Search

Background and Objectives: Glomerular hyperfiltration and albuminuria accompanied by early-stage diabetic kidney disease predict future renal failure. Cigarette smoking has reported to be associated with elevated GFR in cross-sectional studies and with renal deterioration in longitudinal studies. The degree of glomerular hyperfiltration and proteinuria associated with smoking, which presumably is a phenomenon of early renal damage, has not been investigated in a satisfying manner so far., Design, Setting, Participants, & Measurements: This study included 10,118 Japanese men aged 40 to 55 years without proteinuria or renal dysfunction at entry. Estimated GFR was calculated using the Modification of Diet in Renal Disease equation for Japanese. Glomerular hyperfiltration was defined as estimated GFR ≥117.0 ml/min per 1.73 m(2), which was the upper 2.5th percentile value of estimated GFR in the total population. Proteinuria was detected using standard dipstick., Results: During the 6-year observation period, there were 449 incident cases of glomerular hyperfiltration and 1653 cases of proteinuria. Current smokers had a 1.32-time higher risk for the development of glomerular hyperfiltration and a 1.51-time higher risk for proteinuria than nonsmokers after adjustment for baseline age, body mass index, systolic and diastolic BP, antihypertensive medication, diabetes, alcohol consumption, regular leisure-time physical activity, and estimated GFR. Both daily and cumulative cigarette consumption were associated with an increased risk for glomerular hyperfiltration and proteinuria in a dose-response manner., Conclusions: In middle-aged Japanese men, smoking was associated with an increased risk of glomerular hyperfiltration and dipstick proteinuria. Of importance, past smokers did not exhibit any increased risk for these conditions.

Prostaglandin E(2) (PGE(2)), an important mediator of the inflammatory response, acts centrally to elicit sympathetic excitation. PGE(2) acts on at least four E-class prostanoid (EP) receptors known as EP(1), EP(2), EP(3), and EP(4). Since PGE(2) production within the brain is ubiquitous, the different functions of PGE(2) depend on the expression of these prostanoid receptors in specific brain areas. The type(s) and location(s) of the EP receptors that mediate sympathetic responses to central PGE(2) remain unknown. We examined this question using PGE(2), the relatively selective EP receptor agonists misoprostol and sulprostone, and the available selective antagonists for EP(1), EP(3), and EP(4). In urethane-anesthetized rats, intracerebroventricular (ICV) administration of PGE(2), sulprostone or misoprostol increased renal sympathetic nerve activity, blood pressure, and heart rate. These responses were significantly reduced by ICV pretreatment with the EP(3) receptor antagonist; the EP(1) and EP(4) receptor antagonists had little or no effect. ICV PGE(2) or misoprostol increased the discharge of neurons in the hypothalamic paraventricular nucleus (PVN). ICV misoprostol increased the c-Fos immunoreactivity of PVN neurons, an effect that was substantially reduced by the EP(3) receptor antagonist. Real-time PCR detected EP(3) receptor mRNA in PVN, and immunohistochemical studies revealed sparsely distributed EP(3) receptors localized in GABAergic terminals and on a few PVN neurons. Direct bilateral PVN microinjections of PGE(2) or sulprostone elicited sympathoexcitatory responses that were significantly reduced by the EP(3) receptor antagonist. These data suggest that EP(3) receptors mediate the central excitatory effects of PGE(2) on PVN neurons and sympathetic discharge.

