[99mTc-MIBI scintigraphy for the detection of parathyroid lesions in patients with hyperparathyroidism]

The usefulness of 99mTc-MIBI scintigraphy for the detection of parathyroid lesions was evaluated in 17 patients with hyperparathyroidism. Delayed image was used to evaluate the lesions. Detectability of MIBI for parathyroid lesions was 86% (18/21). The smallest lesion detected was parathyroid hyperplasia weighted 270 mg. Ectopic parathyroid adenoma and bone metastases of parathyroid carcinoma were clearly demonstrated. Detectability of MIBI scintigraphy for the lesions including ectopic and metastatic lesions was the highest among those of ultrasonography, CT and MRI methods. MIBI scintigraphy was thought to be useful for the detection of parathyroid lesions, especially for ectopic and metastatic lesions.

Tritium concentrations of blood samples collected throughout Japan

Tritium concentrations were measured for blood samples collected from 20 cities throughout Japan during 1989-1990. The mean 3H concentration was found to be 1.4 +/- 0.4 Bq L-1 and 1.0 +/- 0.4 Bq L-1 (combustion water) for free water 3H and organically-bound 3H, respectively, excluding the abnormally high data of one city. The organically-bound 3H contents clearly depended on the latitudes of sampling locations, although the free water 3H concentrations showed no correlation with the latitudes. Organically-bound 3H is considered to be more suitable than free water 3H as an indicator of long time 3H exposure to human.

[Sex differences in EEG background activity: a study with quantitative analysis in normal adults]

The present study performed quantitative EEG analysis in normal 20 males and 20 females, aged 18-26 years, in order to examine the sex differences in EEG activity at rest. The females had more absolute EEG power than the males, with significant differences observed for delta, theta and beta bands. In contrast, no significant difference was found in peak alpha frequency or relative EEG power for any frequency band. The present findings provide further evidence that females have more absolute power in resting EEG, and emphasize the importance of matching patients and control populations for sex in future investigations dealing with the relationship between resting EEG and various pathological conditions.

Abnormal photic driving responses in never-medicated schizophrenia patients

The present study was conducted to compare electroencephalogram (EEG) driving responses to 10 hertz photic stimulation in 14 drug-naive schizophrenia patients and 16 sex- and age-matched control subjects. The amplitude of photic driving responses (PDRs) recorded from the occipital region was significantly lower in schizophrenia patients than in controls. In eight schizophrenia patients (vs. none in the control group) the PDR amplitudes recorded at the frontal region were higher than those at the occipital region, and frontal to occipital PDR ratios were significantly larger in schizophrenia subjects than in controls. Quantitative analysis of the resting EEG showed that the patients also had a significantly lower amplitude for the alpha frequency band. These findings suggest that the PDRs of schizophrenia patients are abnormal in their amplitude and distribution.

Engraftment of precursor lesions of human cutaneous neoplasms onto C.B-17 SCID mice: a useful in vivo experimental model of carcinogenesis in human skin

Using a full-thickness skin grafting technique, lesional skin from various human neoplastic and preneoplastic skin diseases was transplanted onto SCID (severe combined immunodeficiency) mice. Of 27 grafted lesions, 21 were successfully accepted by the mice and maintained in good condition. All these accepted grafts were finally excised 10-101 days after transplantation for histological examination. In most grafts, the characteristic histological configurations of each disease were well preserved. Immunohistochemical study using monoclonal antibodies to human blood group antigens ABH revealed that some elements of the grafts such as sweat glands were clearly positive, confirming that the tissue was from human skin. Neoplastic (atypical) cells were detected in 9 of 17 accepted grafts containing neoplastic cells from the beginning. The detection rates for neoplastic cells were very high (90%) in grafts from precursor lesions of squamous cell carcinomas such as Bowen's disease (5/5 specimens) and thermal keratosis (2/3). In contrast, no definite neoplastic cells were found in two grafts from extramammary Paget's disease and five grafts from the radial growth component of malignant melanoma. In most of the grafts from latter two diseases, characteristic histological configurations such as elongation of the rete ridges were maintained, suggesting that the neoplastic cells were selectively eliminated from the grafts. Split-thickness grafts of normal human skin were accepted and remained in a good condition for as long as 6 months. Engraftment of human lesional and non-lesional skin onto SCID mice therefore may well provide a useful in vivo experimental model of human skin diseases.

Intraoperative radiation therapy (IORT) for head and neck cancer

PURPOSE

To determine the efficacy of intraoperative radiation therapy (IORT) for patients with advanced or recurrent head and neck cancer.

METHODS AND MATERIALS

Intraoperative radiation therapy was given at 30 sites in 25 patients using a 6-18 MeV electron beam with or without conventional external beam irradiation. A single dose of 10-30 Gy was delivered after surgical resection. Sites treated with IORT were classified into three types after surgical resection: gross residual disease (GR, n = 7), microscopic residual disease (MR, n = 12), and close margin (CM, n = 11). Local control rate, patterns of recurrence, survival rate, and complications were analyzed.

