Smaller Fixation Target Size Is Associated with More Stable Fixation and Less Variance in Threshold Sensitivity

The aims of this randomized observational case control study were to quantify fixation behavior during standard automated perimetry (SAP) with different fixation targets and to evaluate the relationship between fixation behavior and threshold variability at each test point in healthy young participants experienced with perimetry. SAP was performed on the right eyes of 29 participants using the Octopus 900 perimeter, program 32, dynamic strategy. The fixation targets of Point, Cross, and Ring were used for SAP. Fixation behavior was recorded using a wearable eye-tracking glass. All participants underwent SAP twice with each fixation target in a random fashion. Fixation behavior was quantified by calculating the bivariate contour ellipse area (BCEA) and the frequency of deviation from the fixation target. The BCEAs (deg²) of Point, Cross, and Ring targets were 1.11, 1.46, and 2.02, respectively. In all cases, BCEA increased significantly with increasing fixation target size (p < 0.05). The logarithmic value of BCEA demonstrated the same tendency (p < 0.05). A positive correlation was identified between fixation behavior and threshold variability for the Point and Cross targets (ρ = 0.413–0.534, p < 0.05). Fixation behavior increased with increasing fixation target size. Moreover, a larger fixation behavior tended to be associated with a higher threshold variability. A small fixation target is recommended during the visual field test.

The Relationship between Corvis ST Tonometry and Ocular Response Analyzer Measurements in Eyes with Glaucoma

It is important to compare the results of Corneal Visualization Scheimpflug Technology instrument (CST) measurements and Reichert Ocular Response Analyzer (ORA) parameters. The purpose of the study was to investigate the association between CST measurements and ORA parameters in ninety-five patients with primary open-angle glaucoma. Measurements of CST, ORA, axial length (AL), average corneal curvature (CC), central corneal thickness (CCT) and intraocular pressure (IOP) with Goldmann applanation tonometry (GAT) were carried out. The association between CST and ORA parameters was assessed using linear regression analysis, with model selection based on the second order bias corrected Akaike Information Criterion index. Measurements from ORA (corneal hysteresis [CH] and corneal response factor [CRF]) had high intraclass correlation coefficients (ICC) and low coefficients of variation, but some CST parameters showed much lower reproducibility, namely: A1 length, A2 length, highest concavity time and peak distance. Of 12 CST parameters tested, 8 were significantly correlated with CH and 10 were significantly correlated with CRF, however, the magnitude of the correlation coefficients were weak to moderate at best. The optimal model to explain CH using CST measurements was given by: CH = -76.3 + 4.6*A1 time + 1.9*A2 time + 3.1 * highest concavity deformation amplitude + 0.016*CCT (R² = 0.67, p <0.001). Similarly, the optimal model for CRF was given by: CRF = -53.5 + 4.2*A1 time + 1.9*A1 length + 20.8*A1 deformation amplitude + 0.8*A2 time + 0.017*CCT (R² = 0.73, p <0.001). ORA parameters show higher reproducibility than CST measurements. Although many CST parameters are significantly related to ORA parameters, the strengths of these relationships are weak to moderate.

Comparison of corneal biomechanical properties in normal tension glaucoma patients with different visual field progression speed

AIM

To compare the corneal biomechanical properties difference by ocular response analyzer (ORA) in normal tension glaucoma (NTG) patients with different visual field (VF) progression speed.

METHODS

NTG patients with well-controlled Goldmann applanation tonometer (GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled. GAT and ORA parameters including corneal compensated intraocular pressure (IOPcc), Goldmann estimated intraocular pressure (IOPg), corneal hysteresis (CH), corneal resistance factor (CRF) were recorded. VF was tested by Swedish interactive threshold algorithm (SITA)-standard 30-2 fields. All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up. Patients were divided into four groups according to VF change over 3y, and ORA findings were compared between the upper 25(th) percentile group (slow progression group) and the lower 25(th) percentile group (rapid progression group).

RESULTS

Eighty-two eyes of 56 patients were studied. There were 21 eyes (21 patients) each in rapid and slow progression groups respectively. GAT, IOPcc, IOPg, CH, CRF were 12.1±1.4 mm Hg, 15.8±1.8 mm Hg, 12.8±2.0 mm Hg, 8.4±1.1 mm Hg, 7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg, 13.5±2.1 mm Hg, 11.2±1.6 mm Hg, 9.3±1.1 mm Hg, 8.2±0.9 mm Hg respectively in slow progression group (P=0.214, <0.001, 0.007, 0.017, 0.413, respectively). In bivariate correlation analysis, IOPcc, IOPcc-GAT and CH were significant correlated with mΔMD (r=-0.292, -0.312, 0.228 respectively, P=0.008, 0.004, 0.039 respectively).

CONCLUSION

Relatively rapid VF progression occurred in NTG patients whose IOPcc are rather high, CH are rather low and the difference between IOPcc and GAT are relatively large. Higher IOPcc and lower CH are associated with VF progression in NTG patients. This study suggests that GAT measures might underestimate the IOP in such patients.

Revalidating the Usefulness of a "Sector-Wise Regression" Approach to Predict Glaucomatous Visual Function Progression

PURPOSE

We previously developed a method to measure visual function progression using "Progression sectors," which were derived from a clustering analysis of pointwise rates of glaucomatous visual field (VF) progression; however, only short series of VFs, where pointwise linear regression (PLR) is typically not reliable, were analyzed. The purpose of the current study is to further investigate the usefulness of a sector-wise approach in longer series of VFs where the accuracy of PLR is inherently greater.

METHODS

We analyzed 16 VFs from each of 71 eyes in 45 patients. Sectorial averages of total deviation (TD) values were calculated at each "Progression sector," consisting of 23 sectors as well as at "Nouri-Mahdavi" (NM) sectors, consisting of 10 sectors. Linear regression then was applied to predict sectorial averages in the 11th to 16th VFs and absolute prediction errors were compared to PLR.

