Probing the electron delocalization in liquid water and ice at attosecond time scales

We determine electron delocalization rates in liquid water and ice using core-hole decay spectroscopy. The hydrogen-bonded network delocalizes the electrons in less than 500 as. Broken or weak hydrogen bonds--in the liquid or at the surface of ice--provide states where the electron remains localized longer than 20 fs. These asymmetrically bonded water species provide electron traps, acting as a strong precursor channel to the hydrated electron.

Dysmenorrhea among Japanese women

OBJECTIVE

To investigate the epidemiology of dysmenorrhea in Japanese women of menstrual age.

METHODS

A prospective cohort study was conducted using a health diary in a sample representative of Japanese women. Information on health care use was also collected.

RESULTS

Among 823 enrolled participants (age range, 18-51 years), dysmenorrhea (mean duration 1.75 days; range 1-5 days) was reported in 15.8% (95% CI, 13.3-18.3) during the 1-month study period. Common associated symptoms included headache (10.77%), back pain (6.92%), and fatigue (5.38%). No participant with dysmenorrhea visited a physician, while 51.5% of the women used self-medication, and 7.7% used complementary/alternative medicine.

CONCLUSION

Dysmenorrhea is common in Japanese women. In our study, about half used self-medication, while some preferred complementary/alternative medicine. Dysmenorrhea is significantly associated with younger age and employment status.

The influence of the reference electrode in recording F-waves

OBJECTIVE

To demonstrate that many tibial F-waves can be recorded with the tendon electrode and to declare the importance of the "reference" electrode in F-wave recording.

METHODS

In eight lower extremities of four healthy subjects, tibial and fibular F-waves were recorded with the belly and tendon electrodes separately, using the opposite foot electrode as a reference site.

RESULTS

It was found that the mean tibial F-wave persistence proportions were 51.5% with the belly electrode and 86.7% with the tendon electrode. A greater number of tibial F-waves were recorded with the tendon electrode than the belly electrode, while few peroneal F-waves were recorded with the tendon electrode.

CONCLUSION

Many of the standard tibial F-waves were recorded with the tendon "reference" electrode.

SIGNIFICANCE

This phenomenon might be a clue to the difference of the F-wave persistence between the tibial and the peroneal nerves.

A case of primary uterine angiosarcoma: magnetic resonance imaging and computed tomography findings

Primary uterine angiosarcoma is exceedingly rare and has a poor prognosis. Moreover, the radiologic findings of this disease have not been previously documented. We present a case of a 62-year-old woman with primary uterine angiosarcoma who underwent abdominal hysterectomy and bilateral salpingo-oophorectomy. Histologically, interlacing vascular spaces were lined by endothelial cells showing nuclear pleomorphism and mitotic activity. Immunohistochemical staining was positive for the endothelial cell markers CD31, CD34, and Factor VIII, supporting the diagnosis of primary uterine angiosarcoma. Magnetic resonance imaging (MRI) revealed a heterogeneous mass with high and low signal intensity (T2 weighted) in the uterus and an intense contrast-enhanced anterior area within the mass (gadolinium enhanced, T1 weighted). The lesion was also enhanced on computed tomography (CT). Radiologically, the most helpful sign in the characterization of uterine angiosarcoma is marked heterogeneity on T2-weighted MRI with focal areas of high signal intensity, known as the "cauliflower-like appearance." In addition, findings of a strongly enhanced lesion on gadolinium-enhanced T1-weighted MRI and contrast-enhanced CT also support the diagnosis of angiosarcoma.

Risk stratification for in-hospital mortality in spontaneous intracerebral haemorrhage: a Classification and Regression Tree analysis

BACKGROUND

Risk stratification for mortality in intracerebral haemorrhage (ICH) helps guide care, but existing clinical prediction rules are too cumbersome for clinical practice because of their complexity.

AIM

To develop a simple decision tree model of in-hospital mortality risk stratification for ICH patients.

METHODS

We collected information on spontaneous ICH patients hospitalized in a teaching hospital in Japan from August, 1998 to December, 2001 (n = 374). All variables were abstracted from data available at the time of initial evaluation. A prediction rule for in-hospital mortality was developed by the Classification and Regression Tree (CART) methodology. The accuracy of the model was evaluated using the area under receiver-operator characteristic curve.

