Mothers of children with autism are subject to considerable stress by having to adjust to the disorder and to cope with practical and social issues. Evidence on the effects of relaxation training on ...stress of these mothers is scarce. The purpose of this pilot case-series study was to examine the role of a simple 6-week daily stress management technique on mothers of children with autism. Mothers' stress measurements and children's functionality were assessed using validated instruments. Participants were 11 mothers of children with autism seen consecutively in the autism clinic of a children's hospital. Statistically significant median reductions of perceived and parental stress were noted after the 6-week intervention. Median stress scores were lower by 37.1% and 33% from the baseline values of the perceived stress scale and parental stress index, respectively. Stress was not significantly correlated with children's functioning. Stress management seems to have benefits for mothers of children with autism.
a Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
b Department of General Thoracic Surgery, ...Saitama Medical Center, Saitama, Japan
*Corresponding author. Tel.: +81 3 5363 3806; fax: +81 3 5363 3499. E-mail address : yotaro{at}sc.itc.keio.ac.jp (Y. Izumi).
Tissue sealants can prevent the occurrence of pulmonary air leakage, although few studies have evaluated the seal-breaking pressure properties of the various methods. We developed a new method for repairing visceral pleural defects which combines fibrin glue with a sheet material. We used an animal model to compare its efficacy with that of three current techniques up to 24 h after application. Under thoracotomy, 5 x 20 mm visceral pleural defects with a depth of 3 mm were made in beagles. The defects in the normal lungs were repaired using 1 of 4 methods: Method A, fibrin-glue double layer (fibrinogen solution was dripped, followed by thrombin solution); Method B, pack method (fibrin glue combined with polyglycolic acid sheet); Method C, rubbing and spray (fibrinogen was rubbed, followed by spraying of both fibrinogen and thrombin solutions); Method D, fibrin-glue-coated collagen fleece. The defects were repaired also in an emphysematous lung model using Method A, B or C. In the normal lungs, Method B showed significantly higher pressure resistance compared with the other methods at 5 min, 1 and 3 h post-application. Pressure resistance increased with time for all methods. In the emphysematous lungs, Method B showed significantly higher seal-breaking pressure than Methods A and C. Compared with existing tissue sealant methods, the pack method reliably controlled pulmonary air leakage immediately after application.
Key Words: Pulmonary air leakage; Visceral pleural defects; Tissue sealants; Emphysema; Fibrin glue
In order to investigate the mechanism(s) underlying mosaicism for trisomy 21, we genotyped 17 families with mosaic trisomy 21 probands, using 28 PCR-detectable DNA polymorphic markers that map in the ...pericentromeric region and long arm of chromosome 21. The percentage of cells with trisomy 21 in the probands' blood lymphocytes was 6%-94%. There were two classes of autoradiographic results: In class I, a "third allele" of lower intensity was detected in the proband's DNA for at least two chromosome 21 markers. The interpretation of this result was that the proband had inherited three chromosomes 21 after meiotic nondisjunction (NDJ) (trisomy 21 zygote) and subsequently lost one because of mitotic (somatic) error, the lost chromosome 21 being that with the lowest-intensity polymorphic allele. The parental origin and the meiotic stage of NDJ could also be determined. In class II, a "third allele" was never detected. In these cases, the mosaicism probably occurred either by a postzygotic, mitotic error in a normal zygote that followed a normal meiosis (class IIA mechanism); by premeiotic, mitotic NDJ yielding an aneusomic zygote after meiosis, and subsequent mitotic loss (class IIB mechanism); or by a meiosis II error with lack of crossover in the preceding meiosis I, followed by mitotic loss after fertilization (class IIC mechanism). Among class II mechanisms, the most likely is mechanism IIA, while IIC is the least likely. There were 10 cases of class I and 7 cases of class II results.
a Division of General Thoracic Surgery, Department of Surgery, School of Medicine Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
b Department of Thoracic Surgery, Saitama ...Medical Center, Saitama Medical School, Saitama, Japan
*Corresponding author. Tel.: +813-5363-3806; fax: +813-5363-3499. E-mail address : yotaroizumi{at}a2.keio.jp (Y. Izumi).
The aim of this study was to compare the morphology of the bronchial stump after lobectomy between mechanical stapler closure and manual suture closure. The effect of fibrin glue application on each method of closure was also observed. Right upper lobectomy was performed in beagles ( n =31) using staplers (ST group) or sutures (SU group). In a separate experiment, fibrin glue was sprayed onto the stump after each respective method of closure. After one week, the stump region was examined macroscopically, and also by histology. 2 -Test and Mann–Whitney test were used for comparative analysis. The incidence of adhesion formation between the surrounding tissues was significantly reduced in the ST group in comparison to the SU group (22 vs. 80%, P =0.04). The thickness of granulation tissue over the stump was significantly reduced in the ST group in comparison to the SU group (0.8±0.2 vs. 2.5±0.3 mm, P <0.0001). Vessel density in the granulation tissue was also significantly reduced in the ST group in comparison to the SU group (6±2 vs. 16±2, P =0.003). Fibrin glue application after stapler closure significantly increased the incidence of adhesion formation, granulation tissue thickness, and vessel density in the granulation tissue over the stump.
