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Measurement of the serum level of theophylline (TP) is essential for its appropriate use.It has been reported that the metabolic capacity of individual patients can be estimated from simultaneously measuring the serum levels of TP and these metabolites.In this study,we measured the serum TP and metabolite levels in patients treated with 2 types of sustainedrelease TP preparation,and investigated the influence of the pharmacokinetics of TP by employing different forms.The subjects were asthma patients who visited the outpatient clinic of Respiratory Medicine,St.Luke’s International Hospital,between April and October 2003,and were medicated with sustained-release TP tablets (Theodur® or Uniphyl® tablets).Blood samples were collected from patients who gave written consent.They were also interviewed and their medical records were investigated to confirm their backgrounds.The serum TP and metabolite levels were measured by HPLC.In 52 patients treated with Theodur® tablets,there was a strong correlation between the serum TP and 1,3-dimethyluric acid (DMU) levels (r=0.670).However,there was a weak correlation in 30 patients treated with Uniphyl® tablets (r= 0.249).In the two groups,the DMU/TP was within the range of the mean±SD regardless of blood collection points in all patients.The values markedly differed from this range in patients with factors influencing TP metabolism.The results suggest that,in patients receiving Theodur® tablets,their TP-metabolizing capacity can be predicted by simultaneously measuring the serum TP and metabolite levels and calculating the DMU/TP.However,such a prediction is difficult in those receiving Uniphyl® tablets.

Neutrophil activates and injures tissues and organs during sepsis or septic shock. Blood purification therapies such as continuous veno-venous hemofiltration (CVVH) and direct hemoperfusion with polymyxin-immobilized fiber (PMX-DHP) have been used for the treatment of sepsis and septic shock, however, the effects of such therapies on neutrophil activation have previously been poorly understood. We sought to evaluate neutrophil reactive oxygen species (ROS), especially H2O2 production, in the pathophysiology of sepsis or septic shock and the effect of CVVH or PMX-DHP on neutrophil ROS. Seven critically ill septic patients requiring CVVH (and 12 matched septic patients who did not require CVVH as control) and seven septic shock patients treated with PMX-DHP were studied. We found that patients with sepsis or septic shock had significantly higher levels of neutrophil ROS compared with normal volunteers (183 +/- 42, 292 +/- 90, and 103 +/- 30) (P < 0.05, and < 0.005). Neutrophil ROS did not change over time in patients treated either with CVVH or without CVVH. In contrast, neutrophil ROS significantly inhibited PMX-DHP treatment in patients with septic shock (pretreatment; 292 +/- 88 vs. post-treatment; 205 +/- 93, P < 0.05). In conclusion, neutrophil ROS was significantly enhanced in the sepsis or septic shock affected patients. CVVH did not affect neutrophil ROS while PMX-DHP significant inhibited neutrophil ROS.

This study sought to investigate methods of charging nickel/metal hydride (Ni/MH) batteries for use in an electric vehicle(EV). The specific conditions for the multi-step constant-current charging method with regulation of voltage and dT/dt were varied in an attempt to improve high-energy efficiency, shorten charging time, and increase cycle life. A commercial battery system with 12 modules was subjected to a discharge/charge cycling test using patterns of dynamic stress test (DST) 120. Two-step charging with a first-step current of 0.5 CA (1 CA=95 A) was completed in less than 2.5 h after DST120-pattern discharging to 80% DOD. Further, three-step charging with the first step of 1.0 CA reduced charging time to about 1.5 h. Multi-step constant-current charging provided a high-energy efficiency of more than 80%. The battery system withstood over 1800 cycles in a cycling test with reduction DST120-pattern discharge of 20%, but reductions in constant-current discharge of only 7%, due to a gradual decrease of discharge power, independently of the value of the charging current.

An 84-year-old woman was admitted to our hospital with nonproductive cough and dyspnea on exertion. Computed tomography (CT) scan revealed extensive consolidation in the right lung. She was diagnosed with pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma using CT-guided lung biopsy. Her pulmonary images and respiratory symptoms did not improve two months after receiving 4 cycles of rituximab weekly; therefore, yttrium-90 ibritumomab tiuxetan was chosen as salvage therapy. The abnormal shadow on her pulmonary images was significantly reduced two months later, and she had no symptoms without nonhematological toxicities. She has had no progression for 18 months. Furthermore, radiation pneumonitis has not also been observed. We herein reported bulky pulmonary MALT lymphoma treated with yttrium-90 ibritumomab tiuxetan.

A 58-year-old man was given a diagnosis of urachal carcinoma and underwent a partial cystectomy with enbloc removal of the tumor and radical lymphadenectomy in 2006. In April 2009 he was admitted to our hospital because of hemoptysis and left chest pain. Chest CT showed a 4-cm mass shadow in the left S3 and nodular shadows in the right S1 and left S10. Flexible bronchoscopy demonstrated a tumorous lesion at the orifice of the left B3 bronchus. Although the cytological diagnosis suggested high-grade adenocarcinoma, the tumor was producing mucin and consisted of cells with anisonucleosis, which is not typical of primary lung adenocarcinoma. We then performed immunohistochemical and histological examination of a transbronchial lung biopsy specimen. The histological findings of the specimen were very similar to those of the previously resected urachal carcinoma. In addition, the tumor cells were negative for thyroid transcription factor-1 and surfactant precursor protein B, which are specific to primary lung adenocarcinoma. We therefore diagnosed metastatic pulmonary cancer from urachal carcinoma, which is a rare manifestation in bladder cancer. We report a rare case of metastatic pulmonary cancer from urachal carcinoma that required differentiation from primary lung adenocarcinoma in addition to a discussion of the literature.

