Giant splenic cyst with high serum concentration of CA 19-9. Failure of treatment with percutaneous transcatheter drainage and injection of tetracycline

BACKGROUND: Recently, several cases of nonparasitic true splenic cyst with high serum concentration of carbohydrate antigen (CA 19-9) have been reported. CASE: We report a giant splenic cyst presenting with high serum concentration of CA 19-9 in a 21-year-old man without a history of previous trauma. Imaging techniques showed a huge monolocular cyst of the spleen, and laboratory data showed increased serum CA 19-9 levels (326 U/ml; normal, < 37 U/ml). Serologic test was negative for parasitic infection. These findings led us to the diagnosis of epithelial splenic cyst. Percutaneous transcatheter drainage and injection of tetracycline were performed for 2 weeks. The cyst shrank, and the serum CA 19-9 level decreased favorably. However, cystic fluid reaccumulated in a month. CONCLUSIONS: The accumulation of cystic fluid in splenic epithelial cysts may be attributable not only to the secretion of the lining cells but also to influx from the splenic sinuses.     

Reappraisal of Zelen's method in randomized controlled trials]

This paper discusses Zelen's method (a study design with pre-randomization) in randomized controlled trials from the following aspects: 1) compliance of patients with a randomly assigned treatment; 2) infringement of patients' right to choose treatments; and 3) unfairness that only patients assigned to a new treatment are allowed a choice of treatments. The reason Zelen's method is rarely used in the United States or European countries seems to be the lower compliance of treatments in Zelen's method than in the conventional design of randomized controlled trials. Considering the present study practice in Japan, where study subjects are not completely informed by randomized assignment of treatments, Zelen's method is thought to be more practical, and not inferior to the conventional design in terms of compliance.     

Analysis of current distributions in a multi-laminated HTS tape conductor for solenoid coils

A multi-laminated HTS tape conductor has been recently developed for large coils. If the HTS tapes are simply laminated to form the conductor, the current distribution in the laminated tape conductor of the coil is imbalanced because of the differences among inductances of tapes. Transposition of the tapes in the conductor is effective for homogeneous current distribution, but the tape may be damaged due to the lateral bending. The solenoid coil has enough space to transpose the tapes at both ends. However, a proposed theory so far requires a restriction in the number of coil layers for homogeneous current distribution in the laminated tape conductor. It is very important to analyze current distributions in the multi-laminated tape conductor for the solenoid coil with arbitrary layers. In this paper, we apply the Maxwell integral equation to the region contoured by adjacent laminated tapes to analyze the current distributions of the tapes in an infinite solenoid coil, and demonstrate that the flux across the region is conserved as long as the tapes are not saturated, and finally induce the fundamental equations as functions of coil construction parameters, such as layer radii, laminated tape spaces, and winding pitches. We use the fundamental equations for 2-layer and 4-layer coils to verify the homogeneous current distribution of the laminated tape conductor for an arbitrary layer number. Since the flux between the tapes in the inner layer of a 2-layer coil is contributed from the outer layers, the tape space in the outer layer must be larger than that in the inner layer because of the balance between the two fluxes. Moreover, we have developed an analysis method for a finite solenoid coil.     

Measurements of current distributions in a multi-laminated HTS tape conductor for solenoid coils

A multi-laminated HTS tape conductor has recently been developed for large coils. If the HTS tapes are simply laminated to form the conductor, the current distribution in the laminated tape conductor of the coil is unbalanced because of the differences among all tape inductances. Transposition of the tape in the conductor is effective for homogeneous current distribution, but the tape may be damaged due to the lateral bending. In our previous paper, we proposed a new theory to analyze and control current distributions in the multi-laminated tape conductor for a solenoid coil with arbitrary layers. We applied the Maxwell integral equation to the region contoured by adjacent laminated tapes to analyze the current distributions of the tapes in the infinite solenoid coil, demonstrated that the flux across the region is conserved as long as the tapes are not saturated, and finally induced fundamental equations as functions of coil construction parameters, such as layer radius, laminated tape space, and winding pitch. In order to verify the theory, we designed two kinds of coils with homogeneous and inhomogeneous current distributions in the two-laminated tape conductor by adjusting the space between the tapes in the second layer, and fabricated them. In the case when the space between the tapes in the second layer is the same as that of the first layer, 0.31 mm in thickness, we measured the tape currents of 7:3 for the inner and outer tape of the first layer, respectively. We adjusted the space between the tapes of the second layer, 1.78 mm in thickness, while the space of the first layer remained unchanged, 0.31 mm in thickness. We obtained the homogeneous current distribution in the tape conductor. The experimental data were in good agreement with the theory.     

Patients' expectations of information provided at cancer hospitals in Japan

In order to survey patients' views on disease and treatment information that should be provided at hospitals, an anonymous self-administered questionnaire was distributed to patients at Aichi Cancer Center Hospital in 1995. All eligible first-visit outpatients (97 persons), randomly selected revisit outpatients (99 persons; about one in ten refused), and all except six eligible inpatients in good condition at discharge (97 persons) responded. Out of 293 patients (115 males, 174 females and 4 unspecified), 74% answered that they wanted to be informed of their diagnosis irrespective of circumstances, 20% answered that they would want to be informed only in certain circumstances, and 2% did not want to be informed at all. There were no significant differences in response among the three sources of patients. Inpatients wanted more (81%) to be explained about recommended therapy than either first-visit outpatients (67%) or revisit outpatients (67%). The majority considered that about a 30-minute explanation was needed using pamphlet-like written materials or video. When asked what information was needed when choosing a cancer hospital, 71% specified information on the specialty of the hospital, 57% the content of the care provided, 23% the name and specialty of the doctors, 20% the waiting period before scheduled admission, 13% the average admission period, 11% the number of patients with the same disease, 10% the waiting time at the outpatient clinic, 6% the meal menu, and 4% the number of private wards. Forty-three percent wanted an information service covering all hospitals in the region through an information center. The results revealed that patients at this cancer hospital required information on their disease, treatment, and hospital specialty.     