Key Words: Granulation tissue; Bronchial stump; Lung lobectomy
Objectives We sought to examine the relationship between coronary flow reserve (CFR) and myocardial capillary density (MCD) in patients with idiopathic dilated cardiomyopathy, heart failure, and ...normal coronary arteries. Background Coronary flow reserve is depressed in patients with idiopathic dilated cardiomyopathy, particularly in those with end-stage congestive heart failure. Methods We studied 18 patients, 48 ± 10 years of age, who had a mean New York Heart Association functional class of 2.9 ± 1.3, mean left ventricular ejection fraction of 22 ± 8%, and mean pulmonary capillary wedge pressure of 23 ± 10 mm Hg. CFR measurements were made with a 0.014-inch pressure-temperature sensor-tipped guide wire placed in the distal left anterior descending coronary artery. Thermodilution curves were constructed in triplicate at baseline and during maximum hyperemia induced by intravenous adenosine. CFR was calculated from the ratio of mean transit times. Right heart endomyocardial biopsies were performed during the same procedure. Autopsied specimens from nonfailing hearts were used as controls. The tissue was histochemically stained with CD-34 for morphometric measurements of MCD. Results We observed a close linear relationship between CFR and MCD (r = 0.756, p = 0.0001). The MCD in 7 patients with a CFR ≥2.5 (73.2 ± 16) was similar to that measured in normal control patients, (85 ± 11, p = NS). In contrast, the MCD in 11 patients with a CFR <2.5 was 33.2 ± 14, which was significantly lower than in patients with heart failure and normal CFR (73.2 ± 16, p = 0.001) or in controls (85 ± 11, p < 0.0001). Conclusions A marked decrease in MCD was found in patients presenting with congestive heart failure as the result of idiopathic dilated cardiomyopathy and a depressed CFR.
Taxanes (docetaxel and paclitaxel) as well as cisplatin (CDDP) are key chemotherapeutic agents in the treatment of non-small cell lung cancer (NSCLC). Although some indicators of taxane resistance, ...such as beta-tubulin mutations, P-glycoprotein (P-gp) and Bcl-2, have been reported in malignant cells, the mechanisms of taxane resistance in NSCLCs have yet to be fully elucidated. We evaluated in vitro chemosensitivity to docetaxel (DOC) and CDDP in 87 surgically-resected specimens of NSCLC by collagen gel-droplet embedded culture drug sensitivity test (CD-DST). Bcl-2 and P-gp expression in these specimens were also investigated by immunohistochemistry. We examined the association between Bcl-2 and P-gp expression and in vitro chemosensitivity to DOC and CDDP. Out of the 87 NSCLCs that were examined, Bcl-2 and P-gp were expressed in 32 (36.8%) and 28 (32.2%) of the tumors, respectively. Positive Bcl-2 expression was significantly associated with enhanced DOC sensitivity in NSCLCs (p=0.007) while no apparent association was observed between DOC sensitivity and P-gp expression. Interestingly, although DOC, but not CDDP has been reported to be a substrate of P-gp, P-gp expression was significantly inversely correlated with CDDP sensitivity in pulmonary adenocarcinomas (p=0.03). Positive Bcl-2 expression may be a promising indicator in determining in vitro taxane sensitivity in NSCLCs. On the other hand, positive P-gp expression may be an indicator of enhanced in vitro resistance to CDDP in pulmonary adenocarcinomas.
Tumor-associated eosinophils play an important role in the biological behavior of cancer. We have detected eosinophilic infiltration immunohistochemically in tissue specimens from patients with ...pulmonary adenocarcinoma and assessed its association with the prognosis.
Utilizing the monoclonal antibody for EG2 thought to be a specific marker for eosinophils, the authors quantified eosinophil infiltration immunohistochemically in patients with pulmonary adenocarcinoma to investigate the relationship between EG2- positive cell counts and the prognosis.
A significant difference in the rate of patient survival was detected between patients whose tumors had high EG2-positive cells and patients whose tumors had low EG2-positive cells overall (p=0.0086). Multivariate analysis also showed that eosinophils were significantly related to survival (p=0.044).
These data indicate that eosinophilic counts utilizing the monoclonal antibody EG2 serve as a useful independent prognostic marker in pulmonary adenocarcinoma.
We report a 70-year-old man who had a rare complication related to the insertion of Kirschner wires for fixation of a right clavicle fracture. Eight months after the placement of the Kirschner wires, ...he presented with cough and hemosputum. Chest roentgenograms, chest computed tomographic scans, and bronchoscopy revealed that one of the Kirschner wires had migrated through the lung and into the intrathoracic trachea. Immediate thoracotomy was performed to remove the wire. His postoperative course was uneventful.
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