Gastro-esophageal reflux successfully treated with transgastrostomal jejunal tube feeding

1. The release of endogenous gamma-aminobutyric acid (GABA) and glutamic acid in the human brain has been investigated in synaptosomal preparations from fresh neocortical samples obtained from patients undergoing neurosurgery to reach deeply located tumours. 2. The basal outflows of GABA and glutamate from superfused synaptosomes were largely increased during depolarization with 15 mM KCl. The K(+)-evoked overflows of both amino acids were almost totally dependent on the presence of Ca(2+) in the superfusion medium. 3. The GABAB receptor agonist (-)-baclofen (1, 3 or 10 microM) inhibited the overflows of GABA and glutamate in a concentration-dependent manner. The inhibition caused by 10 microM of the agonist ranged from 45-50%. 5. The effect of three selective GABAB receptor antagonists on the inhibition of the K(+)-evoked GABA and glutamate overflows elicited by 10 microM (-)-baclofen was investigated. Phaclofen antagonized (by about 50% at 100 microM; almost totally at 300 microM) the effect of (-)-baclofen on GABA overflow but did not modify the inhibition of glutamate release. The effect of (-)-baclofen on the K(+)-evoked GABA overflow was unaffected by 3-amino-propyl (diethoxymethyl)phosphinic acid (CGP 35348; 10 or 100 microM); however, CGP 35348 (10 or 100 microM) antagonized (-)-baclofen (complete blockade at 100 microM) at the heteroreceptors on glutamatergic terminals. Finally, [3-[[(3,4-dichlorophenyl) methyl]amino]propyl] (diethoxymethyl) phosphinic aid (CGP 52432), 1 microM, blocked the GABAB autoreceptor, but was ineffective at the heteroreceptors. The selectivity of CGP 52423 was lost at 30 microM, as the compound, at this concentration, inhibited completely the (-)-baclofen effect on both GABA and glutamate release. 5. It is concluded that GABA and glutamate release evoked by depolarization of human neocortex nerve terminals can be affected differentially through pharmacologically distinct GABAB receptors.     

Neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy or surgery for operable thoracic esophageal carcinoma

PURPOSE: A prospective clinical trial was undertaken to investigate the feasibility of concurrent chemoradiotherapy for esophageal carcinomas. MATERIALS AND METHODS: Between June 1989 and May 1996, forty patients with operable squamous cell carcinoma of the thoracic esophagus (Stage 0 to III: UICC 1987), ages 45 to 78 years (mean: 64), were enrolled in a study of neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy (CRT group) or surgery (CRT-S group). Neoadjuvant chemoradiotherapy consisted of 44 Gy in 40 fractions for 4 weeks (2.2 Gy/2 Fr/day) through 10-MVX rays, with 2 courses of cisplatin (80-100 mg/body, mean: 60 mg/m2, Day 1, bolus injection) and 5-fluorouracil (500-1000 mg/body/day, mean: 400 mg/m2, Days 1-4, continuous infusion). After completion of neoadjuvant chemoradiotherapy, an intermediate clinical response was assessed by barium swallow, esophagoscopy with/without biopsy, EUS in most cases, thoracic and upper abdominal CT scan, and cervical US. Definitive chemoradiotherapy was performed in patients when regression of more than 75% was evident (CRT Group), and esophageal resection was indicated in those who remained at less than 75% (CRT-S Group). In CRT Group, a cumulative dose of 60-70 Gy for Tis, T1 and 65-75 Gy for T2-T4 tumor with high-dose-rate intraluminal brachytherapy and a total of 3 courses of chemotherapy were planned. In CRT-S Group, intraoperative radiotherapy for abdominal lymphatic system and postoperative supraclavicular irradiation were added. RESULTS: At the time of intermediate assessment, complete response (CR) was observed in 16 patients, a partial response (PR) in 22, and no change (NC) in 2. Thirty responding patients (CR, 16; PR, 14) entered the CRT Group, and 10 nonresponding patients (PR, 8; NC, 2) were followed by surgery (CRT-S Group). Radiotherapy was completed satisfactorily, but chemotherapy was suspended in 26 patients (65%) because of acute toxicity. Clinical CR rate at the completion of treatment showed 90% in CRT Group, and pathologic CR rate 10% in CRT-S Group. The overall median survival was 45 months, survival at 1, 2, and 3 years being 100%, 72%, and 56%, respectively. Local-regional failure was observed in 7 patients (all in CRT Group), distant failure in 6 (3 in CRT Group, 3 in CRT-S Group) and local-regional with distant failure in 1 (CRT Group). Four patients with local-regional recurrence in the CRT Group were salvaged by surgery. Overall survival at 2 and 3 years for CRT vs. CRT-S Group was 72%, 64% vs. 75%, 38%, respectively. No treatment-related mortality was observed. The rate of the 'esophagus conservation' was 65% (Stage 0: 1 of 1, 100%; Stage I: 11 of 12, 92%; Stage II: 8 of 17, 47%; Stage III: 6 of 10, 60%). CONCLUSION: Our results demonstrated that almost all early disease (Stage 0-I) and about half of advanced disease (Stage II-III) could be conserved, their esophagus treated by the multidisciplinary approach centering on high-dose radiotherapy and concurrent chemotherapy.     