RESULTS

The 2-year cumulative local control rate within the IORT port was 54.1% for all cases, 0% for GR, 54.5% for MR, and 81.8% for CM. There were significant differences between GR and MR (p < 0.05), and GR and CM (p < 0.01). The majority of the failures inside the IORT port were associated with recurrence outside the port. Distant metastases occurred in five patients. Four of these had GR. The 2-year cumulative survival rate was 45.1% for all, 0% for GR, 33.0% for MR, and 70.0% for CM. Five patients (22%) experienced late complications. The 2-year cumulative complication rate was 32.8%. Four sites developed osteoradionecrosis and three developed carotid artery blowout. Incidence of complications increased when patients received over 20 Gy with a single dose of IORT.

CONCLUSIONS

Considering both therapeutic ratio and patterns of failure, it is not suitable to treat patients with gross residual disease with IORT. We could not firmly determine the therapeutic value of IORT for patients with microscopic residual disease and close margin. For this subset, further study of moderate dose (less than 20 Gy) IORT combined with adequate postoperative irradiation is needed.

[Basic and clinical studies of fleroxacin on infectious enteritis. Research Group of AM-833 on infectious enteritis]

A clinical study was conducted on fleroxacin (FLRX) in 143 patients and carriers with infectious enteritis (shigellosis, Salmonella enteritis, Campylobacter enteritis, pathogenic Escherichia coli enteritis, Vibrio parahaemolyticus enteritis, cholera, multiple bacterial infections, pathogen-negative enteritis). Furthermore, its antibacterial activity against clinical isolates, fecal concentration and effect on fecal microflora were conducted. FLRX was administered orally in doses of 200 mg once a day (200 mg group) or 300 mg once a day (300 mg group) for 3 days to cholera, for 7 days to Salmonella enteritis and for 5 days to the other infectious enteritis. The clinical efficacy rates were 100% in both the 200 mg and 300 mg groups. The bacteriological efficacy rates were 100% against Shigella spp., Salmonella spp., pathogenic E. coli, V. parahaemolyticus and V. cholerae O1, and 63.6% against Campylobacter spp. in the 200 mg group. The rates of the 300 mg group were 93.3% against Shigella spp., and 100% against Campylobacter spp. and pathogenic E. coli. As adverse effects, skin rash was observed in 1 case each in both groups (1.1%, 2.1%). Abnormal laboratory findings consisted of 1 case of increased eosinophils and 1 case of elevated GOT and GPT levels in the 200 mg group (2.8%), and 1 case of elevated GPT in the 300 mg group (2.9%). The clinical usefulness rates were 92.9% and 93.3% in the 200 mg and 300 mg groups, respectively. Antibacterial activity was somewhat inferior to that fo ciprofloxacin and equal to or better than that of norfloxacin, demonstrating MIC90 values against Shigella spp., Salmonella spp., pathogenic E. coli, V. parahaemolyticus and Campylobacter spp. of 0.1, 0.2, 0.1, 0.2 and 0.78 micrograms/ml, respectively. Peak fecal concentrations of the drug were 49.0 micrograms/g and 274.4 micrograms/g in the 200 mg group, and 43.3 micrograms/g and below the detection limit (5.0 micrograms/g) in the 300 mg group. With respect to fecal microflora (4 cases), a decrease in Enterobacteriaceae was observed in 3 cases during dosing. But this change showed a tendency to recover after completion of dosing. No effects were observed on anaerobic bacteria.

[Quantitative analysis of EEG background activity in drug-naive schizophrenic patients]

In this study we performed quantitative EEG analyses in 12 drug-naive patients who fulfilled DSM-IIIR criteria for schizophrenia and in a group of 12 healthy subjects. The schizophrenic patients were found to have slower activity (delta and theta) than the controls. These differences were most marked in the frontal region for delta band and in the occipital region for theta band. The schizophrenic patients also had more beta 1 activity, particularly in the occipital leads. Conversely, they had less alpha 2 activity over all regions examined. Our findings indicate cerebral dysfunction in schizophrenia and are in line with the hypothesis of hypofrontality in this disorder.

Organically-bound tritium concentration in unhulled rice samples harvested between 1979 to 1991

Organically-bound 3H (OBT) concentrations in unhulled rice samples harvested between 1979 to 1991 are reported. The sample reaped in 1979 had the highest OBT concentration. OBT concentrations in the samples yielded recently have been at approximately 1 Bq (L-combustion water)-1 or less.

[Long term observation on beta-hemolytic streptococci in institutions for handicapped preschool children. Streptococcal Diseases Study Group]

Studies on beta-hemolytic streptococci have been carried out in 2 institutions for handicapped preschool children during the last nine-year period from 1985 to 1993. These studies were based on continuous throat cultures, 4 to 12 times a year, from 244 children including Down's syndrome and mentally retarded children in K-institution (K), and from 134 including cerebral palsy and other cerebrospinal disorders in H-institution (H). A significant difference (p < 0.05) was demonstrated in the isolation rates between K (11.1%) and H (6.4%). In K, isolation rates of beta-hemolytic streptococci ranged from 0 to 43.5%, showing a higher rate in winter (16.5%) than in summer (6.6%), and elevated-isolation rates of homologous types were demonstrate four times during the study period; i.e., type T12 in '87, type T28 in '88, type T1 in '90 and '92. In H, on the other hand, no higher rates (as to group A) were observed in winter or summer. In relation to disorders of children, the rates were 12.6% in Down's syndrome (mean age 2.7y), 10.0% in mentally retarded children (3.9y) and 6.4% in cerebral palsy or others with cerebrospinal disorders (3.3y). Down's syndrome, the youngest group, revealed the highest isolation rate of beta-hemolytic streptococci. In only two cases isolated hemologous types detected were over two times continuously.

