Many reports have suggested that cardiac dysfunction with cardiomegaly is more often observed in patients with chronic hemodialysis. Moreover, cardiac dysfunction has been thought as one of the most important factors affecting the prognosis of these patients. In this study, in order to clarify the role of 1-carnitine in the pathogenesis of cardiomegaly, 33 patients with chronic hemodialysis were studied using the multivariate analysis method. Among the factors which may affect cardiac function, the following 10 variables were examined. 1) age, 2) duration of dialysis, 3) plasma carnitine, 4) serum total cholesterol, 5) serum HDL-cholesterol, 6) triglyceride, 7) systolic blood pressure, 8) diastolic blood pressure, 9) left ventricular voltage on a electrocardiogram at rest and 10) hematocrit. The plasma carnitine levels in these patients were markedly reduced and inversely correlated with the cardiothoracic ratio (CTR) on the chest X-ray films (r=0.38, p < 0.05). In principal component analysis, the CTR was closely related to hematocrit and plasma carnitine levels. By multiregression analysis, both hypo-carnitinemia and anemia were independently shown to be important causes of cardiomegaly. Thus, it is suggested that the cardiomegaly in patients with chronic hemodialysis may be improved by supplemental therapy with 1-carnitine, even in cases with severe anemia.
To investigate HIV-1 transmission from mother to child, samples taken from 3 HIV-1 sero-positive pregnant mothers, 3 children born by caesareans from their mothers and therapeutic abortion from 2 HIV-1 sero-positive mothers were tested for HIV-1 antiboy by westernblot, p24 antigen by antigen caputured ELISA, proviral DNA by Nested-PCR and isolation of HIV-1 virus from peripheral blood, cord blood, amniotic fluid and placenta. HIV-1 proviral DNA was detected in the peripheral blood of all mothers, but p24 antigen and virus isolation were not detected. None of the HIV-1 markers, except for antibody, was detected in the samples from their children and placenta.These facts strongly suggest that there was no HIV-1 transmission from motherto child.
We have developed a system that uses a superconducting magnet to remove arsenic from geothermal water. The advantages of applying a high-field, high-gradient magnetic separator (HGMS) and a reciprocating high-gradient magnetic separator for practical use are presented. Finally, we demonstrate that the capture efficiency of the HGMS does not depend on dimensions, and show that properties of a large HGMS plant can be estimated from our experimental results.
Two Shigella strains (93-119 and 95-619) isolated from stool cultures of imported diarrheal cases in Japan, did not react to any antisera of the established Shigella serovars.These strains had the typical biochemical characteristics of Shigella dysenteriae, and were biochemically identical to each other. Both strains were positive in the Sereny test and other tests for invasiveness; these indicate that they can cause shigellosis in humans.The results of antigenic analyses showed that they did not belong to any of the recognized or provisional serovars, and were serologically indistinguishable.Strain 93-119 is designated as the test strain for this new serovar.
Background: The effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients have been debated. In order to clarify the effect of administered L-carnitine on cardiac function and hypotensive episodes during the hemodialysis procedure, a randomized double-blind placebo-controlled study was performed for 3 months. Methods and Results: Twenty stable outpatients undergoing hemodialysis treatment were divided into two groups: controls (placebo) and treated patients (L-carnitine 900 mg p.o. daily). After 3 months, cardiac function was reevaluated by echocardiography, and hypotensive episodes during hemodialysis were assessed. Free and acyl carnitine levels increased significantly from 22.3 ± 7.1 to 140.3 ± 57.5 μmol/l and from 15.8 ± 2.8 to 94.8 ± 50.4 μmol/l, respectively, in the treated group. The ejection fraction significantly increased from 61.8 ± 16.0 to 64.4 ± 13.8% (p < 0.05) in the treated group. However, there was no difference in other echocardiographic parameters between the two groups. Hypotensive episodes significantly decreased from 4.0 ± 1.7 to 1.3 ± 0.9 times per month (p < 0.05), although patients' body weight did not change significantly. Conclusions: Beneficial effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients were observed. L-Carnitine supplementation might be considered especially for chronic hemodialysis patients with unstable hemodynamic conditions.
The O-specific polysaccharide chain which represents a new type-antigen in lipopolysaccharide (LPS) of Shigella flexneri 88-893 was investigated. The O-polysaccharide chain was found to be composed of repeating units comprising rhamnose, N-acetylglucosamine and glucose (3:1:2). In the passive hemolysis test, group-6 antiserum of S. flexneri exhibited a high hemolytic titer (50% hemolysis titer: 7, 900) against sheep red blood cells (SRBC) sensitized with intact 893 LPS, but virtually no hemolytic activity against SRBC sensitized with alkali-treated 893 LPS. None of the type-specific antisera (I-VI), showed any significant hemolytic titer against SRBC sensitized with either intact or alkali-treated 893 LPS. Thus, 893 LPS contained both the group-6 antigen and a new type-antigen which is distinct from any known type-antigen of S. flexneri.
In order to treat acutely uremic patients in an unstable hemodynamic state, we developed a new system for slow continuous hemodialysis. It is well known that continuous hemofiltration or peritoneal dialysis are successful in terms of removing the excess body water without adverse effects on hemodynamics. On the other hand, hemodialysis is far more effective in eliminating solutes such as uremic toxins, especially under a catabolic state. In order to combine the merits of both interventions, volume control and solute removal were dealt with separately in our system. The main system is composed of a double-pump driven closed circuit for the re-circulated hemodialysis. Volume control was achieved accurately within ±5% error of the set rate. The dialysance was evaluated in vitro and the efficacy of solute elimination was simulated mathematically. It was speculated that slow continuous hemodialysis could be a new method of treating critically ill patients with acute renal failure.
A 43-year-old female was admitted for a labile hypertension and depression. High levels of plasma and urinary noradrenaline strongly suggested a pheochromocytoma. However, clinical investigations revealed a normal adrenal gland and thoraco-abdominal region. Venous samples from multiple sites indicated an increase in noradrenaline in the left jugular vein. Using computed tomography and Gadolinium DTPA (diethylene triamine pentaacetic acid)- enhanced dynamic MR (magnetic resonance) imaging, a tumor was discovered in the cerebello-pontine angle. Carotid angiography showed the feeder arteries clearly. Therefore, the tumor was classified as a noradrenaline-secreting glomus jugulare tumor fed by the carotid artery. After embolization and subsequent medical therapy, blood pressure was well controlled. Twenty cases of intracranial pheochromocytoma have been reported to date. This is the second such case in Japan.
