A pilot/introducer needle for central vein cannulation.

A kit for safe and easy insertion of a central vein cannula was devised. A small gauge (22 gauge) metal pilot needle was equipped with a Y-shaped hub which had a side-port to accept a small gauge (0.46 mm) Seldinger guide wire.

Kinin and angiotensin II receptor antagonists in rats with chronic renal failure: chronic effects on cardio- and renoprotection of angiotensin converting enzyme inhibitors.

Objective: To assess the potential of the kallikrein-kinin and renin-angiotensin systems in mediating the cardio- and renoprotective effects of angiotensin converting enzyme (ACE) inhibitors in rats with chronic renal failure.

Materials And Methods: Spontaneously hypertensive rats (SHR) and normotensive control Wistar-Kyoto (WKY) rats subjected to five-sixths nephrectomy were randomly assigned to treatment with vehicle, a kinin antagonist (Hoe 140) or an ACE inhibitor (cilazapril) or both drugs, intraperitoneally via osmotic minipumps for 4 weeks. In addition, the effects of a chronic infusion of a specific angiotensin receptor antagonist (losartan) alone or in combination with an ACE inhibitor (enalapril) were also investigated in nephrectomized SHR for 2 weeks.

[Interstitial lung disease in patients with connective tissue diseases].

Interstitial lung disease is a significant prognostic factor in connective tissue diseases. To further clarify clinical and immunological features of interstitial lung disease, we studied 894 consecutive patients with connective tissue diseases first evaluated between 1970 and 1993. Interstitial lung disease was found in 101 of 181 (56%) patients with systemic sclerosis, 92 of 183 (50%) with overlap syndrome, 35 of 76 (46%) with polymyositis/dermatomyositis, and 13 of 444 (3%) with systemic lupus erythematosus (p < 0.

[Pathophysiology and Diagnosis of the acute respiratory distress syndrome].

We studied methods for diagnosing the acute respiratory distress syndrome (ARDS) based on its characteristic abnormalities. A gamma-ray external counting method with Tc-99m human serum albumin revealed that pulmonary microvascular permeability was abnormally high in patients with ARDS. With this method, ARDS could be distinguished from cardiogenic pulmonary edema.

Neutrophil-induced lung protection and injury are dependent on the amount of Pseudomonas aeruginosa administered via airways in guinea pigs.

We investigated the roles of neutrophils in mediating both the protective effect against bacterial infection and the harmful effect of lung injury induced after the intratracheal instillation of live bacteria. We examined the mortality rate, lung injury, and bacterial clearance following the intratracheal instillation of Pseudomonas aeruginosa in low (10(4) colony-forming units [CFU]) and high doses (10(8) CFU) in normal (control) guinea pigs, others made neutropenic with cyclophosphamide (CPA), and guinea pigs made neutrophilic with recombinant granulocyte colony-stimulating factor (rG-CSF). Lung injury was assessed by the ratio of the concentration of 125I-labeled albumin in lung tissue to that in plasma (T/P) and the animals' lung weight-to-body weight (LW/BW) ratio.

Significance of the right ventricular free wall in dogs with and without pulmonary constriction.

To evaluate the role of the right ventricular (RV) free wall in cardiac function, RV and left ventricular (LV) wall segment lengths were measured by ultrasonic crystals in 10 open chest dogs with the pericardium preserved. Right coronary artery (RCA) was perfused separately by own blood and the flow was reduced stepwise until active shortening (delta L) of the RV segment disappeared or RCA flow became zero (Ischemia). The experiment was repeated with and without pulmonary stenosis (PS).

[Effects of intravascular latex injection on factors responsible for acute lung injury].

To study the contribution of phagocytosis to the development of acute lung injury, latex particles (2 x 10(9)/kg; mean diameter, 2.84 microns) were injected intravenously or intra-arterially into guinea pigs. 125I-labelled albumin was injected to estimate the degree of lung injury, and 51Cr-labelled red blood cells were injected to correct for blood contamination in the samples.

Mycobacterium avium-intracellulare pleuritis with massive pleural effusion.

Atypical mycobacterial infection is seldom accompanied by pleural involvement. We report a very rare case of Mycobacterium avium-intracellulare pleuritis with massive pleural effusion. The patient was a non-immunocompromised 35-year-old Japanese male with insidious onset of fever, chest pain and anorexia.