RESULTS

Absolute prediction errors associated with linear regression of the "Progression sectors" were significantly smaller than those from PLR (P < 0.05) when predicting values in the 14th to 16th VFs. Conversely, prediction errors with NM sectors were significantly larger than those from PLR and "Progression sectors" (P < 0.01) when predicting values in the 11th to 16th VFs.

CONCLUSIONS

It is useful to use "Progression sectors" to predict future VF progression in short (1-10 VFs) and long (>10 VFs) VF series, compared to PLR and NM sectors.

The Relationship Between Visual Acuity and the Reproducibility of Visual Field Measurements in Glaucoma Patients

PURPOSE

The purpose of this study was to investigate the association between visual acuity (VA) and reproducibility of test-retest visual field (VF) measurements in glaucoma patients.

METHODS

Subjects were comprised of 627 eyes of 627 open-angle glaucoma patients. The reproducibility of two Humphrey VFs (24-2 or 30-2 Swedish Interactive Threshold Algorithm tests) examined twice within the period of 3 months was calculated using the root mean squared error (RMSE) of each VF test point's sensitivity. Visual acuity was measured once at the time of either of the VF measurements. Linear modeling was used to investigate the relationship between reproducibility of VF tests (RMSE) and the following variables: mean total deviation value (mTD), fixation losses (FLs), false positives (FPs), false negatives (FNs), refractive error, age, and VA.

RESULTS

The optimal model to predict test-retest variability (RMSE) of VFs included age, VA, mTD, and FNs as dependent variables. Root mean squared error was significantly larger in eyes with logMAR VA > 0.5 than in eyes with logMAR VA ≤ 0.

CONCLUSIONS

Reproducibility of VF tests becomes poor with the deterioration of VA. Careful consideration is needed when a patient's logMAR VA exceeds 0.5.

Effects of different levels of intraocular stray light on kinetic perimetry findings

PURPOSE

To evaluate the effect of different levels of intraocular stray light on kinetic perimetry findings.

METHODS

Twenty-five eyes of 25 healthy young participants were examined by automated kinetic perimetry (Octopus 900) using Goldmann stimuli III4e, I4e, I3e, I2e, and I1e. Each stimulus was presented with a velocity of 3°/s at 24 meridians with 15° intervals. Four levels of intraocular stray light were induced using non-white opacity filter (WOF) filters and WOFs applied to the clear plastic eye covers of the participants. The visual acuity, pupil diameter, isopter area, and kinetic sensitivity of each meridian were analyzed for each WOF density.

RESULTS

Visual acuity deteriorated with increasing WOF densities (p < 0.01). With a visual acuity of 0.1 LogMAR units, the isopter areas for III4e, I4e, I3e, I2e, and I1e decreased by -32.7 degree2 (-0.2%), -255.7 degree2 (-2.6%), -381.2 degree2 (-6.2%), -314.8 degree2 (-12.8%), and -59.2 degree2 (-15.2%), respectively; kinetic sensitivity for those stimuli decreased by -0.1 degree (-0.1%), -0.8 degree (-1.4%), -1.6 degree (-3.7%), -2.7 degree (-9.7%), and -1.7 degree (-16.2%), respectively. The pupil diameter with each WOF density was not significantly different.

CONCLUSION

Kinetic perimetry measurements with a high-intensity stimulus (i.e., III4e) were unaffected by intraocular stray light. In contrast, measurements with the I4e, I3e, I2e, and I1e stimuli, especially I2e and I1e, were affected. Changes in the shape of the isopter resulting from opacity must be monitored, especially in cases of smaller and lower-intensity stimuli.

Global gene analysis identifying genes commonly regulated by the Ras/Raf/MEK and type I IFN pathways

Oncolytic viruses exploit alterations in cancer cells to specifically infect cancer cells but not normal healthy cells. Previous work has shown that oncogenic Ras interferes with interferon (IFN) signaling to promote viral replication. Furthermore, inhibition of the Ras/Raf/MEK/ERK pathway at the level of Ras, MEK, or ERK was sufficient to restore IFN signaling. In order to identify genes that were commonly regulated by the inhibition of the Ras pathway and the IFN pathway, we treated NIH/3T3 cells that overexpress oncogenic Ras with the MEK inhibitor, U0126, or IFN-α for 6 h, and performed DNA microarray analysis (Gene Expression Omnibus accession number GSE49469). Here, we also provide additional information on the experimental and functional analysis of the genes responsive to U0126 and IFN.

Comparison of Kang's and Littmann's methods of correction for ocular magnification in circumpapillary retinal nerve fiber layer measurement

PURPOSE

To assess and compare the accuracy of Kang's method for ocular magnification correction in circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement with that of the currently used Littmann's method.

METHODS

A total of 148 eyes of 148 healthy participants underwent cpRNFL measurement without correction and with correction by Littmann's method using spectral-domain optical coherence tomography. Correction of ocular magnification by Kang's method is based on the observed uncorrected cpRNFL thickness. The accuracy of Kang's method was compared with that of Littmann's method for magnification correction by using the Pearson product-moment correlation coefficient (r) and Bland-Altman analysis.

RESULTS

A total of 132 eyes were assessed. The two methods used to correct the global cpRNFL thickness were strongly correlated (r = 0.940, P < 0.01), and the mean difference between the two methods was -0.4 μm, with 95% limits of agreement (LoA) of ±6 μm without systemic bias (P > 0.05). Although the cpRNFL thicknesses corrected with the two methods at quadrant and 12-o'clock sectors showed a strong correlation (r > 0.731, P < 0.01), high LoAs ranging from ±13.3 to ±27.9 and systemic biases were observed at nasal and inferior sectors.

