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We examined the effect of famotidine, a histamine-type 2 receptor antagonist, on the immunocompetent cells. The number of DR(+) cells were significantly decreased in patients with systemic lupus erythematosus (P

The two nap sleep test (TNST) was developed and its usefulness for detecting sleepiness in long-distance drivers has been reported. This study's authors attempted to apply the TNST as a clinical test of sleepiness. A normal control group (n = 29), an obstructive sleep apnea syndrome (OSAS) group (n = 9), and another sleep disorder group (n = 6) participated. As a result of polysomnography, the sleep latency and sleep time did not differ among the groups. In contrast, the frequency of micro-arousal and movement arousal was significantly higher in the OSAS group than in the other groups. The TNST is thought to be useful for evaluating disturbance of sleep maintenance.

The expression of mdr1 gene was measured to determine whether it plays a role in clinical resistance to chemotherapy of human malignant lymphomas. mdr1 expression was found in 4 of 9 cases resistant to chemotherapy. Expression of mdr1 was not detectable in any of 7 chemotherapy-sensitive tumors. The 2 cases of reactive lymphadenitis and the 3 samples of normal mononuclear cells did not show any expression of mdr1 gene, either. These results indicate that expression of the mdr1 gene is not always detectable in cases of malignant lymphoma resistant to chemotherapy, but the detectable expression of mdr1 gene may predict clinical resistance to chemotherapy.

The in vivo effects of allogeneic granulocytes on the reconstitution of splenic and bone marrow CFUs and CFUc numbers were investigated using irradiated mice. When allogeneic granulocytes were intraperitoneally injected into irradiated BDF1 mice (260 rads), the reconstitution of CFUs in both spleen and bone marrow as well as the hematocrit were enhanced, while the reconstitution of splenic or bone marrow CFUc numbers was transiently suppressed and then enhanced. The magnitude of enhancement was dose-dependent. These results suggest that granulocytes injected into irradiated mice might act as enhancing effectors on the in vivo reconstitution of hemopoietic cells.

Phosphorylcholine (PC) antibodies in serum from patients with pulmonary infection, and from normal individuals, were studied. Anti-PC antibodies were detectable in the serum from normal individuals at mean concentrations of 320 micrograms/ml for the IgG class and 110 micrograms/ml for the IgM class. Concentrations of anti-PC antibodies which were higher than normal for both the IgG and IgM classes were observed in the serum in pulmonary infection (1,440 micrograms/ml and 210 micrograms/ml, respectively). Despite the significant difference in the concentration of anti-PC antibodies, the PC-specific B cell precursor frequency in the peripheral blood lymphocytes showed no difference between normal individuals and the patients with pulmonary infection, or between the acute phase and the chronic phase in a single patient with chronic pulmonary infection. Serologically, the purified IgG anti-PC antibody did not share the cross-reactive idiotype of TEPC 15, which is the most common idiotype of the murine anti-PC antibodies. However, the purified IgM anti-PC antibody expressed a very weak cross-reactive idiotype of TEPC 15. It appears from these studies that human anti-PC antibodies may play an important biological role in pulmonary infection by microorganisms which possess a PC determinant.

A 34-year-old Japanese woman developed spiking fever, splenomegaly, arthritis, neutrophilia, hyperferritinaemia (22517 ng/ml), elevated C-reactive protein (9.1 mg/ml) and severe thrombocytopenia (1.7 x 10(4)/microl). The patient had depressed antithrombin III activity and abnormally high concentrations of both fibrin degradation products and thrombin-antithrombin complexes. This condition was resistant to high-dose prednisolone therapy (120 mg/day) and non-steroidal anti-inflammatory drugs. We initiated oral methotrexate therapy (7.5 mg/week, orally) with a favourable outcome. The patient's spiking fever subsided on the first day of methotrexate administration. Elevated levels of ferritin and C-reactive protein in the sera rapidly normalised. Methotrexate rapidly improved the disease state which suggested that methotrexate act via modulation of cytokine production or secretion.

