Effect of total adipose weight and systemic hypertension on left ventricular mass in children

To investigate the effect of obesity and hypertension on left ventricular (LV) mass in children, we performed echocardiography and measured the height, weight, and blood pressure of 267 healthy children (145 boys and 122 girls) aged 12 years. The percentage of body fat was estimated using bioelectric impedance to derive the total adipose weight and lean body weight. End-diastolic measurements of LV parameters were obtained from M-mode echocardiograms. The LV mass was calculated by using the formula of Devereux et al. A strong positive correlation was demonstrated between non-normalized LV mass and height or other measures of body size. Systolic blood pressure was weakly correlated with non-normalized LV mass in boys. The impact of height on LV mass differed between boys and girls. Thus, different allometric formulas to normalize the LV mass for height were determined, using the height to the 3.1 and 1.9 powers for boys and girls, respectively. Regression analysis revealed that only total adipose weight affected the normalized LV mass, and that the effect of total adipose weight was greater in girls than in boys. The obese children had a significantly greater normalized LV mass than the nonobese children. The increase in the LV mass due to obesity appeared to be eccentric, because of the lack of an association between the indices of obesity and relative wall thickness. Our data indicate that appropriate normalization of LV mass is necessary for each study population, and that LV hypertrophy due to obesity begins in childhood.

Systemic amyloidosis following ankylosing spondylitis associated with congestive heart failure. A case report

We report the case of a 38-year-old man who developed fatal, systemic amyloidosis following ankylosing spondylitis. He was admitted for symptoms of congestive heart failure. Based on parotid gland biopsy and echocardiography, he was diagnosed as having systemic amyloidosis following active ankylosing spondylitis. However, the clinical course was rapidly progressive and eventually the patient died of acute necrotizing pancreatitis. The association has been reported thus far in a limited number of cases worldwide. The literature has featured localized lesions and a benign clinical course of the amyloidosis. This case, the first report from Japan, indicates that the amyloidosis associated with ankylosing spondylitis might exhibit a rapidly progressive clinical course, thereby suggesting that in such a case, meticulous treatment is required.

Suppressive effect of TNF-alpha on increased production of FdUMP by IFN-alpha

Interferon-alpha (IFN-alpha) exhibits synergistic antitumor activity when combined with tumor necrosis factor-alpha (TNF-alpha) in vitro and in vivo and increases the cytotoxicity of 5-fluorouracil (5-FU) in vitro. Using a colon cancer cell line transplanted into nude mice, we examined the effects of pretreatment for 3 days with IFN-alpha (10(6) IU) and/or TNF-alpha (2.9 x 10(3) JRU) on 5-FU metabolism. 5-FU 30 mg/kg was administered after the pretreatment. IFN-alpha increased the tumor level of 5-fluorodeoxuridine monophosphate (FdUMP), and decreased the free level of thymidylate synthetase. Pretreatment with TNT-alpha alone decreased HUMP whereas TNF-alpha plus IFN-alpha abolished the enhancement of FdUMP production by IFN-alpha. TNF-alpha also suppressed thymidine kinase activity. Neither IFN-alpha nor TNF-alpha altered the incorporation of 5-FU into RNA.

[Normal-sized ovary carcinoma syndrome: histopathological analysis of 14 cases]

Fourteen cases of "normal-sized ovary carcinoma syndrome" (diffuse metastatic malignant disease of the abdominal cavity of the female, with normal-sized ovaries, with no origin assigned definitively by intraoperative or preoperative evaluation, Feuer et al., 1989) were analyzed histologically, histochemically, immunohistochemically and ultrastructurally. Through these studies, 14 cases were divided into 11 primary peritoneal tumors (4 diffuse malignant mesotheliomas and 7 serous surface papillary carcinomas) and 3 metastatic peritoneal tumors (2 ovarian tumors and 1 appendicular tumor). To distinguish serous surface papillary carcinomas from epithelioid diffuse malignant mesotheliomas, examinations such as hyaluronidase digestion test, electron microscopy, and immunohistochemical studies using antibodies for Ber-EP4 and Vimentin were found to be useful. In order to achieve an accurate prognosis of normal-sized ovary carcinoma syndrome, it seems necessary for us to accumulate more information on this syndrome.

