The Bulletin of Tokyo Medical and Dental University最新文献

Two cases of postoperative enterocolitis due to methicillin-resistant Staphylococcus aureus (MRSA) after gastrectomy were experienced. Case 1: A 59-year-old male underwent subtotal gastrectomy for advanced gastric cancer. Diffuse peritonitis progressed after the first operation, so reoperation for drainage was required. Two days after the second operation, a profuse watery diarrhea developed. Case 2: A 46-year-old male underwent total gastrectomy for early gastric cancer. On the fourth postoperative day, frequent vomiting and cholera-like diarrhea started, followed by profound shock several hours later. Both cases were treated successfully by the administration of vancomycin. Stool cultures of both cases revealed MRSA and it had the same minimal inhibitory concentration, coagulase type and enterotoxin type, so that nosocomial infection was indicated.

Despite the apparent demand for a consultation system, only a few expert systems have been developed for laboratory medicine. Some studies on the diagnostic precision of such systems have been reported, but the efficiency of their knowledge bases has not yet been investigated. An expert system, named BLOOD, for data analysis in a hematology laboratory, which is written in C-Prolog and runs on VAX-station, has already been reported to have excellent diagnostic reliability and ability to cope with the fuzziness involved in clinical diagnostic procedures. A quantitative examination of the knowledge base of BLOOD using real laboratory data from 58 patients diagnosed as having iron deficiency anemia clearly revealed the verbosity of the knowledge base, and proved that it was effective for obtaining a group of essential diagnostic rules.

Cytogenetic studies were performed on six cell lines derived from three patients suffering from malignant melanomas. The modal chromosome numbers were in the hypotriploid to hypertetraploid ranges and both the numerical and structural aberrations of chromosomes were found. Aberrations were most frequently observed in chromosomes 1, 6 and 7. Deletion of 1q was consistently present in all cell lines, while loss of 6q was observed in two cell lines of case 1. Translocations t (Y; 6) and t (6;?) occurred in one cell line from case 3. An increased number of copies of chromosome 7 was a characteristic feature of the cell lines from case 2. Since positive correlation between the expression of EGF receptors and an increased dosage of chromosome 7 has been reported for malignant melanomas and the gene for EGFR has been mapped to band 7p12-p13, this phenomenon might be of importance for the proliferation of malignant melanoma. The findings of the present study are generally in agreement with the data previously published in the literature, indicating the existence of specific non-random chromosome lesions during melanoma development.

Recently, problems have occurred frequently such as cervical and exposed dentin surface lesions or root caries and subsequent hypersensitivity because of further increase of the elderly population. This study was projected to device a proper and simple treatment and materials for the adhesive composite restoration for such lesions. The 10-20Ca (10% citric acid containing 20% calcium chloride) solution was found to be a comparatively mild tooth surface conditioning agent and to be effective with a single application to both dentin and enamel. In addition, the use of the SA primer (3% N-methacryloyl 5-aminosalicylic acid in 80% ethanol) and the LVR (visible light-cured, 33% microfilled low viscous Bis-GMA resin) dramatically improved the adhesion and adaptability of the composite restoration in the saucer cavity at the cervical area.

The mandible has two major parts, the corpus and the ramus. These two parts must be considered separately because each has its own functional counterpart with the maxilla and the posterior cranial base. Since the mandible is a single bone, the border of the corpus and the ramus can not be visualized on the conventional two-dimensional lateral cephalometric radiograph. The purpose of this study is to propose a reliable method to distinguish the border between the mandibular corpus and the ramus on the lateral cephalometric radiograph. In this study, 64 dried skulls in different developmental stages were examined. Metallic markers were placed at the diverging point (point T) on both sides of the dried skulls. From the occlusal view of the mandible, point T was considered to be the lingual border of the corpus and the ramus. Then, the lateral cephalometric radiographs of the dried skulls were taken. On each lateral cephalometric radiograph, a vertical line L was drawn from point Ra (the intersection of the occlusal plane and the anterior border of the ramus) to the mandibular plane. Thus, the distance from the midpoint of point T on each side to the vertical line L was measured. As a result, over 80% of the midpoints T were found on the vertical line L. Therefore, the vertical line L from point Ra to the mandibular plane can be considered to play the role of a reasonable reference line for distinguishing between the corpus and the ramus on the lateral cephalometric radiograph.

Although insulin is known to have various actions on the cardiovascular system, its effects on the microvessels in vivo have not been fully elucidated. This study was aimed to examine the effects of the increased endogenous insulin release after meals on the reflex vasoconstriction induced by cold exposure in the rabbit ears using a laser Doppler flowmeter. A reflex blood flow reduction by cold exposure was tested 3-4 hours after meals in the rabbits with or without pretreatment with a somatostatin analogue (Sandostatin, 100 micrograms/body). The degrees of the blood flow reduction were decreased after the diet intake compared to the responses in the fasting state. The blood flow reduction after diet intake in the non-treated group was significantly attenuated compared to the treated group (88.4 +/- 13.0% in the non-treated group vs. 47.5 +/- 13.4% in the treated group at 1 minute of cold exposure; p less than 0.05, and 87.6 +/- 20.2% vs. 40.2 +/- 24.8%, respectively, at 5 minutes of cold exposure; p less than 0.05). The somatostatin-treated rabbits showed a significant suppression of the increase in the serum insulin levels after meals compared to the non-treated control rabbits (17.8 +/- 10.2 microU/ml in the treated group vs. 78.6 +/- 38.3 microU/ml in the non-treated group, p less than 0.05). In the somatostatin-treated rabbits, the exogenously applied insulin caused a decreased response of blood flow to cold exposure. These findings suggest that in the postprandial state the endogenous insulin release may regulate the reactivity of the microvessels to the sympathetic stimuli.