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Background Colorectal cancer (CRC) is the fourth most frequent cause of cancer deaths in the world. Novel biomarkers for the diagnosis, prognosis, and treatment of CRC are required to improve the clinical strategy. Methods We applied shotgun proteomics using isobaric tags for relative and absolute quantitation (iTRAQ) to identify novel biomarkers of CRC, and then we detected leucine-rich PPR-motif-containing protein (LRPPRC) expression in 83 normal colorectal tissues and 133 CRC tissues by immunohistochemistry. Results A total of 570 proteins were identified using iTRAQ. We validated the expression of LRPPRC protein by immunohistochemical analysis of the 77 proteins that showed expression changes in the cancer tissues > 1.5-fold the levels in the normal tissues. The expression levels of LRPPRC were significantly higher in CRC tissues than those in normal colorectal tissues, and the expression levels were related with tumor differentiation and especially high in moderately differentiated CRC tissues. Conclusion We identified a novel, differentially expressed protein, LRPPRC, which has the potential to serve as a molecular target for diagnosis and/or prognosis of CRC.

• Background and Aims Common buckwheat (Fagopyrum esculentum) is a dimorphic self-incompatible plant with either pin or thrum flowers. The S supergene is thought to govern self-incompatibility, flower morphology and pollen size in buckwheat. Two major types of self-fertile lines have been reported. One is a type with long-homostyle flowers, Kyukei SC2 (KSC2), and the other is a type with short-homostyle flowers, Pennline 10. To clarify whether the locus controlling flower morphology and self-fertility of Pennline 10 is the same as that of KSC2, pollen tube tests and genetic analysis have been performed. • Methods Pollen tube growth was assessed in the styles and flower morphology of KSC2, Pennline 10, F1 and F2 plants that were produced by the crosses between plants with pin or thrum and Pennline 10. • Key Results Pollen tubes of Pennline 10 reached ovules of all flower types. The flower morphology of F1 plants produced by the cross between thrum and Pennline 10 were thrum or pin, and when pin plants were used as maternal plants, all the F1 plants were pin. Both plants with pin or short-pin flowers, whose ratio of style length to anther height was smaller than that of pin, appeared in F2 populations of thrum × Pennline 10 as well as in those of pin × Pennline 10. • Conclusion The results suggest that Pennline 10 possesses the s allele as pin does, not an allele produced by the recombination in the S supergene, and that the short style length of Pennline 10 is controlled by multiple genes outside the S supergene.

The positron camera system has been designed to measure heavy-ion ranges in patients' bodies. The pencil-like beam of positron emitters, such as /sup 11/C, is used to check the range directly and precisely by detecting pairs of annihilation gamma-rays emitted from the end point of the beam trajectory. The positron camera consists of a pair of Anger-type scintillation cameras. The efficiency and the spatial resolution are modeled and simulated by a Monte Carlo method and a numerical calculation so that the positron camera has a high position accuracy for a small amount of irradiation dose. The simulation shows that the optimum effective diameter of the camera crystal is 500 mm and its thickness is 30 mm. The crystal diameter is concluded to be 600 mm by taking the outermost photomultiplier mounting into account. The simulation moreover, indicates that the range can be measured within an accuracy of 1 mm under the limitation that the irradiation dose has to be less than a few percent of the therapeutic one.

結腸間膜由来の平滑筋肉腫は比較的稀で, 症状をきたしにくいことから発見時には進行しており転移を伴っていることも多い.S状結腸間膜原発の平滑筋肉腫で症状自覚時にはすでに遠隔転移をきたしており, さらに急速な進展を示し症状自覚後10カ月で死亡した1例を経験したので報告する.症例;62歳, 男性.腹部膨満感, 便秘を主訴に来院.CT, 血管造影の所見よりS状結腸間膜原発の肉腫の診断で結腸部分切除を行った.術前検査で両肺に多発転移を認めており, 化学療法を行ったが肺の転移巣は増大し, 椎弓への転移も出現.症状自覚後10カ月で死亡した.MIB-1標識率70%, DNAヒストグラムではAneuploidyを示しており予後不良の経過をもたらした腫瘍細胞活性の高さを反映しているものと思われた.