Comparative study on topical and oral administration of ofloxacin for Pseudomonas corneal ulcer in rabbits

Pseudomonas aeruginosa is one of the most frequently isolated microorganisms in bacterial corneal ulcers in Japan and other countries. We evaluated a topical application of 0.3% ofloxacin (OFLX) for Pseudomonas corneal ulcer in rabbits and compared it to the clinical effects of OFLX in topical and oral applications. All corneas in the control groups of both experiments showed total leukoma with a score of 4 on the seventh day. On the other hand, in the preventive experiment, all the scores in the OFLX-treated group were 0, and those in the therapeutic experiment were smaller than those of both the control and oral groups. The results indicate that topical OFLX is effective on Pseudomonas corneal ulcer in rabbits.

Axisymmetric analysis of a tube-type acoustic levitator by a finite element method

A finite element approach was taken for the study of the sound field and positioning force in a tube-type acoustic levitator. An axisymmetric model, where a rigid sphere is suspended on the tube axis, was introduced to model a cylindrical chamber of a levitation tube furnace. Distributions of velocity potential, magnitudes of positioning force, and resonance frequency shifts of the chamber due to the presence of the sphere were numerically estimated in relation to the sphere's position and diameter. Experiments were additionally made to compare with the simulation. The finite element method proved to be a useful tool for analyzing and designing the tube-type levitator.

Recurrent episcleritis associated with adult T cell leukaemia

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Application of topical lomefloxacin against experimental Pseudomonas endophthalmitis in rabbits

Lomefloxacin is a new quinolone compound with a broad antibacterial spectrum and excellent penetration into the aqueous humor by topical application. Therefore, an experimental study was done to evaluate the efficacy of topical lomefloxacin against experimental endophthalmitis with Pseudomonas aeruginosa. Lomefloxacin eye drops were instilled six times a day onto infected rabbit eyes and gentamicin, sulbenicillin and saline were also tested comparatively in the same manner as lomefloxacin. Clinical observation for 1 week and counting viable pseudomonas cell numbers in the anterior chamber were done. Among all topical eye drops tested, lomefloxacin was shown to be most effective in lowering clinical scores and viable cell numbers in the anterior chamber. In conclusion, lomefloxacin is expected to be a useful ophthalmic solution in the treatment of pseudomonal endophthalmitis.

Altering clinical features of recurrent herpes simplex virus-induced keratitis

We studied the alteration in the clinical features of herpes simplex virus-induced keratitis (HSK) after the introduction of acyclovir (ACV) (in 1986). Over a nine-year period, this study investigated 101 patients (52 men and 49 women) whose conditions were diagnosed clinically as HSK. In addition, HSK recurred in 48 (47.5%) of the 101 patients. The distribution of clinical types of primary HSK before 1985 did not differ from that after 1986. Recurrent HSK was significantly more frequent in patients aged 26 to 40 years (75.0%). Although the five-year recurrence rates in primary HSK treated with ACV were significantly lower than those in patients treated with idoxuridine, the recurrence frequency before 1985 was equal to that after 1986. The discordance of the decreased recurrence rate in ACV-treated patients and the high recurrence frequency in patients with recurrent disease after the introduction of ACV were considered to be the result of the incomplete inhibitory effect of this drug.