Troglitazone and pioglitazone are one of thiazolidinediones that are high affinity ligand for the nuclear receptor called peroxisome proliferator-activated receptor gamma (PPAR-γ). Troglitazone is a potent inhibitor of clonogenic growth of acute myeloid leukemia cells when combined with a retinoid. However, the effect of pioglitazone to neoplastic cells and normal hematopoietic cells has not been studied yet. Adult T-cell leukemia (ATL), prevalent in western Japan, is a highly aggressive malignancy of mature T lymphocyte. Therefore, we studied antitumor effect of pioglitazone against leukemic cells including ATL as well as normal hematopoietic cells. With 300 μM of pioglitazone, colony formation of ATL cell lines (MT1, MT2, F6T, OKM3T, and Su9T01) was completely inhibited. Colony formation of HUT102, another ATL cell line, was 12 % compared to untreated control. Clonogenic cells of other leukemic cell lines (K562, HL60, U937, HEL, CEM, and NALM1) was also inhibited to 0–30% of control. Colony formation of primary leukemic cells from 5 AML patients was decreased to 15 %. However, normal hematopoietic cells were weakly inhibited with 300 μM pioglitazone; 77 % of CFU-GM, 70 % of CFU-E, and 33 % of BFU-E survived. Cell cycle analysis showed that pioglitazone decreased the ratio of G2/M phase in HL60 cells, suggesting the inhibition of cell division. By Western blotting, PPAR-γ protein level was similar in all leukemic cells and normal bone marrow mononuclear cells. Taken together, pioglitazone effectively eliminate leukemic cells and could be used as an antitumor agent in vivo.

The aim of this study was to examine the role of p38 mitogen-activated protein (MAP) kinase in interleukin (IL)-8 expression in tumour necrosis factor (TNF)-alpha- and IL-1alpha-stimulated human pulmonary vascular endothelial cells. To this end, the phosphorylation and activation of p38 MAP kinase and the effect of SB 203580, a specific inhibitor of p38 MAP kinase activity, on p38 MAP kinase activity and IL-8 expression in TNF-alpha- and IL-1alpha-stimulated human pulmonary vascular endothelial cells were examined. TNF-alpha- and IL-1alpha- induced phosphorylation and activation of p38 MAP kinase and IL-8 expression in human pulmonary endothelial cells. Inhibition of TNF-alpha- and IL-1alpha-induced p38 MAP kinase activity by SB 203580 inhibited TNF-alpha- and IL-1alpha-induced IL-8 protein production as well as IL-8 messenger ribonucleic acid (mRNA) expression, indicating that SB 203580 was effective at the transcriptional level. These results indicate that p38 mitogen-activated protein kinase plays an important role in the tumour necrosis factor-alpha- and interleukin-1alpha-activated signalling pathway which regulates interleukin-8 expression in human pulmonary vascular endothelial cells.

A 22 years old male patient was hospitalized with complaints of obesity, daytimesomnolence and snorring during sleep. Physical examination revealed slight ptosis in eyelidsand grade III tonsillar hypertrophy, however, no other abnormalities were observed. The chest X-ray film showed slight cardiomegaly. Laboratory tests were all within normal limit.Pulmonary function test was normal except slight reduction of RV and elevation of CV. Theventilatory response tests of respiratory center revealed blunt responce to the lowered oxygenconcentration of inhaled gas and weak response to the higher concentration of CO2 in the inhaledgas. The distribution of the sleep stage analyzed with EEG showed stage W of 25%, stage I of 11%, stage II of 36%, stage III of 10%, stage IV of 1% and stage REM of 17%, and the marked reduction of deep sleep was clearly demonstrated. The pattern of respirationwas continuously monitored during sleep by means of the capacitance pneumograph, andperiodic apnea lasting for about 60 seccnds was observed. The arterial oxygen saturationmonitored by an earoxymeter droped to 76%, and ECG recording indicated the occurrence ofsinus bradycardia and premature ventricular contraction during the apnea periods. Thecapacitance pneumograph, which was devised to record chest and abdominal wall movementsseparately, initially showed complete cessation and then paradoxical movement of chest andabdominal wall during apnea. This indicated that the apnea was initially central then followedby obstruction. After reduction of body weight and tonsillectomy, daytime somnolenceand snor on sleep were markedly improved and the period of apnea reduced to 35-45 seconds and reduction of SaO2 was about 90%. The capacitance pneumograph is non-invasive and useful tool for the investigation of sleep induced apnea.