今回, Streptococcus bovis菌血症を契機に発見された大腸癌の1例を経験したので, 報告した.症例は67歳, 男性.肺炎に喘息発作を合併し, その治療目的に入院した.入院中に発熱し, 血液培養からStreptococcus bovisが分離されたため大腸の検索を施行したところ, 直腸癌が発見された.低位前方切除術を施行し, 退院した.Streptococcus bovisによる菌血症と大腸癌との関連は, 欧米ではよく知られているが, 日本ではその認識は低い.現在のところ, Streptococcus bovisと大腸癌の直接の因果関係については不明な点も多いが, 併存率が高いことは事実であり, この認識は重要である.

The isobaric analog state (IAS) of the 11 Li nucleus has been investigated using the (p,n) reaction in inverse kinematics at E( 11 Li ) = 64 A MeV . The IAS has been found in the decay energy spectrum of 11 Be ∗ → 9 Li+p+n at the corresponding excitation energy of 21.16 ± 0.02 MeV with a width of 0.49 ± 0.07 MeV (FWHM). The Coulomb displacement energy, decay width, decay mode and their relation to the halo structure are discussed.

Charge exchange reactions of the 11 Li nucleus have been measured by means of the inverse kinematics on proton and deuteron targets at 63 A MeV. The isobaric analog state of the 11 Li nucleus has been found at E x ( 11 Be) = 21.14 ± 0.03 MeV with the width Γ = 0.25 −0.1 +0.2 MeV. Neutron halo effects and the configuration of halo nucleons are discussed.

肛門管原発の悪性神経鞘腫の1例を経験したので報告する. 症例は72歳, 女性. 肛門部腫瘤のため他院で経肛門的腫瘍切除術を施行されている. その後局所再発を認め, 当外科を受診した. 腫瘍は手拳大, 弾性硬で肛門外にせりだしていた. 多発性肺転移, 骨転移を認めたため姑息的に腹会陰式直腸切除術施行し, 病理組織学的には悪性神経鞘腫と診断された. 7カ月後, 急激に増大する上腹部, 膵上縁の腫瘍に対し腫瘍切除術を施行した. 病理組織では悪性神経鞘腫であった. その後, 骨転移ならびに肺転移巣がしだいに増大し, 腹会陰式直腸切除術後16カ月で死亡した, 消化管原発の悪性神経鞘腫は稀であり, とくに肛門管原発の症例で調べた限りでは報告例がなく, 自験例が初と思われる.

We report a patient with an epidermoid carcinoma an extremely rare brain tumour, in the right cerebellopontine angle cistern. Contrast enhancement is the most important feature for differential diagnosis of epidermoid carcinomas from atypical benign epidermoid cysts.

According to a national survey of dialysis patients in Japan conducted by the Japanese Society for Dialysis Therapy, there were 1,033 patients on dialysis in the Shiga area which has a population of about 1.2 million. Of these 1,033 dialysis patients 140 were the result of diabetic nephropathy. From four hospitals affiliated to Shiga University of Medical Science the medical records of 90 diabetic subjects on dialysis therapy were reviewed and various clinical parameters were analysed and compared with those of patients with chronic glomerulonephritis. Since only one patient had Type 1 (insulin-dependent) diabetes, the remaining 89 with Type 2 (non-insulin-dependent) diabetes were used for this study. The significantly different variables between patients with Type 2 diabetes and chronic glomerulonephritis were age (60.4 vs 54.6 years,p

Background: Filamin myopathy is associated with mutations in the filamin C gene ( FLNC ) and is a myofibrillar myopathy characterized by focal myofibrillar destruction and cytoplasmic aggregates containing several Z-disk-related proteins. Methods: This study investigated 6 Japanese patients with dominantly inherited myofibrillar myopathy manifested by adult-onset, slow and progressive muscle weakness and atrophy in the distal extremities. Results: The abundantly expressed proteins in the affected muscles were identified as filamin C by nano liquid chromatography–tandem mass spectrometry. A genetic analysis of FLNC identified a heterozygous c.8107delG mutation that was localized to the dimerization domain of filamin C. A biochemical crosslinking analysis of bacterially expressed recombinant wild-type and mutant filamin C fragments demonstrated that the mutant monomer disturbed the proper dimerization of the wild-type filamin dimer, resulting in formation of a heterotrimer with the wild-type filamin dimer. The expression study in C2C12 myoblasts showed that the mutant filamin fragments formed cytoplasmic aggregates with endogenous wild-type filamin C. Conclusions: This study provides evidence for the dominant-negative effects of the FLNC mutation. These effects may be mutation-specific and likely result in the variation in the clinical phenotypes seen in patients with filamin myopathy.

Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography (CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventy-two hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.

We report here a case of a 1-year-old girl with retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae (PRSP). Computed tomography disclosed a retropharyngeal mass lesion (4 cm x 3 cm in diameter), and the diagnosis was confirmed by needle aspiration of the retropharyngeal space, which yielded PRSP. To our knowledge, this is the first report of a young subject in whom retropharyngeal abscess was caused by this organism. Retropharyngeal abscess is most common in children younger than 3 or 4 years of age, during which period a high carriage rate of PRSP is also shown. This patient was successfully treated with panipenem/betamipron.

Background: Activation of lipid metabolism is an early event of carcinogenesis and a central hallmark of many cancers including breast cancer. Recent findings argue that stearoyl CoA desaturase-1 (SCD1), a key regulator of the fatty acid (FA) composition and the endoplasmic reticulum resident enzyme that converts saturated FA (SFA) into monounsaturated FA (MUFA) is a novel regulator of carcinogenesis. The distinctive lipids composition of membrane in cancer cells and the biological functions of SCD1, however, still remain uncertain. Imaging mass spectrometry (IMS) is a mass spectrometry-based analyzing technique that enables visualization of the individual molecules without requiring antibodies. It allows comprehensive detection of a wide range of biomolecules, such as lipids. We attempted to visualize the localization of lipids in breast cancer by IMS for better understanding of cancer proliferation. Materials and methods: 13 specimens were obtained from the primary breast cancer patients. All were Japanese woman and aged 41–86 years (mean 61.5y.o.). Only one patient received preoperative systematic therapy. 6 were estrogen receptor (ER) and/or progesterone receptor (PgR) positive and human epidermal growth factor receptor 2 (HER2) negative, 2 were ER and/or PgR positive and HER2 positive, 2 were both ER and PgR negative and HER2 positive and 2 were triple negative. IMS: Samples were immediately chilled in liquid Hexan and stored at −80°. All specimens were sliced into 10 mm thin sections, mounted onto one indium-tin oxide-coated glass slides (Bruker Daltonics) and then sprayed by 2,5-Dihydroxybenzoic acid. Matrix assisted laser desorption ionization (MALDI) technique was used as a soft ionization method. We used time of flight (TOF)/TOF type instrument (Ultraflex, Bruker Daltonics) and all the spectrum were acquired automatically using Fleximaging software (Bruker Daltonics). Each spectral intensity at any mass-to-charge ratio (m/z) was measured at 16 regions of interest (ROI); 13 ROI were picked up from cancerous parts and 3 were from non-cancerous parts. Spectral intensities were compared and statistical analysis was performed by Mann Whitney test. The software was also used to create two-dimensional ion-density maps. Results: In the cancerous parts of all the 13 specimens, two distinct peaks of the molecular ions were detected at m/z 798.5 and 810.5, which were not found in the non-cancerous parts. Median intensity of the molecular ions at m/z 798.5 and 810.5 were 38.9 and 3.18 in the cancerous part, while they were 0.84 and 1.02 in the non-cancerous part (p=0.010 and 0.015, respectively). Tandem mass spectrometry analysis for these two molecules revealed that they were two kinds of phosphatidylcholine (PC), PC (16:0/18:1) and PC (18:0/18:1). Localization of the individual PC was visualized by means of IMS, which showed that in cancerous part accumulation of PCs containing MUFA was more pronounced than those containing SFA only. Conclusion: Two kinds of PC containing MUFA were found to highly accumulate in cancerous parts, which may suggest involvement of SCD1 in the membrane composition regulation and cancer proliferation. Further studies may thus be warranted to explore the relation between PC localization and the SCD1 expression. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-05-05.

Virulent Rhodococcus equi produces 15- to 17-kDa surface protein antigens. These antigens are used as markers to identify virulent R. equi isolates from foals and their environment by Western blot (immunoblot) analysis with naturally infected foal serum. In the present study, a monoclonal antibody (MAb; 10G5) was generated against the 15- to 17-kDa antigens excised from sodium dodecyl sulfate-polyacrylamide gels to develop sensitive and specific immunoblot assays for the identification of virulent R. equi. MAb 10G5 strongly reacted with R. equi ATCC 33701 and L1, which expressed 15- to 17-kDa antigens by Western blot, colony blot, and dot immunobinding assays, but it did not react with strains ATCC 33701P- and L1P-, which lacked the antigens. For identification of virulent R. equi, clinical and environmental isolates were tested by these assays with the MAb, and all virulent strains were successfully identified; these strains possessed virulence plasmids. These results suggest that the MAb is a useful reagent for the identification of virulent R. equi.