To elucidate the effect of γ-aminobutyric acid (GABA) on both psychological and physical fatigue and on the performance advances for task solving, we assigned an arithmetic task for the Uchida-Kraepelin Psychodiagnostic Test (UKT) to 30 healthy Japanese subjects, 9 of whom were diagnosed as having chronic fatigue. The subjects were administered 250 mL of a test beverage containing GABA at the dose of 0, 25, and 50 mg before assigning task for the UKT. Psychological fatigue assessed by the Visual Analogue Scale (VAS) was significantly lower in the group administrated the beverage containing 50 mg GABA than in the control group (p<0.05). The results of the Profile of Mood States (POMS) also indicated that psychological fatigue was significantly reduced in the 50-mg-GABA group. The salivary secretion levels of chromogranin A and cortisol-markers of physical fatigue-in both 25-mg and 50-mg-GABA groups were significantly lower than those in the control group. The 50-mg-GABA group also showed higher score on UKT by solving the arithmetic task more accurately than the control group (p<0.01). The results suggest that intake of GABA-containing beverages, especially those containing 50 mg of GABA, may help reduce both psychological and physical fatigue and improve task-solving ability.

Because the expert nurse of the chemotherapy center collected his profile from his chart and the hospital summary of nursing and we orientated about the induced chemotherapy regimen to the patient who got it after discharge from the ward former, we could not grasp neither his general condition nor mental status adequately. The merit of the outpatient chemotherapy is the improvement of the quality of life, but the patient feels the solitude and anxiety because of the lack of the medical and nursing staff around him. Then we changed that we have visited the patients to collect their profile and orientate about new regimen on his bedside for the smooth conversion to the outpatient chemotherapy. We visited a-total of 45 patients in 2007. Thirty-eight patients visited before their discharge answered, The orientation of the new chemotherapy before my discharge let me get with a security. The visit also enabled both staffs of the chemotherapy center and the ward to possess the common information of each patient and to do the common nursing. We thought that the visit before discharge was effective for the smooth conversion to the outpatient chemotherapy. We would like to reduce the anxiety of the patients who had chemotherapy and to support their struggle against diseases, cooperating to other department and standardizing our care program.

Purpose: In order to analyze spontaneous blink kinematics easily and circumstantially, we developed a new method using an intelligent vision system (IVS) camera with a 1 KHz sampling rate, and evaluated the efficacy of this system., Method: Eleven healthy male volunteers were examined after obtaining informed consent. Eyelid movements in the primary eye position were recorded with an IVS camera twice, for 30 seconds each. Data of upper lid position and lid movement were plotted every 1 msec by image processing of the recorded images. Thereafter blink duration and maximum blink velocity in every spontaneous blink were calculated., Results: Thirty-nine instances of complete lid-closure type and seventy of incomplete lid-closure type of spontaneous blinks were observed. The average duration of the down-phase, the up-phase, and the total blink were the same for both types; about 100 msec., 220 msec., and 320 msec. respectively. The average down-phase maximum velocity was about 180 mm/sec. in complete lid-closures and 120 mm/sec. in incomplete lid-closures. The average up-phase maximum velocity was about 60 mm/sec. in complete lid-closures and 45 mm/sec. in incomplete lid-closures. Blink amplitude and the maximum velocity achieved during lid closing and opening were strongly correlated and exhibited a linear relationship (r = 0.85, r = 0.73 p < 0.0001)., Conclusion: This new, non-invasive system is an easy to use measuring method for blink kinematics and is highly reliable and very useful.

Given the absence of recent reports on the isolation rate of Serratia marcescens by pili type, clinical isolates from respiratory and urinary tract specimens--prime loci of infection by this organism--were subjected to examination. The 123 S. marcescens strains (serotype O2, 67 strains, serotype O14, 56 strains) used in this study were isolated from inpatients at Showa University Fujigaoka Hospital during the 5 years from April 1997 to March 2002. Higher rates of S. marcescens O2 with mannose-resistant (MR)/K Klebsiella-like pili were detected among the respiratory tract-derived strains. On the other hand, more non-hemagglutinating O14 strains were found among the urinary tract-derived strains. Analysis by study phase revealed a rise in the isolation rate of non-hemagglutinating strains, from 0-17.4% for O2 strains and 34.5%-66.7% for O14 strains, between phase I (April 1997 to March 1999) and phase II (April 1999 to March 2002) of the study. In order to examine the increasing non-hemagglutinating strains in detail, the 28 serotype O14 non-hemagglutinating strains, and 8 strains with only mannose-sensitive (MS) pili were subjected to genotyping by pulsed-field gel electrophoresis (PFGE), revealing the presence of 10 clones with disparate genotypes. The A1 strain isolated at the highest frequency was non-hemagglutinating in all cases and possessed the same genotype, indicating proliferation within the hospital over the 5 years of the study. These results indicate that non-hemagglutinating strains were transmitted among patients within the hospital.

