The relation between cubital tunnel syndrome and the elbow alignment

The authors reviewed forty-three surgically managed cases of cubital tunnel syndrome treated during the past twelve years. Surgery had been performed on thirty-one men and twelve women. Their average age was 46.8 years old. The etiology of cubital tunnel syndrome had been determined as follows: There were twenty-three cases of osteoarthritis of the elbow joint. There were four cases of isolated cubitus valgus deformity. There were three cases of isolated cubitus varus deformity. There were three cases of rheumatoid arthritis. One patient had sustained trauma to the cubital tunnel. In nine other patients there were various causes but no joint malalignment. The selection of the surgical technique for the correction of cubital tunnel syndrome was a function of the etiology of the condition. Cubital tunnel syndrome from osteoarthritis was surgically managed with a modified King technique. Ulnar neuropathy with a cubitus valgus deformity was managed with an ulnar nerve anterior transposition. Ulnar neuropathy with a cubitus varus deformity was managed with a neurolysis. The surgical outcome for cubital tunnel syndrome in patients with an angular deformity at the elbow frequently was not optimum. However, although some patients remained symptomatic, the majority of postoperative patients did obtain improved motor strength and conduction velocities. This confirmed the efficacy of surgical management regardless of the cubital tunnel syndrome etiology.

Quantitative measurement of portal blood flow by magnetic resonance phase contrast: comparative study of flow phantom and Doppler ultrasound in vivo

A non-invasive method for measuring portal blood flow by magnetic resonance (MR) phase contrast was evaluated in a flow phantom and 20 healthy volunteers. In a flow phantom study, the flow volumes and mean flow velocities measured by MR phase contrast showed close correlations with those measured by electromagnetic flowmetry. In 20 healthy volunteers, the cross-sectional areas, flow volumes and mean flow velocities measured by MR phase contrast correlated well with those measured by the Doppler ultrasound method. Portal blood flow averaged during the imaging time could be measured under natural breathing conditions by using a large number of acquisitions without the limitations imposed on the Doppler ultrasound method. MR phase contrast is considered to be useful for the non-invasive measurement of portal blood flow.

Evidence for the accumulation of oxidative stress during cellular ageing of human diploid fibroblasts

We have examined the level of 8-hydroxydeoxyguanosine (8-OH-dG) in the DNA of human diploid fibroblast TIG-1 cells at various stages of cellular ageing. Cellular DNA was obtained from cell lysates by simple precipitation with ethanol and analyzed 8-OH-dG levels by an electrochemical detection system. The data reveals that this method is valid for the detection of 8-OH-dG at levels of 1 x 10(-6) 8-OH-dG/dG without altering the recovery of other deoxynucleosides. Using this method, we demonstrate a significant increase in 8-OH-dG content during cellular ageing up to a 50 population doubling level (PDL) of TIG-1 cells, with levels of 0.5 x 10(-6) and 1.6 x 10(-6) 8-OH-dG/dG in young (22 PDL) and old (50 PDL) cells, respectively. The level decreases with further ageing and is 1.3 x 10(-6) 8-OH-dG/dG in senescent cells. We also show that the repair activity for the 8-OH-dG lesion declines significantly during cellular ageing, a phenomenon that might be associated with the increase in 8-OH-dG levels.

Cloning and expression in Enterobacteriaceae of the extended-spectrum beta-lactamase gene from a Pseudomonas aeruginosa plasmid

An extended-spectrum beta-lactamase, the gene for which is located on plasmid pMS350 in Pseudomonas aeruginosa strains, hydrolyzes carbapenems and other extended-spectrum beta-lactam antibiotics. We cloned the pMS350 beta-lactamase gene in an Escherichia coli K-12 strain using the vector plasmid pHSG398, and subcloned it into pMS360, a plasmid with a wide host-range. This resulted in the formation of the recombinant plasmid, pMS363, containing a 4.1-kb DNA insert that includes the extended-spectrum beta-lactamase gene. Plasmid pMS363 was introduced into the P. aeruginosa PAO strain or into six species of Enterobacteriaceae, and the specific activities of the beta-lactamase and MICs of various beta-lactam antibiotics were estimated. The cloned gene was capable of expression in these strains and caused resistance to carbapenem, penem and other beta-lactam antibiotics, with the exception of aztreonam.