[A case of large cell carcinoma of the lung arising from the inner surface of a pulmonary bulla and complicated by hematoma].

A 64-year-old man with a history of smoking was admitted to our hospital, because he was noted to have a solitary mass lesion at the apex of the right lung on a chest roentgenogram. Eight months before admission, he had come to our hospital because of hemoptysis. At that time, however, no abnormal shadow was seen on his chest roentgemogram, except for multiple bullae at both apexes.

A subfamily 2 homo-dimeric glutathione S-transferase mYrs-mYrs of class theta in mouse liver cytosol.

A homo-dimeric subfamily 2 glutathione (GSH) S-transferase (GST) mYrs-mYrs of the class theta was isolated from mouse liver cytosol and purified to homogeneity. The first 28 N-terminal amino acid sequence of the GST was completely identical to that of rat subfamily 2 GST Yrs-Yrs of the class theta. GST mYrs-mYrs cross-reacted with anti-rat GST Yrs-anti-sera but not with anti-sera raised against rat GSTs Ya-Ya (alpha), Yb1-Yb1 (mu), and Yp-Yp (pi) and represented more than 95% of the mouse liver cytosolic GST activity to scavenge the reactive sulfate ester 5-sulfoxymethylchrysene of the potent carcinogen 5-hydroxymethylchrysene.

Effect of external negative pressure on pulmonary 99mTc-DTPA clearance in humans.

We studied the mechanisms by which pulmonary solute clearance is affected by lung inflation. We examined the pulmonary clearance of inhaled technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) together with changes in lung volumes in healthy men after applying graded levels of continuous external negative pressure (CNP) and positive end-expiratory pressure (PEEP). The 99mTc-DTPA clearance increased from the baseline during -15 cm H2O CNP (p < 0.

Neutrophils activated by granulocyte colony-stimulating factor suppress tumor necrosis factor-alpha release from monocytes stimulated by endotoxin.

We investigated the in vitro effects of granulocyte colony-stimulating factor (G-CSF) on tumor necrosis factor-alpha (TNF-alpha) release from monocytes. Peripheral blood monocytes and neutrophils were obtained from healthy donors (n = 8). Neutrophils alone, neutrophils plus monocytes, and monocytes alone were incubated with and without G-CSF (10 ng/ml) and were studied for TNF-alpha release; monocytes subsequently were stimulated by endotoxin (lipopolysaccharide [LPS] at 10 and 1,000 ng/ml).

[Pulmonary alveolar proteinosis associated with myelodysplastic syndrome].

A 57-year-old man with myelodysplastic syndrome developed dyspnea on exertion in September 1993. Chest X-ray film showed diffuse infiltrative shadows in the middle and lower lung fields on both sides. The infiltrates were prominent in the perihilar regions but less so in the periphery, consistent with a "bat wing pattern.

Soluble form of P-selectin in plasma is elevated in acute lung injury.

A number of adhesion molecules on neutrophils and the pulmonary capillary endothelium mediate the neutrophil accumulation in the lungs at the onset of adult respiratory distress syndrome or acute lung injury (ALI). P-selectin, located on both vascular endothelial cells and platelets, has been shown to be one of these neutrophil-endothelial cell adhesion molecules. In this study, we measured the soluble form of P-selectin in plasma (PPS) from 19 patients (surviving, 11; deceased, 8) with ALI due to various causes and assessed the clinical significance of this measurement.

[A case of tropical eosinophilia associated with pleural effusion].

A 52-year-old man was admitted to Keio University Hospital for determination of the etiology of a bilateral pleural effusion associated with marked eosinophilia (10200 cells/mm3). He had been in Vietnam for three years and had returned to Japan in May 1993. He was suffering from tropical eosinophilia, as clearly indicated by eosinophilia, elevation of serum IgE level (708 IU/ml), the presence of anti-dirofilarial antibodies, and the absence of microfilaria in the blood.

Cardiovascular and renal protective effects of losartan in spontaneously hypertensive rats with diabetes mellitus.

1. Cardiovascular and renal benefits of a specific angiotensin II (AII) receptor antagonist, losartan (LOS), were assessed in diabetic rats with renal impairment. 2.

Do kinins mediate cardioprotective and renoprotective effects of cilazapril in spontaneously hypertensive rats with renal ablation?