Solubilization of octafluoronaphthalene by mixed micelles of fluorocarbon and hydrocarbon surfactants in aqueous solutions

Solubilization of octafluoronaphthalene (OFN) by fluorocarbon and hydrocarbon surfactants in aqueous solutions has been examined to investigate the effects of mixing surfactants and added salt. Diethylammonium perfluoronanoate (DEAPFN) micelles have the most solubilization power toward OFN. The difference in micellar solubilization power will be caused by the hydrophobicity of ionic groups and micellar size. Large positive synergistic effects on solubilization behavior were observed in the DEAPFN-diethylammonium tetradecyl sulfate mixed micellar systems. Solubilization of OFN depended on the concentrations of added salt and the aggregation number, that is, the micellar size.     

Diagonal decoupling of linear multivariable systems with constant gain measurement feedback

This note derives a necessary and sufficient condition to diagonally decouple a linear multivariable system through constant gain measurement feedback. This condition is represented in terms of the controllability subspaces and the kernel of a measurement matrix. The number of assignable poles of the resulting closed-loop system is given.     

Clinical assessment of complement activation and leukocyte kinetics during cardiopulmonary bypass: the effect of cepharanthine

Complement activation and leukosequestration to the lung was studied during cardiopulmonary bypass in eleven patients undergoing cardiac operation without blood transfusion. Six patients (group I) received methylprednisolone before and after the bypass, and the other five (group II) received cepharanthine (biscoclaurin alkaloid) before the bypass associated with methylprednisolone therapy. Leukosequestration to the lung was observed at the time of reperfusion of the lung only in group I, although complement activation estimated by the increase of C 4 a and C 3 a was quite similar in both group. Cepharanthine prevented the sequestration of the leukocyte to the lung may be by its membrane stabilizing effect.     

Genetic variation of envelope gp90 gene of equine infectious anemia virus isolated from an experimentally infected horse

Six strains of equine infectious anemia virus (EIAV) were recovered from febrile and non-febrile stages of a horse experimentally infected with the P337-V70 strain given once to a horse. The env gp90 genes of the isolates, the P337-V70 and P337-V26, avirulent virus derived from the P337-V70 strain, were sequenced. A comparison of the gp90 gene sequences revealed that amino acid variations among the viruses tested showed as high as 8.2 to 11.5%. In addition, the comparison also indicated that the isolates that recovered from the non-febrile stage were contained in nucleotide insertions in the principal neutralizing domain (PND) region. The insertions were arranged regularly with smaller segments. The nucleotide sequence of the P337-V26 gp90 gene was found to contain a six-nucleotides insertion and seven nucleotide substitutions outside the PND region, when compared with that of the P337-V70 strain.     

Thermoelectric properties of A-site doped perovskites (Sr0.6Ba0.4)1−xMxPbO3 (M = La, K)

La- and K-doped perovskite-type ceramics, (Sr_0.6Ba_0.4)_1−xLa_xPbO₃ with x = 0.0−0.1 and (Sr_0.6Ba_0.4)_1−xK_xPbO₃ with x = 0.00−0.15, were prepared to modify thermoelectric properties of semi-metallic Sr_0.6Ba_0.4PbO₃ via the doping of electrons and holes, respectively. The electrical conductivity σ and Seebeck coefficient S for the ceramics were measured at temperatures of 373–1073 K in air. With the La doping, electron carriers were successively doped and the material changed from a semi-metal for the undoped Sr_0.6Ba_0.4PbO₃ to a metal for the (Sr_0.6Ba_0.4)_0.9La_0.1PbO₃. With the K doping, the thermoelectric properties were essentially unchanged probably due to the carrier compensation effect by the generation of oxygen deficiencies. The thermoelectric power factor S²σ was maximized to a value of 3.1 × 10⁻⁴ Wm⁻¹ K⁻² at 773 K for the undoped Sr_0.6Ba_0.4PbO₃ ceramic.     

Sonographic detection of tumor blood flow using a new contrast agent in woodchuck hepatomas

The aim of this study was to assess the ability of perfluoropropane-filled albumin microspheres to visualize tumor blood flow in woodchuck hepatomas. Ten tumors in five woodchucks with hepatomas were imaged before and after intravenous injection (dosages of 0.01 ml/kg to 2.0 ml/kg) of an agent using color Doppler sonography and gray scale ultrasonography. Both enhanced imaging modalities demonstrated blood flow around and within all tumors. Enhanced gray scale ultrasonography demonstrated sonographic "tumor blush" in seven tumors (70%). In conclusion, tumor blood flow in woodchucks was visualized more clearly using the agent on both color Doppler and gray scale ultrasonography.