CONCLUSION

No difference was found between Kang's and Littmann's methods for correction of ocular magnification in global cpRNFL thickness measurement. However, with regard to magnification correction for sectoral cpRNFL thickness, further scrutiny of Kang's method is warranted, even in healthy participants, because of the high variability between Littmann's and Kang's methods.

Clustering visual field test points based on rates of progression to improve the prediction of future damage

PURPOSE

To develop new visual field (VF) sectors based on pointwise rates of glaucomatous VF progression ("progression regions") and to evaluate their usefulness for predicting future progression.

METHODS

A training dataset consisting of 10 VFs from each of 412 eyes in 412 open-angle glaucoma patients and a validation dataset consisting of 15 VFs from each of 71 eyes in 45 patients were investigated. First, using the training dataset, the VF was divided into small regions, according to the rates of progression of all 52 test points in the VF. Then, using the initial four VFs of the validation dataset, total deviation (TD) values in the 10th VF were predicted by applying linear regression analysis in derived regions and the absolute prediction error was calculated. The analysis was iterated, predicting TD values of the 10th VF, but each time including an additional VF in the regression (from five to nine VFs). Absolute prediction errors were then compared with conventional pointwise linear regression (PLR) and regression based on Nouri-Mahdavi (NM) sectors.

RESULTS

Twenty-three progression regions were derived. In general, absolute prediction errors were significantly smaller for regression based on these regions compared with PLR and NM sectors.

CONCLUSIONS

Predictions of VF progression can be improved by dividing the VF into small regions based on clusters of test points with similar progression rates.

Effect of Optical Defocus on the Kinetic Perimetry in Young Myopic Participants

PURPOSE

The prospective study evaluated the effects of optical defocus on kinetic sensitivity using automated kinetic perimetry.

MATERIALS AND METHODS

The 17 eyes of 17 healthy young participants were evaluated. All of the participants had myopia (≥ -5.00 D) and mild to no astigmatism (<1.00 D). Automated kinetic perimetry was performed using the Octopus 900 perimeter with Goldmann stimuli III4e, I4e, I3e, I2e, and I1e, with stimuli presented at 14 predetermined meridians, and a velocity of 3°/s. Optical defocus was induced with soft contact lenses, and varied in 1 D increments between 0 and +7 D. Kinetic sensitivity at each defocus was evaluated and compared to sensitivity with no defocus.

RESULTS

Although kinetic sensitivity with the III4e and I4e stimuli decreased slightly at the inferior nasal, total kinetic sensitivity measured with the III4e and I4e stimuli was unaffected by optical defocus. Conversely, kinetic sensitivity measured with the I3e, I2e, and I1e stimuli decreased at defocus greater than +6 D (p < 0.05), + 3 D (p < 0.01), and at a defocus greater than +1 D (p < 0.01), respectively.

CONCLUSIONS

Kinetic sensitivity was unaffected by defocus when measured with III4e and I4e stimuli. However, measurements with I3e, I2e, and I1e stimuli were affected, in particular measurements with I2e and I1e stimuli. Therefore, we conclude that optimal refractive correction with a contact lens or a spectacle lens is required in order to obtain accurate kinetic perimetry results, particularly for lower intensity stimuli.

Effect of maternal stress on fetal heart rate assessed by vibroacoustic stimulation

This study was designed to determine whether maternal stress levels, state and trait anxiety levels, and stress hormones affect fetal heart rate (FHR) patterns after vibroacoustic stimulation (VAS) at 30 weeks of gestation. A total of 24 healthy pregnant women with a single fetus pregnancy were enrolled. Corticotropin releasing hormone (CRH) and adrenocorticotropic hormone in maternal plasma and cortisol, and chromogranin A in saliva were measured. The FHR patterns after VAS were divided into three types: type I, a long period of acceleration or one acceleration lasting > 1 min or at least two accelerations lasting > 15 s; type II, a biphasic response with acceleration followed by deceleration; and type III, no response or prolonged deceleration. In the high trait anxiety group, CRH levels were significantly higher than in the low trait anxiety group, and FHR patterns after VAS showed mostly a type II response pattern. These findings suggest that stress in pregnant women with high trait anxiety may influence FHR patterns after VAS.

Learning Petri network and its application to nonlinear system control

According to recent knowledge of brain science it is suggested that there exists functions distribution, which means that specific parts exist in the brain for realizing specific functions. This paper introduces a new brain-like model called Learning Petri Network (LPN) that has the capability of functions distribution and learning. The idea is to use Petri net to realize the functions distribution and to incorporate the learning and representing ability of neural network into the Petri net. The obtained LPN can be used in the same way as a neural network to model and control dynamic systems, while it is distinctive to a neural network in that it has the capability of functions distribution. An application of the LPN to nonlinear crane control systems is discussed. It is shown via numerical simulations that the proposed LPN controller has superior performance to the commonly-used neural network one.

Universal learning network and its application to robust control

Universal learning networks (ULNs) and robust control system design are discussed, ULNs provide a generalized framework to model and control complex systems. They consist of a number of interconnected nodes where the nodes may have any continuously differentiable nonlinear functions in them and each pair of nodes can be connected by multiple branches with arbitrary time delays. Therefore, physical systems which can be described by differential or difference equations and also their controllers can be modeled in a unified way. So, ULNs constitute a superset of neural networks or fuzzy neural networks. In order to optimize the systems, a generalized learning algorithm is derived for the ULNs, in which both the first order derivatives (gradients) and the higher order derivatives are incorporated. The derivatives are calculated by using forward or backward propagation schemes. These algorithms for calculating the derivatives are extended versions of back propagation through time (BPTT) and real time recurrent learning (RTRL) by Williams in the sense that generalized nonlinear functions and higher order derivatives are dealt with. As an application of ULNs, the higher order derivative, one of the distinguished features of ULNs, is applied to realizing a robust control system in this paper. In addition, it is shown that the higher order derivatives are effective tools to realize sophisticated control of nonlinear systems. Other features of ULNs such as multiple branches with arbitrary time delays and using a priori information will be discussed in other papers.