1. We assessed the potential of the kallikrein-kinin system in mediating the cardioprotective and renoprotective effects of an angiotensin-converting enzyme inhibitor (ACEI), cilazapril (CIL) in rats with renal ablation. 2.

Effects of recombinant human erythropoietin on blood pressure and renal function in SHR with chronic renal failure.

1. The effects of chronic administration of erythropoietin (EPO) on blood pressure and renal function in rats with ablation of renal mass were assessed. 2.

Venous invasion as a prognostic factor in colorectal cancer.

Venous invasion as a prognostic factor was evaluated in 124 patients with colorectal cancer. By classifying the patients as having either negative to mild invasion or moderate to marked invasion, a significant correlation was found between the degree of venous invasion and clinicopathological variables such as lymphatic invasion, lymph node metastasis, liver metastasis, and DNA ploidy. Significantly more favorable survival was seen in those with a lower degree of vascular invasion; however, of the six prognosticators analyzed by Cox's proportional hazard model, the only significant factors were depth of invasion and DNA ploidy.

Endothelin receptors in ischemic rat brain and Alzheimer brain.

Endothelin (ET) binding sites in male Wistar rat brains subjected to a 20-min four-vessel occlusion (transient forebrain ischemia model) which induces hippocampal neuron death, and in human brains with Alzheimer disease, were mapped by quantitative in vitro autoradiography employing [125I]ET-1 as a radioligand. Rats were decapitated 4 or 7 days after ischemia. In the rat brain, the [125I]ET-1 binding sites were remarkably increased in the hippocampal CA1 and dentate gyrus, ventral thalamic nucleus, and cortical vessels 4 and 7 days after ischemia, when many reactive astroglia were observed.

Immunohistochemical analysis of rat and human respiratory cilia with anti-dynein antibody: comparison between normal cilia and pathological cilia in primary ciliary dyskinesia.

Wistar Imamichi rat and human respiratory cilia were examined with anti-dynein antibody (AD2), which is specific for sea urchin sperm flagellar dynein. AD2-labelled fresh-frozen normal rat and human cilia stained clearly by immunofluorescence and the peroxidase-antiperoxidase (PAP) technique. On immunoelectron microscopy, AD2 labelled the outer dynein arms of normal human cilia.

[A case of Mycobacterium fortuitum pulmonary disease in a healthy young woman successfully treated with ciprofloxacin and doxycycline].

A 22 year-old woman was admitted to our hospital complaining of subtle fever and productive cough. She did not smoke and had no underlying disease. Her chest radiograph showed infiltration in the right upper lung field.

[Changes in intraoperative and postoperative colloid oncotic pressure after open heart surgery especially in relation to non-blood priming or blood priming].

In order to evaluate the colloid oncotic pressure (COP) is useful index of hemodynamics and respiratory recovery after open heart surgery, cardiac index (CI), pulmonary capillary wedge pressure (PCWP), (A-a) Do2 and COP were measured in 34 patients during 48 hours after the cardiopulmonary bypass (CPB). The patients were divided into non-blood priming group: 11 patients and blood priming group (23 patients). In addition, blood priming group divided into two groups, one with dopamine (more than 15 micrograms/kg/min), epinephrine or intraaortic balloon pumping (severe blood subgroup, n = 6) and the other without these treatments after open heart surgery (slight blood subgroup n = 17).

Antihypertensive and renal-protective effects of losartan in streptozotocin diabetic rats.

Objective: To assess the renal benefits of a specific angiotensin II receptor antagonist, losartan, in diabetic rats with renal impairment.

Design And Methods: Uninephrectomized streptozotocin diabetic spontaneously hypertensive rats (SHR) were randomly assigned to receive vehicle, or to receive losartan or captopril, or both, intraperitoneally via osmotic minipumps for 8 weeks.

Results: Blood pressure and urinary protein excretion in the diabetic SHR increased progressively during the experimental period.

Long-term course of bronchiectasis and bronchiolitis obliterans as late complication of smoke inhalation.

We describe the long-term course of a patient with bronchiectasis and bronchiolitis obliterans, both of which developed as late complications of a smoke inhalation injury. Sequential chest X-rays obtained during the observation period showed gradual progression of bronchiectasis from the saccular to the cystic type. Symptoms, spirometry and blood gas analysis, however, remained stable for 15 years.