Dihydropyrimidinase deficiency: structural organization, chromosomal localization, and mutation analysis of the human dihydropyrimidinase gene

Dihydropyrimidinase (DHP) deficiency (MIM 222748) is characterized by dihydropyrimidinuria and is associated with a variable clinical phenotype. This disease might be associated with a risk of 5-fluorouracil toxicity, although no cases have been reported. We present here both the molecular characterization of the human DHP gene and, for the first time, the mutations causing DHP deficiency. The human DHP gene spans >80 kb and consists of 10 exons. It has been assigned to 8q22, by FISH. We performed mutation analysis of genomic DNA in one symptomatic and five asymptomatic individuals presenting with dihydropyrimidinuria. We identified one frameshift mutation and five missense mutations. Two related Japanese adult subjects were homozygous for the Q334R substitution, whereas two other, unrelated Japanese infant subjects were heterozygous for the same mutation, but this mutation is not common in the Japanese population. A Caucasian pediatric patient exhibiting epileptic attacks, dysmorphic features, and severe developmental delay was homozygous for W360R. Using a eukaryotic expression system, we showed that all mutations reduced enzyme activity significantly, indicating that these are crucial DHP deficiency-causing mutations. There was no significant difference, in residual activity, between mutations observed in the symptomatic and those observed in the asymptomatic individuals.     

Health promoting properties of protein hydrolysates produced from oil palm (Elaeis guineensis) kernel

This study aimed to determine the lipid-lowering properties, antioxidant capacity (AC) and angiotensin-I converting enzyme (ACE)-inhibitory activity of oil palm kernel protein hydrolysates (OPKHs) that were produced using protease and pepsin-pancreatin hydrolysis. The effects of the OPKHs on apolipoprotein B (apoB) secretion was assessed using HepG2 cells as a model and the AC of the OPKHs was determined based on ABTS radical scavenging activity and ferric reducing antioxidant power (FRAP). Both protease and pepsin-pancreatin hydrolysates reduced apoB secretion significantly (p<0.05). The OPKHs scavenged ABTS radicals effectively and demonstrated a high reducing power even at a low concentration (1 mg/mL). The AC of the OPKHs was significantly correlated with the OPKHs protein content. However, the OPKHs demonstrated very low ACE-inhibitory activity. The pepsinpancreatin hydrolysate demonstrated significant lipidlowering properties, favourable AC and ACE inhibitory activity in compared to protease hydrolysate. Therefore, OPKH demonstrate the potential as a nutraceutical for functional foods.     

Enhanced bioactivity of polyvinylidene chloride films using argon ion bombardment for guided bone regeneration

Polyvinylidene chloride (PVDC) is a long chain carbon synthetic polymer. The objective of this study was to improve the bioactivity of PVDC films through surface modification using argon (Ar) ion bombardment to create Ar-modified PVDC films (Ar-PVDC) to address the clinical problems of guided bone regeneration (GBR), which is technique-sensitive, and low bone regenerative ability. First, the effects of Ar ion bombardment, a low temperature plasma etching technique widely used in industry, on PVDC film wettability, surface chemistry, and morphology were confirmed. Next, fibroblast-like and osteoblast-like cell attachment and proliferation on Ar-PVDC were assessed. As a preclinical in vivo study, Ar-PVDC was used to cover a critical-sized bone defect on rat calvaria and osteoconductivity was evaluated by micro-computed tomography analysis and histological examinations. We found that the contact angle of PVDC film decreased by 50° because of the production of –OH groups on the PVDC film surface, though surface morphological was unchanged at 30 min after Ar ion bombardment. We demonstrated that cell attachment increased by about 40 % and proliferation by more than 140 % because of increased wettability, and 2.4 times greater bone regeneration was observed at week 3 with Ar-PVDC compared with untreated PVDC films. These results suggest that Ar ion bombardment modification of PVDC surfaces improves osteoconductivity, indicating its potential to increase bone deposition during GBR.     

Arginine-481 mutation abolishes ligand-binding of the AMPA-selective glutamate receptor channel alpha1-subunit

Arginine-481 is located in the putative agonist-binding region preceding the putative transmembrane segment M1 of the alpha1-subunit of the AMPA-selective glutamate receptor (GluR) channel. This amino acid is completely conserved among GluR proteins. A site-directed mutagenesis study using a baculovirus expression system showed that substitution of glutamate, glutamine and lysine for arginine-481 of the recombinant alpha1-subunit protein abolishes binding to [3H]AMPA completely. The present study provides the first direct experimental evidence that the conserved charged arginine-481 residue is essential, directly or indirectly, for the acquisition of ligand-binding activity by the receptor protein.