Atropine for the treatment of organophosphate poisoning inhibits enterokinesis, and prevents gastrointestinal decontamination in some cases. In our department, a treatment method to prioritize gastrointestinal decontamination by intestinal lavage has been performed since 2001. In this study，we retrospectively examined the age, sex, causative substances，initial symptomst, herapeutic strategies, respiratory care, interval until the amelioration of symptoms/laboratory data, and admission period based on medical records of 62 patients with organophosphate poisoning who were treated in our department. In addition, for severe-status patients, the interval until recovery was compared among treatment methods in 24 patients with a minimum serum cholinesterase (ChE) level of ≤ 3 U/L. In the severe-status patients，there were no significant differences in the interval until recovery to a serum ChE level of ≥ 52 U/L (aim of symptom reduction) among the gastric lavage, pralidoxime methiodide, and activated carbon groups. However, the interval was significantly shortened in the intestinal lavage treatment group. There were no significant differences in the tracheal intubation or admission periods among all treatment methods. The results of this study suggested that the duration of symptoms is shortened when intestinal lavage is performed as initial treatment.

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Some retinal pigment epithelial (RPE) cells migrate and cause proliferative vitreoretinopathy and age-related macular degeneration. Transforming growth factor-β (TGF-β) is a major factor in these diseases and promotes cellular migration in RPE cells. Myocardin-related transcription factor A (MRTF-A) is a key factor in cell migration that regulates actin-associated proteins, such as gelsolin. In this study, we examined whether MRTF-A and gelsolin are related to the promotion of cellular migration in RPE cells induced by TGF-β. Using a wound-healing assay, the migration of adult retinal pigment epithelial cell line-19 (ARPE-19) cells treated with both 12.5 ng/ml TGF-β2 and/or 3 µM CCG-203971, an inhibitor of MRTF-A, or 0.1% DMSO (vehicle) was measured 24 h after wounding. The expression levels of gelsolin were examined by quantitative real-time PCR and western blot. TGF-β2 led to increased migration of ARPE-19 cells. This promotion of cell migration was diminished by CCG-203971. TGF-β2 led to increased gelsolin mRNA and protein expression in ARPE-19 cells. These expression levels were also reduced by CCG-203971. These results suggest that the MRTF-A pathway is related to TGF-β-induced promotion of ARPE-19 cell migration.

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To examine the factors contributing to the pro-longation of the mechanical ventilation period after liver transplantation, we retrospectively inspected adult living donor liver transplant recipients. A total of 46 adult liver failure patients who had undergone liver transplantation from a living donor were enrolled in this study. The subjects were divided into two groups based on the postoperative mechanical ventilation period: Group 1 comprised patients who had left within 24 hours of the postoperative ventilator use ‹n = 33›, and Group 2 consisted those who had been mounted on a ventilator for over 24 hours after surgery ‹n = 13›. The duration of mechanical ventilation was 11.0 ‹9.2, 12.0› hours in Group 1 and 36.5 ‹33.0, 154.0› hours in Group 2. Group 1 had younger patients and more men than Group 2‹p < 0.05›. There were no significant differences in pre-anesthetic laboratory data except for the serum aspartate aminotransferase level between the two groups, but hemoglobin concentration and hematocrit at the end of surgery were significantly higher in Group 2‹p < 0.05›. The patient’s age, sex, and hematocrit at the end of surgery affected the postoperative duration of mechanical ventilation in the regression analysis ‹p < 0.05›. Older age, female sex and high value of hematocrit at the end of surgery were factors of longer postoperative mechanical ventilation period in liver transplant patients.

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