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We purified a novel angiotensin-I converting enzyme (ACE) inhibitor from fish sauce Ishiru prepared from squid, and identified it as the tripeptide Leu-Ala-Arg (LAR). IC₅₀ of this ACE inhibitor was 2.5 μM, demonstrating high potency among peptides previously purified from fish sauces. Moreover, LAR acted as an antihypertensive peptide, reducing systolic blood pressure in spontaneously hypertensive rats.

We have treated 12 popliteal aneurysms in ten patients from 1965 to 1989. There were seven men and three women, aged 34 to 78 years (mean, 61.5 years). Two patients had bilateral aneurysms. The chief complaint was pain at rest, claudication, coldness, etc. in eight patients, a mass or induration at the popliteus in two patients, peroneal nerve or vein compression in one patient each. Angiography showed thrombotic obstruction in six legs and distal occlusion in one leg. Ten of aneurysms of eight patients were treated surgically. In two patients, the operation was done on emergency basis. Amputation was not necessary in any case. The operative method was usually excision of the aneurysm. Reconstruction was made with artificial vessels in the first patient who underwent bilateral aneurysm surgery. Auto-saphenous vein were used in other seven patients. All vein grafts were patent at follow-up (mean follow-up period, 4 years and 3 months). Arteriosclerotic changes were histologically observed in all aneurysms. Complications such as thrombotic obstruction and distal occulsion are frequent and leg amputation is necessary in some cases. Arterial reconstruction with an auto-saphenous vein is necessary for popliteal aneurysm.

Purpose: Consensus is lacking regarding the optimal antibiotic treatment for pediatric complicated appendicitis. This study determined the optimal first-line antibiotic treatment for pediatric patients with complicated appendicitis based on peritoneal fluid cultures. Methods: This retrospective study examined the cases of pediatric patients who underwent appendectomy for complicated appendicitis at our institution between 2013 and 2019. Peritoneal fluid specimens obtained during appendectomy were cultured for the presence of bacteria. Results: Eighty-six pediatric patients were diagnosed with complicated appendicitis.Of them, bacteria were identified in 54 peritoneal fluid samples. The major identified bacteria were Escherichia coli (n=36 [66.7%]), Bacteroides fragilis (n=28 [51.9%]), α-Streptococcus (n=25 [46.3%]), Pseudomonas aeruginosa (n=10 [18.5%]), Enterococcus avium (n=9 [16.7%]), γ-Streptococcus (n=9 [16.7%]), and Klebsiella oxytoca (n=6 [11.1%]). An antibiotic susceptibility analysis showed E. coli was inhibited by sulbactam/ampicillin in 43.8% of cases versus cefmetazole in 100% of cases. Tazobactam/piperacillin and meropenem inhibited the growth of 96.9-100% of the major identified bacteria. E. coli (100% vs. 84.6%) and P. aeruginosa (100% vs. 80.0%) were more susceptible to amikacin than gentamicin. Conclusion Tazobactam/piperacillin or meropenem is a reasonable first-line antibiotic treatment for pediatric complicated appendicitis. In the case of aminoglycoside use, amikacin is recommended.