A new control method of nonlinear systems based on impulse responses of universal learning networks

A new control method of nonlinear dynamic systems is proposed based on the impulse responses of universal learning networks (ULNs), ULNs form a superset of neural networks. They consist of a number of interconnected nodes where the nodes may have any continuously differentiable nonlinear functions in them and each pair of nodes can be connected by multiple branches with arbitrary time delays. A generalized learning algorithm is derived for the ULNs, in which both the first order derivatives (gradients) and the higher order derivatives are incorporated. One of the distinguished features of the proposed control method is that the impulse response of the systems is considered as an extended part of the criterion function and it can be calculated by using the higher order derivatives of ULNs. By using the impulse response as the criterion function, nonlinear dynamics with not only quick response but also quick damping and small steady state error can be more easily obtained than the conventional nonlinear control systems with quadratic form criterion functions of state and control variables.

Brachial-ankle pulse wave velocity measured automatically by oscillometric method is elevated in diabetic patients with incipient nephropathy

AIMS

To examine whether brachial-ankle pulse wave velocity (baPWV), a possible early marker of atherosclerotic vascular damage, is associated with albuminuria in patients with Type 2 diabetes.

METHODS

BaPWV was measured by automatic oscillometric method in 346 Type 2 diabetic patients with normoalbuminuria (a mean level of three times measurements of albumin-to-creatinine (ACR)<30 microg/mg creatinine; n=200), incipient nephropathy (a mean level of ACR> or =30 and <300 microg/mg creatinine; n=119), and clinical nephropathy (a mean level of ACR> or =300 microg/mg creatinine; n=27), and without peripheral vascular disease.

RESULTS

BaPWV (cm/s) was significantly higher in patients with incipient nephropathy (1722 +/- 382) and clinical nephropathy (1763 +/- 322) than in patients with normoalbuminuria (1559 +/- 343, P<0.0001, respectively). By univariate analysis it correlated significantly with age (r=0.44, P<0.0001), systolic blood pressure (r=0.55, P<0.0001), diastolic blood pressure (r=0.42, P<0.0001), albuminuria (r=0.24, P<0.0001) and HbA1C (r=0.11, P<0.05). Albuminuria revealed an independent significant association with baPWV (P<0.01) after adjustment for age, sex, smoking, BMI, HbA1C, hyperlipidemia, and hypertension. Multiple regression analysis showed age, diastolic blood pressure and albuminuria were independently associated with baPWV (adjusted R2=0.42, P<0.0001).

CONCLUSIONS

The results might indicate a possible link between the pathogenesis of atherosclerosis and diabetic nephropathy. Future studies are needed to clarify the usefulness and its predictable value.

Musculoskeletal disorders among hospital nurses in rural Japan

INTRODUCTION

Although musculoskeletal disorders (MSD) represent a significant occupational problem for hospital nurses, few investigations target nurses in rural facilities. This study investigated the prevalence and correlates of MSD among nurses within an affiliated hospital conglomerate of rural Japan.

METHODS

A self-reporting survey was used as diagnostic tool; the reliability, validity and cost-effectiveness of this method has been established.

RESULTS

An initial group of 329 nurses was recruited from three affiliated, rural locations in Yamanashi prefecture, central Japan; 247 usable replies were obtained (final response rate: 75.1%). The 12-month period-prevalence of self-reported MSD at any body site was 91.9% (95% CI 87.8-94.7). Low back pain (LBP) was the most commonly reported MSD with a prevalence of 82.6% (95% CI 77.4-86.8). Next most reported were shoulder (61.1%, 95% CI 54.9-67.0), neck (36.8%, 95% CI 31.1-43.0), upper back (29.1%, 95% CI 23.8-35.1), knee (23.5%, 95% CI 18.6-29.1) and upper leg MSD (19.4%, 95% CI 15.0-24.8). MSD of the wrist (14.2%, 95% CI 10.4-19.1), upper arm (13.0%, 95% CI 9.3 -17.7) and lower arm (11.7% 95% CI 8.3-16.4) were less common. Logistic regression indicated that nurses who were regularly involved in the manual handling of patients had an increased LBP risk of 16.7 (OR 16.7, 95% CI 1.3-412.7, p = 0.0340) when compared with nurses who were not involved in manual handling of patients.

CONCLUSION

Overall, our study indicated that MSD is common among rural Japanese nurses and its prevalence is consistent between related facilities. The excessive amount of LBP, however, suggests that Japanese nurses are at higher risk of this condition compared with their foreign counterparts.

Improvement of generalization ability for identifying dynamical systems by using universal learning networks

This paper studies how the generalization ability of models of dynamical systems can be improved by taking advantage of the second order derivatives of the outputs with respect to the external inputs. The proposed method can be regarded as a direct implementation of the well-known regularization technique using the higher order derivatives of the Universal Learning Networks (ULNs). ULNs consist of a number of interconnected nodes where the nodes may have any continuously differentiable nonlinear functions in them and each pair of nodes can be connected by multiple branches with arbitrary time delays. A generalized learning algorithm has been derived for the ULNs, in which both the first order derivatives (gradients) and the higher order derivatives are incorporated. First, the method for computing the second order derivatives of ULNs is discussed. Then, a new method for implementing the regularization term is presented. Finally, simulation studies on identification of a nonlinear dynamical system with noises are carried out to demonstrate the effectiveness of the proposed method. Simulation results show that the proposed method can improve the generalization ability of neural networks significantly, especially in terms that (1) the robust network can be obtained even when the branches of trained ULNs are destructed, and (2) the obtained performance does not depend on the initial parameter values.