RESULTS

Overall in-hospital mortality rate was 20.2%. The CART methodology identified four groups for mortality risk, varying from low (2.1%) to high (58.9%). Level of consciousness (coma) was the best single predictor for mortality, followed by high ICH volume (cut-off 10.4 ml), and then age (cut-off 75 years). The accuracy of our CART model (0.86) exceeded that of a multivariate logistic regression model (0.81).

DISCUSSION

ICH patients can easily be stratified for mortality risk, based on three predictors available on admission. This simple decision tree model provides clinicians with a reliable and practical tool.

Clinical outcome and risk factors for recurrence in borderline ovarian tumours

We investigated the long-term prognosis of borderline ovarian tumours and determined risk factors for recurrence. One hundred and twenty-one borderline ovarian tumours treated between 1994 and 2003 at the participating institutions in the Tohoku Gynecologic Cancer Unit were retrospectively investigated for clinical stage, histopathological subtype, surgical technique, postoperative chemotherapy, the presence or absence of recurrence, and prognosis. The median follow-up period was 57 months (1-126 months). One hundred and nine cases (90.6%) were at clinical stage I. The histopathological subtypes consisted of 91 cases of mucinous tumour (75.2%), 27 cases of serous tumour (22.3%), and three cases of endometrioid tumour. Conservative surgery was used in 53 cases (43.8%), radical surgery in 68 cases (56.2%), a staging laparotomy in 43 cases (35.5%), and postoperative adjuvant therapy in 30 cases (24.8%). Recurrence was found in eight cases, but no tumour-related deaths were reported. Although no significant difference in disease-free survival rate was seen between different clinical stages, the difference in disease-free survival rate between serous and non-serous (mucinous and endometrioid) types was significant (P<0.05). The 10-year disease-free survival rate was 89.1% for the radical surgery group and 57.4% for the conservative surgery group -- this difference was significant (P<0.05). In the conservative surgery group, cystectomy and serous tumour were independent risk factors for recurrence. Although recurrence was observed, the long-term prognosis of borderline ovarian tumour was favourable, without tumour-related deaths. Considering the favourable prognosis, conservative surgery can be chosen as far as the patient has a non-serous tumour and receive adnexectomy. However, in cases of serous type and/or receiving cystectomy special care should be given as relative risk rates of recurrence elevate by 2-4-folds.

Esophageal pemphigus vulgaris with carcinoma: postoperative steroid therapy based on pemphigus-related antibodies

A 71-year-old man had been treated as an outpatient for pemphigus vulgaris. Endoscopic examination disclosed an ulcerated lesion in the middle of the esophagus. A biopsy specimen was diagnosed pathologically as squamous cell carcinoma. At surgery, the esophageal mucosa beyond the resection margin appeared edematous and blistered. We carried out anastomosis with sutures rather than staples at the site where the epithelium was least damaged, to minimize likelihood of anastomotic breakdown from poor blood flow. Histopathologic examination of the resected specimen additionally showed blisters and acantholytic cells throughout the esophageal mucosa, so esophageal pemphigus was diagnosed in addition to carcinoma. The patient's general condition deteriorated from worsening of pemphigus. We initiated steroid therapy, making adjustments according to changes in titers of anti-intercellular bridge antibody and antibodies to the cell adhesion molecules (desmoglein 1 and 3). Fever and extensive blistering subsided dramatically, and the patient was discharged in good condition on hospital day 103. When performing esophagectomy in the presence of esophageal pemphigus, the anastomosis must be fashioned cautiously because any mechanical stress can abrade the friable edematous esophageal mucosa. While steroid therapy is known to be effective for pemphigus vulgaris, our findings indicate that in patients with postoperative deterioration of their general condition, marked improvement can be obtained by using antibody titers to guide timing and dose in steroid administration.

