[The improvement on the nursing procedure for pregnant women and newborns and the decrease of Staphylococcus aureus infections in newborns and infants in our hospital]

Knowing the importance of prevention of Staphylococcus aureus infections, especially that of Methicillin-resistant S. aureus (herein after abbreviated as MRSA) in the newborn room, we improved the nursing procedure in the room and examined subsequent changes in the onset condition of the above infection in newborns and infants less than 1-year-old. The infection was detected in 13 cases of stage 1 (stage according to the nursing procedure since the opening of our hospital): 6 cases (all MRSA) had their onset in the room. MRSA was detected in 11 cases, suspecting a hospital cross infection in relation to the period of birth and coagulase type. The infection was detected in 9 cases of stage 2 (stage of prevention of inter-newborn hospital cross infection through environmental purification within the newborn room, through hand and finger disinfection of medical workers, through improved bathing, etc.); 2 cases (1 of MRSA, 1 of Methicillin-sensitive S. aureus [hereinafter abbreviated as MSSA]) had an onset in the room. MRSA was detected in 5 cases, but hospital cross infection was thought difficult to be responsible. The MRSA infection was detected in 4 pregnant cases (0.8%) of stage 3 (stage of effortful prevention of MRSA from carrying into the ward following examination of possible intra-nasal MRSA establishment in pregnant women in addition to similar newborn nursing to stage 2), indicating pregnant women's possible carrying MRSA into the newborn room. S. aureus infection was detected in 9 cases; 2 cases (MSSA) had an onset in the above room.(ABSTRACT TRUNCATED AT 250 WORDS)

Cloning of a cDNA encoding tobacco omega-3 fatty acid desaturase

A cDNA was isolated from a tobacco (Nicotiana tabacum cv. SR1) leaf cDNA library using, as a hybridization probe, a cDNA fragment from the gene (fad7) encoding Arabidopsis thaliana chloroplast omega-3 fatty acid (FA) desaturase. The deduced 379-amino-acid (aa) sequence has 67-71% identity to those deduced from the previously described genes encoding the omega-3 FA desaturases of A. thaliana. The absence of an N-terminal extension transit peptide in the deduced aa sequence of the cDNA clone and the accumulation pattern of the mRNA corresponding to this cDNA in leaf and root tissues indicate that the isolated cDNA encodes a tobacco microsomal omega-3 FA desaturase.

Selective decrease of eumelanin in hypopigmented epidermis of hypomelanosis of Ito

A Japanese infant had bilateral hypopigmented macules in a whorled or marble-cakelike configuration on her trunk and extremities. Her irides were bluish gray and her hair was dark brown. She had photophobia and macrocephaly with developmental delay. Analysis of peripheral lymphocytes and dermal fibroblasts disclosed a normal chromosomal pattern. A new finding was that the eumelanin content of the hypopigmented epidermis was decreased. We suggest that at least a portion of patients with this disorder have a defect in eumelanogenesis in hypopigmented skin.

Treatment of linear localized scleroderma with the anti-allergic drug, tranilast

A 14-year-old boy with linear localized scleroderma had a dramatic improvement in contractures after treatment with N-(3',4'-dimethoxycinnamoyl) anthranilic acid (tranilast, Rizaben). The observation that this anti-allergic drug was effective in localized scleroderma lends further support to the concept that mast cells play a role in increased collagen synthesis in this disease.

Growth and/or acid production of Candida albicans on soft lining materials in vitro

Effects of soft lining materials on the growth and/or acid production of Candida albicans were investigated using a simplified method monitoring the pH change in the growth medium. Reverse sigmoidal pH curves were observed with all samples and, as compared with acrylic, all soft lining materials inhibited fungal growth or acid production in the following way, i.e. delay of the beginning of a rapid and linear decline in pH, decreases in the rate of linear change in pH and increases in minimum pH. Further examinations using a surface-modified glass tube revealed that the order of Candida growth agreed with the relative hydrophobicity and adherence capacity of substrates, suggesting that this adherence capacity affected the yeast growth on their surfaces. Besides adherence capacities of substrates, the powder, liquid and plasticizer of some soft lining materials directly inhibited Candida growth. Thus, the results obtained here revealed that several factors within soft lining materials affected Candida growth and/or acid production.