Radical radiation therapy for adenocarcinoma of the uterine cervix

PURPOSE

Analysis of the therapeutic value of radical irradiation for patients with uterine cervical adenocarcinoma with special reference to pelvic disease control.

PATIENTS AND METHODS

20 patients with uterine cervical adenocarcinoma were treated with a combination of external beam and intracavitary irradiation (four patients stage IB, one stage IIA, three stage IIB and twelve patients stage IIIB). Seven patients were treated with high dose-rate (HDR) intracavitary irradiation, eleven with low dose-rate (LDR) intracavitary irradiation and two with HDR and LDR.

RESULTS

Six out of the 20 patients experienced pelvic recurrence (all stage IIIB patients). Analysis of the relation between pelvic recurrence and dose rate of intracavitary irradiation revealed that LDR showed a higher pelvic disease control rate than HDR (6/7 vs. 0/4) in stage IIIB patients. Intracavitary irradiation doses of LDR were 1.2 to 1.5 times higher than those of HDR. Three out of the 20 patients developed rectal complication grade 2 (two patients treated with HDR, one with LDR). The five-year cumulative survival rate was 67.2% for all, 100% for stage I and II, and 43.3% for stage IIIB patients.

CONCLUSION

These results suggest that locally advanced uterine cervical adenocarcinoma should be treated with a higher dose using LDR intracavitary irradiation. If adequate total doses can be delivered, pelvic disease control of uterine cervical adenocarcinoma is comparable with that achieved for squamous cell carcinoma.

Simultaneous multielemental analysis of daily food samples by inductively coupled plasma mass spectrometry

Several toxic elements in total composite food samples of hospital diets were determined simultaneously by inductively coupled plasma mass spectrometry (ICP-MS). Trace element concentrations of Be, Cr, As, Cd, Sn, Sb, Ce, Hg and Pb changed widely ranging from a few ng.g-1 to less than 3 micrograms.g-1 in all 24 samples collected through a year. Be, Sn, and Hg were not detected in rice sample alone, and other trace elements, with the exception of Cr and As, were less than approximately 50% levels, as compared with mixed diet samples. The daily intakes of these toxic elements were in the ranges of a few to several hundreds of micrograms.

Gender differences in quantitative EEG at rest and during photic stimulation in normal young adults

In the present study quantitative EEG analysis was performed in 20 male and 20 female healthy adults in order to examine the gender differences in EEG activity at rest and during photic stimulation. The females generally showed a higher amplitude in the resting EEG than the males, with significant differences observed for the delta, theta, alpha 2 and beta bands at the limited electrode sites. The gender differences were more pronounced in EEG activity during photic stimulation, and the females had a higher EEG amplitude in the frequency band identical or harmonically related to the stimulus frequency. These findings provide further evidence that the gender differences exist in EEG activity in both stimulus and nonstimulus conditions.

[Role of postoperative irradiation for carcinoma of the uterine cervix: multivariate analysis of prognostic factors and patterns of failure]

We retrospectively analyzed the patterns of recurrence in 48 patients who underwent postoperative irradiation following surgery for carcinoma of the uterine cervix. The end points of pelvic control, distant metastases and disease-free survival were analyzed for parameters including FIGO stage, nodal status, degree of stromal invasion, histology and tumor size. Univariate and multivariate analyses showed that some prognostic parameters had little influence on pelvic control rate, but had a marked impact on the incidence of distant metastases and disease-free survival rate. These results suggest that postoperative irradiation improves pelvic control rate, but has little therapeutic benefit in preventing distant metastases or improving survival rate. In conclusion, we should give more consideration to adjuvant systemic therapy in addition to postoperative irradiation for high-risk patients.

Organ distribution of silver and the effect of silver on copper status in rats

Tissue distribution of silver, alteration in tissue concentration of copper, zinc and iron, as well as changes in serum ceruloplasmin (CP) status were investigated in Fischer 344 rats after intraperitoneal (i.p.) administration of silver (9.3 mumol Ag/kg body wt.) as silver nitrate alone or combined with zinc (46.5 mumol Zn/kg) as zinc sulfate once a day for six successive days. Silver deposited in all the tissues examined, particularly in the pancreas, showing silver concentration in the serum, kidney, heart and lung to be significantly increased by simultaneous injection of zinc, while zinc concentration in the liver, pancreas and heart was significantly affected by silver. The most prominent effect of silver administration was observed in the copper status. As the result of altered copper metabolism by silver administration, copper concentration in the liver, pancreas and kidney was significantly changed, and serum copper concentration and CP oxidase activity were decreased to 60% and 25% of the control value, respectively. However, immunoblot analysis of serum CP in silver-treated groups showed only a slight decrease in protein levels, suggesting that most of the CP existed as an oxidase inactive apo-form. Simultaneously administered zinc hardly affected such changes. These results indicate that silver administration causes a disturbance of copper metabolism, and that zinc hardly plays a protective role against such changes.