The water-jet method has been used during hepatic resection. The instrument cuts the hepatic tissue with the high pressure of the fine water flow, while the exposed elastic intrahepatic vessels are spared injury. A comparative study on the water-jet method with the previously employed conventional methods was undertaken. Hepatic resections were performed on 35 patients using the water-jet method. Cirrhosis of the liver was associated with 10 of the 24 patients with hepatocellular carcinoma. An ordinary saline solution was used as the jet, which was projected at a pressure of between 12 kg/cm2 and 20 kg/cm2 through a 0.15/mm-diameter nozzle. A higher jet pressure was needed to cut the fibrotic hepatic parenchyma. In the case of normal liver, the intrahepatic vessels of more than 0.2 mm were well preserved. In most of the cases, the loss of blood when cutting the hepatic parenchyma can be easily reduced with a jet pressure of 15-16 kg/cm2, thus preserving the fine vessels more than 0.2 mm in diameter without injury. When the same pressure was applied in the cutting of a cirrhotic liver, it took much longer time compared to that of a non-cirrhotic normal liver parenchyma. The cut surface was smooth compared to that after using CUSA, although its disadvantages lie in the formation of air bubbles, which obscure the operative field. The controlled projection of a jet of water under optimal pressure may ensure a safe hepatic resection of both normal and cirrhotic livers. Furthermore, because of its uncomplicated form, a wide range of applications can be expected, while the lower cost will also expedite its large-scale use for economic reasons.

Recent studies have shown that nasal CPAP is very effective in the treatment of patients with obstructive sleep apnea syndrome (OSA). In the present study, we examined the effects of short term nasal CPAP therapy in 10 cases of OSA patients. Nasal CPAP was used for 10 to 14 days and polysomnography was performed at two consecutive nights without nasal CPAP and at one night with nasal CPAP. Uchida-Kraepelin tests were performed before the initiation of nasal CPAP therapy and also 7 to 14 days after the nasal CPAP therapy. Apnea index reduced significantly in all cases from 49.0±20.3 episodes/hour without therapy to 3.1±3.3 with nasal CPAP (P

We have investigated the relationship between acute airway hyperresponsiveness and polymorphonuclear cell (PMN) migration in airways following saline or endotoxin (ET) aerosol inhalation in 63 guinea pigs. In 20 of these animals, granulocytopenia was induced by prior treatment with hydroxyurea (HU). Airway responsiveness (AR) to inhaled methacholine, together with leukocyte counts in bronchoalveolar lavage fluid (BALF) and in tracheal epithelium, was also examined before and at 30 min, 1, 3 and 6 hr after saline or ET inhalation. In saline inhalation groups, AR and PMN counts in BALF and in tracheal epithelium did not differ from control animals at any time points. However, in ET inhalation groups AR increased significantly at 1 and 3 hr and returned to the pre-exposure level at 6 hr. This period of hyperresponsiveness was associated with an increment of PMN migration into tracheal epithelium. However, the increment of PMN counts in BALF was delayed to 3 and 6 hr after ET. In HU treated animals, AR and PMN counts in BALF and in tracheal epithelium did not change during 6 hr after ET inhalation. These results suggest that the hyperresponsiveness induced by ET inhalation either depends upon PMN migration into the tracheal epithelium.

Effect of various drugs on histamine induced bronchoconstriction and exercise-induced asthma (EIA) has been examined by many investigators, however, results are inconsistent. The purpose of the present study was to investigate the effect of sodium cromoglycate (SCG) on histamine inhalation challenge with 12 asthmatics and on EIA with 15 patients who developed bronchoconstriction following exercise. Cumulative doses of histamine to produce the 20% reduction of forced expiratory volume in one second (PD20FEV1) were significantly decreased in asthmatics, however, the slopes of dose response curves (reactivity) varied significantly and were not differed from those of normal subjects. The reproducibility of dose-respons curves obtained from 10 patients was very good. Pretreatment with SCG did not affect both PD20FEV1 and slope of doserespons curves in asthmatics. Cases of EIA were divided to responders who had V50 larger than 120% and non-responders who had V50 smaller than 120% based upon the flow-volume curves of air and HeO2 obtained at 5 minutes after exercise. Responders (8 cases) showed relatively mild airway obstruction following exertion which tended to return to pre-exercise levels with time. On the other hand, non-responders (7 cases) developed significant post-exertional bronchoconstriction which did not recover without medication. SCG protected EIA moderately and/or markedly except for 3 cases of responder in whom no protection was observed.These results indicate that the mechanism to induce bronchospasms was different between histamine challenge test and EIA.