We have performed an experiment of Coulomb excitation of a doubly magic nucleus 56Ni to its first excited 2+ state at 2.7 MeV in inverse kinematics. Radioactive 56Ni particles at an incident energy 70.7 MeV/nucleon with 1500 s−1 was obtained via fragmentation of 58Ni at RIPS facility of RIKEN. The E2 transition probability B(E2) between the 0+ ground state to the first 2+ state was deduced to be 580±70 e2fm4 by a coupled channel analysis assuming Coulomb excitation mechanism. The present result agrees with the value deduced from the 56Ni+p inelastic scattering experiment at GSI.

Mitochondrial encephalomyopathies are rare genetic diseases that affect organs and tissues with high oxidative activity, such as the brain, striated muscles, and heart. Although these conditions have received attention in the medical literature, there is an absence of published information on this topic in the nursing literature. The purpose of this article is twofold: (1) to provide an overview of mitochondrial encephalomyopathies and (2) to present a protocol to guide nursing practice. Protocol development is based on a case history and guided by Dungan's model of dynamic integration. The protocol addresses perceived family needs, nursing interventions, and outcomes of care.

We report 2 autopsy-proven cases of motor neuron disease/amyotrophic lateral sclerosis (MND/ALS), who developed the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) prior to the respiratory failure. With respect to the underlying mechanisms of SIADH in the cases, we considered two factors; 1) dysfunction of the feedback system in ADH secretion via intrathoracic volume receptors caused by changes in intrathoracic circulation, and 2) primarily functional abnormalities in the limbic system which could influence hypothalamic osmoreceptors. It appears that SIADH can be followed by an exacerbation of respiratory dysfunction in MND/ALS.

Breast cancer is the leading cause of cancer and mortality in women worldwide. Recent studies have argued that there is a close relationship between lipid synthesis and cancer progression because some enzymes related to lipid synthesis are overexpressed in breast cancer tissues. However, lipid distribution in breast cancer tissues has not been investigated. We aimed to visualize phosphatidylcholines (PCs) and lysoPCs (LPCs) in human breast cancer tissues by performing matrix assisted laser desorption/ionization-imaging mass spectrometry (MALDI-IMS), which is a novel technique that enables the visualization of molecules comprehensively. Twenty-nine breast tissue samples were obtained during surgery and subjected to MALDI-IMS analysis. We evaluated the heterogeneity of the distribution of PCs and LPCs on the tissues. Three species [PC(32∶1), PC(34∶1), and PC(36∶1)] of PCs with 1 mono-unsaturated fatty acid chain and 1 saturated fatty acid chain (MUFA-PCs) and one [PC(34∶0)] of PCs with 2 saturated fatty acid chains (SFA-PC) were relatively localized in cancerous areas rather than the rest of the sections (named reference area). In addition, the LPCs did not show any biased distribution. The relative amounts of PC(36∶1) compared to PC(36∶0) and that of PC(36∶1) to LPC(18∶0) were significantly higher in the cancerous areas. The protein expression of stearoyl-CoA desaturase-1 (SCD1), which is a synthetic enzyme of MUFA, showed accumulation in the cancerous areas as observed by the results of immunohistochemical staining. The ratios were further analyzed considering the differences in expressions of the estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and Ki67. The ratios of the signal intensity of PC(34:1) to that of PC(34:0) was higher in the lesions with positive ER expression [corrected]. The contribution of SCD1 and other enzymes to the formation of the observed phospholipid composition is discussed.

