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Gradual lengthening by distraction osteogenesis is widely used for congenital brachymetatarsia. The usual presenting complaint is the patient's cosmetic appearance. Osteotomy is an integral element. A nonincisional surgical approach for ostetomy can reduce dorsal longitudinal scarring and help preserve the periosteal blood supply to the bone during surgical dissection. Between June 2003 and January 2019, we performed gradual lengthening by callus distraction with nonincisional osteotomy for congenital brachymetatarsia on 13 digits in 5 patients. All 5 patients were female, and their average age was 18 years old. The lengthened bones involved three first metatarsals, two third metatarsal and eight fourth metatarsal bones. The mean gain in length was 15.2 mm (10-21 mm). The mean duration of distraction was 36.2 days (30-48 days). The mean duration of consolidation was 62.8 days (28-103 days). The lengthened segment consolidated in all cases. One patient had early consolidation and did not wish to undergo further surgery. There were no cases of trouble due to drilling for osteotomy. All patients had a normal gait and were satisfied with the cosmetic results. Level of Clinical Evidence: 4

Summary:. We report a case of reconstruction of a left midfoot defect with a chimeric partial scapula and skin flap in a 20-year-old man. After radical debridement, bone and soft tissue defects were reconstructed with a chimeric scapula and skin flap. The postoperative course was uneventful. The patient could walk well without support, and bone union was achieved 6 months after surgery. In 14 months of follow-up, no clinical complications (including new ulcer or stress fracture) were noted and full ambulation was achieved, with the patient returning to his previous work. We suggest that the chimeric scapula and skin flap may be a useful alternative option for midfoot reconstruction.

Objectives Tumor-specific cytotoxic T lymphocytes can be efficiently activated in vivo by dendritic cell (DC)-based vaccination. This trial assessed the clinical efficacy and toxicity of DC-based immunotherapy in patients with advanced breast carcinoma. Methods DC-based immunotherapy (DC vaccine alone or DC vaccine plus lymphokine-activated natural killer (NK) cell therapy) was administered to 26 patients with unresectable breast carcinoma refractory to standard treatment. After leukapheresis, DCs were generated from CD14 + monocytes by 6 day cultivation with GM-CSF and IL-4. DCs were then matured by OK-432 treatment and pulsed with cancer-associated antigens, such as WT1, MUC1, and HER2. DCs were administered 5–8 times intradermally at 14-day intervals. Results Twenty-six patients with performance status (PS) of 0 ( n = 4), 1 ( n = 14), 2 ( n = 4) and 3 ( n = 4), and a median age of 55.5 years were eligible for this study. Of the 26 patients, DC vaccine was administered in combination with chemotherapy in 50%. Best response by RECIST, 1 patient showed a complete response (CR), 14 had partial response (PR), and 17 had stable disease (SD). The response ratio was 15.4％. None of the patients experienced adverse events of grade 2 or higher during the treatment period. The median overall survival (OS) time was 552.9 days (95% CI; 402.6–703.3 days). Log-rank test analysis demonstrated that the better PS groups (i.e., 0, 1) had significantly better survival times compared to those in poorer PS groups (i.e., 2, 3) (MST, 709.6 days, 95% CI, 502.2–917.0; vs. 200.4 days, 95% CI, 0–410.7; P Conclusion DC vaccine-based immunotherapy demonstrates promising OS times and tolerable toxicities in the setting of breast carcinoma. A full risk/benefit analysis of DC-based vaccines in patients with metastatic breast carcinoma will be determined in a future phase II trial.

Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in patients with acute coronary syndrome (ACS), and is a powerful predictor of long-term mortality. Differences in the clinical utility and pathophysiological implication of NT-proBNP and conventional cardiac markers in patients with ST elevation (STE) vs non-STE (NSTE) ACS were investigated in the present study. Methods and Results Ninety consecutive patients admitted with acute chest pain and a diagnosis of unstable angina or acute myocardial infarction were analyzed. Patients with ≥Killip class II were excluded to focus on the effect of myocardial ischemia on the release of cardiac markers. The markers were measured on admission and analyzed according to the time from onset. Conventional cytosolic marker (creatine kinase-MB) and myofibril marker (troponin T: TnT) were both significantly higher in STE-ACS patients compared with NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 3 h of onset, suggesting a larger ischemic insult despite the smaller extent of myocardial necrosis compared with STE-ACS patients. There was no significant correlation between NT-proBNP level and left ventricular ejection fraction (LVEF) obtained at acute-phase echocardiography in either NSTE-ACS patients (LVEF 57.7±11.2%) or STE-ACS patients (LVEF 55.1±12.7%). Comparison between NT-proBNP and TnT levels revealed a marked difference of elevations, with significantly augmented elevation of NT-proBNP (p