Limited visual search on the WAIS Picture Completion test in patients with schizophrenia

The Wechsler Adult Intelligence Scale was examined in 39 patients with schizophrenia, the visual cognitive task of Picture Completion showing the most impairment. In order to clarify the role of eye movements in Picture Completion, searching eye movements in 12 schizophrenic patients and 12 normal controls were recorded using an infrared eye-mark recorder. Schizophrenic patients as a group showed fewer eye fixations, and shorter total length of scan path than normal controls during the last 10 s of exposure to the picture. However, the patients who responded correctly, did so with a similar number of fixations and similar length of total scan path to those of normal controls. The patients who failed in the task took a significantly longer time for the first survey of the picture than the successful patients and normal controls. The less efficient strategy of visual search seen in the patients who failed might be a manifestation of poor reality testing and be related to frontal lobe dysfunction.

Evidence for involvement of phospholipase C-gamma 2 in signal transduction of platelet-derived growth factor in vascular smooth-muscle cells

In order to examine the mechanisms underlying smooth-muscle cell proliferation, we investigated effect of platelet-derived growth factor (PDGF) dimers on proliferation of rabbit vascular smooth-muscle cells (VSMCs) and also involvement of phospholipase C (PLC) isoforms in the signal transduction. PDGF-BB and -AB, but not -AA, stimulated cell proliferation and intracellular production of inositol trisphosphate. Northern and Western analyses demonstrated that VSMCs mainly expressed PLC-gamma 2 and PLC-delta 1 among four PLC isoforms tested. A number of cellular proteins, including PLC-gamma 2, but not PLC-delta 1, were phosphorylated on a tyrosine residue by the stimulation of either PDGF-BB or -AB. These results suggest a functional association of PDGF receptor and PLC-gamma 2 that might be responsible for PDGF-dependent VSMC growth. In addition, the expression of PLC-gamma 2 was extremely low in the primary VSMC cultures and was induced during further cultivation of the primary cultures, indicating that an acquisition of PDGF-signal-transducing components, including PLC-gamma 2, may be an important step for proliferation of smooth-muscle cells.

A single universal primer for the T-cell receptor (TCR) variable genes enables enzymatic amplification and direct sequencing of TCR beta cDNA of various T-cell clones

We designed a primer for the PCR directed against a highly conserved sequence of the TCR V beta gene. The V beta-universal primer, in combination with a constant region-specific primer, enabled us to amplify TCR beta cDNA of allo-HLA class-II-reactive T-cell clones by PCR without prior knowledge of their V beta sequences. The amplified TCR cDNA was purified by agarose gel electrophoresis and subjected to direct sequencing. In nine of ten T-cell clones analyzed, direct TCR sequencing gave readable sequence ladders, including two-thirds of V beta, junctional, and J beta regions. One T-cell clone gave an unreadable mixed-profile sequence ladder, indicating that this clone expressed more than one major TCR beta transcript. Even in this case, however, it was possible to determine two different TCR beta sequences separately using sequence primers specific to one of the 13 J beta segments deduced from the mixed ladder. Thus, direct sequencing utilizing the single V beta-universal primer enabled a simple, rapid, and reliable sequence determination of TCR beta cDNA of all T-cell clones analyzed.

The osteogenic potential of fracture hematoma and its mechanism on bone formation--through fracture hematoma culture and transplantation of freeze-dried hematoma

This study was conducted to provide further evidence of the inherent osteogenic potential of the fracture hematoma. The fracture hematoma was separated into its cellular and extracellular elements. The hematoma cells were cultured to study bone formation by the cellular elements alone. Bone formation acceleration factor was added to the cultured fracture hematoma cells. The cell responded to this stimulation by differentiation into chondrocytes. Fracture hematoma was freeze-dried to study the presence of osteoinduction by the extracellular factors in the fracture hematoma. The freeze-dried fracture hematoma was packaged in methylmethacrylate pellets and within capsules of hydroxyapatite. These pellets and capsules in response to extracellular humoral factors from the freeze-dried fracture hematoma. The results of experimental implantation of the cultured fracture hematoma cells revealed that these cells had the potential to differentiate into chondroblasts or osteoblasts when bone induction factors and bone acceleration factor was added to their media. These extracellular humoral factors are known to be present in the fracture hematoma.