Increased synchronization of cortical oscillatory activities between human supplementary motor and primary sensorimotor areas during voluntary movements

In human, both primary and nonprimary motor areas are involved in the control of voluntary movements. However, the dynamics of functional coupling among different motor areas has not been fully clarified yet. Because it has been proposed that the functional coupling among cortical areas might be achieved by the synchronization of oscillatory activity, we investigated the electrocorticographic coherence between the supplementary motor and primary sensorimotor areas (SMA and S1-M1) by means of event-related partial coherence analysis in 11 intractable epilepsy patients. We found premovement increase of coherence between the SMA proper and S1-M1 at the frequency of 0-33 Hz and between the pre-SMA and S1-M1 at 0-18 Hz. Coherence between the SMA proper and M1 started to increase 0.9 sec before the movement onset and peaked 0.3 sec after the movement. There was no systematic difference within the SMA (SMA proper vs pre-SMA) or within the S1-M1, in terms of the time course as well as the peak value of coherence. The phase spectra revealed near-zero phase difference in 57% (20 of 35) of region pairs analyzed, and the remaining pairs showed inconsistent results. This increase of synchronization between multiple motor areas in the preparation and execution of voluntary movements may reflect the multiregional functional interactions in human motor behavior.

Magnetic resonance imaging and clinical findings examined in adulthood-studies on three adults with Rett syndrome

PURPOSE

To clarify magnetic resonance imaging (MRI) findings in three adult patients with Rett syndrome who had been diagnosed with mental retardation and autism.

METHOD

Clinical and MRI findings in three adult cases with Rett syndrome were studied. Ages (in years) in three adult cases with Rett Syndrome were 46 in Case 1, 35 in Case 2 and 20 in Case 3. They were able to walk and their convulsions were well controlled.

RESULTS

MRI findings in all patients showed mild cerebral atrophy, especially in the frontal and temporal lobes and two of the cases also had mild cerebellar atrophy. One case also showed a narrowing of the brainstem and thinning of the corpus callosum.

CONCLUSIONS

These results indicate that abnormalities in MRI imaging, in cases where there is narrowing of the brainstem and thinning of the corpus callosum, may be due to congenital hypoplasia. It was also seen that cerebellar atrophy became more distinct in older cases.

Effects of cryopreservation of pronuclear-stage rabbit zygotes on the morphological survival, blastocyst formation, and full-term development after DNA microinjection

The objectives of this study were to examine the freezing sensitivity of pronuclear-stage rabbit zygotes and to produce transgenic rabbits using the cryopreserved zygotes. Zygotes were cryopreserved either by one of two vitrification protocols or by one of the two conventional freezing protocols. The morphological survival rates of zygotes subjected to two-step freezing in 1.5 M ethylene glycol and 0.1 M sucrose (74%) or to vitrification in 7.2 M ethylene glycol and 1.0 M sucrose (81%) were higher than those subjected to freezing in 1.5 M DMSO (46%) or to vitrification in a mixture of 2.0 M DMSO, 1.0 M acetamide, and 3.0 M propylene glycol (41%). But the in vitro development into blastocysts of zygotes cryopreserved by vitrification (17%) or to a lesser extent by freezing (52%) was impaired, when compared to that of fresh control zygotes (89%). Next, a fusion gene composed from bovine aS1-casein promoter and a human GH structural gene (2.8 kb) was microinjected into the pronucleus of rabbit zygotes frozen-thawed in ethylene glycol and sucrose. Then, the presence of exogenous DNA in the genome of newborn offspring was determined by PCR. The post-injection survival of frozen zygotes (97%) was the same as that of fresh control zygotes (96%). However, of 18 offspring derived from 414 frozen-thawed and DNA-injected zygotes, no transgenic rabbits were produced. Of 52 offspring derived from 403 DNA-injected fresh zygotes, 3 transgenic rabbits were found. Here we report the first rabbit offspring resulting from zygotes cryopreserved at the pronuclear-stage, although the cryopreservation procedure employed must be improved if zygotes are to be used for systematic production of transgenic rabbits.

Microbial desulfurization of alkylated dibenzothiophene and alkylated benzothiophene by recombinant Rhodococcus sp. strain T09

The dibenzothiophene (DBT) desulfurizing operon, dsz, was introduced into various benzothiophene (BT)-desulfurizing bacteria using a Rhodococcus-E. coli shuttle vector. Of the tested recombinant bacteria, only those from Rhodococcus sp. strain T09 grew with both DBT and BT as the sole sulfur source. These recombinant cells desulfurized not only alkylated BTs, but also various alkylated DBTs, producing alkylated hydroxybiphenyls as the desulfurized products. Recombinant strain T09 also desulfurized alkylated DBT in an oil-water, two-phase resting-cell reaction. The dsz operon had the same desulfurizing activity when inserted into the vector in either orientation, indicating that the promoter region of the operon was functional in strain T09.

Comparison of source localization of interictal epileptic spike potentials in patients estimated by the dipole tracing method with the focus directly recorded by the depth electrodes

The purpose of the study was to investigate the accuracy of location of equivalent current dipoles estimated by the dipole tracing method (DT) utilizing a realistic 3-shell (scalp-skull-brain) head model (SSB-DT). Three patients with intractable complex partial seizures, diagnosed as having typical temporal seizures were investigated. We recorded the interictal spike potentials with surface electrodes (International 10/20 system) and with intracerebral depth electrodes simultaneously. We compared the location of dipoles of the spikes estimated by the SSB-DT with the focus of the spikes determined by the recording from the depth electrodes. We found that the location of the dipoles estimated by SSB-DT corresponded to the location of the depth electrodes, which could record the epileptic spikes. This finding proved that SSB-DT is reliable and valid for estimating neural activity in deep locations such as the limbic system.