Genetic heterogeneity of dominantly inherited olivopontocerebellar atrophy (OPCA) in the Japanese: linkage study of two pedigrees and evidence for the disease locus on chromosome 12q (SCA2)

We did a linkage study of 2 multigenerational pedigrees with dominant olivopontocerebellar atrophy (OPCA) other than SCA1, with chromosome 12q microsatellites. Multipoint linkage analysis led to the conclusion that the disease locus locates within the 6.2 cM interval between IGF1 and D12S84/D12S105. This result coincides with that of Cuban ataxia pedigrees designated as SCA2. Our study provides genetic evidence that dominant OPCA in the Japanese consists of at least two genetically different disorders; SCA1 and SCA2.

[Changes in luminal diameter of internal thoracic arteries five years after coronary artery bypass grafting]

Five years after coronary artery bypass grafting, 23 internal thoracic arteries (ITAs) were reexamined angiographically, and their luminal diameters were compared with those of one month after the operation. Proximal diameter, just below the subclavian artery, and distal diameter, just above the anstomosis, were measured. One month after surgery, these were 2.38 +/- 0.48 mm and 1.69 +/- 0.39 mm, respectively. After five years, the proximal diameter had not changed significantly (2.48 +/- 0.47 mm), but the distal diameter had increased to 1.96 +/- 0.58 mm (p < 0.05). Especially when there was no competitive flow with the ITA, the distal diameter showed a marked increase from 1.80 +/- 0.35 mm to 2.27 +/- 0.42 mm (p < 0.01). Twelve ITAs were grafted to coronary arteries having less than critical stenosis, and five of them showed distal narrowing or so-called string sign after five years. This seemed to be a form or physiological atrophy resulting from competitive flow, and the patients had no anginal pain in spite of their poor ITA runoff. When coronary artery stenosis is less than 75%, a choice is difficult between an ITA or a saphenous vein graft. We think that the graft must be selected considering the possibility of stenosis progression, if the jeopardized area is important for the patient. An ITA graft would be advisable in such cases.

Immunohistochemical localization of lysyl oxidase in normal human skin

Lysyl oxidase (EC 1.4.3.13), a copper-dependent enzyme which catalyses the formation of aldehyde cross-links, and acts primarily on collagen and elastin, is known to be increased during wound healing and in fibrotic disorders including liver cirrhosis and atherosclerosis, and to be decreased in some hereditary connective tissue diseases and in malignant cell lines. A recent study showed that lysyl oxidase might possess tumour suppressor activity as an antioncogene for ras. Little is known about the localization of this enzyme in human skin. In this study, we determined immunohistochemically the localization of lysyl oxidase in normal skin of young and elderly subjects obtained from sun-exposed and unexposed regions of the body. All skin samples tested had similar distributions of lysyl oxidase. The enzyme was present both extracellularly and intracellularly. Extracellularly, a few granular aggregates of immunoreactants were observed along collagen and elastic fibres. These granules were more common in the adventitial portion of the dermis than in the reticular portion. Of all sun-exposed and unexposed regions studied, the skin of the face displayed the greatest amount of extracellular immunoreactants. Immunopositive granules were observed intracellularly in fibroblasts, vascular endothelial cells, sweat glands, sebaceous glands, arrector pili muscles and some keratinocytes. These findings provide evidence that, as suggested in recent reports, lysyl oxidase may have a variety of intracellular functions.