Simultaneous determination of organotin compounds in fish and shellfish by gas chromatography with a flame photometric detector

In the present study the levels of the organotin compounds were determined in fish and shellfish which were purchased from retail markets in Niigata, Japan. The concentrations of dibutyltin (DBT), tributyltin (TBT), diphenyltin (DPT) and triphenyltin (TPT) compounds were separately determined by FPD-gas chromatography. Eight species (yellowtail, tuna, cuttlefish, olive flounder, northern shrimp, cinnamon flounder, Japanese sea bass and oyster) were studied and five samples of each species were analyzed in each season, which meant 40 samples in one season, and 160 in total. Among the compounds of interest, DBT, TBT and TPT were detected. The highest concentrations detected were 0.674 microgram/g for DBT, 0.669 microgram/g for TBT and 0.186 microgram/g for TPT. DBT was detected as much as TBT, however, its concentration was not correlated with that of TBT. Seasonal changes of the mean value of the concentration of DBT and TBT were observed. In some species, such as yellowtail and Japanese sea bass, combined contaminations of these organotin compounds were also evident. This study is the first step to elucidate possible health hazards by environmental pollution of organotin compounds on human beings.

Scanning eye movements in schizophrenic patients. Relationship to clinical symptoms and regional cerebral blood flow using 123I-IMP SPECT

Eye movements during the Benton Visual Retention Test were examined using an eye-mark recorder in 32 schizophrenic patients and 32 normal controls. The patients had significantly fewer eye fixations, longer mean duration of fixation and shorter length of mean scan path than the controls. In the patients, these eye movement parameters were significantly correlated with the negative symptom score but not with the positive symptom score on the Positive and Negative Syndrome Scale. These parameters had a significant correlation with the composite score on the Scale for the Assessment of Negative Symptoms (SANS). In particular, they were highly correlated with avolition-apathy and affective flattening or blunting scores on SANS subscales. Thus, examination of scanning eye movements seemed to be a good objective index of negative symptoms. Secondly, regional cerebral blood flow (rCBF) was examined using N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) and single photon emission computer tomography in 17 of 32 patients. With regard to the relationship between the eye movement parameters and rCBF, the mean duration of fixation was negatively correlated with 123I-IMP uptake in the left superior frontal area and left basal ganglia. The mean length of the scan path was correlated with uptake in the left superior frontal area. These findings suggest that the characteristic eye movements of schizophrenic patients are likely to be related with dysfunction of the frontal-basal ganglia neural circuit.

Acute toxicity of tri-n-butyltin chloride (TBTC) in the Syrian golden hamster

The effects of tri-n-butyltin chloride (TBTC) on Syrian golden hamsters were studied. TBTC in single doses of 0, 29.6, 44.4, 66.7, 100 or 150 mg/kg were given to 10 male hamsters in each group and the mortality rates were determined two weeks thereafter. They were 0% (0/10), 0% (0/10), 10% (1/10), 10% (1/10), 30% (3/10) and 70% (7/10) for 0, 29.6, 44.4, 66.7, 100 and 150 mg/kg groups, respectively. In the case of females, seven groups consisting of 10 animals each were given TBTC at doses of 0, 29.6, 44.4, 66.7, 100, 150, or 225 mg/kg. The mortality rates determined two weeks after the TBTC treatment were 0% (0/10), 10% (1/10), 10% (1/10), 0% (0/10), 40% (4/10), 30% (3/10) and 90% (9/10) for 0, 29.6, 44.4, 66.7, 100, and 225 mg/kg groups, respectively. Based on these mortality data, the LD50s via oral administration were determined as 146.9 mg/kg (95% C.I. 111.8-193.3 mg/kg) for the male and 172 mg/kg (95% C.I. 127.2-233.4 mg/kg) for the female. Regarding pathological changes, animals experienced lesions in the bile duct, such as the dilatation of the common bile duct and cholestasis, and/or adhesion of the bile duct to the liver, gallbladder, pancreas and duodenum. In a separate experiment, a single dose of 44.4 mg/kg TBTC was administered orally to 12 male hamsters, then the concentrations of TBTC and its metabolite, di-n-butyltin chloride (DBTC), in the liver were analyzed by means of gas chromatography for 14 days after the treatment. The maximum concentrations of TBTC and DBTC appeared one day after the administration, and decreased rapidly thereafter. The concentration of DBTC was found to be higher than that of TBTC throughout the experimental period.