But Spatial and temporal frequency was varied in a visual stimulation protocol in order to investigate the effect of those parameters in the fMRI signal measured in the visual cortex. Objectifs and Methods Three normal healthy volunteers participated in this study. The data were acquired with a 3T clinical scanner using 2mm 3 isovoxel for the functional images and 1mm 3 .for the high-resolution anatomical images. In order to weight the magno and parvocellular layer response, two different checkerboard stimuli were used. The high temporal frequency checkerboard flickered at 14Hz and had a spatial frequency of 50min of arc. The low temporal frequency checkerboard flickered at 4Hz and had a spatial frequency of 5min of arc. The contrast was 100% for all checkerboard stimuli. Each presentation cycle consisted of one stimulation and one rest condition, 18 seconds each. The whole experiment lasted for eight cycles. The data were analyzed with the Brain Voyager software. Results As expected, the visual cortex responded significantly to all checkerboard stimulations. The fMRI signal measured in the occipital pole area was greater for the 4Hz/5min of arc stimulation when compared with the 14Hz/50min of arc stimulation. On the other hand, the response in the anterior calcarine fissure was greater for the temporal/spatial frequency of 14Hz/50min of arc. Discussion These results indicate that the anterior calcarine fissure responded particularly to visual stimuli related to the magnocellular system, which is mainly linked to the peripheral visual field. Likewise, the most posterior areas of the occipital cortex responded most importantly to the stimulation associated to the parvocellular system, which is located in a more central area of the visual field. Conclusion Our method permitted to locate the cortical responses related to the parvo- and magnocellular systems.

But Psychophysical and electrophysiological studies have shown that the cortical response related to binocular summation increases with low contrast stimuli. In this study, we investigated this effect using functional MRI (fMRI). Since this technique records signals related to blood flow, it is important to optimise the parameters of stimulation in order to maximise the measurement of the cortical response. Presentation time, and spatial and temporal frequency were varied in order to explore the phenomenon in depth. Objectives and Methods Three normal healthy volunteers participated in this study. Their binocular function was defined by >60 seconds of stereopsis using the TNO test. The data were acquired with a 3T clinical scanner using 2mm 3 isovoxel for the functional images and 1mm 3 .for the high-resolution anatomical images. In order to weight the magno or parvocellular layer response, two different checkerboard stimuli were used. The high temporal frequency checkerboard flickered at 14Hz and had a spatial frequency of 50min of arc. The low temporal frequency checkerboard flickered at 4Hz and had a spatial frequency of 5min of arc. The contrast was 20% for all checkerboard stimuli. Each cycle was of 24 seconds and consisted of one stimulation and a rest condition. The duration of the stimulation was 6, 9, or 12 seconds. Binocular and monocular conditions were repeated every 2 cycles. The data were analyzed with the Brain Voyager software. Results The fMRI signal increased in all subjects with the increase in presentation time. For all stimulations, the signal was greater in the binocular condition compared to the monocular condition. Moreover, the binocular/monocular ratio was different depending on the location of the cortical response. Discussion These results suggest the existence of different cortical processings underlying the phenomenon of binocular summation. Conclusion Efforts are being done to make this method capable to evaluate abnormal binocular function.

But Glaucoma is associated with specific optic disk changes and corresponding visual field defects. A recent post-mortem study showed structural changes in the lateral geniculate nucleus (LGN) and visual cortex of a glaucoma patient. In our study, we examined the optic radiations as well as grey matter density in the visual cortex of a glaucoma patient by means of diffusion tensor imaging (DTI) and D T weighted images. Materials and Methods One patient (male, 32y) diagnosed with congenital glaucoma that had previously been under multiple filtration surgery and eye drops treatment for more than 10 years was examined using a clinical 3T MR scanner. Seven healthy normal subjects constituted the control group. DTI was performed using 64 directions of motion-proving gradient with a b-factor of 1000 s/mm 2 . Fractional anisotropic (FA) maps were analyzed within the FSL package in order to detect potential differences in the optic radiations. The 3D T1-weighted images were acquired at 1mm isovoxel and grey matter density differences were evaluated using the Voxel Based Morphometry (VBM) option in SPM5. Results Compared to the control group, our analysis showed statistically decreased FA values in the optic radiations of the glaucoma patient. Grey matter density was as well statistically lower in the anterior part of primary visual cortex. Discussion These results suggest that structural changes in the optic radiations and visual cortex occur in glaucoma. To confirm these preliminary findings, this analysis will be carried out in cases of acquired glaucoma. Conclusion This non-invasive technique enables the exploration of changes in cerebral structures such as tracts and grey matter related to visual function.