Using defatted and SH-blocked bovine serum albumin (BSA), measurements of differential scanning calorimetry (DSC) have been made at pH 7 on the complexes of BSA and a series of sodium alkyl sulfates used were sodium decyl sulfate (SDeS), sodium octyl sulfate (SOS), sodium hexyl sulfate (SHS) and sodium ethyl sulfate (SES). Results obtained were compared with those on the system BSA-sodium dodecyl sulfate (SDS) studied previously. Two peaks P1 and P2 existed in the DSC curve of BSA. These peaks originate in the heat-induced transition of BSA. The pattern of DSC curve changed with the amount of the ligand added, i.e. with the molar mixing ratio ligand/BSA (1). The change for systems BSA-SDeS, BSA-SOS and BSA-SHS was qualitatively the same as that for the system BSA-SDS (2). Interestingly, SES, which is not a surfactant, interacts with BSA. The change for the system BSA-SES was qualitatively the same as that for the system BSA-Na2SO4. All alkyl sulfates suppressed the heat-induced transition at lower concentrations. A linear relationship was obtained for the plots of log(D/A)1 versus log CMC, where (D/A)1 is the molar mixing ratio of anionic surfactant (D) to BSA (A) at which the most heat-stable complex is formed. This suggests that the hydrophobic force has a serious effect on the formation of heat-stable complexes.

Base equilibria of arginine (basic amino acid) in the absence of a micelle and then in a micellar solution of sodium dodecyl sulfate (SDS) have been studied by ultrasonic absorption measurements. Forward (γ 2 k f ) and backward (k b ) rate constants, the apparent base dissociation constant K b (=k b /γ 2 k f ), and the volume change (ΔV) for the reaction were obtained. Micellar effects for arginine were greater than those for a neutral amino acid measured previously. This is discussed in terms of total charge of the amino acids. Similar experiments were carried out for aspartic acid (acidic amino acid)-cationic micelle of dodecyl-ammonium chloride (DAC). Relaxation was considered due to the protolysis of aspartic acid. A slightly lower micellar effect than that for an aromatic carboxylic acid-dodecylammonium chloride (DAC) system was noted. ΔV was smaller than that for an aromatic carboxylic acid with the same pK a

Ultrasonic relaxation absorption has been measured in aqueous solutions of amino acids (tryptophan, leucine, glycine, phenylalanine, asparagine) in the absence and in the presence of micelles of sodium dodecylsulphate. The relaxation absorption was ascribed to the base equilibrium of amino acids, and the rate constants, the base dissociation constant, and the volume change of the reaction were obtained. The smaller micellar catalytic effect for the base equilibrium of amino acids, compared to those of amines and ammonia was ascribed to the electrostatic effect of the carboxylate group. The reaction mechanism, including the interactions of amino acid and the SDS micelles, were discussed.

SummaryBackgroundThe expanding role of cardiac markers – cytosolic [heart-type fatty acid-binding protein (H-FABP) and creatine kinase MB (CK-MB)], myofibril [troponin T (TnT)], and cardio-endocrine [N-terminal pro-B-type natriuretic peptide (NT-proBNP)] – has been clarified in patients with acute coronary syndrome and those with heart failure. However, these applications for early risk stratification in the cardiac emergency, and the influence of renal function on these evaluations have not been fully investigated.Patients and methodsWe investigated the prognostic value of these representative cardiac markers and influence of renal function on these evaluations in 165 consecutive patients who were admitted for cardiac emergency because of chest pain or dyspnea.ResultsThere were significant correlations between TnT and CK-MB (r=0.512, p