A comparative study on the integration of exogenous DNA into mouse, rat, rabbit, and pig genomes

Transgenic mammals, from small laboratory rodents to domestic animals, have been successfully produced to date, but their production efficiency within or across species has been variable. This is probably due to the differences in the type of injected DNA and/or technical procedures employed in each laboratory, as well as the reproductive characteristics of the species. Here we report the direct comparison of the efficiencies of producing transgenic mice, rats, rabbits and pigs by one technician using a fusion gene composed of the bovine alpha S1-casein promoter and human growth hormone (hGH) gene. Before the fusion gene was injected into the zygotes, high magnitude centrifugation to visualize the pronuclei was necessary for all of the pig zygotes and one-third of the rabbit zygotes, but not for mouse and rat zygotes. Post-injection survival of the mouse zygotes (67.1%) was lower than those of the rat, rabbit and pig zygotes (89.6 to 100%). The volume change of the pronucleus following DNA injection was the lowest in mice (50% increase), moderate in rabbits (148% increase), and the most prominent in rats (238% increase). The data from only 1 pig zygote indicated a 22% increase in the pronucleus volume by DNA injection. The PCR analyses of the tail DNA of new born offspring indicated that 0.8% (4/493), 4.8% (22/463), 0.8% (3/367) and 0.9% (2/221) of the injected eggs in mice, rats, rabbits and pigs, respectively, developed into transgenic offspring. Some of the founder animals in all four species expressed the transgene in the mammary gland which was confirmed in hGH mRNA by RT-PCR and/or hGH peptide in Witch's milk with ELISA. These results suggest that the maximum volume of DNA solution injectable into the pronucleus is a possible factor explaining the species differences in the production of transgenic animals.

Improvement of desulfurization activity in Rhodococcus erythropolis KA2-5-1 by genetic engineering

Rhodococcus erythropolis KA2-5-1 can desulfurize dibenzothiophene (DBT) into 2-hydroxybiphenyl. A cryptic plasmid, pRC4, which was derived from R. rhodochrous IFO3338, was combined with an Escherichia coli vector to construct an E. coli-Rhodococcus shuttle vector. The complete nucleotide sequence of 2582-bp pRC4 was analyzed. Based on the characteristics of its putative replication genes, pRC4 was assigned to the family of pAL5000-related replicons. The desulfurization gene cluster, dszABC, and the related reductase gene, dszD, cloned from KA2-5-1, were reintroduced into KA2-5-1 and efficiently expressed. The DBT desulfurization ability of the transformant carrying two dszABC clusters and one dszD on the vector was about 4-fold higher than that of the parent strain, and the transformant also showed improved desulfurization activity for light gas oil (LGO). Sulfur components in LGO before and after the reaction were analyzed with gas chromatography-atomic emission detection.

Kinetic analysis of microbial desulfurization of model and light gas oils containing multiple alkyl dibenzothiophenes

The reaction mechanism of biodesulfurization was investigated using whole cells of Rhodococcus erythropolis KA2-5-1, which have the ability to convert dibenzothiophene (DBT) into 2-hydroxybiphenyl. The desulfurization patterns of alkyl DBTs were represented by the Michaeis-Menten equation. The values of rate constants, the limiting maximal velocity (Vmax) and Michaelis constant (Km), for desulfurization of alkyl DBTs were calculated. The relative desulfurization activities of various alkyl DBTs were reduced in proportion to the total carbon numbers of alkyl substituent groups. Alkyl DBTs that had a total of six carbons of alkyl substituent groups were not desulfurized. The type or position of alkyl substituent groups had little effect on desulfurization activity. The desulfurization activity of each alkyl DBT, when mixed together, was reduced. This phenomenon was caused by apparent competitive inhibition of substrates. Using the apparent competitive inhibition model, the desulfurization pattern of a multiple components system containing alkyl DBTs was elucidated. This model was also applicable for biodesulfurization of light gas oil.

Photo-responsive retention behavior of azobenzene-modified cyclodextrin stationary phase in micro-HPLC

An azobenzene-modified gamma-cyclodextrin stationary phase (Az gamma-CDSP) was prepared and its photo- and temperature-responses for the retention of perylene and pentacene were investigated using a mixture of methanol and water as the mobile phase in micro-HPLC. The retention of perylene slightly increased, whereas that of pentacene significantly decreased by UV light irradiation to Az gamma-CDSP. These retentions recovered upon irradiation with visible light. Both retentions decreased upon an increase in the column temperature. It was presumed that the trans-azobenzene moiety acts as a preventive cap for perylene and a spacing for pentacene in filling the CD cavity. An azobenzene-modified stationary phase changed its retention behavior with the column temperature and the light irradiation. An improvement in the micro-HPLC system and the optimization of the molecular structure of the photo-responsive stationary phase would provide selective retention control by the irradiation of light in micro-separation systems.

Effects of higenamine on regulation of ion transport in guinea pig distal colon

Effects of higenamine on Na+, K+ and Cl- transport were studied on stripped guinea pig distal colonic mucosa in vitro using Ussing chambers. Addition of 10(-5) M higenamine induced a biphasic change in short circuit current (Isc): a transient increase followed by a long-lasting decrease that was accompanied by an increase in transepithelial conductance (Gt). The initial phase with an increase in Isc was partially inhibited by serosal bumetanide and abolished by mucosal diphenylamine-2-carboxylate, a chloride channel blocker, indicating transient induction of Cl- secretion. The second phase with a decrease in Isc was composed of two effects: the inhibition of the amiloride-sensitive electrogenic Na+ absorption and the stimulation of the bumetanide-sensitive K+ secretion. However, the initial transient increase was not observed at the lower concentration of higenamine (10(-8)-10(-6) M). All the changes in Isc and Gt induced by higenamine were suppressed by the non-selective beta-adrenergic receptor antagonist propranolol and by the beta2-adrenergic receptor antagonist ICI-118,551, but not by the beta1-adrenergic-receptor-selective antagonist atenolol or by the alpha-antagonists phentolamine, prazosin and yohimbine. These results suggest that higenamine inhibits electrogenic Na+ absorption and stimulates electrogenic K+ and Cl- secretion through beta2-adrenergic receptors in guinea pig distal colon.

