[Application of Holter electrocardiography to exercise testing for the group examination of school children: comparison between obese and normal children]

Application of Holter electrocardiography to an exercise test for heart function is useful in the group examination of school children. The circulatory responses to a step test among obese boys and girls and control were as follows: 1. Four cases of arrhythmia were detected, of whom 2 cases were discovered during exercise. ST-segment depression of 0.1 mV or more during and after exercise was recognized in 29 cases, 27 of the junctional- and 2 of the sagging slope, with a higher percentage in obese girls than in normal girls. 2. Serial ECG records during the procedure, performed for all children with the same single-step test, showed differences in the circulatory responses among the test groups. The load was estimated to be 76-86% of the maximal heart rate predicted by Cummings, with obese and girl groups being higher than other groups. The comparison revealed that the heart rate (HR) responses to exercise done by the boys increased faster than those by the girls at 1 minute after exercise. There were differences between obese and control and between boys and girls in HR at recovery, and also in HR before and 4 minutes after exercise between two sexes, which findings agree with other reports. 3. Concerning anthropometric factors, either the skinfold thickness or the obesity index was related to the HR at the peak of the exercise as well as immediately after it and to the half time. By contrast, the arm muscle diameter was found unrelated to the HR. Using this method, applied these combination of Holter ECG and step test to a group examination, we got ECG data for 254 subjects, 97.5% of which were suitable for analysis. We found this method to be effective for detecting ECG changes and for determining HR responses to exercise. This method is safe, simple, and inexpensive and is applicable to examination not only for school children but also for different population groups, for the estimation of circulatory responses.

[On the usefulness of the Benn index for obesity of school children compared to the Kaup index and the Rohrer index]

The criteria of a good obesity index derived from height and weight are that (1) it should be highly correlated with weight, but independent of height and (2) it should be highly correlated with any reasonable obesity measures like skinfold thickness or body density. We examined the usefulness of the Benn index relative to the traditional indices, the Kaup index and the Rohrer index, based on the above criteria. The subjects were 1200 students (600 boys and 600 girls) in the 9th grade of 6 junior high schools in and around the city of Morioka, Iwate in 1985. Three weight-for-height indices for each grade were calculated by the longitudinal data of their heights and weights from the 1st to the 9th grades. As a result, the Benn index was found to best fit the criteria. So, we would like to recommend the use of the Benn index as the screening measure for obesity in school children.

[Phenotypic expression and functional manifestation of fetal and maternal natural killer (NK) cells]

The NK cells, considered to play an important role in host defense, are reported to show heterogeneity during the cellular development. To document the heterogeneity, studies were carried out on the phenotypic expressions, the cytolytic activities, the responsiveness to recombinant interleukin 2 (rIL-2) and on the ultrastructure of the NK cells of the blood obtained at the time of delivery from 24 pairs of mothers and umbilical cords. The phenotypic expressions were Leu7+-11-(6.2 +/- 2.1%, SD), Leu7+-11+(5.6 +/- 1.8), and Leu7--11+(5.5 +/- 2.1) in the maternal NK cells, whereas the cord blood NK cells expressed only Leu7--11+(8.2 +/- 2.4). The cytolytic effect of the NK cells on K562 target cells was assayed by a method to determine ATP release. The activity of the maternal blood NK cells was 80.4 +/- 10.5%, SD whereas the cord blood samples showed only 40.5 +/- 8.5, after 4-hour incubation; the difference between the maternal and cord NK cells was statistically significant (p less than 0.01). The NK cells were incubated with rIL-2 (10 units), and the cytolytic activity was determined. The activity of the cord blood NK cells was significantly enhanced already after incubation for 2 hours and it lasted until incubation had continued for 4 hours. However, the rIL-2 effect was not significant after incubation for 5 hours. On the other hand, the activity of the maternal blood NK cells was not influenced significantly by rIL-2.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular effects of the new cardiotonic agent 1,2-dihydro-6-methyl-2-oxo-5-(imidazo[1,2-a]pyridin-6-yl)-3-pyridine carbonitrile hydrochloride monohydrate. 1st communication: studies on isolated guinea pig cardiac muscles

