Makoto Murao

Intragastrointestinal Alcohol Fermentation Syndrome: Report of Two Cases and Review of the Literature

Two patients with frequent attacks of alcohol intoxication following the intake of an ordinary meal are presented. The causative agents were Candida albicans and C. krusei in the first case and C. albicans in the second. The essential factors of this syndrome were abnormal proliferation of the causative agent, abnormal stagnation of food in the alimentary tract, intake of a carbohydrate diet as the substrate for the alcohol fermentation and low threshold of the patient to alcohol. Thirty-seven other cases have been reported in Japan since 1952, with patients aged from 1 to 75 years. All those concerned with alcohol intoxication, especially in the forensic sciences, should bear this syndrome in mind. Key Words: Alcohol intoxication; Endogenous alcohol; Gastrointestinal moniliasis; Candida albicans; Intragastrointestinal alcohol fermentation.

Evaluation of aerosols of prostaglandins E1 and E2 as bronchodilators

SummaryAerosols of prostaglandin E1 (PGE1) and E2 (PGE2) were evaluated as bronchodilators in 32 subjects (6 normals, 15 with bronchial asthma and 11 with chronic bronchitis). PGE2 caused a significant decrease in pulmonary resistance (mean values 3.2 and 2.6 cm H2O/l/sec before and after inhalation, respectively). There were no significant changes in pulmonary resistance after PGE1. Bronchoconstriction occurred in some subjects whose pulmonary resistance had been within normal limits. Static pulmonary compliance did not show any definite change. The frequency dependence of dynamic compliance was measured in 19 subjects; in 3 the results suggested that bronchoconstriction after PGE1 preferentially affected small airways; in 1 other subject bronchodilatation occurred exclusively in the small airways. Arterial Po2 decreased in 4 out of 5 patients after inhalation of PGE1. This was thought to be due to greater unevenness of the ventilation perfusion ratio, since the dynamic pulmonary compliance became more dependent on respiratory frequency even though pulmonary resistance improved in these subjects. The pulse rate did not change significantly, but mean blood pressure decreased in 8 out of 15 subjects. Cough and irrtation of the pharynx were noted in 42 and 62 per cent of subjects during and after the inhalation of PGE1 and PGe2, respectively. Five and 23 percent of the subjects complained of headache after inhaling PGE1 and PGE2. The results suggest that aerosols of PGE2 have a bronchodilating action which could be of use in clinical practice, if untoward responses such as irritation of the pharynx, cough and headache could be avoided.

Chromate lung cancer with special reference to its cell type and relation to the manufacturing process

The manufacturing process of the chromate industry can be classified into five steps. The main hazardous pollutants of the first step are trivalent chromate compounds, and those of the second and third steps are hexavalent chromate compounds. Analysis of the detailed working history of chromate workers with bronchogenic carcinoma, yielded the following results: the work history of chromate lung cancer patients in the first step, which produced mainly trivalent chromate dust, was rather short. Patients with small cell carcinoma were engaged mainly in the second step (98.1% of the total working months), where they were heavily exposed to hexavalent chromate dusts. Patients with squamous cell carcinoma were engaged rather evenly in the second and fourth steps, and somewhat longer in the third step. Comparisons of the exposure periods revealed that the working history of small cell carcinoma patients was significantly shorter than that of squamous cell carcinoma patients. There were many more heavy smokers among the squamous cell carcinoma group as compared to the small cell carcinoma patients. Based on these results, it is concluded that the cell type of occupational lung cancer was mainly small cell carcinoma when the exposure to carcinogenic agents was heavy, and that the carcinogenicity of chromate was derived mainly from hexavalent chromate rather than trivalent compounds.