4114 Background: Most ductal adenocarcinomas of the pancreas are hypovascular as compared with the surrounding parenchyma on dynamic CT. Coded phase-inversion harmonic ultrasonography more clearly depicts fine vessels in pancreatic tumors after the infusion of ultrasound contrast than dynamic CT. In the present study, we observed the vascularity of pancreatic tumors by means of this technique and investigated its usefulness for evaluation of response to gemcitabine. Methods: Thirty-three patients with inoperable pancreatic carcinomas were enrolled in this study. They received gemcitabine (1 g/m2) 3 times in a cycle (4 weeks). Contrast-enhanced harmonic ultrasonography (CE-US) was performed immediately before the fist cycle and after completing each cycle, by the use of a GE LOGIQ 9 Series unit. We classified patients into 2 groups according to the changes of tumor vascularity observed by CE-US. Group A represents those with tumors in which tumor vascularity was increased during a certain period after the chemotherapy. Group B represents those with tumors in which tumor vascularity was not increased throughout the observation period. Tumor makers (serum CEA, CA19–9, Span-1 and Dupan-2) and median survival time (MST) were employed for the evaluation of therapeutic response and compared between the 2 groups. Results: CE-US demonstrated the increase of tumor vascularity after the chemotherapy in 17 of 33 patients (Group A). MST in the Group A (306 days) was significantly longer than that in the Group B (187 days). The reduction of tumor makers (reduction by 50 % of either serum CEA, CA19–9, Span-1 or Dupan-2) was observed in all patients (17/17) in the group A and in 25 % of patients (4/16) in the group B. The increase of tumor vascularity was noted when the tumor makers were reduced. The increased vascularity turned to decline in parallel with the tumor progression. Conclusion: CE-US is useful for the evaluation of chemotherapeutic response in terms of vascularity. The increased vascularity in pancreatic carcinomas after the chemotherapy may represent the improvement of vascular sclerosis and tumor invasion in small arterioles. No significant financial relationships to disclose.

We examined zinc transfer during hemodialysis and serum zinc concentrations of hemodialyzed patients. 10 outpatients were studied during a single dialysis and 6 hospitalized patients were monitored during a week-long series of dialysis. Serum zinc concentrations increased significantly by diffusion and hemoconcentration after 5-hour dialysis. In 6 hospitalized patients, the daily protein and calorie intake were measured to examine the relationship between serum zinc and diet. We found a good correlation between serum zinc concentrations and total serum protein or daily calorie intake.

Aluminum transfer and dialysance during haemodialysis and plasma aluminum concentrations in haemodialysis patients were examined. Plasma aluminum in 30 volunteer outpatients tended to decrease after 5-hour dialysis (6.35 +/- 3.02 micrograms/dl before haemodialysis; 5.41 +/- 2.60 micrograms/dl after haemodialysis). The decrease was mainly due to diffusion despite haemoconcentration evidenced by a significant increase in the haematocrit and total plasma protein during dialysis. To study the changes resulting from diffusion, we measured aluminum in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. There was a non-significant decrease in the plasma aluminum of arterial blood from 6.20 +/- 2.90 to 5.64 +/- 2.55 micrograms/dl, but a significant increase in the dialysate aluminum from 0.38 +/- 0.18 micrograms/dl to 1.10 +/- 0.66 micrograms/dl. Aluminum diffused across the dialyzer from the blood to the dialysate in 23 cases and into the blood in 7 others. When aluminum dialysance is high, plasma aluminum can be removed to the dialysate during haemodialysis.

Anhand eigenes Krankengutes von 226 Schaftfrakturen in den verschiedenen langen Roehrenknochen, die fuer dieses Studium ausgesucht waren, wurde die Bedeutung einer Zug-Druck-Kraft im Bereiche der Fraktur nach klinischer Untersuchung und Beobachtung erfasst.Das Objekt der Untersuchung und Beobachtung war der Verlauf der Frakturspaltue-berbrueckung, das Verhalten eines eingebrachten Osteosynthesematerials, sowie die Bildung des Kallusses.Es stellte heraus, waehrend der Fixationsperiode das Frakturende sehr haeufig deutliche Knochenresorption zeigte (besonders beim Oberschenkelknochen). Aus dieser Beobachtung laesst sich ueber die Bedeutung der Zug-Druck-Kraft folgendes sagen: Zunaechst ist die Zug-Druck-Kraft mechanisch fuer das staendiges Kontakterhalten der Frakturflaechen bedeutsam. Sie sorgt nicht nur stabile Fixation, sondern verringert auch die Last auf das Osteosynthesematerial, damit die auf den betroffenen Knochen uebertraegt. Es beguenstigt dadurch die Knochenheilung, stellt die Knochenwiderstandsfaehigkeit wieder her, und zwar wirkt der biologische Effekt ein.Somit sollte ein Osteosynthesematerial sowohl struktuell auch eingenschaftlich nicht die Zug-Druck-Kraft beeintraechtigen muessen.