A case of hemolytic transfusion reaction due to Lewis b antibody was reported.The patient, 62-year-old farmer, was suffered from echinococcosis. He has no history to be transfused. His blood types were A, CCDee, Le (a-b-), MNSs, P2, kk, Fy (a+b-), Jk (a+b+), Xg (a+), Di (a-), and he had anti Lea & Leb antibodies.Right hepatic lobectomy was undergone. Total amount of bleeding in this operation was about 3, 000ml. And during the operation, 1, 600ml of Le (a-b-) blood and 800ml of Le(a-b+) blood was given.Two days after the operation, hemolytic jaundice and bleeding tendency from DIC appeared. Some part of the lost blood volume was replaced by incompatible Le (a-b+) blood, because Le (a-b-) blood was difficult to obtain due to its low frequency. Moreover few papers reported on hemolytic reaction by anti Leb antibody. Hemolytic reaction and DIC syndrome became even stronger as the days go by.After the transfusions of Le (a-b-) blood units alone, hemolytic anemia, jaundice and bleeding tendency were improved before long. Anti-Leb antibody titer which elevated initially decreased gradually after stoppage of using Le (b+) blood.According to these clinical features and laboratory data, we concluded that this hemolytic reaction was occured from Le (b+) incompatible blood transfusion.

In order to investigate the differences between EIA positive and negative subjects, pulmonary function data at rest, atopic tendency and bronchial sensitivity and reactivity were compared. Pulmonary function data revealed no significant difference between two groups except closing volume which was higher in EIA positive patients (p less than 0.01) and also Rrs which was higher in EIA positive patients only in female (p less than 0.05). Incidence of positive skin tests and higher levels of IgE were more frequent in EIA positive, however, IgE was not significantly different. Relationship between % fall of FEV1 after exercise and bronchial sensitivity was examined, however, no correlation was found in two parameters. Bronchial reactivity was not different in two groups. This suggests that EIA positive patients cannot be distinguished from EIA negative by pulmonary function data at rest or by atopic tendency, and also that different mechanisms play a role to produce airway constriction following exercise and inhalation challenge.

As a cause of dyspnea, upper airway obstruction (UAO) is rarely considered. However, it should be recognized that dyspnea could be improved by an adequated treatment if dyspnea is caused by UAO.In order to find out sensitive parameter of pulmonary function test in UAO, we performed several expriment: 1. Spirometry, respiratory resistance (Rr), Flow-Volume (F-V) curve in normal subjects with external resistance (4-9mm of orifice diameter). 2. Spirometry, Rr and F-V curve in UAO, and normal and chronic obstructive lung diseases (COPD). 3. Exercise study on normal subjects with and without external resistance.Naomaru, Miyaji;Takashi, HorieFollowing results are obtained:1) FIV and MVV are sensitive spirometry to detect UAO.2) Expiratory portion of F-V curve is flat near peak flow and inspiratory portion reveals reduced flow at entire lung volume. Reduction of PEF, PIP and VI50, and elevation of VE50/VI 50, VE25/. PEF and FEV1.0/ PEF are sensitive parameter.4) Exercise performance is significantly impared in UAO.

Many papers have reported on the thermal shrinkage mechanism of drawn polymers. The cause of the thermal shrinkage is very complex, because that relates to many factors. In this study, atactic polystyrene, a noncrystalline polymer, was used to eliminate factors related to the melting and crystallization effects, and it is considered that there is a relation between the change of the polymer's structure due to heat treatment and thermal shrinkage. It is observed in a certain temperature range that the thermal shrinkage of drawn polystyrene is not caused by increase of the entropy but results in decrease of the entropy.

A case of lipoblastoma of the parapharyngeal space in a 37-year-old male was reported.The patient complained of a swelling in the left parotid region.The tumor, existed in the parapharyngeal space, was removed using a cervical approach without angle mandibulotomy.A histopathological examination revealed lipoblastoma. Parapharyngeal lipoblastoma is a rare finding. No report of such nature is found in the literature of this country, there is only a report of single instance in those of America.