Strain difference of susceptibility to 4-nitroquinoline 1-oxide-induced tongue carcinoma in rats

Strain difference of susceptibility to 4-nitroquinoline 1-oxide (4NQO)-induced squamous cell carcinomas of the tongue among Dark-Agouti, Long-Evans, Sprague-Dawley, ACI/Ms, Fischer 344, Donryu and Wistar/Furth rats was surveyed by evaluating the survival times, incidences and sizes of developed tumors as markers of susceptibility. Administration of 4NQO dissolved in drinking water induced squamous cell carcinomas in various sites of the upper digestive tract mucosa of all the experimental male and female rats of the seven strains. Regarding the mean survival times, Wistar/Furth rats survived much longer than any other strain of rats, and Dark-Agouti showed the shortest survival. The incidence of large, mass-type carcinomas of the tongue of Dark-Agouti rats was higher than in any other strain of rats, while that of Wistar/Furth rats was the lowest. Subsequently the mitotic activity and bromodeoxyuridine incorporation in the tongue epithelium of Dark-Agouti and Wistar/Furth rats were estimated after a short-term administration of 4NQO. There was a pronounced difference between the two strains of rats, because the proliferative responses of the tongue epithelium of Dark-Agouti rats to the 4NQO stimulation were much higher than those of Wistar/Furth rats. These results indicated that there are marked differences in the susceptibility to 4NQO-induced tongue carcinoma among the seven strains of rats, and that Dark-Agouti and Wistar/Furth rats could be useful as models of highly and poorly susceptible strains, respectively, for further genetic analysis.

Two cases of cicatricial pemphigoid showing atypical immunofluorescent findings

We describe two patients with the clinical symptoms of cicatricial pemphigoid (CP). Biopsy specimens of the conjunctiva were taken. Histologic examination revealed subepidermal bullae and infiltration of inflammatory mononuclear cells. Direct immunofluorescent study showed immunoglobulins bound to the basement membrane zone (BMZ) in these patients. The patients also had intercellular immunoglobulin deposition in the conjunctival epithelium. No circulating anti-BMZ antibodies were detected, but one patient had a circulating antiintercellular antibody. Rare cases of CP with atypical immunofluorescent findings are reported.

Aortic dissection associated with aortitis syndrome

A 50-year-old woman with aortitis syndrome complicated by aortic dissection, is reported. The dissection was observed at the level of the descending thoracic aorta by aortography and at the intimal side of the dilated aorta on CT. An aneurysm of the right subclavian artery and a diffusely thick wall of the abdominal aorta were also observed. This case suggests that the uneven wall of the aorta in aortitis syndrome might be dissected at the intimal side by dilatation.

[Endophthalmitis in Japan--a nationwide study with reference to type and etiology]

A nationwide clinical study on bacterial and fungal endophthalmitis was done with special reference to their type and etiology. Two hundred and eighty cases of endophthalmitis were reviewed. All cases were divided into two categories such as exogenous (trauma, surgery, and ulcer) and endogenous (metastasis). Penetrating trauma was responsible for 93 cases (33.2%), surgery for 88 cases (31.4%), ulcer for 11 cases (3.9%) and metastasis for 88 cases (31.4%). Out of the 280 cases, 79 cases (28.2%) were microbiologically diagnosed through aqueous or vitreous tap or biopsy. The total numbers of isolated organisms amounted to 87 consisting of 43 Gram-positive bacteria, 30 Gram-negative bacteria and 14 fungi. The positive isolation was 31 out of 86 (36%) from the aqueous and 52 out of 103 (50%) from the vitreous. Exogenous types associated with trauma, surgery or ulcer were mainly caused by Gram-positive bacteria of 37 strains, led by coagulase-negative staphylococci in 14 cases. On the other hand, endogenous cases were mainly due to Gram-negative bacteria of 14 strains including Klebsiella pneumoniae in 5 cases, E. coli in 4 cases and fungi of 11 strains including candida spp in 9 cases.