[Clinical effects and safety of granisetron administration against CDDP chemotherapy in lung cancer. Lung Cancer Study Group]

Granisetron (3 mg/body) was administered immediately before single CDDP administration (80 mg/m2 or more) to 53 patients with lung cancer. This chemotherapy was performed a total of 73 times. Concerning Grade 2 or 3 nausea and vomiting, good conditions were observed on day 1 (day of treatment), most marked aggravation on day 2, and initiation of improvement on day 4. Vomiting was slight on day 1, most aggravated on day 2, but began to improve on day 3; good results were generally observed thereafter. Decreased appetite was slight on day 1, but was most aggravated on day 3 and 4; its recovery was delayed even until day 7. In the treatment for delayed emesis, comparison was made among the group treated with granisetron alone who did not require treatment for delayed emesis, the group with delayed emesis treated with granisetron, and the group with delayed emesis treated with drugs other than granisetron. Slightly better results were observed in terms of nausea, vomiting, and the frequency of vomiting in the group treated with granisetron alone on days 2 and 3. However, no significant difference was observed in decreased appetite among the 3 groups. Granisetron had no side effects and was safe. It inhibited vomiting, but measures to improve decreased appetite are needed.

Multifocal eosinophilic granuloma presenting as progressive brainstem and cerebellar dysfunction

A 55 year old woman with multifocal eosinophilic granuloma (MEG) is described. She developed facial numbness and twitching followed by slowly progressive cerebellar symptoms. Two years later polyuria and polydipsia were noted. A CT of the brain showed multifocal enhancing lesions, and MRI showed areas of hyperintensity on T2 weighted studies in the cerebellar peduncles, pons, and midbrain. Radiographs of the skull, pelvis, and long bones were normal, but a 99mTc diphosphonate bone scan and MRI showed bone lesions compatible with granuloma. The diagnosis of MEG was made by bone biopsy. This is believed to be the first case of MEG with such unusual clinical profiles and radiographical findings. Skeletal surveys are indicated for patients with unexplained focal or multifocal inflammatory changes in the cerebellum.

N-methyl-D-aspartate induces phase shifts in circadian rhythm of neuronal activity of rat SCN in vitro

The suprachiasmatic nucleus (SCN) acts as a pacemaker for mammalian circadian rhythms. Receptors for excitatory amino acids like N-methyl-D-aspartate (NMDA) and non-NMDA receptors have both been found to play an important role in the transmission of photic information from the retina to the SCN. Therefore, we investigated whether the application of glutamate receptor agonists could reset the phase of the circadian rhythm of SCN firing activity in vitro. Treatment with NMDA (0.1-10 microM) for 15 min or 1 h during the early part of the subjective night produced phase delay, whereas treatment during the late subjective night caused an advance in phase. The phase-response curve for NMDA was similar to that previously obtained in response to light pulses in vivo. Application of DL-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid hydrobromide (AMPA) (1 or 10 microM), a non-NMDA-receptor agonist, also produced a dose-dependent phase delay of SCN activity. The NMDA-induced phase delay was antagonized by an NMDA-receptor antagonist MK-801. These findings suggest that both NMDA and non-NMDA receptors may be involved in the transmission of information to the SCN via the retinohypothalamic tract. In addition, both the advances and delays in phase caused by NMDA were potentiated by cotreatment with neuropeptide Y, whereas AMPA-induced phase delay was not potentiated by neuropeptide Y. This points to a functional link between NMDA and neuropeptide Y receptor-mediated mechanisms in the SCN.

Immunohistochemical approach for the investigation of nerve distribution in the shoulder joint capsule

Twenty six shoulder joint capsules obtained from 13 autopsy cases were studied to evaluate the nerve distribution using immunohistochemical techniques. Immunohistochemical staining of polyclonal S-100 protein or protein gene product 9.5 was more sensitive, specific, and reproducible compared with conventional gold chloride methods. A small number of clustered nerve fibers were found in the superficial layer, and many nerve fibers with large diameters were found in anteroinferior portions of the deep layer. Nerve fibers of various sizes were more numerous in posterosuperior and anterosuperior portions of the boundary zone between labrum and capsule. A Pacinian corpuscle was clearly recognized in a capsule. In the central portion of the long head of some biceps brachii tendons, relatively large nerve fibers continued from capsules. The results suggest that the capsule and long head of the biceps brachii tendon may play a partial role in the stability of the shoulder joint through afferent feedback.