Fever is induced by a neuronal mechanism in the brain. Prostaglandin (PG) E2 acts as a pyrogenic mediator in the preoptic area (POA) probably through the EP3 subtype of PGE receptor expressed on GABAergic neurons, and this PGE2 action triggers neuronal pathways for sympathetic thermogenesis in peripheral effector organs including brown adipose tissue (BAT). To explore pyrogenic efferent pathways from the POA, we determined projection targets of EP3 receptor-expressing POA neurons with a special focus on rat hypothalamic regions including the dorsomedial hypothalamic nucleus (DMH), which is known as a center for autonomic responses to stress. Among injections of cholera toxin b-subunit (CTb), a retrograde tracer, into hypothalamic regions at the rostrocaudal level of the DMH, injections into the DMH, lateral hypothalamic area (LH) and dorsal hypothalamic area (DH) resulted in EP3 receptor immunolabelling in substantial populations of CTb-labeled neurons in the POA. Bilateral microinjections of muscimol, a GABA(A) receptor agonist, into the DMH and a ventral region of the DH, but not those into the LH, inhibited thermogenic (BAT sympathetic nerve activity, BAT temperature, core body temperature and expired CO2) and cardiovascular (arterial pressure and heart rate) responses to an intra-POA PGE2 microinjection. Further immunohistochemical observations revealed a close association of POA-derived GABAergic axon swellings with DMH neurons projecting to the medullary raphe regions where sympathetic premotor neurons for febrile and thermoregulatory responses are localized. These results suggest that a direct projection of EP3 receptor-expressing POA neurons to the DMH/DH region mediates febrile responses via a GABAergic mechanism.

Immunoglobulin G (IgG) antibodies to Epstein-Barr virus (EBV) nuclear antigens 2 and 1 (EBNA-2 and EBNA-1, respectively) were studied using sera from healthy individuals of a population with a high incidence of asymptomatic primary EBV infections during infancy or childhood in Japan. Two CHO-K1 cell lines expressing EBNA-2 and EBNA-1 were used for anticomplement and indirect immunofluorescence assays. The positivity rate for EBNA-2 IgG rose in the 1- to 2-year age group, increased and remained at a plateau ( approximately 45%) between 3 and 29 years of age (3- to 4-, 5- to 9-, 10- to 14-, and 15- to 29-year age groups), and then reached 98% by age 40 (>/== 40-year age group). Both seropositivity for EBNA-1 and seropositivity for EBNAs in Raji cells (EBNA/Raji) were detected in the 1- to 2-year age group, remained high, and finally reached 100% by age 40. The geometric mean titer (GMT) of EBNA-2 IgG reached a plateau in the 5- to 9- and 10- to 14-year-old groups and remained elevated in the older age groups (15 to 29 and >/== 40 years). The GMT of EBNA-1 IgGs increased to a plateau in the 1- to 2-year-old group and remained unchanged in the older age groups. The GMT of EBNA/Raji IgGs also reached a plateau in the 1- to 2-year-old group, remained level throughout the 3- to 14-year age groups, and decreased in the 15- to 29-year-olds. EBNA-2 IgGs emerged earlier than EBNA-1 IgGs in 8 of 10 patients with infectious mononucleosis, who were between 1 and 27 years old, and declined with time in three of eight cases. These results suggest that EBNA-2 IgG antibodies evoked in young children by asymptomatic primary EBV infections remain elevated throughout life, probably because of reactivation of latent and/or exogenous EBV superinfection.