A 24-year-old man, whose aunt and grandmother had died of colon cancer, whose mother had intestinal polyposis and who had many relatives on his mother's side suffering from various intestinal diseases, experienced lower abdominal pain and bloody stoool. X-ray and endoscopical examination of the gastrointestinal tract disclosed polyposis throughout the colon and several polyps in the stomach and small intestine, some of which were biopsied and which revealed no malignancy histologically. Ostemoa in the right mandibula and hard palate were also discovered. These findings led to a diagnosis of Gardner's syndrome. To prevent malignant change in these polyps and to preserve the normal function of defecation, total colectomy followed by ileorectal anastomosis was performed. The resected specimen showed 279 various types of polyps (2-12mm in diameter) which had a histology of tubular adenoma. Postoperative defection state was good. For the remaining polyps in the rectum, serial endoscopic resection was planned from three weeks after the operation.

Effects of tidal volume (VT), end-expiratory pressure (EEP), and environmental temperature (Tenv) on elastic recoil force (Pel) and edema formation were examined in open-chest anesthetized rabbits. Sixty-two rabbits in four groups were ventilated for 3 h with VT of either 10 or 25 ml/kg body wt, EEP of 0 or 2 cmH2O, and Tenv of 18 or 35 degrees C. After ventilation, Pel at 80% of total lung capacity (P80) was significantly increased when ventilation was performed with the combination of large VT, 0 EEP, and low Tenv. This change was prevented by altering any one of the three conditions, e.g., small VT, positive EEP, or high Tenv. Similarly, elevation of minimum surface tension and reduction of surface activity index of lavages from excised lungs after ventilation were observed only when increased P80 was noted. Additionally, the increase of P80 was well correlated with increment of wet weight-to-dry weight ratio and degree of perivascular cuffing and alveolar edema formation of excised lungs. These results indicate that elevation of Pel after high tidal ventilation in open-chest animals in vivo was influenced by level of EEP and Tenv and that the degree of edema formation was closely related to the increase of Pel. The increased Pel is presumably primary and causes fluid accumulation.

Although nasal continuous positive airway pressure (CPAP) is effective in improving nocturnal obstructive apnoea, daytime sleepiness and well-being in patients with obstructive sleep apnoea syndrome (OSAS), not all patients tolerate this treatment. Since optimal CPAP titration is essential to maintain compliance, it is important to elucidate the factors that help to determine the optimal pressure. However, the determinants of the optimal CPAP level are controversial.The subjects comprised 27 Japanese male patients with OSAS who underwent standard polysomnography (PSG), pulmonary function tests, arterial blood gas analysis, cephalometry and CPAP titration. Twenty normal controls also underwent cephalometric analysis.The apnoea–hypopnoea index (AHI), mean oxygen saturation (mean S aO2) and the lowestS aO2during sleep were found to be 54·7±22·6, 89·0±5·6%, and 69·7±9·0%, respectively by PSG. The mean optimal CPAP was 9·6±1·8 cmH2O. The cephalometric angles (SNA, SNB and NSBa) were similar to those found in the control subjects, but MP-H, and PNS-P were significantly longer than those in the control subjects as shown by cephalometry. The optimal CPAP was correlated with the mean SaO2(P

The protective effects of N-acetylcysteine (NAC) have been documented in experimental and clinical acute lung injury. However, the effect of NAC on the secretion of interleukin-8-(IL-8), which is an important mediator of the pathogenesis of acute lung injury through the recruitment of neutrophils, has not been determined. In the present study, therefore, we examined the effect of NAC on IL-8 secretion by IL-1 alpha-stimulated bronchial epithelial cells. NAC inhibited IL-8 secretion by bronchial epithelial cells in a dose-dependent manner. In addition, the structurally unrelated antioxidants, butylated hydroxyanisole (BHA) and pyrrolidine dithiocarbamate (PDTC) also effectively inhibited secretion. These results indicated that an antioxidant-sensitive mechanism might be involved in inhibition of IL-8 secretion by IL-1 alpha-stimulated bronchial epithelial cells. The protective effects of NAC on acute lung injury have been suggested to be due to scavenging reactive oxygen intermediates (ROIs) and stimulation of glutathione synthesis. In addition to this, our results may provide an alternative explanation for the efficacy of NAC on acute lung injury.