Sexual dimorphism in the Japanese cranial base: a Fourier-wavelet representation

An approach, computational shape analysis (CSA), is presented here which utilizes a Fourier-wavelet representation to numerically describe shape features of biological forms. Two elements are involved: 1) elliptical Fourier functions (EFFs), to provide estimates of global aspects, and 2) continuous wavelet transforms (CWTs) to generate an objective estimate of localized features. EFFs are computed, using a set of pseudohomologous points, to create a precise analog of the boundary. This computed contour is then normalized by scaling and rotated in two-dimensional space to insure a representation that is invariant with respect to starting point, size, and orientation. The predicted point coordinates derived from the EFFs are submitted to CWT for further processing. Wavelet coefficients are then computed to identify localized features, localization being a subjective process with EFFs. The advantage of wavelets is that they eliminate the inevitable subjectivity inherent in the choice of measurements. To test the usefulness of CSA, a sample of cranial base (CB) lateral radiographic outlines was available. Five archaeological periods, Yayoi, Kofun, Kamakura, Edo, and Modern, were utilized (n = 297). Statistically significant differences in sex and archaeological age were found. Although archaeological age differences were present, they were small and random in character, suggesting stability in the CB structures. In contrast, sexually dimorphic differences were present in every group from the Yayoi to the Modern period. This presence of sexually dimorphic differences in shape was consistent with earlier studies of M. nemestrina, G. gorilla, and P. troglodytes. Consequently, it is suggested that the pattern of sexual dimorphism documented in the Japanese CB is a primate pattern with an ancient evolutionary history. The results demonstrate, both visually and numerically, that CSA is a powerful approach for describing both global and localized features of craniofacial structures such as the CB.

Post-activation depression of the soleus H-reflex in stroke patients

PURPOSE

We examined post-activation depression in 35 stroke patients and 10 healthy subjects, and investigated whether their clinical symptoms were correlated to post-activation depression.

METHODS

Post-activation depression of the soleus H-reflex evoked by electrical stimulation of the common peroneal nerve with supramaximal intensity of motor response on the tibialis anterior muscle.

RESULTS

Post-activation depression was decreased on the affected side of the stroke patients. There was a significant difference between the affected and unaffected sides of the patients with post-activation depression, but no difference between the unaffected sides of the patients and healthy subjects. The presence of ankle clonus and the decrease in post-activation depression were correlated.

CONCLUSION

Decreased post-activation depression in stroke patients suggests that a mechanism other than postsynaptic inhibition, such as reciprocal Ia inhibition and Ib inhibition, and presynaptic inhibition, may contribute to the exaggerated stretch reflexes, in particular, the manifestation of clonus.

A new method of superficial peroneal nerve conduction studies

Herein, we report a new method for obtaining sensory nerve conduction velocities (SCVs) in the distal segment of the superficial peroneal nerve (SPN). Twenty lower extremities from 10 normal subjects (mean age: 33.4 years) were evaluated. The recording electrodes were placed on the dorsal surfaces of the ankle and foot. We stimulated the SPNs on the anterior edge of subjects' fibulas, and evoked sensory nerve action potentials (SNAPs) antidromically. SCVs were calculated based upon the distances and the latencies. The mean SCV was 41.3 +/- 4.3 m/s in the distal segment, which was slower than in the proximal segment (51.7 +/- 3.9 m/s). We were able to stimulate only the SPN with certainty. In conclusion, the described technique should be of clinical value in diagnosing peripheral neuropathy.

Conversion of Lactobacillus pentosus D-lactate dehydrogenase to a D-hydroxyisocaproate dehydrogenase through a single amino acid replacement

The single amino acid replacement of Tyr52 with Leu drastically increased the activity of Lactobacillus pentosus NAD-dependent D-lactate dehydrogenase toward larger aliphatic or aromatic 2-ketoacid substrates by 3 or 4 orders of magnitude and decreased the activity toward pyruvate by about 30-fold, converting the enzyme into a highly active D-2-hydroxyisocaproate dehydrogenase.