Unangenehme Komplikationen wie Krampfanfaelle sind nicht selten bei der myelographischen Untersuchung mit wasserloesslichem Kontrastmittel beobachtet. Es sei aber meistens an der verwendeten Dosis vom Kontrastmittel zurueck zu fuehren.Anlass dieser Beobachtung wurde es versucht, bei den 62 Patienten so weit wie moeglich die Menge des Kontrastmittels zu reduzieren, wie etwa 1/3 der herkoemmlichen klinisch verwendeten Dosis, wobei stellte es heraus, die gefuerchtete Komplikationen dadurchgaenzlich vermieden liess, denn noch auswertbare Myelographien dargestellt werden konnten.Der angewendete Kontrastmittel war Conray 60 und es liess sich folgende zusammenfassend sagen;1) Injizierte Fluessigkeitmenge betraegt insgesammt 3.0ml. (Kontrastmittel+Liquor).2) Mischverteilung liegt in Mittelwert von zwischen (Kontrastmittel:Liquor) 1:1 und 1:2.3) Naemlich eine Kontrastmittelmenge von etwa 1.3ml.4) Bei den obigen Bedingungen ist es besser zunaechst den Roentgentisch um 10° schraeg zu stellen. Durch Verstellung des Tisches kann gewuenschter Untersuchungsabschnitt erweitert werden.Fuer die myelographische Untersuchung hat diese Methode sicherlich einige Nachteile, zur Durchsicht eines Bandscheibevorfalls ist es jedoch vollkommen ausreichend.

Sowohl die Sprungsgelenkluxation, auch die Banderverletzen bei der Malleorusfraktur sind als nicht seltene Komplikation beobachtet worden.Die Wiederherstellung des anatomischen Verhaltnisses sowie genaue Fixation sind deshalb so wichtig, weil dadurch die Reposition des Gelenkes und die Reparatur der verletzten Bander erfolgt werden konnen.Bei 111 Fallen von frischer Malleolusfraktur aus meiner klinik wurde es uber die verschiedene Typen der Fraktur, uber die Indikation zur operative und konservativen Behandlung, uber die operative Methoden, und schliesslich uber das Ergebnis der Behandlung eingehend diskutiert, Das Ergebnis kann im Allgemeinen als sehr befriedigend bezeichnet werden.

Dialysis anemia is one of the severe complications in chronic hemodialysis patients. A high-aluminum dialysate causes microcytic hypochromic anemia in hemodialysis patients by aluminum intoxication. W

Nachuntersucht sind 244 Unterarmschaftfrakturen von 161 Patienten. Es ergibt folgende Ergebnisse:1) Operativ behandelte Ulna und Radiusbrueche, ausschliesslich versorgt mit Metalplatten erzielten durchaus befriedigendes Ergebnis.2) Bei der Osteosynthese sind exakte Reposition und einwandfreie Fixation unentbehrlich.3) Gegenwaertig verfuegbare Metalplatten fuer Unterarmknochen sind meistens nicht nur voluminoes zu gross, sodern auch zu robust konstruiert.4) Frakturen im Bereich der distalen Unterarmgegend (Distalende nicht im Begriff) werden ueberwiegend bei jungeren Patienten beobachtet. Mehrzahl davon gehoeren zu der Gruenholzfraktur5) Bei der distalen Unterarmbruechen kommt es im Lauf der Zeit nicht selten eine volare Konvexdeformitaet vor. Gegen diese Verformung besteht es noch keine gute Loesung.

Zur Diskussion gestellt wurde hier zunachst uber das Behandlungsergebnis von der lateralen Humeruskondylenfraktur bei insgesammt 31 Patienten, die in meiner Privatklinik behandelt worden waren.In den Fallen, wobei die Frakturfragmente nicht uber 1mm. verschoben waxen, erziehlte konservative Behandlung das gute Ergebnis.Bei einem Kinde hat es eine Pseudoarthrose gebildet, bei denen anfanglich keine Fragmentverschiebung zu erkennen war. Durch blutige Reposition konnte eine sichere Frakturheilung erreicht werden. Man sah jedoch in 2 Fallen die Frakturheilung in Cubitus varusstellung (nach langerer Beobachtungszeit von jeweils 1.5 und 4 Jahren).Es taucht bei der blutigen Reposition stets das Problem mit dem geeigneten Fixationsmittel auf. Der Fechtendraht nach Professor M. Yamamoto hat es logisch gelosst und er ist leicht verwendbar. Mein eigenes verbesserten Modell wurde bei der Gelegenheit vorgestellt.Es gab die Falle, die nicht einfach von einer Transkondylenfraktur zu differenzieren liessen.Bei der medialen Kondylenfraktur ist es wegen ihrer ausserst Instabilitat, kann eine exakte Fixation nur dann ermoglicht werden, wenn man einen wirkungsvollen Fixationsdraht verwendet.

