Inhibitory Effects of Valproate on Impairment of Y-maze Alternation Behavior Induced by Repeated Electroconvulsive Seizures and c-Fos Protein Levels in Rat Brains

We previously showed that inhibition of repeated electroconvulsive shock (ECS)-induced seizures through 7-day administration of anti-epileptic drugs suppressed the impairment of spontaneous alternation behavior in the Y-maze test in rats. To clarify the precise mechanism(s), we investigated the effect of valproate on such impairment and examined the levels of brain-derived neurotrophic factor (BDNF) and c-Fos protein in the prefrontal cortex and the hippocampus 24h after the last administration of ECS. Seven-day intraperitoneal (i.p.) administration of valproate (400mg/kg) suppressed the impairment of spontaneous alternation behavior. Repeated ECS increased the BDNF protein levels in the hippocampus and prefrontal cortex in the presence or absence of valproate, indicating that the increase in BDNF protein levels resulted from electrical stimulation. c-Fos protein levels were significantly decreased in the hippocampal dentate gyrus after repeated ECS, but valproate had no significant effect on decreased c-Fos protein levels. Valproate＋ECS significantly increased the c-Fos protein levels of the prefrontal cortex compared with the ECS group. These findings suggest that the inhibitory effect of valproate on repeated ECS-induced impairment of spontaneous alternation behavior may be linked to the prefrontal cortex

Risk factors for unsuccessful removal of central venous access ports implanted in the forearm of adult oncologic patients

Purpose: To evaluate the risk factors for unsuccessful removal of a central venous access port (CV port) implanted in the forearm of adult oncologic patients. Materials and methods: This study included 97 adult oncologic patients (51 males, 46 females; age range, 30–88 years; mean age, 63.7 years) in whom removal of a CV port implanted in the forearm was attempted at our hospital between January 2015 and May 2021. Gender, age at removal, body mass index, and diagnosis were examined as patient characteristics; and indwelling period, indwelling side, and indication for removal were examined as factors associated with removal of a CV port. These variables were compared between successful and unsuccessful cases using univariate analysis. Then, multivariate analysis was performed to identify independent risk factors for unsuccessful removal of a CV port using variables with a significant difference in the univariate analysis. A receiver-operating characteristics (ROC) curve was drawn for significant risk factors in the multivariate analysis and the Youden index was used to determine the optimum cut-off value for predicting unsuccessful removal of a CV port. Results: Removal of CV ports was successful in 79 cases (81.4%), but unsuccessful in 18 cases (18.6%) due to fixation of the catheter to the vessel wall. Multivariate logistic regression analysis showed that the indwelling period (odds ratio 1.048; 95% confidence interval 1.026–1.070; P  60 months had unsuccessful removal. Conclusion: The indwelling period is an independent risk factor for unsuccessful removal of a CV port implanted in the forearm of adult oncologic patients, with a cut-off of 41 months

Corneal Nociceptors and Tear Deficiency

Chronic tear deficiency enhances the excitability of corneal cold-sensitive nerves that detect ocular dryness, which can lead to discomfort in patients with dry eye disease (DED). However, changes in corneal nerve excitations through the polymodal nociceptor “transient receptor potential vanilloid 1” (TRPV1) and the potential link between this receptor and symptoms of DED remain unclear. In this study, we examined the firing properties of corneal cold-sensitive nerves expressing TRPV1 and possible contributions of chronic tear deficiency to corneal nerve excitability by TRPV1 activation. The bilateral excision of lacrimal glands in guinea pigs decreased the tear volume and increased the frequency of spontaneous eyeblinks 1–4 weeks after surgery. An analysis of the firing properties of the cold-sensitive nerves was performed by single-unit recordings of corneal preparations 4 weeks after surgery in both the sham-operated and gland-excised groups. Perfusion of the TRPV1 agonist, capsaicin (1 μM), transiently increased the firing frequency in approximately 46–48% of the cold-sensitive nerves characterized by low-background activity and high threshold (LB-HT) cold thermoreceptors in both groups. Gland excision significantly decreased the latency of capsaicin-induced firing in cold-sensitive nerves; however, its magnitude was unchanged. Calcium imaging of cultured trigeminal ganglion neurons from both groups showed that intracellular calcium elevation of corneal neurons induced by a low concentration of capsaicin (0.03 μM) was significantly larger in the gland excision group, regardless of responsiveness to cold. An immunohistochemical study of the trigeminal ganglion revealed that gland excision significantly increased the proportion of corneal neurons enclosed by glial fibrillary acidic protein (GFAP)-immunopositive satellite glial cells. Topical application of the TRPV1 antagonist, A784168 (30 μM), on the ocular surface attenuated eye-blink frequency after gland excision. Furthermore, gland excision enhanced blink behavior induced by a low concentration of capsaicin (0.1 μM). These results suggest that chronic tear deficiency sensitizes the TRPV1-mediated response in the corneal LB-HT cold thermoreceptors and cold-insensitive polymodal nociceptors, which may be linked to dry eye discomfort and hyperalgesia resulting from nociceptive stimuli in aqueous-deficient dry eyes