[Studies on insulin secretion and clearance in obese and diabetic children (7-11 years old) and adolescents (12-16 years old) investigation by oral glucose tolerance tests (O-GTT)]

We analyzed O-GTT obtained from 375 children (group A; 7-11 years old) and adolescents (group B; 12-16 years old), including 96 normal non-obese cases, 266 simple obese cases (172 with normal O-GTT, 79 with border line type O-GTT and 15 with diabetic type O-GTT), 8 obese NIDDM cases and 5 non-obese NIDDM cases. The results were as follows; 1) The levels of epsilon CPR (in terms of total sum of the values measured at 0, 30, 60, 120 and 180 minutes on O-GTT) in the obese children and adolescents were only 1.5 and 1.2 times as high as in the control group. The levels of epsilon CPR/epsilon IRI molar ratio in the control group were 2.0 and 2.3 times as high as in the obese children and adolescents. These data suggest that hyperinsulinemia in the obese children and adolescents is caused mainly by decreased hepatic insulin extraction rather than by increased insulin secretion. 2) In the non-obese NIDDM adolescents, the levels of epsilon CPR decreased to about 3/4 of those in the control group; in contrast, the epsilon CPR/epsilon IRI molar ratio increased. Therefore, it seems that there is increased hepatic insulin extraction as well as decreased insulin secretion in the non-obese NIDDM adolescents. 3) In the obese NIDDM adolescents, the levels of epsilon CPR were nearly the same as in the control group and the epsilon CPR/epsilon IRI molar ratios were slightly lower as the disease state of NIDDM counterbalanced obesity.

Effects of MCPA and other phenoxyacid compounds on hepatic xenobiotic metabolism in rats

The effects of ethyl 4-chloro-2-methylphenoxyacetate (MCPA) and other phenoxyacid compounds on hepatic xenobiotic metabolizing enzymes were studied in male rats. These compounds were administered orally 200 mg/kg/day to the rats for 2 weeks. Both MCPA and clofibrate increased the hepatic level of cytochrome P-450. In the MCPA-treated group, the activities of aniline hydroxylase and 7-ethoxycoumarin O-deethylase increased by 15% and 1.5-fold, respectively. The free acid form of MCPA increased these activities more potently than MCPA. Both MCPA and its free acid did not change the activity of aminopyrine N-demethylase. A marked increase in the activity of aniline hydroxylase was noted in the 2,4-dichlorophenoxyacetic acid-treated group, whereas the aminopyrine N-demethylase activity significantly decreased in the same group. Clofibrate also increased the activities of hepatic microsomal cytochrome P-450-mediated oxidation tested, but to a lesser extent when compared with the effects of MCPA. These results indicate that MCPA may have a potent effect on the hepatic metabolizing enzymes in rats, and also that the induction of xenobiotic metabolizing enzymes may change when the chemical moiety of phenoxyacid compounds is modified.

Effects of ethyl 4-chloro-2-methylphenoxyacetate on hepatic peroxisomal enzymes in rats

Effects of ethyl 4-chloro-2-methylphenoxyacetate (MCPA) and clofibrate on the activities of hepatic lipid metabolizing enzymes in the peroxisomal fraction from rat liver were studied, and these drugs were found to potentiate the peroxisomal enzyme activity. The results imply that MCPA affects lipid metabolism as well as clofibrate.

Cytogenetic analysis of human bile for mutagenicity and co-mutagenicity

Cytogenetic analysis was used to test whether or not human bile induced chromosome abnormalities in lymphocytes grown in culture. Bile was obtained from gallbladders resected for various reasons such as cholecystitis, cholelithiasis, polypus and cancers of the biliary tract, stomach and pancreas. After adding human bile to a final concentration of 25 microliters/ml or 12.5 microliters/ml, the culture medium was incubated at 37 degrees C for 72 hr. Air-dried slides were stained with conventional Giemsa and the numerical and structural chromosome abnormalities were scored. Positive and negative controls in terms of chromosome abnormalities were established by using 0.03 micrograms/ml mitomycin C (MMC) and 0.9% normal saline, respectively. Cytogenetic analysis was successfully performed in 6 out of 10 bile samples (60.0%). Bile alone did not induce numerical or structural chromosome abnormalities. Structural abnormalities increased significantly in the 25 microliters/ml bile + 0.03 micrograms/ml MMC group, compared with the 0.03 micrograms/ml MMC group: 36.0% vs. 20.7% in the chromatid-type gaps and breaks, 27.8% vs. 22.7% in the chromosome-type gaps and breaks, and 8.3% vs. 3.2% in the exchange-type abnormalities. It is likely that the interaction between bile and MMC is synergistic rather than additive.