Cardiotonic effects and the mechanism of action of 1,2-dihydro-6-methyl-2-oxo-5-(imidazo[1,2-a]pyridin-6-yl)-3-pyridine carbonitrile hydrochloride monohydrate (E-1020), a new cardiotonic agent, were investigated in vitro. E-1020 (10(-7)-10(-4) mol/l) produced a concentration-dependent positive inotropic effect in papillary muscles. E-1020 also caused an increase in contractile force in the right atria which was accompanied by small increases in spontaneous beating rate. The inotropic effect of E-1020 on papillary muscles was not altered by treatment with beta-adrenoceptor or histamine H2-receptor blockade, but was attenuated by the muscarinic agonist, carbachol. E-1020, like isoprenaline (isoproterenol, Iso), restored the contraction of papillary muscles which had been arrested in a high-potassium solution. The inotropic response of papillary muscles to Iso was potentiated by pretreatment with E-1020 at a minimally-effective inotropic concentration (3 x 10(-7) mol/l). E-1020 did not affect the activity of dog kidney Na+, K+-ATPase. On the other hand, the compound specifically inhibited the cyclic AMP-specific isoenzyme (fraction III) of phosphodiesterase and caused an elevation of cyclic AMP content in guinea pig hearts. These results indicate that E-1020 is a potent cardiotonic agent with a minor chronotropic effect and that its inotropic action is mainly mediated by the rise in cardiac cyclic AMP content due to the inhibition of cyclic AMP-specific phosphodiesterase.

Existence of both IL-1 alpha and beta in normal human amniotic fluid: unique high molecular weight form of IL-1 beta

We investigated the possible existence of IL-1 in human amniotic fluid (AF). Since AF from most full-term deliveries appeared to contain an inhibitor(s) for thymocyte proliferation, AFs were fractionated by gel filtration prior to IL-1 assay. IL-1 activities eluted in two peaks at positions of 90,000-60,000 MW and 20,000-15,000 MW. Growth inhibitory activity eluted at the position of 70,000-50,000 MW, and its effect appeared to be non-specific because these fractions inhibited the growth of various cell lines. Using isoelectric focusing (IEF) techniques, pI values of 6.8-7.3 for the higher MW IL-1 as well as 4.9-5.5 and 6.7-7.0 for the lower MW IL-1 were obtained. Antibody against human IL-1 alpha partially neutralized the activity of the lower MW IL-1, though it exhibited little effect on the higher MW IL-1. In contrast, antibody against human IL-1 beta almost completely neutralized the activity of the higher MW IL-1 and partially neutralized the activity of the lower MW IL-1. These results suggest that most of the higher MW IL-1 is beta-type, and the lower MW IL-1 is a mixture of alpha and beta-types. IL-1 beta appeared to exist as a complex (combined with AF components) or as an aggregate of the lower MW IL-1 forms. These findings indicate that both IL-1 alpha and IL-1 beta are present in normal human AF from full-term deliveries, though IL-1 beta exists as a higher MW form aggregated with an unknown molecule.