Clinical application of breath analysis for dimethyl sulfide following ingestion of dl-methionine

After overnight-fasting, the concentration of dimethyl sulfide in expired alveolar gas (alv-DMS) was determined serially following ingestion of 2 g of DL-methionine in normal subjects and patients with liver diseases. Alv-DMS rose to a peak in 30 to 90 min, declined markedly within 3 h, and then decreased gradually. Half-disappearance times (T 1/2) (mean +/- S.E. min) in each experimental group were: normal (N = 9) 61.7 +/- 4.7, acute hepatitis (N = 6) 62.5 +/- 6.8, chronic hepatitis (N = 10) 84.0 +/- 13.0, and liver cirrhosis (N = 13) 159.2 +/- 30.4, respectively. Cirrhotics had a T 1/2 significantly longer than that of the other three groups: vs. normal P less than 0.02, vs. acute hepatitis P less than 0.05, and vs. chronic hepatitis P less than 0.05. T 1/2 of alv-DMS following ingestion of DL-methionine seems to be of clinical interest.

Effects of long-term administration and withdrawal of clonidine on activity of sympathetic efferent nerve unit in spontaneously hypertensive rats.

Daily administration of clonidine for 5 weeks (approx. 300 micrograms/kg/day, p.o.) produced significant decreases in blood pressure and renal sympathetic efferent activity in spontaneously hypertensive rats (SHR). After cessation of clonidine administration, blood pressure and sympathetic nerve activity recovered rapidly from the depressed levels to the untreated control levels. These findings could indicate that clonidine-induced hypotension and its rapid recovery to control after withdrawal of clonidine are caused by corresponding changes in sympathetic efferent nerve activity.

Role of Chemosensitivity during Exercise in Normal Subjects and Patients with Pulmonary Emphysema

In 11 normal subjects (mean age = 22.8 years) and 8 patients with pulmonary emphysema (mean age = 70.4 years), the role of chemosensitivity in determining ventilation, cardiac output, lactic acid, and cyclic AMP and GMP was evaluated quantitatively during 150 or 30 W exercise and simulated exercise. Simulated exercise was done while the subjects took a rest by regulating arterial blood gases at exercise levels in patients and at PaO2 = 65 mm Hg and PaCO2 = 48 mm Hg in normal subjects. In normal subjects, the role of arterial blood gases in determining exercise ventilation, cardiac output, cyclic AMP and GMP are large, while those contributed much less to lactic acid. In patients, PaO2 contributed only half of the exercise ventilation. It accounted for a negligibly small portion of exercise cardiac output, lactic acid, and cyclic GMP. These results indicate, by deduction, that either augmentation of chemosensitivity, pH, or humoral factors is responsible for about half of the changes of exercise ventilation in patients with pulmonary emphysema. These factors seem to influence cardiac output, lactic acid, and cyclic AMP and GMP more strongly than PaO2 alone in exercising patients.

Changes in Potassium Content of Erythrocytes during Exercise in Man

Abstract. Factors affecting erythrocyte K+ content and plasma electrolytes during light exercise were examined in 8 normal subjects and 27 patients with chronic obstructive lung disease. The patients were classified into bronchitis, emphysema and intermediate groups. Arterial blood was obtained during rest, after 2, 5, and 7 min. of exercise on a bicycle ergometer (30 km/h without mechanical brake), and at 10 and 20 min. during recovery for analysis of PO2, PCO2, plasma H, Na+, K, and Cl‐, erythrocyte K+ content and whole blood lactate. Plasma H increased significantly in all subjects after 2 min. of exercise and PCO2 rose in normal, bronchitis, and emphysema groups during exercise, whereas PO2 did not change significantly. Plasma K rose promptly after the beginning of exercise and remained at high values during exercise. The rapid rise in PCO2 was associated with a significant decrease of calculated erythrocyte K in patients with chronic bronchitis. Although changes in plasma H were dependent on both PCO2 and lactate, erythrocyte K+ changes were significantly related only to changes in PCO2. These results indicate that the decrease in erythrocyte K+ is mainly controlled by changes in arterial PCO2 during light exercise in patients with chronic bronchitis.

A study on lung cancer among chromate workers Relationship between cell type and chromium compounds

クロム肺癌に発癌の関与する物質を検討するため, クロム酸塩製造工程別の従事期間を肺癌例と非癌例で検討した.肺癌例は6価クロムを取り扱う従事者に多かった.特に, 小細胞癌例では全従事期間のほとんど全てを水溶性の6価クロムを取り扱う工程に従事していた.クロム肺癌の発癌物質として, 水溶性の6価クロムが関与している可能性が示された.