No abstract

Inflammatory cytokines are suspected to play an important role in the pathophysiology of left ventricular (LV) remodeling. We investigated whether high-sensitivity C-reactive protein (CRP) (hs-CRP) is a predictor for LV remodeling in patients with acute myocardial infarction (AMI) with successful reperfusion, and also whether such a situation can be avoided by the administration of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB). The subjects were 139 patients with an initial attack of anterior myocardial infarction successfully treated by reperfusion therapy. They were randomly divided into the following two groups: an angiotensin (AG) group (91 patients treated with ACEI/ARB) and a NON-AG group (48 patients not treated with ACEI/ARB). Levels of hs-CRP, creatine kinase, human atrial natriuretic polypeptide, brain natriuretic peptide (BNP), fasting blood glucose, serum lipids, fibrinogen, fibrin degradation product, prothromloin time, and activated partial thromboplastin time were measured immediately after 1, 2, 3, and 7 days, and 1 months after the onset of AMI. ACEI or ARB administration lowered hs-CRP levels and prevented the development of LV remodeling. Peak CRP levels significantly correlated with BNP levels during the acute stage (r = +0.54, P < 0.0001), end-diastolic volume index (r = +0.78, P < 0.0001), end-systolic volume index (r = +0.36, P = 0.0405), ejection fraction (r = -0.45, P = 0.0052), left ventricular end-diastolic diameter (r = +0.61, P < 0.0001), cardiac output (r = -0.52, P = 0.0005), cardiac index (r = -0.41, P = 0.0099), and systolic pulmonary arterial pressure (r = +0.48, P = 0.0017) 1 month after the onset of AMI in the NON-AG group but not in the AG group. Logistic multivariate analysis revealed that peak CRP alone was an independent risk factor for the development of LV remodeling in the NON-AG group (odds ratio = 1.79, P = 0.002). These results suggest that hs-CRP is a useful factor for predicting LV remodeling. Furthermore, ACEI or ARB administration to AMI patients showing increased hs-CRP levels during the early stage of the disease could prevent LV remodeling.

In a 58-year-old male, upper digestive endoscopy revealed a protruding lesion in the esophagus on a medical examination. The patient was referred to the Department of Surgery in our hospital to undergo surgery. On the initial consultation, upper digestive endoscopy showed a smooth, soft, black purple, type II protruding lesion measuring approximately 25 mm at 35 cm apart from the incisor. For diagnostic treatment and patient's request, endoscopic mucosal resection (EMR) was performed. The resected specimen measured 25 mm x 25 mm. The histological findings suggested cavernous hemangioma. To treat esophageal hemangioma, esohagectomy, tumor enucleation, or sclerotherapy has been performed. However, recently, thorough preoperative examination, such as endoscopic ultrasonography (EUS), has facilitated endoscopic resection, such as EMR.

The effects of whipping temperature (5 to 15 degrees C) on the whipping (whipping time and overrun) and rheological properties of whipped cream were studied. Fat globule aggregation (aggregation ratio of fat globules and serum viscosity) and air bubble factors (overrun, diameter, and surface area) were measured to investigate the mechanism of whipping. Whipping time, overrun, and bubble diameters decreased with increasing temperature, with the exception of bubble size at 15 degrees C. The aggregation ratio of fat globules tended to increase with increasing temperature. Changes in hardness and bubble size during storage were relatively small at higher temperatures (12.5 and 15 degrees C). Changes in overrun during storage were relatively small in the middle temperature range (7.5 to 12.5 degrees C). From the results, the temperature range of 7.5 to 12.5 degrees C is recommended for making whipped creams with a good texture, and a specific temperature should be decided when taking into account the preferred overrun. The correlation between the whipped cream strain hardness and serum viscosity was high (R(2)=0.906) and persisted throughout the temperature range tested (5 to 15 degrees C). A similar result was obtained at a different whipping speed (140 rpm). The multiple regression analysis in the range of 5 to 12.5 degrees C indicated a high correlation (R(2)=0.946) in which a dependent variable was the storage modulus of whipped cream and independent variables were bubble surface area and serum viscosity. Therefore, fat aggregation and air bubble properties are important factors in the development of cream hardness. The results of this study suggest that whipping temperature influences fat globule aggregation and the properties of air bubbles in whipped cream, which alters its rheological properties.

The size of bubbles and degree of fat globule aggregation in cream have been reported to influence the shape retention ability of whipped cream. Shape retention ability also changes when whipped cream is stored. In order to investigate bubble size and fat globule aggregation, fresh cream with ./ῌ (w/w) fat was whipped to sti#ness at di#erent speeds (+.*, +2* or ,** rpm). Di#erences in resistivity against deformation during storage were found in whipped cream prepared at di#erent whipping speeds. It appears that the degree of fat globule aggregatation and overrun of the whipped cream influenced resistivity against deformation. Furthermore, higher correlation was found between the overrun and the continuous phase viscosity of the sample whipped at +.* rpm, and between the average bubble size and the degree of fat globules aggregation of the sample prepared at ,** rpm. The present results suggest that the degree of fat globule aggregation in the continuous phase influence the shape retention ability of cream whipped at +.* rpm, and that the presence of aggregates of fat globules on the surface of bubbles influence the shape retention ability of the cream whipped at ,** rpm.