Effect of azelastine on the release and action of leukotriene C4 and D4

The effect of azelastine on the release of leukotriene C4 and D4 (LTC4 and LTD4), and the antagonistic action of the drug against the leukotrienes were determined by using in vitro tests and compared with those of ketotifen and chlorpheniramine. Azelastine inhibited LTC4 and LTD4 release from guinea pig lung fragments passively sensitized with homologous anti-ovalbumin IgGl-b antibody. The 50% inhibitory concentration (IC50) of azelastine was 6.4 X 10(-5) M for a 15-min preincubation or 4.7 X 10(-5) M for a 30-min preincubation. Ketotifen and chlorpheniramine were inhibitory only at the highest concentration tested (3 X 10(-4) M), giving inhibitions of 35.6 and 21.3%, respectively. Azelastine also inhibited calcium ionophore A23187-induced release of leukotrienes from human polymorphonuclear leukocytes; the IC50 values were 3.6 X 10(-5) M for 15 min and 2.3 X 10(-6) M for 30 min of preincubation. Ketotifen and chlorpheniramine were inhibitory only after a 30-min preincubation, with IC50 values of 2.1 X 10(-5) and 5.9 X 10(-5) M, respectively. The potent inhibition by azelastine might be partly a result of the inhibition of 5-lipoxygenase, since 5-hydroxyeicosatetraenoic acid formation in rat basophilic leukemia cell homogenate was inhibited by azelastine. Pretreatment of guinea pig ileum with azelastine antagonized LTC4- and LTD4-induced contraction of the ileum with IC50 values of 7.0 X 10(-6) and 1.1 X 10(-5) M, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical studies on aztreonam in various infections in obstetrics and gynecology]

Aztreonam (AZT) was administered to 10 patients with obstetric and gynecologic infections to evaluate its clinical effect. Two-four grams of AZT per day (b.i.d.) were administered for the treatment for 4-15 days by intravenous drip infusion or intravenous injection. AZT was effective for 3 cases of pelvic peritonitis, 1 case of pyoovarium and 2 cases of Bartholin's abscess. For 2 cases of intrauterine infection, AZT was effective for 1 case, and the other case could not be judged. For 2 cases of local infection, AZT was effective for 1 case and ineffective for 1 case. Efficacy rate was 89% for the 9 cases excluding the 1 unevaluable case. Microbiological effect was determined for 4 out of 10 cases. Two strains of Haemophilus influenzae and one each of Escherichia coli, Bacteroides fragilis and Streptococcus intermedius were isolated, but all of them were eliminated for a elimination rate of 100%. Neither abnormal laboratory findings in hepatic or renal functions, etc. nor side effects were recognized.

[Complete remission of recurrent ovarian dysgerminoma obtained by combined chemotherapy with cisplatin, adriamycin and cyclophosphamide]

Based on the clinical course of ovarian dysgerminoma with multiple metastatic foci in the lung recurring at 7 years and a half after initial therapy, various problems of diagnosis, treatment, and administration of this tumor were discussed. As to the multiple recurrent foci, complete remission was obtained by 3 courses of combined chemotherapy with cisplatin, adriamycin and cyclophosphamide. Generally speaking, this type of tumor is remarkably sensitive to various kinds of oncostatics, and chemotherapy involving the above chemotherapeutic agents is worth trying in selective cases of advanced or recurrent cases.

[Analysis of side effects of a combination chemotherapy of cisplatin and adriamycin in gynecological malignancies: comparison between intravenous and intraarterial administration]

In 23 cases of gynecological malignancies, comparative analysis of the side effects of a combination chemotherapy of cisplatinum (CDDP) and adriamycin (ADM) was performed in terms of administration routes: intravenous and intraarterial. 50 mg/m2 of CDDP and 50 mg/m2 of ADM were administered intravenously once for three weeks. 12.5 mg of CDDP and 10 mg of ADM per one catheter were infused intraarterially once or twice a week. More than severe leukocytopenia was observed in all cases of systemic administration, while in 25% of intraarterial infusion. In 90% of intravenous administration and in about a half of intraarterial cases, thrombocytopenia was noted. Myelosuppression was severest at 10 the to 12th day after administration. The value of creatinine clearance (C-Cr) was within normal limits in 10% of cases of intravenous and in nearly 50% of cases of intraarterial administration. No mortal cases due to myelosuppression and no renal failure ware observed. Most cases of intravenous administration were suffered from severe vomiting, while only in half cases of intraarterial chemotherapy milder emesis appeared. Antiemetic drugs should be administered at least for one week after systemic chemotherapy, and also intraarterial chemotherapy, if necessary.

