Supramolecular ferric porphyrins and a cyclodextrin dimer as antidotes for cyanide poisoning.

OBJECTIVES: This study aimed to evaluate the antidotal effect of a newly developed supramolecular complex, ferric porphyrins and a cyclodextrin dimer (Fe(III)PIm3CD), that possess a higher binding constant and quicker binding rate to cyanide ions than those of hydroxocobalamin (OHCbl) in the presence of serum protein. METHODS: First, in vitro cytochrome activity and cell viability were evaluated in murine fibroblast cells cultured with various doses of Fe(III)PIm3CD and potassium cyanide (KCN). Next, BALB/c mice were pretreated with intravenous OHCbl (0.23 mmol/kg), Fe(III)PIm3CD (0.23 mmol/kg), or saline and then received KCN (lethal dose 100% (LD100): 0.23 mmol/kg) through a stomach tube. Finally, as a resuscitation model, KCN-induced apnea was treated with a bolus injection of an equimolar dose of antidotes followed by a slow infusion of the same reagent. RESULTS: Fe(III)PIm3CD showed dose-dependent antidotal effects in vitro. Pretreatment with Fe(III) PIm3CD prevented KCN-induced apnea significantly better than OHCbl. Resuscitation with Fe(III)PIm3CD resulted in an earlier resumption of respiration than that seen with OHCbl. However, 24-h survival was similar among the treatments (Fe(III)PIm3CD, nine of nine mice; OHCbl, eight of nine mice). CONCLUSION: Fe(III)PIm3CD exerted significant antidotal effects on cyanide toxicity in vitro and in vivo, with a potency equal in the mortality of cyanide-poisoned mice or superior in the respiratory status during an acute phase to those of OHCbl.

Characteristics of adult scald burn patients-a single center study in western Kanagawa Prefecture.

Burns sustained in bathtubs are a social and medical problem in Japan, especially among the elderly. Between October 2003 and March 2009, 22 adult scald burn patients (men, 17; average age, 65.3 ± 21.2 years) were transferred to Tokai University. In this study, we investigated the characteristics of these patients, and compared clinical parameters among patients with burns sustained in a bathtub (n = 10) and those with burns sustained due to other causes (n = 12). The average percentage total body surface area (%TBSA), dermal and deep burn area, and abbreviated burn severity index (ABSI) were 27.6 ± 23.8, 19.9 ± 20.5%, 7.8 ± 13.1%, and 7.7 ± 3.1, respectively. All patients in the bathtub burn group were elderly, 6 developed internal diseases, 3 had alcohol-related burns, and 4 died. Additionally, their %TBSA and ABSI were higher than those of the non-bathtub burn group patients. Burns sustained in bathtubs were more severe than those sustained due to other causes. The bathtub-related burn patients were elderly, and their burns were extensive and deep; hence, they were at a higher risk of developing internal diseases. Thus, introduction of safer bathing styles and bath systems will decrease incidences of bathtub-related burns.

A case of hemosuccus pancreaticus associated with hereditary pancreatitis.

We report a 25-year-old male with hemosuccus pancreaticus associated with hereditary pancreatitis. He was originally diagnosed as having familial chronic pancreatitis at the age of 12, because his brother was also diagnosed as having pancreatitis. No history of pancreatitis was found in their parents. The patient was admitted because of a growing pancreatic pseudocyst. While he had undergone conservative treatment for the pseudocyst, computed tomography incidentally revealed a pancreatic pseudoaneurysm. Endoscopic examination revealed spontaneous bleeding from the major papilla. Interventional embolization was successfully performed. An R122H mutation in the cationic trypsinogen gene was identified in this patient, his brother, and his mother, indicating that they have hereditary pancreatitis. To our knowledge, this is the first report of hemosuccus pancreaticus associated with hereditary pancreatitis. Mutational screening is useful for the diagnosis of hereditary pancreatitis, especially in patients whose diagnosis is inconclusive based on the traditional clinical criteria.

Attenuated cardiovascular adjustment to sustained static exercise after carbohydrate loading.

We examined whether a higher plasma lactic acid (LA) concentration resulting from carbohydrate (CHO)-loading affects the cardiovascular responses to exercise through a greater activation of LA-induced metaboreflex. Before and after CHO-loading, LA concentration, mean arterial blood pressure (MAP), heart rate (HR), cardiac output (CO), rating perceived exertion (RPE), and integrated electromyogram (iEMG) of the vastus lateralis were studied during a sustained static knee extension of single legs in 16 volunteers. The CHO-loading comprised an exhaustive bout of one-legged cycling (73+/-3% of maximal oxygen uptake for 130-160 min) and consuming a low-CHO diet for 2-3 days and a high-CHO diet for the next 3 days. In the leg that performed the exercise (the experimental leg), the LA concentration after CHO-loading was significantly increased, but the magnitude of MAP, HR, and CO responses during static exercise was significantly decreased in parallel with a significant reduction of RPE and iEMG. In the control leg, there were no changes in the variables before and after CHO-loading. These results suggest that the increased LA concentration resulting from CHO-loading did not affect the cardiovascular adjustment to the sustained exercise. Other mechanisms related to the reduction of RPE and iEMG seem to be responsible for the attenuated cardiovascular responses observed in the experimental leg after CHO-loading.

[The efficacy of SEMS for malignant upper gastrointestinal stenosis, evaluated by a "home index"].

We used a self expandable metalic stent (SEMS) on 24 patients (average age 68.6 years, 20 males, 4 females) with malignant upper gastrointestinal stenosis from August, 1997 to March, 1999. The primary diseases of the 24 patients were gastric cancer (13 cases: 54%), esophageal cancer (10 cases: 42%) and paraesophageal lymph node metastasis of breast cancer (one case: 4%). In this study, we present a "Home Index" as an indicator to evaluate a patient's quality of life, and investigated the efficacy and problem of SEMS.

Cloning and characterization of a novel class I cytokine receptor.

The human gp130 cDNA sequence was used as a query to search an expressed sequence tag database (dbEST) to identify cDNA sequences with similarity to the cytokine class I receptor family. A novel class I cytokine receptor was identified in a human infant brain cDNA library and was named WSX-1. Full-length cDNA sequences for human and murine WSX-1 were isolated and characterized. The WSX-1 cDNA encodes a 636 amino acid transmembrane protein with an extracellular domain of 482 amino acids and a cytoplasmic domain of 96 amino acids. The structure of the WSX-1 protein most closely resembles that of gp130. Northern blot analysis indicates high levels of expression in thymus, spleen, lymph node, and peripheral blood leukocytes, suggesting a role for WSX-1 in modulation of the immune response.