Von den Fallen, wobei die Osteosynthese zum Tibiaschaftbruch in meiner klinik vorgenommen wurden, wurde das Behandlungsergebnis von 32 Fallen mit Osteosynthese Ohne Kompression (nach gebrauchlichen Platten nach AMAKO) erforscht.Und zugleich, die Starke der Platten und Form des Schraubenloches, die der wichtige Unterschied zwischen Kompressionsplatte und Non-Kompressionsplatte ist, betrachte ich beifugend mit dem einfache Exaeriment nach einem Modell.Die Ergebnisse der klinische Falle ist zufriedend. Insofern entsprechende postoperative Behandlung durchgefuhlt wirt, konnen weicherere Platte im Vergleich mit der Kompressionsplatte und langlich runde Schraubenloch der Non-Kompressionsplatte einige Vorteil haben.

Bilateral lesions of the suprachiasmatic nucleus of the hypothalamus of rats abolished circadian rhythms of oxygen consumption and of the respiratory quotient (RQ). The RQ remained constant at a level intermediate between the maximum (about 1.0) and minimum (about 0.9) values in control animals.

A 1-year-old boy was infected with Yersinia pseudotuberculosis serotypes 1b and 3, and his 3-year-old brother was infected with Y. pseudotuberculosis serotype 1b; both had drunk water from puddles in a garden of their housing district of Miyoshi City, Hiroshima Prefecture, Japan. The Y. pseudotuberculosis serotype 1b and 3 strains isolated from soil from the dried-up puddles and sand and feces from the sandbox proved to be from a stray cat. The restriction endonuclease patterns of the plasmid in each strain of Y. pseudotuberculosis serotypes 1b and 3 were identical. These data provide evidence for the transmission of Y. pseudotuberculosis through water, sand, and soil contaminated by feces from cats infected with this species.

Zinc transfer during hemodialysis and plasma zinc concentrations in hemodialysis patients were examined. Fifteen volunteer outpatients undergoing hemodialysis showed significant increases in plasma zinc from 74.0 +/- 7.8 to 88.1 +/- 9.7 micrograms/dl after a 5-h dialysis. The increase was mainly the result of hemoconcentration as evidenced by a significant increase in the hematocrit and total serum protein during dialysis, but was also due to diffusion. To study the changes resulting from diffusion, zinc was measured in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. There was a significant (p less than 0.01) increase in the plasma zinc of the arterial blood from 74.7 +/- 8.1 to 80.2 +/- 6.5 micrograms/dl, but a nonsignificant decrease in the dialysate zinc from 10.6 +/- 2.5 to 9.5 +/- 5.9 micrograms/dl. Zinc diffused across the dialyzer from the dialysate to the blood in 12 cases and into the dialysate in three others.

A tool, Patient Indicators of Nursing Care, was designed to measure quality of nursing care, defined in this study as prevention of nursing care complications. Nursing-accountable complications are seen as the presence of negative patient care outcomes as evidenced by observable physiologic indicators. A negative outcome results when either an observed indicator which was present at admission remains evident up to seven days postadmission or an absent indicator becomes evident during this time period. PINC is a 24-item list. Th list is first administered up to 48 hours postadmission; the second administration takes place between five and seven days postadmission. Scoring of PINC is based on the idea that four important presence-absence conditions exist and that each represents a value of quality of nursing care. Split-half reliability was computed for PINC, based on a sample of 124 patients from four hospital settings. The Spearman-Brown reliability coefficient was .871. An item analysis was accomplished by computing the correlation of each item with the total score. The computed correlation of .797 was a measure of interrater agreement. Face validity was established early in the test development by having the investigators judge the items in terms of observability, availability, and credibility. Predictive validity was not explicity examined although a major difference in PINC scores was found between critical care patients and other groups.