Kazuo Mimura

Prevention of ongoing lipid peroxidation by wound excision and superoxide dismutase treatment in the burned rat

To determine if wound excision and superoxide dismutase (SOD) treatment prevent ongoing lipid peroxidation after burn injury, the plasma, kidney, and lung lipid peroxide (LPO) levels in 25% total body surface area (TBSA) burned rats was studied. The animals were given intraperitoneal bovine copper-, zinc-SOD (Cu/Zn-SOD) (50,000 U/kg dissolved in saline) or saline immediately after burns and were operated by wound debridement and allograft 2 hours after the burn. We measured LPO levels of 6-hour postburn plasma and tissues by the thiobarbituric acid (TBA) method, and measured the manganese SOD (Mn-SOD) by an enzyme-linked immunosorbent assay. Wound excision alone prevented the increase of plasma LPO levels but could not prevent the increase in tissues. The combination of wound excision and Cu/Zn-SOD treatment markedly inhibited the increase in both plasma and tissue LPO levels after the burn, but did not prevent the increase in Mn-SOD. Wound excision in conjunction with SOD-treatment might be therapeutic in the management of severe burns.

Superoxide dismutase with prolonged in vivo half-life inhibits intravascular hemolysis and renal injury in burned rats

Although superoxide radicals and related metabolites have been postulated to underlie the pathogenesis of burn injury, critical evidence supporting this hypothesis is lacking. To test whether superoxide radicals play critical roles in burn injury, the effect of a superoxide dismutase (SOD) derivative (SM-SOD) was tested on intravascular hemolysis and renal tubular injury in rats subjected to burn shock. Within 3 hours after a given full-thickness burn of approximately 24% of body surface area, plasma levels of lipid peroxides increased significantly with concomitant increase in intravascular hemolysis. Histological examination showed a marked deposition of hemoglobin-like casts in renal tubules of the burned rats. Intravenous administration of SM-SOD (10 mg/kg) 30 minutes before the burn injury significantly inhibited the increase of plasma lipid peroxides and the occurrence of intravascular hemolysis. SM-SOD also inhibited the deposition of casts in renal tubules. These results indicate that superoxide radicals play critical roles in the pathogenesis of intravascular hemolysis and renal damage induced by burn injury.

Septic shock due toPseudomonas aeruginosa in a previously healthy woman

Pseudomonas aeruginosa septicemia rarely occurs in non-immunocompromised adults. We present a case of septic shock followingPseudomonas aeruginosa pneumonia in a previously healthy 48-year-old woman. The onset was sudden, with back pain, pyrexia and shock. Chest radiographs revealed pneumonia, andPseudomonas aeruginosa was identified from blood and sputum cultures. Therapy with dopamine, piperacillin and fluid replacement led to a prompt recovery. Laboratory tests failed to reveal any immunological deficits. Including this case, only five cases ofPseudomonas aeruginosa septicemia in patients though to be non-immunocompromised have been reported. Two remarkable features of this type ofPseudomonas infection are apparent: i) it commonly develops from pneumonia and ii) it has a better prognosis than that in immunocompromised hosts.

Fatal traumatic subarachnoid hemorrhage due to rupture of the vertebral artery

An unusual case of traumatic subarachnoid hemorrhage (SAH) due to rupture of the intracranial vertebral artery is reported. A drunk 51-year-old man received blows with a fist to the face and lost consciousness. A massive basal SAH was identified by CT-scan. Autopsy revealed a rupture of the vertebral artery but no skull fracture or cerebral contusion.

The autotransfusion effect of external leg counterpressure in simulated mild hypovolemia

We examined the cardiovascular response of external leg counterpressure in healthy volunteers at 100 mm Hg compression pressure. To stimulate mild hypovolemia, measurements were made with the subjects in a 60 degrees head-up tilt position. Left ventricular end-diastolic volume (LVEDV) and cardiac output (CO) were calculated from two-dimensional echocardiography. Flow through the inferior vena cava (IVC) below the origin of the hepatic veins was determined by the Doppler ultrasound technique. The application of counterpressure significantly increased LVEDV, CO, and arterial blood pressure over that seen with tilting without the device. These responses were accompanied by a small but significant increase in IVC flow. We therefore concluded that external leg counterpressure transferred blood to the central circulation by compression of the venous capacitance vessels (an autotransfusion effect) in mild hypovolemia, but such an effect may not benefit patients in a hypovolemic shock state because of the small amount of translocated blood.

GASTRIC CARCIONMA WITH SITUS INVERSUS VISCERUM TOTALIS REPORT OF A CASE

内臓逆位症は5,000人から10,000人に1人の割にみられるまれな疾患であるが, これに胃癌を合併した症例はわが国で21例と少ない.われわれは全内臓逆位症に合併した進行胃癌の1例を経験したので若干の文献的考察を加えて報告する.症例は41歳女性.主訴は心窩部痛および体重減少で, 入院後右胸心, 内臓逆位症に加えて前庭部中心の進行胃癌であることが判り, 胃亜全摘, R3廓清, 横行結腸合併切除さらにBI吻合を施行した.P1H0N3S3のStage IVで非治癒切除ではあったが, 術後経過は良好で3週間後に退院した.1年以上経った現在も元気に会社勤務に復している.