[Intra-arterial infusion of oncostatics in recurrent cervical carcinoma]

Five cases of recurrent cervical carcinoma with restricted recurrent site in the pelvis were treated with intra-arterial infusion of oncostatics via the internal iliac artery. The tip of the catheter was put in the internal iliac artery, just proximal to the superior glutea artery, through the a. glutea inferior or superior with ligation of both the a. glutea superior and inferior so as to get a high concentration of drugs at the lesion. Several chemotherapeutic agents, such as Cisplatin, adriamycin, pepleomycin, mitomycin C and 5-FU, were infused through the other end of the catheter, which was fixed at the subclavian fossa of the anterior chest. The clinical efficacies according to Karnofsky's criteria were 0-C in one case, 1-A in 1 case and 1-B in 3 cases. The overall response rate above 1-B was 60%. Two cases were dead, one due to inflammation in the pelvic dead space and D.I.C. and other due to myocarditis and heart failure. The other three were alive and treated with weekly intra-arterial infusion at our outpatient clinic. No troubles, such as spontaneous removal of the catheter, inflammation around the catheter or bleeding, have been encountered. The toxicities in the case of intra-arterial infusion were less prominent than in the case of intravenous administration of the same dosage of the oncostatics.

[Studies on the etiology of infectious disease of female internal genitalia - bacterial flora in the female genitalia and surrounding tissues]

The present studies were carried out to clarify the indigenous bacterial flora in the female internal genitalia and surrounding tissues and the pathogenesis of parametritis. Twenty nine patients with uterine tumors which consisted of sixteen carcinomas and thirteen benign tumors underwent abdominal total hysterectomies. Each tissue aseptically collected from the uterus and adnexae was cultured for 48 hours under aerobic or anaerobic conditions and the bacterial species were isolated and identified. In benign uterine tumors, anaerobic bacteria were isolated in six patients and aerobic or anaerobic bacteria were identified In the endometrium, fallopian tube and parametrium of five of the patients. In a group of carcinoma in situ (stage 0), many bacteria were isolated in two patients after conization. In the uterine carcinomas, as the stage advanced, the rate of bacterial isolation from parametrium and lymph node became higher. The rate of anaerobic bacterial isolation, except for one from the vagina, was nine out of sixteen patients with carcinomas but three out of thirteen patients with benign tumors. The results revealed that the bacterial flora in the vagina spread to the internal genital organ and surrounding tissues via the ascending or cervical lymphatic pathway and remained there as nonpathologically indigenous bacterial flora. These results suggest that these indigenous bacterial flora in the internal genitalia and the surrounding tissue may cause an opportunistic infection.

Geographical pathology of gastric carcinoma: a comparative study on histological types between high and low mortality areas in Japan

A histological comparison of 1,687 cases of gastric carcinoma in Niigata, a high mortality prefecture for this cancer, and 954 cases in Kagoshima, a low mortality area, was carried out in order to investigate whether or not this difference in mortality reflects any change of histological type of gastric carcinoma. In both series, in both males and females , the proportion of adenocarcinoma increased with increase of the patients' age, while that of diffuse carcinoma decreased. When data from the two prefectures were compared, there was no significant difference in age group distribution of each histological type. It appears that the same histological types of gastric carcinoma occur throughout Japan.

Chronic toxicity and hepatocarcinogenicity of (+) rugulosin, an anthraquinoid mycotoxin from penicillium species: preliminary surveys in mice