Clinical, microbiological, and immunological studies following initial preparation in adult periodontitis

This study investigated the clinical, microbiological and immunological changes induced in adult periodontitis by initial preparation. Microflora in periodontal lesions was mainly examined by cultural methods, and serum IgG antibody levels were measured by an enzyme linked immunosorbent assay. Black-pigmented gram negative anaerobes, especially Porphyromonas (Bacteroides) gingivalis, was predominant in periodontal pockets with adult destructive periodontitis. Significantly elevated serum IgG antibody levels to P. gingivalis was found in high frequency, and these serum IgG antibody levels correlated with the presence of P. gingivalis in periodontal pockets, not with other bacteria tested. Total-CFU was significantly reduced and clinical conditions were improved after supragingival plaque control, but the microflora themselves showed few changes. Although reduction of total-CFU and changes in microflora were observed following scaling and root planing, it was found to be difficult to completely eliminate periodontopathic bacteria from periodontal pockets. Although serum IgG antibody levels to P. gingivalis was significantly reduced following initial preparation, the levels were still elevated from those of the controls. It was found that the presence of P. gingivalis was correlated with clinical conditions, including bleeding on probing and residual pocket depth following initial preparation.

Bactericidal effects on subgingival bacteria of irrigation with a povidone-iodine solution (Neojodin)

This study was undertaken to determine the optimal concentration of a povidone-iodine solution (Neojodin: NJD) for irrigation of subgingival pockets. Three different dilutions were prepared (undiluted, 20%, and 10%). Statistically significant reduction of total colony forming units (CFU) was shown after irrigation with undiluted NJD solution when compared to control sites. Although reduction was not significant after irrigation with 20% or 10% NJD solution, total CFU were reduced to less than 1% in several sites, which was not true with biological saline.

Selenium contents in human gallbladder bile

The selenium contents in human gallbladder bile were analyzed. Thirty-seven subjects were studied; 22 patients with cholelithiasis in Niigata Prefecture and 15 patients (13 with cholelithiasis and 2 with gallbladder polypus) in Kochi Prefecture. Five ml of bile was withdrawn with a syringe from the gallbladder during the operation and stored at -20 degrees C until analysis. For the analysis by gas chromatograph with an electron-capture detector, 0.2 ml of sample was used. The mean selenium contents in bile were 269 +/- 39.0 (mean +/- S.D.) ng/ml for the subjects in Niigata and 285 +/- 84.4 ng/ml in Kochi; without significant difference. Of 37 samples analyzed, the mean content was 276 +/- 61.0 ng/ml.

[A rapid diagnosis (SK-013) for periodontitis based on the enzymatic activity of periodontopathic bacteria. The relationship between the enzymatic activity (SK-013) and B. gingivalis, B. forsythus, T. denticola in subgingival microflora]

SK-013 was developed for rapid detection of the peptidase activity in subgingival plaque samples. The purpose of this study was to determine whether SK-013 could be a marker for the presence of periodontopathic bacteria including Treponema denticola, Bacteroides gingivalis and Bacteroides forsythus which produce trypsin-like enzyme. Subgingival plaque samples were taken with 3 paper points from 10 clinically healthy sites and 30 periodontal diseased sites. The SK-013 activity of plaque sample was assayed and the cells of T. denticola, B. gingivalis and B. forsythus in the sample were counted by immunofluorescence technique. In diseased sites, both the SK-013 activity and the cell counts of these organisms were significantly higher than those in healthy sites. The proportions and cell counts of these organisms and the SK-013 activity were closely correlated with clinical parameters including Gingival Index, Plaque Index, and Probing depth. The correlation between the presence of these organisms and the SK-013 activity was significant. Correlation coefficients between the presence of T. denticola and the SK-013 activity were higher than those of others.