Quantitative EEG analysis at rest and during photic stimulation in drug-naive patients with first-episode paranoid schizophrenia

In the present study, quantitative EEG analysis was performed at rest and during 10 Hz photic stimulation in 14 drug-naive patients with first-episode paranoid schizophrenia and 20 sex- and age-matched control subjects. Compared with the normal controls, the patients had significantly lower alpha-2 band amplitude in the resting EEG over all recording regions. No significant group differences were found in other frequency bands. In addition, EEG analysis during photic stimulation demonstrated that the patients had a rather uniform topographic profile in EEG amplitude for the alpha band, with significant group differences being confined to the posterior regions in the left hemisphere. There were no significant group differences in the amplitude for the frequency bands harmonically related to the stimulus frequency. These findings provide further evidence that schizophrenic patients have abnormal EEG activity in both non-stimulus and stimulus conditions, and suggest a dysfunction in the mechanisms underlying EEG alpha generation in schizophrenia.

[Digestion method for detection of ferruginous bodies in human tissues from autopsy cases]

We compared three sodium hypochlorite digestion methods and two potassium hydroxide digestion methods for detection of ferruginous bodies in human tissues. The following results were obtained. 1. Methods using sodium hypochlorite were effective for digestion of lung tissue samples, but only in part for greater omentum tissue samples. The potassium hydroxide digestion method worked well for preparation of lung and greater omentum tissue samples. 2. Results obtained by the different digestion methods were compared by Kruskal-Wallis test and Mann-Whitney U-test. No significant difference was detected in concentrations of ferruginous bodies and naked fibers in samples of lung, and tumor and normal tissues of the greater omentum among the digestion methods. 3. A more simplified procedure for sample processing with potassium hydroxide digestion was recommended for detection of ferruginous bodies in human tissues.

[Influence of age and sex on threshold dose of mercury in Minamata disease as determined by hair mercury concentration]

The influence of age and sex on the threshold dose of mercury in Minamata disease was studied by dose-response analysis based on mercury concentrations in hair obtained mainly from adults living near the Agano River at the beginning of Niigata Minamata disease outbreak in 1965. The subjects were 174 male and 694 female inhabitants of polluted areas including 55 males and 66 females officially recognized as Minamata disease patients. Because of the large sex differences in numbers and age distributions, the data were analyzed separately for males and females. While revealing no sex difference in the threshold dose, hockey-stick regression analysis indicated an effect of age on threshold dose in females. Logistic regression analysis showed no interaction between age and hair mercury concentration. These results suggest that, in adults, neither sex nor age exert a considerable effect on the threshold dose of mercury in Minamata disease.

Development and evaluation of capture enzyme-linked immunosorbent assays for detection of immunoglobulin G and M antibodies to group A streptococcal antigens

Capture enzyme-linked immunosorbent assays (ELISAs) were developed to detect immunoglobulin G and M antibodies to group A streptococcal (GAS) antigens, streptolysin O, streptokinase, and group A carbohydrate. The sensitivities and the specificities of the IgM capture ELISAs to each GAS antigen were high enough to distinguish the patients with GAS infections (diagnosed as GAS pharyngitis or scarlet fever) from the control groups (healthy people and patients with pharyngitis from whom GAS could not be isolated). On the other hand, the specificities of the IgG capture ELISAs were not very effective in diagnosis of GAS infections. When the capture ELISA and an indirect ELISA detecting IgM antibodies to group A carbohydrate were compared, false-positive reactions due to rheumatoid factor occurred in the indirect ELISA, but did not occur in the capture ELISA. These results indicate that the capture ELISA works better than the indirect ELISA in detecting the IgM antibody, and that the IgM capture ELISA to GAS antigen provides a rapid and highly reliable serodiagnosis for GAS infections employing only a single serum.

Versatility of the free or pedicled superficial cervical artery skin flaps in head and neck burns

The usefulness of the free or pedicled superficial cervical artery skin flap in reconstructive surgery of head and neck burns is reported. This flap can be made with the pivot point near the cervical region. Moreover, it can be elevated as a free or long vascular pedicled flap. Therefore, it is widely applicable in reconstructing the scar contractures of the head and neck, particularly in extensively and deeply burned patients.

Deficiency of holo-, but not apo-, ceruloplasmin in genetically copper-intoxicated LEC mutant rat

Long-Evans Cinnamon(LEC) mutant rats exhibited less than 5% of normal levels of serum ceruloplasmin oxidase activity, but immunoblot analysis showed normal levels of immunologically detectable ceruloplasmin protein in sera from the mutant rats. Immunostaining of cryosections from the liver tissues with anti-ceruloplasmin antibody showed no significant difference between normal and LEC rats. Results from pulse labeling of ceruloplasmin for 3 hours with [35S]methionine in primary hepatocyte culture, followed by immunoprecipitation, SDS-PAGE and fluorography, showed only minor changes in ceruloplasmin protein synthesis and secretion. These results suggest that the mutation(s) does not affect ceruloplasmin gene expression, but results in a failure in the mechanism whereby copper is incorporated into newly synthesized apoceruloplasmin to produce oxidase active holoform.