(+) Rugulosin (RUG) is bis-anthraquinoid pigment produced by fungi such as Penicillium rugulosum Thom, P. tardum and others, and its chemical structure is very close to (-) luteoskyrin, one of bis-anthraquinoid pigments of Penicillium islandicum Sopp and hepatocarcinogenic to mice and rats. This investigation was concerned with the subacute and chronic effects of RUG on hepatic injury and hepatocellular tumor induction in male mice fed purified diets for 22 days containing 1.5 mg/5 g diet/animal per day or whole feeding period containing 0.3 and 0.75 mg RUG/5 g diet/animal per day. A half of male DDD mice receiving 1.5 mg RUG for the initial 22 days of feeding died 1-3 weeks thereafter from the acute hepatic injury characterized by fatty degeneration and liver cell necrosis, and hepatocellular carcinoma developed in one out of 14 mice surviving the feeding of control diet for additional 400 days. Each one fourth of cases of male ddYS mice receiving 0.3 and 0.75 mg RUG for 500-700 days developed hyperplastic nodules of liver cells. These data suggest that RUG is possibly a weak hepatocarcinogen for male mice with a potency les than one tenth of (-) luteoskyrin.

Toxic effects of rice culture of Aspergillus candidus and its metabolite, xanthoascin, on Japanese quails

Laying Japanese quails were fed on diet of 1:1 mixture of basal diet and rice cultures of 2 strains of Aspergillus candidus. During 20 days of feeding, egg production was significantly reduced in these groups compared with the birds fed unmolded rice. The liver of the quails sacrificed at 20 days showed fatty degeneration of hepatic cells. Following withdrawal of the moldy rice, rate of egg production recovered in 5 days. The suppressive effect of egg production seems to be secondary to hepatic injury. In the other experiment, xanthoascin, a purified mycotoxin of A. candidus, was given subcutaneously between 2 to 5 mg/g body weight. In all groups mortality was about 80%. Survivors produced no eggs 10 days following the injection. The liver of quails that died in 1 to 4 days showed focal necrosis, fine droplet fatty degeneration and bile thrombosis of bile ductules. The features are similar to those observed previously in mice and rats, but the quail is far more sensitive to injected xanthoascin than rodents.

Myositis ossificans progressiva with parathyroid hyperplasia and polycystic ovary

A report was made on an autopsy case of myositis ossificans progressiva in a girl who died at the age of 8 year and 11 months. The first symptom appeared as right wryneck ten days after birth. Parathyroid hyperplasia and polycystic ovary with high level of serum parathyroid hormone, FSH and LH were confirmed at autopsy. Parathyroid hyperactivity might be a secondary response to the continuous stimulation by increased peripheral consumption of calcium ions due to relentlessly progressive ossification in fibrous connective tissue.

Distribution of zearalenone-producing Fusarium species in Japan

One hundred sixty-six isolates of Fusarium spp. from domestic cereal grains, feed, and other sources were examined for their ability to produce zearalenone on autoclaved moist rice grains. They belonged to the following species (number of producers/number tested): F. roseum (9/28), F. roseum (Culmorum) (3/4), F. roseum (Gibbosum) (2/5), F. roseum (Avenaceum) (1/2), F. roseum (Scirpi) (0/1), F. tricinctum (1/4), F. tricinctum (Sporotrichiella) (0/7), F. lateritium (1/1), F. episphaeria (0/2), F. moniliforme (0/3), F. oxysporum (0/12), F. rigidiusculum (0/4), F. solani (0/4), F. splendens (0/1), F. nivale (0/2), and Fusarium spp. (15/86). Zearalenone was isolated from molded rice by ethanol extraction and purified by column chromatography. Selected isolates of F. roseum M-3-2 and F. roseum (Gibbosum) A-O-2 produced 50 to 100 mg of zearalenone per kg of rice. Increased yields (250 to 407 mg/kg of rice) were obtained by F. roseum M-3-2 when the substrate was supplemented with 1% peptone.

Biological and chemical detection of trichothecene mycotoxins of Fusarium species

The procedure for biological and chemical detection of trichothecene-type mycotoxins and its application to the screening of Fusarium for toxic strains were described.

Solaniol, a toxic metabolite of Fusarium solani

Fusarium solani M-1-1 isolated from moldy bean hulls produces T-2 toxin, diacetoxyscirpenol, and a new toxic trichothecene, solaniol, in Czapek-Dox-peptone medium.