[In vitro synergism of two-drug combinations among cefamandole, flomoxef and imipenem against MRSA]

First of all, vancomycin (VCM) showed good antimicrobial activity against Staphylococcus aureus including methicillin-sensitive and -resistant strains. MIC90 of VCM was 1.56 micrograms/ml. Effects of different 2-drug combinations among cefamandole (CMD), flomoxef (FMOX) and imipenem (IPM), and activity of VCM alone were examined in vitro against 5 clinical isolates of methicillin-sensitive S. aureus (MSSA) and 22 isolates of methicillin-resistant S. aureus (MRSA). In a checkerboard study, synergism was observed against 4 strains of the 5 MSSA and all 22 strains of the MRSA with IPM and CMD, FMOX and IPM, and FMOX and CMD combinations. Mean MICs of these combinations were as low as one-fourth to one-tenth as those of individual drugs.

[Synthesis of thieno[2,3-d]pyrimidine derivatives and their antifungal activities]

4-Chlorothieno[2,3-d]pyrimidines were prepared by the chlorination of 4-oxo-3,4-dihydrothieno[2,3-d]pyrimidines with phosphoryl chloride. 4-Oxo-3,4,5,6,7,8-hexahydro[1]-benzo- and 4-oxo-6-phenylthieno[2,3-d]pyrimidine were synthesized by the cyclization of 2-acylaminothiophene-3-carboxamide derivatives with base. 2-Methyl-4-oxo-3,4-dihydrothieno[2,3-d]pyrimidine was prepared by the treatment of 2-methyl-4-trichloromethylthieno-[2,3-d]pyrimidine with sodium hydroxide in aqueous methanol. A series of 4-alkylamino- and 4-arylaminothieno[2,3-d]pyrimidines were synthesized by the nucleophilic substitution of 4-chlorothieno[2,3-d]pyrimidines with various amines. These compounds were evaluated for antifungal activity against Piricularia oryzae. The preventive effects on Rice blast, Sheath blight, and Cucumber powdery mildew were also determined by pot tests.

The 24 h-urinary excretions of albumin, beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase activity in children with IDDM

Microalbuminuria in diabetics is considered to be a sensitive indicator of early diabetic nephropathy. In this paper, 24 h-urinary excretions of albumin, BMG and NAG activity were measured in forty-one children with insulin-dependent diabetes mellitus. Moreover, the relationships between the urinary excretions of these substances and various clinical parameters of diabetes were analyzed. The mean values (mean +/- SD) of 24 h-urinary albumin, BMG and NAG activity in the diabetic children were 8.0 +/- 10.6 mg/day, 61.2 +/- 69.0 micrograms/day and 1.87 +/- 1.30 U/day, respectively. No significant differences were found between diabetic children and normal controls for these mean values. Nor were significant correlations between the various clinical parameters of diabetes and the urinary excretions of any of these substances found. However, nine of the forty-one diabetic children (22.0%) had higher levels of these urinary substances than those (mean + 2SD) in normal controls. Screening of the 24 h-urinary albumin, BMG and NAG activity should be performed routinely in young patients with diabetes.

[Development of breath detector for halitosis (1). Theory and method]

A Breath Detector was developed and its clinical application was investigated. It is very difficult to judge how one's own breath smells. The sense of smell is the most unreliable of the senses and has still not been scientifically clarified. Everyone who tried to accurately express the strength and the character of some smell will be puzzled to see the difficulty of expression. A smell on one's breath is actually impossible to expressed on the same scale as for weight or length. On a laboratory basis, it is certainly possible to clarify the concentration and the mass of some odor by using graphic or numerical values with Gas chromatography. However such measuring methods at laboratories are not available in our daily clinical life when it is required to check easily, anytime and anywhere. In consideration of the above, We believe that this Breath Detector with a built-in small special gas sensor will act a substitute for an analyzer, and that the device can express how strong the smell on one's breath is. Therefore we recommend Breath Detector as a product many patients have been waiting for.

