Effects of gastric acidity on peristomal infection after percutaneous endoscopic gastrostomy placement.

Peristomal infection is a common complication following percutaneous endoscopic gastrostomy (PEG) placement. This study investigated the effect of gastric acidity on peristomal infection, including type of bacteria and the relationship between bacteria cultured from the oropharynx and PEG tube site. Sixty-seven patients with dysphagia underwent PEG placement at Otaki Hospital between 1998 and 2001. Gastric acidity was evaluated by 24h pH monitoring. Patients were observed for peristomal infection for two weeks after PEG placement, with specimens collected from the oropharynx and PEG tube site. Twenty-one (31.3%) of the patients who had undergone PEG insertion developed peristomal infections. Of 52 patients who were not colonised with meticillin-resistant Staphylococcus aureus (MRSA) in the oropharynx, 11 cases (21.2%) developed peristomal infection. The median gastric pH of infected patients (11 cases) was 5.05+/-2.55 (mean+/-SD) and in patients without infection (41 cases) it was 3.06+/-1.83 (P=0.019). Peristomal infection developed in 66.7% (10/15) of patients carrying MRSA compared with only 21.2% (11/52) of patients who were not colonised by MRSA (P<0.001). The incidence of peristomal infection was affected by gastric acidity and the presence of MRSA in the oropharynx.

Internal tissue displacement measurement based on ultrasonic wave Doppler signal digital detection and its application to fetal movement monitoring.

We have developed a fetal movement monitoring system based on small displacement measurement of internal tissues. When ultrasonic pulses are transmitted to the fetus, the reflected ultrasonic waves which have a Doppler frequency shift due to the fetal movements are detected by using an ultrasonic pulsed Doppler technique. In this paper, we propose a displacement measurement method for internal tissues which is based on the Doppler signal digital detection technique. In the method, the received ultrasonic RF signals are sampled with a sampling frequency of four times higher than the centre frequency of the ultrasonic waves; the Doppler frequency shift signals are derived using digital signal processing. From the detected signals, the internal displacements are estimated using the arc-tangent method. The basic algorithm of the detection method has already been used in the area of blood flow sensing, however, we apply the algorithm to the displacement measurement of internal tissues. The comparison between the proposed method and the conventional method is presented. The fetal movement quantitative monitoring system based on the method which has been constructed is shown.

[A cross-sectional analysis on relationships between maximum oxygen uptake and risk factors for cardiovascular diseases].

We examined the relationships between maximum oxygen uptake (Vo2max) and cardiovascular risk factors including age (year), systolic blood pressure (mmHg), diastolic blood pressure (mmHg), serum total cholesterol level (mg/dl), serum high-density lipoprotein level (mg/dl), serum triglyceride level (mg/dl), blood glucose level (mg/dl), serum uric acid level (mg/dl), body fat (%bw), Body Mass Index (BMI), alcohol (points/day), cigarettes (/day), and physical activity (METs.exercise time/30 days). The alcohol point was defined as follows: beer 633ml = a glass of whiskey and water - sake 180ml = 1 point, and totaled at 30 days. The subjects of our study were 162 males (aged 40.6 +/- 13.1) and 133 females (aged 41.3 +/- 11.1) who underwent medical and physical examinations at the Fukui Industrial Health Center from April, 1991 to June, 1992. As a result of simple correlation analysis in males, Vo2max had significantly negative correlations with age (r = -0.223, p < 0.01), systolic blood pressure (r = -0.228, p < 0.01), diastolic blood pressure (r = -0.239, p < 0.01), or serum triglyceride level (r = -0.258, p < 0.001), serum uric acid level (p < 0.05), body fat (r = -0.230, p < 0.01), and BMI (r = -0.312, p < 0.001), and was positively correlated with physical activity (r = -0.249, p < 0.01). On the other hand, in females, age (r = -0.224, p < 0.01), systolic blood pressure (r = -0.222, p < 0.01), diastolic blood pressure (r = -0.267, p < 0.01), serum triglyceride level (r = -0.261, p < 0.001), body fat (r = -0.280, p < 0.01), and BMI (r = -302, p < 0.001), had significantly negative correlations with VO2max. However, partial correlations were tested after controlling body fat, BMI, cigarette, alcohol, physical activity, and age, none of the factors correlated with VO2max significantly. These findings suggest that the risk factors for cardiovascular diseases are related to VO2max, and the life style has an influence on these correlations. Thus, VO2max may be a comprehensive indicator for health promotion among the working population. Furthermore a longitudinal study is required to determine whether the increase in VO2max is related to the improvement in the risk of cardiovascular diseases.