[Analgesic effects of Tsumura-shuuji-bushi-matsu and mesaconitine]

"Tsumura-shuuji-bushi-matsu" (TJ-3021) is a herbal medicine produced from Aconiti tuber through autoclaving to decrease its toxicity. In this study, the analgesic effects of TJ-3021 and mesaconitine (MA) was examined in rats and mice. TJ-3021 (300 mg/kg, p.o.) or MA (0.5 mg/kg, p.o.) depressed the acetic acid-induced writhing significantly. In Randall-Selitto's method, TJ-3021 (1000 mg/kg) increased the pain threshold ratio in the inflamed foot significantly but not in the normal foot. In the hot plate method or on adjuvant-induced arthritic pain, TJ-3021 (1000 mg/kg) significantly increased the pain threshold, and its effect was less than that of "nama-bushi-matsu" (TNB), which was produced from the same Aconiti tuber without autoclaving. Repeated cold stress (RCS) for 65.5 hr decreased the pain threshold ratio on the paw pressure in rats by 60%. TJ-3021 (300 mg/kg) significantly increased the pain threshold ratio in RCS rats, and its activity was almost the same degree as that of TNB. MA (0.5 mg/kg) significantly increased the pain threshold ratio in RCS rats or on the adjuvant-induced arthritic pain; and in RCS rats, it was more potent than morphine (1 mg/kg, p.o.).

[Concentration and form of asbestos fibers in tap drinking water contaminated from a water supply pipe with asbestos-cement]

The identification and concentration of asbestos fibers in tap drinking water supplied in a central area of Akita Prefecture, Japan, were determined by phase-contrast microscopy and a scanning electron microscope equipped with an energy-dispersive X-ray microanalyzer. The following results were obtained. 1. Asbestos fibers were found in the tap water from two areas in which an asbestos-cement pipe was used for public water supply. The concentrations of asbestos fibers in the tap water were 2.7 x 10(4) to 27.0 x 10(4) fibers per liter of water in area A and 10.0 x 10(4) to 21.0 x 10(4) in area B. On the other hand, no asbestos fiber contamination was observed in tap water of area C, which shared a common water source with area A. A vinyl chloride pipe was used over the entire length of the water supply in route C. 2. Crocidolite was the predominant type of asbestos fiber detected in the tap water. Chrysotile and a mixture of chrysotile and amosite were also observed. 3. Almost all asbestos fibers detected in the tap water possessed the form of thick or sheaved fibers with lengths ranging from ca. 5 to 10 microns. Their shapes were very different from those of asbestos fibers found in the atmosphere. The typical form of the latter is short (ca. 1 micron in length) and needle-like. 4. It was suggested that the contamination of asbestos fibers in the tap water was caused by erosion and peeling off of the inner wall of the asbestos-cement pipe used as a conduit. In order to evaluate the safety of drinking water in Japan, an extensive survey on asbestos-fiber contamination in tap water is necessary.

[Results of radiation therapy of extrahepatic bile duct carcinoma]

From January 1975 to August 1988, 40 patients with extrahepatic bile duct carcinoma were treated by external irradiation at Chiba University Hospital and the National Medical Center Hospital. Thirty-four patients (male: 20, female: 14) were evaluable. Eighteen patients were postoperative cases because the surgical margin was positive for tumor cells in the postoperative pathological examination; the other 16 were inoperable cases. Survival in postoperative and inoperable cases was not significantly different, with median survival times of 13.8 and 8.1 months, respectively. Survival in the recanalization-positive and negative-groups was significantly different (p less than 0.05) after irradiation, with median survival times of 13.5 and 6.0 months, respectively. Complications of therapy were recognized in 68% of all cases. They were mainly gastrointestinal symptoms such as nausea, vomiting, erosive gastritis and loss of appetite, but they were not severe. Distant metastasis was recognized in only 4 patients (10%): three had bony metastasis and one had supraclavicular and pulmonary hilar lymph node metastasis. Ninety percent of all cases died from hepatic failure or peritonitis carcinomatosa due to failure to obtain local control by external irradiation. A more effective modality of treatment is necessary to cure these patients.

A fetal type of Minamata disease. An autopsy case report with special reference to the nervous system

Our knowledge concerning the pathology of fetal cases of human Minamata disease (methylmercury poisoning) is relatively limited. We report here a case with description of the distribution of mercury in the systemic organs, and the ultrastructural changes of the nervous system after a survival of 29 yr. The patient was a female born in 1957, with a body wt of 3000 g, who died in 1987. She carried a diagnosis of cerebral palsy, and had a convulsion at age 3 yr. Mercury levels in her mother's hair were 101 micrograms/g at the time of examination in 1959. At autopsy, the body measured 43 cm and weighed 23 kg. The brain weighed 920 g and showed marked cerebral atrophy, mild neuronal loss in the calcarine, postcentral and precentral cortices, cerebellar atrophy, and segmental demyelination of peripheral nerves. Mercury granules were present in the brain, kidney, and liver. Ultrastructural examination of the calcarine, post- and precentral cortices, and cerebellar cortices, showed severe atrophy of nerve cells, with a decrease in rough ER and an increase in nuclear chromatin and preservation of mitochondria. Autophagosomes were increased in number. In addition, high electron density, globular and dense bodies, measuring 0.3-1.8 microns in diameter, were found, surrounded by limited membrane, within both cerebral and cerebellar neurons. In the cellebellum, synapses were well-preserved.