[Development of breath detector for halitosis (2). Clinical evaluation]

A breath detector was developed and its clinical application was investigated. 20 patients that included self-halitosis patients and periodontally diseased patients with halitosis were the subjects of this investigation. Measuring by breath detector was tried third time and most high score was taken for one's smell revel. The same time mouth air was analyzed by gas chromatograph. The amount of volatile sulphur compounds in mouth air was made a comparison between the two methods. The intensity of halitosis by olfactory panel were divided into four groups, (-) good, (+/-) slight, (+) warn, (++) severe. And we investigated that breath detector's judgement and olfactory panel were in agreement or not. A breath detector was very sensitive for volatile sulphur compounds as well as gas chromatograph. It was therefore concluded that breath detector seemed to be potentially useful in clinical objective evaluation of halitosis and periodontal diagnosis.

Acute effect of TRH, flunarizine, lithium and zotepine on amygdaloid kindled seizures induced with low-frequency stimulation

We assessed the acute effects of various drugs on amygdaloid kindled seizures induced with low-frequency stimulations. We used the number of stimulating pulses required for the induction of epileptic afterdischarge (pulse-number threshold; PNT) as an indicator of the seizure generating threshold and the duration of induced seizures (AD duration; ADD) as an indicator of the seizures. TRH increased the PNT without affecting the ADD at a high dose (1.2 mg/kg). Flunarizine decreased the PNT and ADD simultaneously at a high dose (50 mg/kg). Lithium increased the PNT without affecting the ADD at two doses (100 mg/kg, 200 mg/kg). Zotepine decreased the PNT without affecting the ADD at two doses (8 mg/kg, 16 mg/kg). We propose that the technique of low-frequency kindling is a useful experimental model in assessing the effects of antipsychotic or antiepileptic drugs on the excitability of the limbic regions.

[Functional recovery following surgical removal of traumatic epidural hematoma--factor analysis]

Factors contributing to functional recovery following evacuation of epidural hematoma were analyzed in 53 subjects. Subjects were limited to the cases with "pure" epidural hematoma. Fifty-three cases were classified into 3 groups based on presence or absence, and duration of preaggravation period (PAP) following occurrence of head trauma (Fig. 1). Level of consciousness at operation and at PAP is summarised in Fig. 2. Major neurological signs at operation are summarized in Table 1. Gradings of functional status were divided to 6 (Table 2). Gradings of 53 subjects which were judged 1 month after removal of epidural hematoma are summarized in Fig. 3.

RESULTS

1) As to outcome in relation to duration of preaggravation period (PAP) and consciousness level at operation (Fig. 4): The patients whose PAP was shorter and whose consciousness level at operation was more severe, took outcome of lower (worse) gradings. 2) As to outcome in relation to interval from the end of PAP to operation and PAP (Fig. 5): The patients whose PAP are within 3 hours, took outcome of relatively good recovery only when epidural hematoma was removed within 5.5 hours after the end of PAP. 3) As to outcome in relation to interval from the end of PAP to operation and consciousness level at operation (Fig. 6): The patients whose consciousness level at operation was better than semicoma took good recovery when epidural hematoma was evacuated within 5.5 hours after the end of PAP. This was right even in the patients who presented with decerebrate posture.(ABSTRACT TRUNCATED AT 250 WORDS)

Atlantoaxial dislocation associated with neurofibromatosis. Report of three cases

Atlantoaxial dislocation was found in three patients with neurofibromatosis. Roentgenographic findings included marked reduction of sagittal diameter at the C-1 vertebral level, and cervical spine abnormalities associated with mesodermal dysplasia, such as posterior scalloping of the cervical spinal bodies with dural ectasia and vertebral body deformity (vertebral body dysplasia). Although the relationship of the atlas and axis did not change with neck position, all three patients had progressive neurological deficits and were treated by decompressive surgery combined with fusion. The pathogenesis of atlantoaxial dislocation associated with neurofibromatosis is discussed.

[Atlantoaxial dislocation in neurofibromatosis.--Report of three cases--]

Atlantoaxial dislocation has received little attention in many studies of spinal deformity in neurofibromatosis. The only four cases of atlantoaxial dislocation associated with neurofibromatosis has been previously reported in the literature. We reported three rare cases of atlantoaxial dislocation associated with neurofibromatosis. These characteristics in roentgenogram were as follows; (1) marked narrowing of sagittal diameter at C1 level without instability (instability index 0%) (2) association with other mesodermal dysplasia, such as posterior vertebral body scalloping, vertebral body dysplasia, dural ectasia etc. Neurofibromatous tissue was found around the anterior region of the odontoid process in one of our three patients. We speculate that atlantoaxial dislocation in neurofibromatosis may be due to mesodermal dysplasia. On the other hand, a neurofibroma was found around the anterior region of the odontoid process in our third case. Therefore, there is a possibility that atlantoaxial dislocation in the instance was caused by the neurofibroma involving transverse atlantal ligament.