One hundred fifty-six isolates of Serratia marcescens from patient specimens in Showa University Fujigaoka Hospital between April 1999 and March 2002 were investigated in this study. Forty-two isolates with serotype O2, detected mainly from patient respiratory specimens, were susceptible to the antimicrobial agents tested, whereas 30 isolates with serotype O14, detected mainly from patient urine, were resistant. Moreover, 19 isolates with serotype O14 susceptible to imipenem were intermediate or resistant to meropenem, while they did not produce metallo beta-lactamase. Both serotypes were significantly distributed in the ICU and surgical wards, compared with other wards. Ten isolates with O2/B (bacteriocin type) 16 and 14 isolates with O14/B76J, showing identical or closely-related clones by pulsed-field gel electrophoresis (PFGE) analysis of Spe I-restricted chromosome, were detected from different inpatients' specimens during approximately 2 and a half years. The existence of such long-lasting microorganisms suggested the possibility of hospital-acquired infection caused by inadequate use of antimicrobial agents and disinfection procedures for medical tools such as bite blocks and catheters.

Cytotoxicity and effect on guinea pig wounds were compared with three kinds of 10% povidone-iodine solution (isodine, neojodine, J-iodine) and povidone-iodine. It gave the following results: 1. In the Chang conjunctiva cell where remarkable toxicity was observed in the used cell line, the toxicity emphasized was 10 times using povidone-iodine < J-iodine < neojodine < isodine. In addition, a toxic difference was recognized between cells, in the order of Chang conjunctiva > SIRC > FRSK > human fibroblast for isodine and neojodine. 2. As for the influence on cells achromatized in sodium thiosulfate, alteration was not recognized in isodine, J-iodine using half-maximum cytotoxicity concentrations (CC50), and, in neojodine and povidone-iodine, elimination of drug toxicity was recognized in Chang conjunctiva/FRSK cells. 3. Strong toxicity was seen in isodine and neojodine in the toxicity test using colony formation method, however on washing with PBS (-), an easing of the toxicity effect could be seen to 0.01%. 4. Polyoxythylene nonylphenyl ether, NP-10 was the most toxic in the used surfactants in this study, and the toxicity by 100 times when compared with sodium polyoxyethylene lauryl ether sulfate, SBL-2N. Prominent sensitivity was observed in Chang conjunctiva cells with regard to the cell line and subsequently showed toxicity in order of SIRC > FRSK > human fibroblast. Remarkably, the difference between solutions of isodine and J-iodine was made more clear from the 5th culture. 5. In this study, significantly guinea pig wounds, povidone-iodine blocked all examples significantly recognized as dallying by distance between epidermal cells. In addition, isodine was meaningful area. Although their ware not offer the significant differences, the solutions obstructed the sliding of epidermal cells in comparison with povidone-iodine, and a delaying tendency of inflammation was also recognized. The toxic difference between povidone iodine solutions was regarded as the influence of surfactants added to the povidone-iodine. Based on this foundation study, more detailed clinical testing is necessary in determine where sterilization to wounds/mucosa/eyes with solutions containing additive is a suitable panpractice or not.

Cytotoxic effect and guinea pig wound cure stage, pus fabrication presence in infected wound were compared with strong acidic electrolyzed water (AcEW) and povidone-iodine solution (PVP-I), chlorhexidine (CHG) and benzalkonium chloride (BAC). It gave the following results: In a cytotoxic test, the toxicity was recognized in 0.1%-0.01% PVP-I, in 0.0002-0.0004% CHG, in 10-0.1 micrograms/ml BAC, but there was no toxicity in AcEW. By a guinea pig wound cure process, no significance was recognized between each pharmaceutical agent in epidermal cell migration, but by an inflammation locus area, the significance was considerable in comparison with no-treatment. The pyopoiesis of P. aeruginosa infected wound was recognized in a ratio of 38.2% physiological saline, 27.3% CHG, 20.6% PVP-I and 12.1% AcEW. When pollution locus includes an infection image of bacteria, while draining AcEW instead of physiological saline, disinfection, indication was expected, and, as for the disorder in cure stage. I do not agree with that mentioned above. As for AcEW, availability by organism use was recognized for the cytotoxic effect of antiseptic instead of action of acceleration for wound cure.