[Comparison of clinical efficacy of rokitamycin (RKM) and ofloxacin (OFLX) for the treatment of Campylobacter enteritis by a double-blind method. The Research Committee for the Effect of Rokitamycin, Research Group for Infectious Enteritis]

The clinical efficacy, safety and usefulness of Rokitamycin (RKM), a new macrolide antibiotic, were compared with those of Ofloxacin (OFLX) for the treatment of Campylobacter enteritis by a double blind method. The daily dose level of RKM or OFLX was 600 mg. They were orally administered in three divided doses for 5 days. Of 223 cases studied, 106 cases were diagnosed as Campylobacter enteritis. Ninety cases (RKM group: 50, OFLX group: 40) except for 16 excluded or drop-out cases were analysed. There was no significant difference between the two groups in any background factors. The effectiveness and usefulness was evaluated in 88 cases (RKM group: 48, OFLX group: 40). The results obtained were as follows: 1. In a total of 82 strains of Campylobacter jejuni/coli (RKM group: 42, OFLX group: 40), the bacteriological efficacy rate of RKM (95.2%) was superior to that of OFLX (70.0%) with a significant difference (p = 0.006). 2. In 76 symptomatic patients (RKM group: 42, OFLX group: 34) on the day of the beginning of drug administration, the clinical efficacy rate was 97.6% in the RKM group and 85.3% in the OFLX group with no significant difference between the two groups. 3. In 88 evaluable patients, the global clinical efficacy rate of RKM (95.8%) was superior to that of OFLX (67.5%) with a significant difference (p = 0.001). 4. Side effect was observed in 1 (1.9%) of the 54 patients in the RKM group and none of the 44 patients in the OFLX group. Slightly abnormal laboratory findings were seen in 4 (10.8%) of the 37 patients treated with RKM and 3 (9.7%) of the 31 patients treated with OFLX, but there was no significant difference between the two groups. 5. In 88 evaluable patients, the clinical usefulness of RKM (91.7%) was superior to that of OFLX (67.5%) with a significant difference (p = 0.01). From these results, RKM is considered to be a very useful agent for the treatment of Campylobacter enteritis.

[A clinical experience of rokitamycin on Campylobacter enteritis. Research Group of Rokitamycin on Infectious Enteritis]

Rokitamycin, a newly developed macrolide, was administered to a total of 107 cases, 16 years old or more, in order to evaluate its clinical efficacy, safety and usefulness on Campylobacter enteritis. Daily dosage of 600 mg of rokitamycin was administered orally in three divided doses for 5 days. Bacteriological and clinical efficacies were judged by the attending doctors from the evaluation criteria made by the committee and from the days required for improvement of diarrhea, defervescence and so on, respectively. Antibacterial activities against the isolates were tested of rokitamycin (RKM), erythromycin (EM), josamycin (JM) and ofloxacin (OFLX). The results were as follows; 41 symptomatic patients and 5 carriers were evaluated. Clinical efficacy (n = 41) was 100% (excellent; 34.1%, good; 65.9%). Bacteriological efficacy (n = 41) was 97.6%. Eight of the 9 cases with consecutive stool cultures were free of the bacteria on and after one day of the drug administration. Clinical usefulness (n = 46) was 97.8%. Slight epigastric pain was seen in only one as a side effect. The items of abnormal laboratory findings were 4 elevated GPT and/or GOT and one increased number of WBC in 4 cases. MIC90 of RKM, EM, JM and OFLX against 41 clinical isolates of C. jejuni were 1.56, 3.13, 3.13 and 0.78 micrograms/ml, respectively. Rokitamycin was considered clinically useful to treat Campylobacter enteritis.

[A dying clinical diagnosis of scarlet fever--the last sixteen years survey]

11,119 patients with scarlet fever admitted in the last sixteen years, from 1973 to 1988, to Sapporo City General Hospital, were studied statistically on symptoms and laboratory findings. The results were summarized as follows: 1. Annual number of patients have reduced suddenly since 1981, and become zero in 1989. The patients increased in number during the winter season. Eighty two percent of the cases were between 3 and 8 years of age, and the average age was 5.8 year-old. 2. Cases of above-38 degrees C temperature were seen in about 81.4%, and from 2 to 5 days-duration of temperature were seen in 86.6% of the patients in the year 1976. Cases of above-moderate rash were observed in 68.2%, sever redness of throat in 29.9%, strawberry tongue in 86.3% and angular stomatitis in 37.7% of the patients. In recent statistical analysis (1982-1988), we found, however, a tendency that patients having stronger symptoms were being introduced to our hospital. 3. The higher rates of cases showing elevated ASD titer were seen in the elder patients and in the winter. C-reactive protein (CRP) titers were mostly in the range of (-) to (greater than or equal to 6+), having 2.4 + on an average. 4. Patients who developed into overt nephritis were not seen. Cases of microscopic hematuria (greater than or equal to 3 red cells/f in urine sediments), however, were observed in 1.1% (125/11,119). Sever complications were hardly seen. 5. Reappearance of beta-hemolytic streptococci (on a week after discharge) were found in 3.1% (241/7,877). 6. Reinfection or relapse cases of scarlet fever were found in 6.7% (642/9,585).(ABSTRACT TRUNCATED AT 250 WORDS)

[EEG data filing system with personal computer and magneto-optical disc]

We established a new computerized EEG filing system, in which an EEG machine was connected to an EEG filing unit which consisted of a personal computer with a 32 bit CPU, 18 channel analog -to-digital and digital-to-analog converters, and a magneto-optical disc driver. This system has the following merits. The system was space-saving, the space required to store the EEG data, being only 1/500 of that required for storing EEG record. Though the system had two independent EEG filing units, our original file configuration enabled us to have access to all of the recorded EEG data anytime for more than 10 years. The system enabled us to display EEG data continuously on the high resolution CRT, just as if turning the page of an EEG record paper, and through the quick scanning, enabled us to view the entire EEG pattern. Furthermore, the system enabled us to conduct reliable digital analysis for EEG data by entering the EEG data without artifacts into a data processor after confirmation on the display. In the system, we used data files with the MS-DOS operating system. This enabled us to analyze the data obtained by a personal computer operating on other systems, by transferring the data to a floppy disc operating on our system. Our EEG filing system allows quick access to data as well as mass data storage.