Drug resistance of Escherichia coli isolated in Nepal

We collected Escherichia coli strains from 59 Nepalese porters in 1971 and surveyed for their drug resistance. Drug-resistant E. coli strains were isolated from four porters. (TC. CM. SM. SA. APC.)-resistant strains were isolated from two porters and SA- or APC-resistant strains were isolated from each of the others. The R factors were demonstrated from the multiple-resistant E. coli strains.

[Bilateral traumatic abducens nerve palsy without skull fracture or intracranial hematoma-a report of 3 cases and consideration of the mechanism of injury (author's transl)]

Three cases of bilateral traumatic abducens nerve palsy were presented and the mechanism of damage to the abducens nerve was discussed in relation to the analysis of traumatic force at the time of impact and topographical anatomy of the abducens nerve in detail. Case 1. A 70 year old man sustained a traffic accident with one hour loss of consciousness. Physical examination revealed a contused area on the medial side of his right forehead. Neurological examination revealed bilateral abducens nerve palsy (Fig. 1). There were no ther cranial nerve abnormalities. Roentgenograms of the skull, including views of the base and orbit showed no fracture. At follow up examination 12 months later, bilateral Duane's retraction syndrome could be noticed with slight increase in size of the pupil on each side of lateral gaze (Fig. 2). Case 2. A 32 year old women sustained a traffic accident with 31 days of loss of consciousness. At the time of admission, bilateral abducens nerve palsy and slight left hemiparesis were noticed in semicomatose condition. Right carotid angiogtam showed no evidence of intracranial hematoma. One month later, the right eye began to abduct and 2 months later, the left eye began to abduct. Three months after the injury, bilateral abducens nerve palsy could no longer be demonstrated. No retraction syndrome was observed during this period. Case 3. A 3 year old boy sustained a traffic accident with 32 days of loss of consciousness. At the time of admission, neurological examination showed bilateral abducens palsy and left sided decerebrate posture in comatose condition. At the time of discharge 3 months after admission, bilateral abducens palsy, right hemiataxia, left spastic hemiparesis and scanning speach were noticed. Three months later, right eye began to abduct and 4 months later, the left eye began to abduct. At follow up examination 6 months later, there was no evidence of abducens nerve palsy. Topographical details of anatomy of the abducens nerve are shown in Fig. 3, 4. It is greatly speculated that both abducens nerves are streched by the lineal accerelated force on mid sagittal plane at the time of impact, then the apex of petrous pyramid acts as the fulculum, so that the abducens nerves are compressed, contused and streched at this point (Fig. 5-a). The authors pointed out that the abducens nerve are impossible to be damaged at the petroclinoid ligament (Grüber's lig.) by the upward movement of the brainstem, because the abducens nerve is fixed downward below this ligament by the dura and apex of the petrous pyramid (Fig. 4-b, c). One case showed bilateral acquired retraction syndrome with slight increase in size of the pupil on each side of lateral gaze, the fact greatly suggesting that the sympathetic nerve have intimate relationship to the miss direction during the recovery stage of abducens nerve palsy.

Drug resistance and distribution of R factors in Salmonella strains

Drug resistance and the distribution of R factors in Salmonella strains were surveyed using 1,980 strains isolated in Japan from 1955 to 1973. Resistances were mostly restricted to sulfanilamide (SA), tetracycline (TC), and streptomycin (SM), and combinations thereof. The demonstrated frequency of strains resistant to chloramphenicol (CM) was very low as compared with that in Escherichia coli and Shigella strains. In relation to resistance to TC, CM, SM and SA, the frequency of isolation of single resistance was the highest, followed by triple, double, and quadruple resistance in that order. Low frequency of isolation of quadruple resistance was due to the low frequency of CM resistance in Salmonella strains and differed from the E. coli or Shigella group. R factors with single TC resistance was most common, followed by those with TC,SM,SA; SM,SA; TC,CM,SM,SA; and single (SM and SA) resistance, in that order. Kanamycin and ampicillin resistance was unusual and mostly transmissible.