Prognostic value of impaired myocardial fatty acid uptake in patients with acute myocardial infarction

Impaired cardiac fatty acid uptake, assessed by the radiolabelled fatty acid analogue beta-methyl-p-iodophenyl pentadecanoic acid (I-123-BMIPP), is observed in the myocardium following acute ischaemic events, but the long-term prognostic implication has not been established. This study aimed to determine the prognostic value of cardiac BMIPP uptake in patients with acute myocardial infarction. Following the assessment of thallium-201 and I-123-BMIPP uptake, 101 post-infarct patients were prospectively followed up with primary end points of cardiac death, heart failure and non-fatal infarction. During a mean follow-up of 28 months, three cardiac deaths, three non-fatal infarctions, 23 revascularizations and four recurrences of angina pectoris were observed. Multivariate analysis identified reduced uptake of BMIPP and perfusion, no beta-blocking treatment and greater thallium-BMIPP mismatch (i.e. larger BMIPP defect than thallium defect) as significant predictors for overall cardiac events. Prior myocardial infarction, reduced left ventricular ejection fraction and greater thallium-BMIPP mismatch were selected as independent predictors of harder cardiac events. Female patients, those with greater BMIPP defect or greater thallium-BMIPP mismatch showed worse clinical outcomes. The inclusion of BMIPP data improved the prognostic values of conventional significant predictors. In conclusion, impaired myocardial I-123-BMIPP uptake and perfusion-BMIPP mismatch are related to a high probability of fatal and non-fatal cardiac events, suggesting the aetiological relevance and prognostic value of impaired cardiac fatty acid metabolism in viable, but jeopardized, myocardium following acute myocardial infarction.

Change in circulating blood volume following craniotomy

OBJECT

The importance of monitoring circulating blood volume (CBV) during perioperative management is widely recognized in critically ill patients. The purpose of this study was to investigate the change in CBV following craniotomy by using indocyanine-green pulse spectrophotometry.

METHODS

Circulating blood volume and plasma hormones related to stress and fluid regulation were measured five times: preoperatively, immediately postoperatively, and 1, 2, and 7 days after craniotomy was performed in 17 patients with a brain tumor or an unruptured aneurysm. The mean value of CBV preoperatively was 82 ml/kg, which decreased to 64 ml/kg (78%) immediately postoperatively and gradually recovered to 82 ml/kg on Day 7 postsurgery (p = 0.0069). The mean values of adrenaline, noradrenaline, arginine vasopressin, renin, and aldosterone were highest immediately postoperatively. The mean intraoperative balances of water and sodium were 1,090 ml and 113 mEq, respectively. Partial correlation coefficients of CBV to noradrenaline and serum sodium during the entire study were -0.430 (p = 0.0036) and 0.418 (p = 0.0048), respectively.

CONCLUSIONS

Attention should be paid to decreased CBV following craniotomy, which is caused by the shift of fluid to interstitial spaces due to surgical stress. Hypovolemia can be suspected from a postoperative decrease in serum sodium.

Production of transgenic rabbits using centrifuged pronuclear zygotes

Superovulation of female rabbits was induced by subcutaneous injection(s) of porcine FSH. Zygotes were recovered 17 to 19 hr after hCG injection and were classified into two categories under a microscope equipped with Nomarski interference-contrast optics at x 200 magnification: (A) zygotes with clearly visible pronuclei, or (B) zygotes with visualized pronuclei after 10 min centrifugation at 12,000 x g. No significant difference between strains was found in the proportion of category-A zygotes (JW 72.6% vs NZW 79.3%). Pronuclei of category-A zygotes were located in the center of the cytoplasm, and the pronuclei of category-B zygotes were slightly moved by centrifugation toward the mass of cytoplasmic lipid droplets. Exogenous DNA solution (5 microg/ml of fusion gene composed of bovine alphaS1-casein promoter and human growth hormone structural gene) was microinjected into the pronucleus of the JW zygotes. The pronucleus of category-A zygotes with a mean volume of 7.4 pl swelled up to 16.6 pl (132% increase), while that of category-B zygotes with a mean volume of 6.1 pl swelled up to 15.9 pl (148% increase). Nevertheless, similar proportions of category-A and category-B zygotes developed into offspring after transfer to recipient females (11.1 and 11.2%, respectively). The efficiency to produce hGH-carrying transgenic rabbits was 0.9% (2/235) from category-A zygotes and 0.5% (1/215) from category-B zygotes (P>0.05). To date, transgenic rabbits have been produced without centrifugation of pronuclear zygotes. However approximately 25% of fertilized rabbit zygotes can be used for DNA microinjection after they have been centrifuged to visualize their pronuclei.

Adenine-induced selective apoptosis toward HIV chronically infected cells in vitro

A novel strategy for anti-HIV therapy is the clearance of the residual infected cells from the body. Here, we show that 6-aminopurine, adenine, induced selective apoptosis toward HIV-1 producing chronically infected MOLT4 cells (MOLT4/HIV) without augmentation of virus production, whereas the growth of uninfected MOLT4 was stimulated. This selective apoptosis did not occur with other adenine nucleotides or with other bases. The purine ring and the amino residue of adenine were responsible for the apoptosis induction and selectivity, respectively. In addition, adenine slightly but consistently reduced viable cell numbers and the production of virus in a fraction of HIV-1 chronically infected human peripheral blood mononuclear cells (PBMCs/HIV) at day 7. On the other hand, blastogenic response of normal PBMCs to PHA, PWM and Candida albicans were potentiated in the presence of adenine. These results indicated that the effect of adenine may be attributable to activation-induced selective apoptosis toward virus-infected cells.