Brachial plexus block using a nerve stimulator and a conventional needle

A technique for blocking the brachial plexus using a electrostimulator and conventional, non-special plastic cannula with an obtulator consist of conductive metal is described. This cannula is cheaper and more conventional than special plastic-coated needle. Brachial plexus block is useful anesthesia for surgical treatment of fractures, dislocations, skin and muscle injuries of the forearm and hand. However, the blockade does not seem to be completely reliable because of the anatomical variations among individuals and the consequent difficulty in locating of the brachial plexus. Therefore the method using an electrostimulator and a special plastic-coated needle for the brachial plexus block was reported in 1962 by Greenblatt. Employing a conventional plastic cannula for intravenous use instead of a special plastic-coated needle reported by Greenblatt. We could attain nerve block completely reliably, safely and easily.

Temporal frequency deficit in patients with senile dementia of the Alzheimer type: a visual evoked potential study

To study the temporal aspect of visual processing of senile dementia of the Alzheimer type (SDAT), we recorded the steady-state visual evoked potentials (VEPs) to LED goggle stimulation at five different temporal frequencies in 14 patients with SDAT and 14 control subjects. For comparison, we also studied 14 patients with vascular dementia (VD). All subjects were women, and their ages were closely matched. Temporal frequencies were 5, 10, 15, 20, and 30 Hz. The steady-state VEPs were Fourier analyzed, and both the amplitude and phase of the first and second harmonic responses were obtained. There was a significant difference in the amplitude across the three groups for stimulation at 15, 20, and 30 Hz, but no difference at a stimulation of 5 and 10 Hz. Multiple comparison tests revealed that patients with SDAT had a significantly smaller amplitude than normal controls. Patients with VD had lower amplitudes than normal subjects, but this was not statistically significant. In the phase data, there were also no statistically significant differences across the three groups for any of the temporal frequencies. These results indicate that a temporal frequency deficit exists in SDAT. This phenomenon may be explained by the pathology that affects the early stage of visual signal processing.

Influence of thickness and location on the residual monomer content of denture base cured by three processing methods

The influence of thickness and location on the residual monomer content of acrylic resin plates was examined when they were processed by three methods: a conventional method, fluid resin technique, and a microwave curing method. The residual monomer contents were measured by gas liquid chromatography. The levels of residual monomer were influenced by the processing methods and thicknesses of acrylic resin specimens, but not by location within the specimens. These results suggest that dimensional accuracy and stability of acrylic resin dentures could be influenced by the processing method, the thickness of the bases, and the shape and size of the dentures.

Genetic Enhancement of Cold Tolerance by Expression of a Gene for Chloroplast [omega]-3 Fatty Acid Desaturase in Transgenic Tobacco

The increased production of trienoic fatty acids, hexadecatrienoic (16:3) and linolenic (18:3) acids, is a response connected with cold acclimation of higher plants and is thought to protect plant cells against cold damage. Transgenic tobacco (Nicotiana tabacum cv SR1) plants that contain increased levels of 16:3 and 18:3 fatty acids, and correspondingly decreased levels of their precursors, hexadecadienoic and linoleic acids, were engineered by introduction of a chloroplast [omega]-3 fatty acid desaturase gene (the fad7 gene) isolated from Arabidopsis thaliana. When exposed to 1[deg]C for 7 d and then cultured at 25[deg]C, the suppression of leaf growth observed in the wild-type plants was significantly alleviated in the transgenic plants with the fad7 gene. The low-temperature- induced chlorosis was also much reduced in the plants transformed with the fad7 gene. These results indicate that increased levels of trienoic fatty acids in genetically engineered plants enhance cold tolerance.