PTBDにおけるVirtual Fluoroscopic Preprocedural Planningの有用性の検討

Purpose: To retrospectively evaluate the usefulness of virtual fluoroscopic preprocedural planning (VFPP) in the percutaneous transhepatic biliary drainage (PTBD) procedure. Materials and Methods: Twenty-two patients who were treated by PTBD were included in this study. Twelve patients were treated using PTBD intraoperative referencing coronal computed tomography (CT) images (i.e., coronal CT group), and 10 patients were treated using PTBD intraoperative referencing VFPP images (i.e., VFPP group). To analyze the effect of the intraoperative referencing VFPP image, the VFPP group was retrospectively compared with the coronal CT group. Results: The characteristics of both patient groups were not statistically significantly different. There were no significant differences in the targeted bile duct, diameter and depth of the target bile, breath-holding ability, number of targeted bile duct puncture attempts, change in the targeted bile duct, and exchange of the drainage catheter. However, the X-ray fluoroscopy time and the procedure time were significantly shorter in the VFPP group than in the coronal CT group (196 vs. 334 seconds, P < 0.05; and 16.0 vs. 27.2 minutes, P < 0.05). Conclusion: Intraoperative referencing using the VFPP imaging in PTBD intuitively can be a useful tool for better localization of the guidewire in the bile duct, and therebyshorten the X-ray fluoroscopy time and procedure 1 time while minimizing radiation exposure and complications

Percutaneous drainage of psoas and iliopsoas muscle abscesses with a one-step technique under real-time computed tomography fluoroscopic guidance

PURPOSE : To evaluate the utility and safety of drainage catheter installation for psoas/iliopsoas muscle abscesses using a one-step technique under the guidance of real-time computed tomography (CT) fluoroscopy. MATERIALS and METHODS : Ten psoas or iliopsoas muscle abscesses in 7 patients that were treated with percutaneous drainage were included in this study. All drainage procedures were carried out using a one-step technique under real-time CT fluoroscopic guidance. RESULTS : The drainage catheter insertion was performed successfully with the one-step technique in all lesions. Improvements in the patients’ symptoms and blood test results were seen after the drainage procedure in all cases. In addition, postoperative CT scans demonstrated that the abscesses had reduced in size or disappeared in all but one patient, who was transferred to another institution while the drainage catheter was still in place. No major complications were seen in any case. CONCLUSION : The one-step procedure is simple to perform. The percutaneous drainage of psoas or iliopsoas muscle abscesses with the one-step technique under real-time CT fluoroscopic guidance is accurate and safe. Moreover, compared with the two-step technique the one-step procedure results in a shorter drainage procedure and exposes the patient and operator to lower amounts of radiation

ショクドウガン ジュツゴ ソウキ ニ キカン イカンロウ オ ガッペイ シタ 1レイ

The patient was a４５-year-old man. He had suffered from nephrotic syndrome at time of his twenties and had steroid salvage treatment. But he retired the treatment by himself. Esophageal tumor was suspected at the screening, and he was referred to our hospital. Preoperative diagnosis was the adenocarcinoma of the esophagogastric junction（cT２N０M０ stage Ⅱ）． Thoracoscopy assisted subtotal esophagectomy in prone position with D２dissection was performed. Gastric role was prepared in laparoscopic approach, and pulled up to the neck via posterior mediastinal route. Although early postoperative course was uneventful and esophageal fluoroscopy on the７th day showed no leakage, sudden dyspnea appeared on the８th day. CT examination and Bronchoscopy showed tracheoesophageal fistula. Unfortunately, the fistula didn’t get well, and we considered that it was difficult to close the fistula by only conservative treatment. Esophageal covered stent was inserted on the５６th day. After that, he could start ingestion intake and was discharged from hospital on the８５th day. Now, he is being followed up in our hospital

Transport of Thymidine inte the Developing Silk Gland as a Rate-limiting Step for the Formation of DNA Precursors.

Developmental changes in the rate of thymidine uptake into the posterior silk gland of Bombyx mori was investigated by incubating the organ in a medium containing labelled thymidine. In the glands taken at day 2 of the 5th instar when the gland rapidly synthesizes DNA, the whole cell uptake of thymidine followed Michaelis-Menten kinetics with an apparent K\u27m of 25 μM. This value was larger than the measured concentration of thymidine (1 to 2 μM) in the hemolymph where the glands originally exist, and smaller than the Km of the silk gland thymidine kinase (for the thymidine substrate) as determined by a partially purified enzyme (3.3 μM). On the other hand, the older silk glands in which the rate of DNA synthesis is low (day 4 of the 5th instar) incorporated thymidine with kinetics less of the Michaelis-Menten type but in more of a linear manner; the apparent K\u27m value for the whole cell uptake of thymidine became as high as about 1 mM. These findings suggest that the uptake system of the silk gland for extracellular thymidine may serve as a rate-limiting step in the formation of steady state intracellular thymidylate pools

Transport of Thymidine inte the Developing Silk Gland as a Rate-limiting Step for the Formation of DNA Precursors.

Developmental changes in the rate of thymidine uptake into the posterior silk gland of Bombyx mori was investigated by incubating the organ in a medium containing labelled thymidine. In the glands taken at day 2 of the 5th instar when the gland rapidly synthesizes DNA, the whole cell uptake of thymidine followed Michaelis-Menten kinetics with an apparent K'm of 25 μM. This value was larger than the measured concentration of thymidine (1 to 2 μM) in the hemolymph where the glands originally exist, and smaller than the Km of the silk gland thymidine kinase (for the thymidine substrate) as determined by a partially purified enzyme (3.3 μM). On the other hand, the older silk glands in which the rate of DNA synthesis is low (day 4 of the 5th instar) incorporated thymidine with kinetics less of the Michaelis-Menten type but in more of a linear manner; the apparent K'm value for the whole cell uptake of thymidine became as high as about 1 mM. These findings suggest that the uptake system of the silk gland for extracellular thymidine may serve as a rate-limiting step in the formation of steady state intracellular thymidylate pools