OBJECTIVE: To examine whether changes in interleukin (IL)-6 and IL-10 concentrations in patients with systemic inflammatory response syndrome (SIRS) can predict a poor outcome. DESIGN: Prospective study. SETTING: Emergency and intensive care unit of a medical school hospital. PATIENTS: Twenty-five patients who fulfilled the criteria for SIRS. INTERVENTIONS: Blood samples were collected for cytokine determinations. MEASUREMENTS AND MAIN RESULTS: IL-6 and IL-10 concentrations were measured by enzyme-linked immunosorbent assay in plasma samples. Blood samples were obtained at 0, 1, 2, and 4 days from patients who fulfilled the criteria for SIRS. Of 25 patients, 19 survived and the other six patients died of multiple organ failure. Although IL-6 and IL-10 concentrations in survivors decreased gradually from 186.1 +/- 34.4 to 93.6 +/- 18.9 (SEM) pg/mL (p < .05) and from 77.4 +/- 21.2 to 32.0 +/- 11.8 pg/mL (p < .05), IL-6 concentrations in nonsurvivors did not. Although the ratio of IL-6 to IL-10 in survivors was almost stable, the ratio in nonsurvivors increased from 5.5 +/- 3.1 to 18.7 +/- 2.8 (p < .05). Multivariate analysis showed that when heart rate, mean arterial pressure, IL-6, IL-10, and the ratio of IL-6 to IL-10 were taken into account, there only remained a relationship between the ratio of IL-6 to IL-10 and outcome. CONCLUSIONS: In nonsurvivors, IL-6 concentrations did not decrease, IL-10 concentration decreased, and the ratio of IL-6 to IL-10 increased. An increase in the ratio of IL-6 to IL-10 indicated a correlation with a poor outcome.

High-risk acute coronary syndrome is characterized by vulnerable-plaque with subocclusive thrombus and down-stream microemboli spreading minor myocardial damage, resulting in non-ST-elevation myocardial infarction. Advances in the understanding of the pathogenesis and consequences of acute coronary syndrome have stimulated development of novel biomarkers, and expanded their role in the different spectrum of the underlying pathophysiology, namely multi-biomarker strategy; consisted of biomarkers for 1) myocardial necrosis(membrane damage to myofibril necrosis), 2) plaque destabilization, 3) myocardial stress(ischemic stress per se and end-diastolic atrial or ventricular wall stress), 4) myocardial ischemia, and 5) inflammatory process. In this article, we review clinical importance of novel biomarkers referring our previous clinical investigation and other reports, especially troponin T for detection of minor myocardial damage associated with vulnerable plaque with thrombus/embolus, heart-type fatty acid -binding protein for earlier detection of myocardial damage and it's role for the rule-out triage, N-terminal pro-BNP for earlier risk stratification in cardiac emergency, and soluble CD40 ligand for earlier identification of plaque destabilization with platelet activation in non-ST-elevation acute coronary syndrome.

Background: Measurement of brain natriuretic peptide (BNP) has become a potent diagnostic aid as a means of identifying patients with systolic or diastolic dysfunction. Due to better stability in circulating blood, we reasoned that measurement of N-terminal proBNP (NT-proBNP) may be a more discerning marker for the detection and evaluation of chronic heart failure. Methods: The relationships between plasma concentrations of NT-proBNP and BNP, and aetiology, New York Heart Association (NYHA) classification, and left ventricular ejection fraction (LVEF) were analyzed in 105 patients with chronic heart failure. Sixty-seven healthy volunteers were studied as the controls. Results: Both NT-proBNP and BNP showed progressive increases (P

The base dissociation of ammonia has been studied by an ultrasonic absorption method in both the absence and presence of SDS micelle in aqueous solution, and kinetic parameters were obtained. The micellar catalyzed reaction mechanism, including the interactions of ammonium ion with SDS micelles, are discussed.

IL-10 is an anti-inflammatory cytokine. Its blood concentration is said to rise in response to various invasive stimuli together with inflammatory cytokines. Studies on the effects of hemorrhagic shock on cytokine production are few, and they refer mainly to inflammatory cytokines. In this study, IL-10 was measured in patients with hemorrhagic shock. Its transition over time and its relation to inflammatory cytokines was investigated. The subjects were four patients in hemorrhagic shock due to non-trauma and 17 patients in hemorrhagic shock due to trauma. Their average age was 40.1 years. The APACHE-II score for the trauma subjects was 18.6 and 25.8 for non-trauma, with an average of 20.0 for all subjects. The average ISS of the trauma subjects was 26.1. A positive correlation was found between IL-10 and IL-6 (r = 0.777). IL-6 is generally regarded as reflecting the severity of a patient's condition, and as a consequence of our findings, IL-10 should also be useful as a marker of patient severity. Changes in cytokine levels were assessed in relation to the cause of hemorrhage. IL-6 and IL-10 levels were high in hemorrhagic shock due to trauma but did not rise remarkably in shock due to non-trauma, indicating that tissue injury is an important factor in causing high cytokine levels.