Squamous cell carcinoma antigens (SCCA) 1 and 2 are highly homologous proteins of the serpin family, although they inhibit different types of proteinases. We investigated the expression of both SCCA mRNAs in tumor tissues, in various cell lines (A431, SAS, Ca9, HeLa, SKGIIIa, HSC-2, HSC-3, HSC-4 and KB) and in HSC cell lines in the presence of tumor necrosis factor-alpha (TNF-alpha). The expression of SCCA2 mRNA could be differentiated from that of SCCA1 in tumor tissues and cell lines by means of reverse transcription-polymerase chain reaction (RT-PCR). The ratio between SCCA1 and SCCA2 mRNA expression showed selective expression of SCCA2 mRNA in SCC tissues from the uterine cervix compared to SCC tissues from the esophagus or skin. In addition, a significant level of SCCA2 mRNA expression was detected in the HSC-4 cell line, but not in Ca9, HeLa, SKG-IIIa, or HSC-3 cells. In contrast, SCCA1 mRNA was detected in all samples tested. These results suggest that the level of expression of SCCA2 mRNA detected by RT-PCR can be used to evaluate the status of SCC tumors. Next, we studied the effect of TNF-alpha on SCCA1 and SCCA2 mRNA expression in HSC cell lines. SCCA1 mRNA expression was constantly increased in the three HSC cells examined with increasing time of exposure to TNF-alpha. In contrast, SCCA2 mRNA expression was specific for HSC-4 cells. The survival rate of HSC-4 cells pretreated with TNF-alpha (6.3 ng/ml) for 48 h was found to be 72%, compared with 42% and 9% for HSC-3 and HSC-2 cells, respectively, after apoptotic stimulation by TNF-alpha (10 ng/ml) and cycloheximide (10 microg/ml) for 18 h. Furthermore, selective expression of SCCA2 mRNA in HSC-4 pretreated with TNF-alpha protected these cells from TNF-alpha-mediated apoptosis. Thus, SCCA2 overexpression in squamous tumor cells contributed to their survival by protecting them against TNF-alpha-induced apoptosis.

The rate of bacterial elimination for the stamp method was compared with regular hand-washing (using soap and tap water), hygienic hand-washing (using alcoholic antiseptics), and hand-washing using strong acidic electrolyzed water (the SAEW method) in routine work. After routine work, the average number of bacteria remaining on the nurse's hands with using the SAEW-method, rubbing method and tap water method, were: 54 +/- 63, 89 +/- 190, 128 +/- 194 CFU/agar plate, respectively (n = 81). In this study. It was clarified that a much larger number of Bacillus sp. were detected for the rubbing method than for the other methods. After further nurse work, the most number of absorbed bacteria on a nurse's hands were counted after cleaning a patient's body. The rate of bacteria elimination for hand-washing with soap and tap water after taking care of a patient was insufficient, especially when before care was provided the number of bacteria on the nurse's hands were less than 100 CFU/agar plate. From these results, the following manual for sanitary hand washing is recommended: 1. At first, dirty hands should be cleaned and the number of bacteria should be reduced using soap and tap water or by scrubbing with disinfectants. 2. After the number of bacteria has been reduced, use the SAEW method routinely. 3. For care requiring a high level of cleanliness or if no tap water facilities are available, use the rubbing method. Finally, routine use of the SAEW method in ICU could be recommended with conventional disinfectants and soap and tap water on a case by case basis for less than adverse reactions, such as in the case of rough-hands or keeping a low level of bacteria on hands.