Effects of nitric oxide synthase inhibitors on N-methyl-D-aspartate-induced phase delay of circadian rhythm of neuronal activity in the rat suprachiasmatic nucleus in vitro

Excitatory amino acid (EAA) receptors such as N-methyl-D-aspartate (NMDA) and non-NMDA receptors have been suggested to play an important role in the regulation of photic information from the retina to the suprachiasmatic nucleus (SCN). Therefore, we investigated the role of glutamate as a retinohypothalamic transmitter by analyzing the phase-resetting effects of NMDA and a non-NMDA agonist, (R,S)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA), on the circadian rhythm of SCN firing activity. Nitric oxide (NO) production is believed to be an essential intermediate in NMDA-induced cGMP production in the CNS. Thus, we examined the effects of blockers of NO production on NMDA- or AMPA-induced phase delay of SCN activity rhythm. N-nitro-L-arginine methylester (L-NAME) blocked NMDA- but not AMPA-induced phase shift, indicating the involvement of NO synthesis in NMDA-induced phase changes. L-arginine but not D-arginine caused a phase delay, and L-NAME blocked L-arginine-induced phase delay. In addition, cotreatment with NMDA and L-arginine did not have an additive effect. These results suggest that NO production itself is involved in the phase change of SCN neuron activity, and NMDA-induced phase changes are also mediated via activation of NO synthesis in this nucleus.

Receptor-mediated endocytosis of thrombin-antithrombin III complex by the human monocytoid cell line U937

Receptor-mediated endocytosis of thrombin-antithrombin III (TAT) complex was characterized with the monocytoid cell line U937. At 4 degrees C, U937 cells bound TAT but not antithrombin III in a rapid, specific, saturable, and reversible manner. [125I]TAT binding to U937 cells was not inhibited by antithrombin III and hardly by thrombin, but 75% inhibited by a 50 molar excess of the unlabeled TAT. There were about 79,000 binding sites/cell (Kd = 68 nM). The TAT receptor on U937 cells may be distinct from the serpin-enzyme complex (SEC) receptor, since a synthetic peptide corresponding to the recognition sequence of SEC receptor did not compete with TAT binding to the cells. Receptor-bound TAT was internalized into the cells after switching the temperature from 4 to 37 degrees C and thereafter degraded in lysosomes.

[Flumazenil antagonism of midazolam-induced respiratory depression]

Flumazenil, a benzodiazepine antagonist, reliably reverses midazolam-induced sedation, but its effect on respiratory depression has not been clarified completely. Ten healthy male volunteers received midazolam 0.1 mg.kg-1. Then they received flumazenil 0.5 mg (n = 9) and 1.0 mg (n = 1), intravenously. Rib-cage (RC) and abdominal wall (ABD) movement was measured by mercury-in-silastic strain gauge. Nasal air flow (FLOW), genioglossal electromyogram (EMG) and oxygen saturation (SaO2) were recorded simultaneously. Midazolam caused significant increases of RC movement and respiratory rate, and decreases of ABD movement, FLOW, EMG and SaO2. After administration of flumazenil, although respiratory rate returned to the pre-midazolam values, RC movement decreased on the contrary. ABD movement, FLOW, EMG, SaO2 did not recover to the pre-midazolam values. These data suggest that flumazenil 0.5 mg reverses midazolam-induced sedation completely, but is partially effective for some parameters related to respiratory depression.

Recurrent generalized lichen nitidus associated with amenorrhea

A case of recurrent generalized lichen nitidus is reported. The eruptions developed in the proliferative phase of the menstrual cycle, but there has been a marked improvement after administration of estrogen and progesterone for the treatment of amenorrhea. Hormonal factors may play a role in the development of lichenoid tissue reaction in the lesions of this disease.

Solitary glomus tumour with mucinous degeneration

Four cases of solitary glomus tumour are reported, three of the angiomatous type, and one of the epitheliomatous type. In all cases, mucinous degeneration was seen, the extent of which correlated with the number of glomus cells.