The kinetics of the protolysis of aromatic carboxylic acids solubilized in a micelle of dodecylpyridinium chloride has been studied by the ultrasonic relaxation absorption measurements. The rate constants are dependent on the acid dissociation constant K a and the results are interpreted by means of the Bronsted catalysis law. The micellar catalytic effect is discussed in comparison to those in the acid and base equilibria of carboxylic acids and amines in the micellar solutions. The volume change of the reaction is also found to be dependent on K a .

Ultrasonic absorption was measured in hexane solutions of octylammonium alkanoates (nonanoate, decanoate, dodecanoate, and tetradecanoate). The value of critical micelle concentration (CMC) was determined to be 0.02 M (1 M=1 mol dm−3) for all the surfactants. The excess ultrasonic absorption, observed in the solutions above the CMC, was ascribed to the association-dissociation of the monomer to and from the micelle. From the concentration dependences of the ultrasonic parameters, the mean aggregation number of the micelle, the rate constants, and the enthalpy change of the above reaction were obtained. These results were discussed in relation to the shape of the reversed micelle and the solute-solvent interactions.

Micellar catalytic effects on the base dissociation of methylamine have been studied by ultrasonic absorption method. The dissociation constant, the rate constants, and the volume change of the reaction were obtained in the absence and in the presence of SDS. The micellar catalytic effects observed for methylamine was smaller than those for amines of long alkyl chain, which was ascribed to the facts that the former is incorporated into the micellar ionic atmosphere in the concentrated micellar solution while the latters are solubilized into micelles.

The ultrasonic relaxation absorption has been measured in aqueous solution of dipentylamine, dihexylamine, dioctylamine, N-methylphenethylamine, and N-ethylbenzylamine in the presence of the sodium dodecyl sulfate(SDS) micelle. The relaxation absorption has been ascribed to the base equilibrium of the amines on the surface of the micelle: RR′NH2++OH−\oversetkf\undersetkb\ightleftharpoonsRR′NH+H2O. The rate constants γ±2kf, kb, the apparent base dissociation constant Kb (=kb⁄γ±2kf), and the volume change in the base equilibrium ΔV were obtained, where γ± is the mean activity coefficient for RR′NH2+ and OH−. The dependence of the rate constants on Kb revealed that, in the detailed mechanism of the base equilibrium of the amines, RR′\underset(I)NH2++OH−\oversetk12\undersetk21\ightleftharpoons(RR′NH\underset(II)2+···OH−)\oversetk23\undersetk32\ightleftharpoonsRR′N\underset(III)H+H2O, the rate-determining step is the proton-transfer process, (II) \ightleftharpoons (III). The pKb values of the secondary amines ...

Hydrolyse de methyl-1 heptylamine, tetramethyl-1,1,3,3 butylamine, phenyl-4 butylamine, phenyl-3propylamine phenethylamine et benzylamine en presence de micelles de laurylsulfate de Na

Etude de la relaxation dans des solutions d'acide benzoique (et ses derives) en presence du chlorure de dodecylammonium. La relaxation est attribuee a la protolyse de l'acide carboxylique sur la surface de la micelle. Parametres cinetiques

Dipolar correlation functions of non-interacting symmetric top molecules were obtained by quantum mechanical calculation. The effect of the rotation-vibration interaction on the correlation function is discussed, taking the constant ζ of the Coriolis coupling and the asymmetry Ix/Iz as parameters. It is shown that the decay of the correlation function for perpendicular vibrations very much depends on the sign and the magnitude of ζ. Some relationships between the shape of the correlation function and the value of the parameters are given.

The ultrasonic absorptions of Aerosol OT in dodecane solution were measured in the frequency range 5–95 MHz at various temperatures. An excess absorption caused by single relaxation was observed above the second critical micelle concentration. This is attributed to the conformational change in structure of two kinds of Aerosol OT micelles, since the maximum excess absorption per wave length depends on the concentration and temperature. The thermodynamic and kinetic parameters were determined in relation to the reaction.

Hydrolyse de methyl-1 heptylamine, tetramethyl-1,1,3,3 butylamine, phenyl-4 butylamine, phenyl-3propylamine phenethylamine et benzylamine en presence de micelles de laurylsulfate de Na

Dipolar correlation functions of non-interacting symmetric top molecules were obtained by quantum mechanical calculation. The effect of the rotation-vibration interaction on the correlation function is discussed, taking the constant ζ of the Coriolis coupling and the asymmetry Ix/Iz as parameters. It is shown that the decay of the correlation function for perpendicular vibrations very much depends on the sign and the magnitude of ζ. Some relationships between the shape of the correlation function and the value of the parameters are given.