The patient was a 70-year-old woman. She was admitted to our hospital complaining of fever and dyspnea. Chest CT scan showed a 50 x 30-mm tumorous shadow in S6 of the left lung and honeycomb lung in both lower lobes. As the result of cytodiagnosis with ultrasonic echo, adenocarcinoma was diagnosed. Clinical stage was IIIA (T3N2M0). We selected carboplatin and paclitaxel with bevacizumab as first-line chemotherapy, but at 7 days after the initiating it, the chest X-ray showed left pneumothorax. A chest drainage tube was placed in the left thoracic cavity. The patient was treated repeatedly pleurodesis with minocycline and OK-432. The pneumothorax required 3 weeks to cure. We selected carboplatin and paclitaxel without bevacizumab for the second course, and the pneumothorax did not recur. Pneumothorax was a serious adverse event associated with bevacizumab-containing chemotherapy. It is necessary to be aware of the possibility of pneumothorax when we treat lung adenocarcinoma with bevacizumab-containing chemotherapy.

Objective: Measurement of the serum level of theophylline is essential for its proper use; however, it is difficult to infer the metabolic ability of individual patients by only the serum theophylline level and to decide the appropriate medication. In this study, we simultaneously measured serum theophylline and metabolite levels in patients treated with theophylline, and investigated their usefulness. Experimental: The subjects were asthma patients who visited the outpatient clinic of Respiratory Medicine, St Luke's International Hospital, between April and October 2003, and were medicated with sustained-release theophylline tablets (Theodur®). The serum level of theophylline and its metabolites was measured by HPLC in patients who gave written consent. Results: A strong correlation was noted between the serum theophylline (TP) and 1,3-dimethyluric acid (DMU) levels of 52 patients (r = 0.670), and DMU/TP was about 0.04. In a patient whose the DMU/TP was 0.216, it was recognized that metabolic ability was promoted due to a history of smoking. Discussion: In this study, it was shown that simultaneous measurement by HPLC of the serum level of theophylline and its metabolites and DMU/TP was useful to assess the metabolic ability of individual patients. Copyright © 2010 John Wiley & Sons, Ltd.

Neutrophil activates and injures tissues and organs during sepsis or septic shock. Blood purification therapies such as continuous veno-venous hemofiltration (CVVH) and direct hemoperfusion with polymyxin-immobilized fiber (PMX-DHP) have been used for the treatment of sepsis and septic shock, however, the effects of such therapies on neutrophil activation have previously been poorly understood. We sought to evaluate neutrophil reactive oxygen species (ROS), especially H2O2 production, in the pathophysiology of sepsis or septic shock and the effect of CVVH or PMX-DHP on neutrophil ROS. Seven critically ill septic patients requiring CVVH (and 12 matched septic patients who did not require CVVH as control) and seven septic shock patients treated with PMX-DHP were studied. We found that patients with sepsis or septic shock had significantly higher levels of neutrophil ROS compared with normal volunteers (183 +/- 42, 292 +/- 90, and 103 +/- 30) (P0.05, and0.005). Neutrophil ROS did not change over time in patients treated either with CVVH or without CVVH. In contrast, neutrophil ROS significantly inhibited PMX-DHP treatment in patients with septic shock (pretreatment; 292 +/- 88 vs. post-treatment; 205 +/- 93, P0.05). In conclusion, neutrophil ROS was significantly enhanced in the sepsis or septic shock affected patients. CVVH did not affect neutrophil ROS while PMX-DHP significant inhibited neutrophil ROS.

We treated a patient with lung adenocarcinoma who responded to chemotherapy with vinorelbine (VNR) plus carboplatin (CBDCA) on an outpatient basis. The patient was a 68-year-old man. He visited a local physician complaining of wet coughing, headache and general fatigne. The symptoms remained unchanged and the patient was admitted to our department for treatment in June 2000. A massive shadow in the right upper lobe and multiple cerebral metastases were found. Based on this, the diagnosis was lung adenocarcinoma (T3N2M1, clinical stage IV). Whole-brain irradiation and systemic chemotherapy were initiated from July 2000. The patient received 1 course of systemic chemotherapy with vindesine (VDS) plus cisplatin (CDDP) on an inpatient basis. This regimen was replaced with combination therapy of paclitaxel (TXL) plus CBDCA in the outpatient setting, along with VNR plus CBDCA due to side effects caused by TXL. The cerebral metastases almost disappeared due to whole-brain irradiation. Chest CT after 3 courses revealed a reduction in primary tumor size. The VNR plus CBDCA combination therapy was continued for a further 6 courses. As the result, neither the primary tumor nor the cerebral metastases enlarged. The combination therapy with VNR plus CBDCA seems to be a useful regimen that can maintain high QOL and be conducted for a long term on an outpatient basis.