integrated channel current on the glutamate concentration was examined. A sharp concentration dependence of up to ca. 1.5 x 10(-7) M and 3 x 10(-6) M for the multichannel and single-channel type sensors, respectively, was observed. A high selectivity for L-glutamate compared with D-glutamate for inducing the channel current was observed. A detection limit as low as ca. 3 x 10(-8) M was attained for the multichannel type sensor. This remarkable sensitivity is discussed in terms of the potential use of GluR ion channel protein for a new type of sensing system.

[Retinochoroidopathy and systemic state in toxemia of pregnancy].

We carried out a retrospective study of 74 patients with toxemia of pregnancy with reference to retinochoroidal complications. Thirty-two patients (43.2%) had overt retinochoroidal disease; 23 cases (group A) showed retinal hemorrhages and cotton-wool spots compatible with hypertensive retinopathy, while 9 cases (Group B) had widespread serous retinal detachment associated with choroidal vasculopathy. There was no significant difference between the two groups in the severity of toxemia of pregnancy, in the hematologic examinations or in the fetal prognosis, although Group A showed a higher rate of fetal mortality, and Group B had a more significantly decreased platelet count and lower concentration of fibrinogen that may indicate a mild form of chronic disseminated intravascular coagulopathy.

Stimulatory effect of calcitonin on bone formation in tissue culture.

The present investigation was undertaken to clarify the in vitro effect of synthetic [Asu1,7]eel calcitonin (CT) on bone metabolism in tissue culture. Calvaria were removed from weanling rats (3-week-old male) and cultured for periods up to 96 h in Dulbecco's Modified Eagle Medium supplemented with antibiotics and bovine serum albumin. The experimental cultures contained 1.0 to 100 ng/ml CT. All cultures were incubated at 37 degrees C in 5% CO2-95% air. Bone calcium content was increased significantly by the presence of 10 and 100 ng/ml CT. This increase was blocked by the presence of 10(-6) M cycloheximide or 10(-7) M actinomycin D. Bone alkaline phosphatase activity was significantly increased by the presence of 100 ng/ml CT for 48 and 96 h. Bone acid phosphatase activity was not altered significantly by CT (1-100 ng/ml). The incorporation of [3H]proline into the acid-insoluble residues of bone tissue was significantly increased by the presence of CT (1-100 ng/ml) for 96 h. This increase was completely blocked by the presence of 10(-7) M cycloheximide. Bone DNA content was significantly raised by the presence of 10 and 100 ng/ml CT for 96 h. Furthermore, the culture with CT (10 and 100 ng/ml) produced a significant decrease in glucose concentration in the medium. Also, CT (10 and 100 ng/ml) stimulated the production of pyruvic acid from bone tissue. These results suggest that CT had a direct stimulatory effect on bone formation and mineralization in vitro, and that the hormone stimulates energy metabolism in bone cells.