[Left Sylvian fissure meningioma in a one-year-eight-month old child]

We report a case of a Sylvian fissure meningioma in a one-year-eight-month old child who experienced the onset of a convulsive seizure. He had no neurological deficit and no developmental disorders. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large left temporal tumor which was well enhanced and without dural attachment. Angiography revealed a slight tumor stain in the left Sylvian fissure supplied by branches of the internal carotid artery. Total removal of the tumor was performed, and we found that the tumor had no dural attachment, but was strongly attached to the M2 segment of the left middle cerebral artery. Pathological examinations revealed it to be a fibrous meningioma without malignancy. This is the youngest case among the reported five pediatric deep Sylvian meningiomas. Introducing this case, we discuss the clinical features of pediatric meningiomas.

Ovarian mucinous cystadenocarcinoma as a cause of Zollinger-Ellison syndrome: report of a case and review of the literature

Gastrin producing ovarian tumor is a rare cause of the Zollinger-Ellison syndrome. We report the case of an ovarian carcinoma showing increased plasma gastrin concentration. A 60-yr-old woman presented with epigastric pain and diarrhea. Physical examination showed a large mass in the lower abdomen. Computed tomography revealed a large multilocular ovarian cyst. Upper gastrointestinal endoscopy examination showed multiple ulcerations of the stomach and duodenum. The plasma gastrin level was 1500 pg/ml. No tumors were found in the pancreas and duodenum, and salpingo-oophorectomy was performed. Histologic examination revealed a mucinous tumor of borderline malignant potential. Immunoperoxidase studies for gastrin showed many gastrin-producing cells within the epithelium of the tumor. There have been 11 cases (including our patient) of gastrin-producing ovarian tumor reported in the literature. We review here the relevant literature. Although ovarian gastrinoma is extremely rare, it should be considered as a possible cause of the Zollinger-Ellison syndrome in women.

Operon structure and functional analysis of the genes encoding thermophilic desulfurizing enzymes of Paenibacillus sp. A11-2

Paenibacillus A11-2 can efficiently cleave two carbon&bond;sulfur bonds in dibenzothiophene (DBT) and alkyl DBTs, which are refractory by conventional petroleum hydrodesulfurization, to remove sulfur atom at high temperatures. An 8.7-kb DNA fragment containing the genes for the DBT desulfurizing enzymes of A11-2 was cloned in Escherichia coli and characterized. Heterologous expression analysis of the deletion mutants identified three open reading frames that were required for the desulfurization of DBT to 2-hydroxybiphenyl (2-HBP). The three genes were designated tdsA, tdsB, and tdsC (for thermophilic desulfurization). Both the nucleotide sequences and the deduced amino acid sequences show significant homology to dszABC genes of Rhodococcus sp. IGTS8, but there are several local differences between them. Subclone analysis revealed that the product of tdsC oxidizes DBT to DBT-5,5'-dioxide via DBT-5-oxide, the product of tdsA converts DBT-5,5'-dioxide to 2-(2-hydroxyphenyl) benzene sulfinate, and the product of tdsB converts 2-(2-hydroxyphenyl)benzene sulfinate to 2-HBP. Cell-free extracts of a recombinant E. coli harboring all the three desulfurization genes converted DBT to 2-HBP at both 37 and 50 degrees C. In vivo and in vitro exhibition of desulfurization activity of the recombinant genes derived from a Paenibacillus indicates that an E. coli oxidoreductase can be functionally coupled with the monooxygenases of a gram-positive thermophile.

Universal learning network and its application to chaos control

Universal Learning Networks (ULNs) are proposed and their application to chaos control is discussed. ULNs provide a generalized framework to model and control complex systems. They consist of a number of inter-connected nodes where the nodes may have any continuously differentiable nonlinear functions in them and each pair of nodes can be connected by multiple branches with arbitrary time delays. Therefore, physical systems, which can be described by differential or difference equations and also their controllers, can be modeled in a unified way, and so ULNs may form a super set of neural networks and fuzzy neural networks. In order to optimize the ULNs, a generalized learning algorithm is derived, in which both the first order derivatives (gradients) and the higher order derivatives are incorporated. The derivatives are calculated by using forward or backward propagation schemes. These algorithms for calculating the derivatives are extended versions of Back Propagation Through Time (BPTT) and Real Time Recurrent Learning (RTRL) of Williams in the sense that generalized node functions, generalized network connections with multi-branch of arbitrary time delays, generalized criterion functions and higher order derivatives can be deal with. As an application of ULNs, a chaos control method using maximum Lyapunov exponent of ULNs is proposed. Maximum Lyapunov exponent of ULNs can be formulated by using higher order derivatives of ULNs, and the parameters of ULNs can be adjusted so that the maximum Lyapunov exponent approaches the target value. From the simulation results, it has been shown that a fully connected ULN with three nodes is able to display chaotic behaviors.

[Peripartum cardiomyopathy]

Heart failure in the last month of pregnancy or with in 5 months after delivery has long been recognized as peripartum cardiomyopathy. Additional criteria include the absence of other identifiable causes of heart failure and the absence of other prior heart disease. Estimate of the incidence vary from 1 in 1300 to 4000 pregnancies. The mortality rates of this disorder in the acute phases and subacute phases range from 25 to 50 percent the prognosis is especially poor in patients with cardiomegaly persisting > 6 months and in patients with low left ventricular ejection fraction.