Evaluation of cerebral blood flow in patients with idiopathic orthostatic hypotension using Tc-99m HMPAO brain SPECT during postural testing.

To determine whether regional cerebral blood flow (rCBF) would change on standing in patients with idiopathic orthostatic hypotension (IOH), Tc-99m HMPAO SPECT studies were performed during postural testing in five patients with IOH. After 10 minutes of quiet rest on a bed, the patients arose quickly and, at the same time, the radiotracer was injected intravenously. SPECT data were obtained with a ring-type SPECT scanner. Another dose of Tc-99m HMPAO was injected with the subjects in the supine position, and SPECT was performed again. Image subtraction was used to evaluate the change in rCBF caused by postural testing. In all patients, the authors observed a decrease of rCBF ni the frontal cortex and basal ganglia. This preliminary study suggests that changes in rCBF occur in patients with IOH on standing, and Tc-99m HMPAO SPECT performed during postural testing may have an important role in evaluating these changes.

[A study of crossed cerebellar diaschisis on 123I-IMP SPECT images and its redistribution phenomenon].

Crossed cerebellar diaschisis (CCD) is interpreted as a functional deactivation, presumably caused by a loss of excitatory or inhibitory afferent inputs on the corticopontocerebellar pathway and others. A redistribution phenomenon (RD) is usually observed in the contralateral cerebellum with CCD on delayed images of 123I-IMP SPECT. This phenomenon was analyzed in a view point of rCBF measurement in 24 patients with brain tumor, infarction and so forth. Regional CBF was measured by the microsphere method with 123I-IMP and a delayed-to-early counts ratio (D/E ratio) was used. As a result, there was no relation between rCBF and the D/E ratio in the cerebellum, which means that RD is occurred by other factors except for rCBF in the cerebellum. Regional CBF and the D/E ratio in the contralateral and ipsilateral cerebellum was 46.3 ml/100 g/min, 1.01 and 57.0 ml/100 g/min, 0.86, respectively. These results mean that the high activity of IMP gradually decreased in the ipsilateral cerebellum, while, the low activity in the contralateral cerebellum was almost stable, and the difference of both activity reduced after 5 hours and RD was observed on the delayed image. The data indicate that retention mechanism of IMP and vascular permeability are not affected in the cerebellum with CCD.

Chimeric HU-IHF proteins that alter DNA-binding ability.

Chimeric proteins between Escherichia coli histone-like HU and IHF were constructed by genetic engineering, in which part of the arm region was replaced by the corresponding region of IHF alpha (designated as HupANhimA) or IHF beta (HupANhimD); alternatively, an alpha-helix 2-beta 1 region was replaced by the corresponding region of IHF alpha (HupAXhimA) or IHF beta (HupAXhimD) (symbols N and X indicate NotI and XhoI junctions). These proteins were synthesized in a hupA-hupB double-deletion mutant. HupANhimA exhibited marked reduction in nonspecific DNA binding in vitro, and a drastic loss of HU activity in replicative transposition of Mu phage in vivo. HupANhimD also showed a significant reduction in the ability for DNA binding, though this protein supported Mu phage development. In contrast, the other two chimeric HU proteins showed only slight changes in nonspecific DNA-binding ability: they retained activities for transposition of Mu phage in vivo. These observations confirm that the flexible arm of HU-2, a domain proposed for DNA binding [Tanaka et al., Nature 310 (1984) 376-381; Goshima et al., Gene 96 (1990) 141-145], plays an important role in the physiological function of this protein. The results indicate that a unique conformation of the arm structure of HU protein, particularly the N-terminal half of a two-strand antiparallel beta-ribbon of the structure, is important for the DNA-binding ability of this protein.