[Acute megakaryoblastic leukemia developing 11 years after diagnosis of essential thrombocythemia]

A 57-year-old man was diagnosed to have essential thrombocythemia (ET) in July 1977. He was doing well with continual medication of carboquone but was hospitalized because of slight unconsciousness and gait disturbance in May, 1988. His laboratory data were as follows: WBC count 81,600/microliters with 55% of blasts with cytoplasmic blebs, Hb 10.2 g/dl, and platelet count 2.6 x 10(4)/microliters. Bone marrow aspiration revealed hypercellular marrow with 72.8% blasts. Chromosomal analysis showed tetraploidy with 7p+ and 19p+. Cytochemistry of blasts showed the positivity for platelet peroxidase and CDw 41. The diagnosis of acute megakaryoblastic leukemia was made. Meningeal leukemia was also suspected by the cerebrospinal fluid data, and cytarabine was intrathecally injected. Then the percent of blasts of peripheral blood gradually decreased and the data of cerebrospinal fluid improved. However, several days later the patient became comatose probably due to cerebral bleeding, and died. In this case, two possibilities were considered (1) that a blastic transformation to acute leukemia from ET, and (2) that a secondary leukemia developed as a result of the chemotherapy, independently of ET. Since there was no evidence of myelodysplastic syndrome, it was concluded that this case represented a blastic transformation of ET.

Rapid changes in concentrations of essential elements in organs of rats exposed to methylmercury chloride and mercuric chloride as shown by simultaneous multielemental analysis

An in vivo study of rats given a dominant lethal dose of methylmercury chloride (MMC) or mercuric chloride (HgCl2) was conducted to elucidate the rapid biotransformation of essential elements. The elements were measured by inductively coupled plasma atomic emission spectrometry. For the rat brain Zn concentrations were higher in the MMC group than in the HgCl2 and control groups. The highest Cu concentration was found in HgCl2 dosed rat liver. For the rat kidney the highest Zn concentration was seen in the MMC group. From principal component analysis on the time dependent behaviour of each element in rat organs, characteristics specific to Cu in the liver and kidney and Mn in the brain were found after exposure to HgCl2 and Ca and Zn in the brain after exposure to MMC.

[A five-year follow-up study on blood pressure and serum cholesterol in junior high school children]

Blood pressure and serum cholesterol changes over a five-year period were studied in 299 junior high school children (127 males and 172 females) examined during 1980-1984 in Akita Prefecture, Japan. The six factors studied were height, weight, body mass index (by Minowa's method), systolic blood pressure, diastolic blood pressure and serum cholesterol. Mean values for systolic and diastolic blood pressure increased more than 10 mmHg during the five years in both sexes. Significant positive correlations between initial and follow-up blood pressure ('tracking') were observed. The correlation coefficients for systolic blood pressure in males and in females were 0.33 and 0.28 respectively, and those for diastolic blood pressure were 0.36 in males and 0.19 in females. While there were no significant differences in serum cholesterol levels between the two periods in either sex, the correlation coefficients, which were higher than those for blood pressure, were 0.55 in males and 0.45 in females. Among the six factors at each period, significant positive correlations were observed between height and systolic blood pressure at the initial period, and between obesity and systolic blood pressure at both periods in males and females. A significant positive relationship between obesity and serum cholesterol was seen at the follow-up period in both sexes. These data suggest that a moderate degree of 'tracking' occurs in blood pressure and serum cholesterol during childhood, and that obesity is an important factor related to blood pressure and serum cholesterol.

[Malignant histiocytosis with complex chromosomal abnormality: successful treatment with CHOP-E chemotherapy]

A 43 year-old man admitted to our hospital because of fever and splenomegaly. Laboratory findings were as follows: Hb 9.5 g/dl, Plts 4.9 X 10(4)/microliter, LDH 2,348 IU/l. Bone marrow findings showed tumor cell 47% with or without phagocytosis. The tumor cells were stained positive lysozyme and alpha 1 antitrypsin. Cytogenetic study was 47, XY, -7, -8, +9, -11, -12, -19, -21, 3q+, 6p+, +6 markers. This case was diagnosed as malignant histiocytosis. Complete remission was achieved with CHOP-E chemotherapy. Remission has been maintained with repeated this therapy. Etoposide deserves a good evaluation in the treatment of malignant histiocytosis. Some cases of malignant histiocytosis with a t(2; 5) (p23; q35) translocation were often reported in Europe and America, while there was no specific chromosomal abnormalities with malignant histiocytosis in Japan.