Testicular toxicity of dietarily or parenterally administered bisphenol A in rats and mice

Male Crj:Wistar rats, HsdHot:Holtzman SD rats, Crj:CD-1(ICR) mice and C57BL/6CrSlc mice were administered bisphenol A (BPA) in the diet at a level of 0 (control) and 0.25% for 8 weeks. Daily BPA intake was about 200 and 400 mg/kg for rats and mice, respectively. No conspicuous signs of general or reproductive toxicity were observed after administration in any strain of these animals. Serum testosterone concentrations were not decreased in BPA-fed rats and mice. Successive subcutaneous administration of BPA at a dose of 200 mg/kg/day for 4 weeks significantly decreased the testis, epididymis, prostate and seminal vesicle weights, and the testicular daily sperm production in Jcl:Wistar rats. Successive intraperitoneal administration of BPA at a dose of 20 mg/kg/day for 4 weeks decreased the prostate and seminal vesicle weights but not the testis or epididymis weights. An intraperitoneal dose of 2 mg BPA/kg/day did not cause any toxicity. These results indicate that dietarily administered BPA is less toxic to most strains of rats and mice, and the maximum non-toxic dose and/or minimum toxic dose may be about 200 mg/kg/day. Subcutaneous or intraperitoneal BPA is much more toxic on male reproductive and sex accessory organs than dietary.

Solitary true cyst of the pancreas in an adult: report of a case

BACKGROUND

Solitary true cyst of the pancreas is rare in adults, and the differential diagnosis of cystic lesions of the pancreas is challenging.

AIM OF THE STUDY

To describe a solitary true cyst of the pancreas in an adult and discuss the differential diagnosis.

METHODS

A 50 yr old woman presented with a mass lesion in the right upper quadrant of the abdomen. Abdominal computed tomography showed a cystic lesion, with a maximum diameter of 12 cm, between the inferior surface of the liver and the ascending colon. The cyst was homogenous and had smooth edges. On magnetic resonance imaging, a unilocular cyst was seen that was low intensity on T1-weighted images and very high intensity on T2-weighted images. No connection between the cyst and the pancreatic ductal system was demonstrated on endoscopic retrograde cholangiopancreatography. Laparotomy was performed with a presumptive diagnosis of cystic tumor of the pancreas.

RESULTS

On pathologic examination, the cyst was serous and was lined with a single layer of normal cuboidal epithelium that was periodic acid Schiff stain negative. Meticulous examination failed to identify honeycomb-like microcysts characteristic of serous cystadenoma. The final diagnosis was a solitary true cyst of the pancreas.

CONCLUSION

The differential diagnosis of solitary true cyst from other cystic lesion of the pancreas usually is based on histology. Particular care must be taken to distinguish this lesion from macrocystic serous cystadenoma.

Cost analysis of paediatric tuberculosis treatment in Japan

OBJECTIVE

To estimate the cost of treating a tuberculosis (TB) case and to analyse TB-related medical service utilisation, a cost-of-illness study was conducted for all patients with a primary diagnosis of TB admitted to a public hospital in Japan.

METHODS

Retrospective analysis by abstracting in- and out-patient medical records of 57 paediatric patients diagnosed with TB during 1993-1998 at a public hospital in Osaka prefecture. Costs were estimated based on third party's payer perspectives according to the service utilisation pattern. In addition to cost data, sociodemographic information and service utilisation pattern were also extracted from the medical records. Cost of preventing a case of TB was abstracted from the published literature.

RESULTS

The average cost of treatment was 8384 US dollars (95%CI 5667-11,099), while the average length of hospitalisation was 63 days (95%CI 43-84). Based on 20-80% vaccine efficacy, the cost of preventing a case of TB was 35,950-175,862 US dollars. In univariate analysis, site of TB (P = 0.04) was significantly associated with TB treatment cost, while case-finding method (contact tracing, symptoms, etc.) was associated with length of hospitalisation (P = 0.03). Multivariate regression analysis, however, showed none of the factors to be significant predictors of TB treatment cost and length of hospital stay.

CONCLUSION

The cost of treating a case of paediatric TB is much lower than that of preventing one. Japan's universal BCG vaccination policy should be re-examined in the light of economic, social and political issues.