D-glucose transfer rates derived from single-injection and steady state tracer experiments in the isolated guinea-pig placenta

In isolated guinea-pig placentae the transfer of D-[3H]glucose and L-[14C]glucose was investigated in single injection (SIE) and steady state (SSE, n = 11, placental weight 4.5 +/- 1.14 g) experiments at constant perfusion flow rates (3 ml/min). In SIE, a mixture of D- and L-glucose was injected as a bolus into either the fetal or maternal side of the placenta, uptake curves were obtained and the maximal extraction values Umax were derived. From these the membrane rate constants Kmc and Kfc of either the maternal or fetal side of the trophoblast membrane were calculated. The specific placental transfer rate constants were computed for the maternal-fetal (Kspec,mf) and fetal-maternal (Kspec,fm) direction from the amount of label transferred to the acceptor side in either SIE or in SSE (where labelled D- and L-glucose had been added to the stock solution). The chemical concentration of D-glucose was changed (5, 50 and 100 mmol/l, n = 11) and it was found that all rate constants decreased with increasing D-glucose concentration. At a D-glucose concentration of 5 mmol/l, Kmc was 3.11 +/- 1.59 ml/min (n = 6) and Kfc 2.69 +/- 0.5 ml/min (n = 5), the combined membrane rate constant (which determines the total placental transfer) was estimated to be 1.44 ml/min. This value was not significantly smaller than the mean (both directions) transfer rate constant Kspec in SIE (1.51 +/- 0.89 ml/min) or SSE (1.52 +/- 0.56 ml/min). Thus the results from uptake and transfer experiments are consistent. From the rate constants D-glucose fluxes at different chemical D-glucose concentrations were estimated. Whereas the mean Km values for all fluxes based on the various rate constants were about 30 mmol/l, the maximal flux Vmax was highest at the maternal trophoblast membrane (159.1 +/- 70.2 mumol/min), it was 107.9 +/- 11.6 mumol/min at the fetal side and 67.3 +/- 7.9 mumol/min in SIE or SSE for placental transfer in both directions. It is concluded that D-glucose carriers predominate at the maternal side of the trophoblast, and that maternal-fetal glucose transfer is proportionate to the transplacental glucose concentration difference within the physiological range of glucose concentrations.

[The suppressive effect of intravenous fluconazole against endogenous candida endophthalmitis in rabbits]

The therapeutic effect of intravenous fluconazole against endogenous candida endophthalmitis was investigated in rabbits. Twelve albino rabbits and a candida strain isolated from the human vitreous were used. Endogenous candida endophthalmitis was made by intravenous inoculation of 8 x 10(5) candida albicans spores in rabbits. In the first of two series of experiments, three rabbits out of six were injected intravenously with 5 mg/kg.b.w. of fluconazole at 30 minutes, 1 day and 2 days after inoculation. Another three control rabbits received no medication. The clinical course of the eyes was observed for a week and the viable cell numbers of candida in the eye were counted at 7 days after inoculation. Three rabbits treated with fluconazole developed no ocular lesions and no candida spores whatsoever were isolated from the eyes. In contrast, three rabbits in the control group developed bilateral chorioretinitis and candida albicans was isolated from each of 6 eyes. In the second series, three out of six rabbits were injected intravenously of the same dose of fluconazole as described above for four days starting at 3 days after inoculation, when chorioretinitis was first observed. No medication was given to another three rabbits as a control. All six rabbits in this series developed chorioretinitis similarly and candida spores were isolated from all eyes at 7 days after inoculation. These results show that intravenous fluconazole is effective in the prevention of the endogenous candida endophthalmitis in rabbits but ineffective for these short term therapeutic applications after onset.

[A comparison study of SPECT and MRI in remote effects of chronic cerebrovascular disease]

A comparison study of SPECT and MRI was performed to investigate remote effects in 10 patients with chronic cerebrovascular disease. Hypoperfusion in the cerebellar hemisphere contralateral to supratentorial lesions, the overlying cerebral cortex ipsilateral to subcortical lesions, the thalamus ipsilateral to cortical lesions, and the visual cortex distant to optic radiation lesions was demonstrated using SPECT with 123I-IMP. Although hypoperfusion in these remote areas was considered to be related to irreversible degenerative processes in the chronic phase, MR images did not reveal any abnormalities.