Postnatal development of protein gene product 9.5 and calcitonin gene-related peptide immunoreactive nerve fibres in rat temporomandibular joint disc

Protein gene product 9.5 (PGP 9.5), an immunohistochemical marker of whole nerve fibres, and calcitonin gene-related peptide (CGRP), a marker of thin nerve fibres, were used to elucidate the postnatal development of nerve fibres in rat temporomandibular joint (TMJ) disc. At birth, PGP 9.5-immunoreactive nerve fibres exhibited running towards the central area of the disc, invading by approximately 95 m from the disc attachment. The nerve fibres existing inside the disc became longer during postnatal development. The number of nerve fibres in the disc increased in a progressive manner up to 40 days after birth. CGRP-immunoreactive nerve fibres also presented changes essentially similar to those of PGP 9.5-immunoreactive nerve fibres. However, the proportion of CGRP-immunoreactive nerve fibres to PGP 9.5-immunoreactive ones was approximately 80%, and remained constant up to 40 days after birth. In conclusion, the distribution and the number of nerve fibres are variable during postnatal development, although the ratio of thin nerve fibres remains invariable. It is emphasized that these changes of innervation in the TMJ are associated with the development of masticatory function.

A case report of intravenous leiomyomatosis extending into the heart

The patient was a 47-year-old woman who underwent total hysterectomy for uterine leiomyoma in 1994. Two years later, intracaval and intravenous tumors were found by ultrasonic cardiography, magnetic resonance imaging, enhanced chest computed tomography, and venography. The patient underwent total removal of these tumors. Pathological findings indicated that these tumors were leiomyomas. After comparing the present findings with those of similar cases in the literature, we concluded that our patient had intravenous leiomyomatosis extending into the heart.

[Central nervous system involvements in Duchenne/Becker muscular dystrophy]

Duchenne/Becker muscular dystrophy (DMD/BMD) are the most common inherited muscular diseases caused by mutations in the dystrophin gene. The identification of novel dystrophins in the brain has recently implicated its absence or malfunction etiologically in mental retardation (MR). We therefore examined the relationship between molecular abnormalities and clinical phenotypes. Deletions of the dystrophin gene were analyzed in a total of 137 DMD/BMD patients (DMD 94, BMD 43) to determine central nervous system (CNS) symptoms. The mental capacity was assessed and patients with IQs below 70 were defined as mentally retarded. Thirty-nine percent of DMD boys and 12% of BMD patients were classified as mentally retarded. Eight DMD and 2 BMD patients were diagnosed as having autism. Forty-four percent of DMD and 79% of BMD patients had deletions in the dystrophin gene. All the DMD/BMD patients with deletions upstream of the 5' end of the gene were mentally normal. All of DMD/BMD patients with MR and/or autism had deletions containing the 3' end, although some patients with similar deletions were mentally normal. Our data suggest that Dp140, Dp71 and/or Dp116, the C-terminal translational products of dystrophin, may be related to MR and/or autism in DMD/BMD. However, there was an exception in our series. Three of eight sibling pairs in our cases had different phenotypes, although they had the same mutations in the dystrophin gene. Thus the CNS phenotypes were not determined by the mutations of dystrophin gene alone, and the interaction of dystrophin with other nuclear genes may play important roles.

Expression of cementum-derived attachment protein in bovine tooth germ during cementogenesis

Cementum-derived attachment protein (CAP) is a 56 kDa collagenous protein that promotes attachment of mesenchymal cells. Previous studies have shown that the presence of CAP is restricted to cementum in adult human tissues. In this study, we report generation of a monoclonal antibody against CAP and its use for the investigation of CAP in developing bovine tooth germs. Mice were immunized with CAP purified from bovine cementum, and a monoclonal antibody, 3G9, was produced. Immunohistochemical staining of bovine tooth germ at root forming stage using 3G9 antibody showed that the tissue distribution of CAP expression was limited to cementum matrix and cementoblasts during cementogenesis. Alveolar bone did not stain with the 3G9 antibody, whereas anti-type I collagen stained positively. CAP was purified from bovine tooth germs with immunoaffinity purification using the 3G9 antibody. Examination of the immunoaffinity-purified fraction showed that CAP existed in tooth germ as a 65 kDa protein. The protein was susceptible to bacterial collagenase. To investigate the possible biological function of CAP during cementogenesis, we isolated dental follicle cells from the bovine tooth germ, and showed that they adhered to surfaces containing CAP. These data demonstrate that CAP is expressed by bovine cementoblasts as a 65 kDa protein and that the CAP may have a function in cementogenesis.