The tissue distribution of 2,3,7,8-chlorine substituted dibenzo-p-dioxins in humans who died of cancer

The tissue distribution of 2,3,7,8-chlorine substituted dibenzo-p-dioxins was conducted in 11 patients who died of cancer. The concentration of octachlorodibenzo-p-dioxin (octa-CDD) was the highest in each organ and tissue and hepta-CDD was also found at relatively high levels, second only to OCDD. The levels of 1,2,3, 7,8-penta-CDD and 1,2,3,6,7,8-hexa-CDD in the spleen were the highest, respectively. 2,3,7,8-Tetra-CDD was also detected and its concentration was the highest in the gonad (0.8-3.2 pg/g-range). From the 2,3,7,8-TCDD toxic equivalent calculations, the highest equivalent value was obtained from a 54-year-old female who died of cancerous goiter. This individual had the highest concentrations of 2,3,7,8-substituted penta- and hexa-CDDs among the 11 patients.

Visual dysfunction in treated schizophrenia suggested by visual evoked potentials from pattern-reversal stimulation

Steady-state visual evoked potentials (steady-state VEPs) from pattern-reversal stimulations were compared in treated schizophrenic patients and normal subjects matched for sex and age. The VEP amplitudes were more variable in the patients than in the controls. Furthermore, the VEP amplitudes of the patients mostly showed little or no change when the check size was varied, in contrast to the controls who showed a marked check size effect. These results suggest that schizophrenics receiving drugs have dysfunction of the visual system, especially an inability to respond adequately to changes of visual information.

[Study of quantitative measurement of tricuspid regurgitation using Doppler echocardiography]

The volume of tricuspid regurgitation (VTR) was measured using two-dimensional color and continuous wave Doppler echocardiography. The value of VTR showed significant correlations with the maximum area (r = 0.77), the maximum distance (r = 0.73) and the maximum width (r = 0.59) in the regurgitant signal, right ventricular pressure (r = 0.63) and the diameter of right atrium (r = 0.40). When the tricuspid regurgitation was divided into two types in viewpoint of its flow direction-flow directed to center of atrium (A type) and that directed to atrial septum (B type), VTR showed closer correlations with the maximum area (r = 0.90) and the maximum distance (r = 0.87) in A type. But in B type, their relativities were decreased (r = 0.51 and r = 0.40, respectively). The VTR was well related with the severity of tricuspid regurgitation based on the Miyatake's classification. This evidence indicated that the quantitative measurement of tricuspid regurgitant volume using two-dimensional color and continuous wave Doppler echocardiography is more accurate and useful compared with conventional semi-quantitative method.

[Effect of mercuric chloride on phospholipid peroxidation in rat]

Individual molecular species of mercuric chloride induced phospholipid peroxide formed in rat brain, liver and kidney were determined using the multi-channel UV-high-performance liquid chromatography (HPLC) combined with potentiometric determination. Mercuric chloride (0.5 mg/kg/day) was administered subcutaneously to rats for 3 days. In accordance with a specified time schedule following administration (0.5, 1, 3 and 5 days), rats were decapitated and the phospholipids of brains, livers and kidneys were extracted and purified. The samples were then injected into the HPLC and the ratio (235 nm/203 nm) of peak area of each phospholipid was calculated. The peroxide value of each sample was determined using the calibration curve of the auto-oxidized standard phospholipids which were analyzed by both potentiometric determination and UV HPLC. Kidney phospholipid peroxides were easier induced than those in other organs reached their maximum peak (20.5 meq./kg) at 1 day after initial administration. Phospholipid peroxides in kidney and brain showed similar movement, while those in liver showed their maximum peak 3 days later. Of the phospholipids, phosphatidylserine and phosphatidylethanolamine seemed to be more susceptible to lipid peroxidation induced by mercuric chloride, the common feature of these two phospholipids being that both of them have primary amine group(s) on their polary heads and both are located on the cytosolic side of cell membrane. These results may be explained by mechanisms that relate to the interaction between mercurials and cell membranes or that between mercurials and primary amine groups of phospholipids. Further study is necessary to clarify the specific mechanisms involved in the induction of lipid peroxidation by mercurials and the interaction of mercurials with phospholipids.

[Amyotrophic lateral sclerosis and mercury--preliminary report]

The mercury and selenium content in the hair of 13 ALS cases was studied by neutron activation analysis. The total mercury content of the hair was 3.70 +/- 2.73 ppm (mean +/- standard deviation) in the ALS patients as a whole, 4.46 +/- 3.16 ppm in the ALS patients from the middle of Kii Peninsula, and 2.49 +/- 1.38 ppm in the ALS patients from other region. As the comparison, mercury content was 2.43 +/- 0.79 ppm in the patients with Parkinsonism, and 2.10 +/- 1.13 ppm in the patients with multiple sclerosis (MS). The selenium content of the hair was 0.36 +/- 0.35 ppm for all ALS patients as a whole, 0.45 +/- 0.25 ppm in the ALS patients from the middle of the Kii Peninsula, and 0.21 +/- 0.47 ppm in the ALS from other region. There were no cases with higher values than mean values of control group, except one case from other regions. It is well known that the selenium decreases the toxicity of mercury in the human body. From these data mercury with low content of selenium might be one of the environmental factors which are thought to be involved in producing of ALS.

Immunohistochemical detection of heterophile Hanganutziu-Deicher antigen in human malignant melanoma

The Hanganutziu-Deicher (HD) antigen is a heterophile antigen whose immunodominant molecule is N-glycolylneuraminic acid, a sialic acid that cannot be found in normal tissues of either humans or chickens. Using biotinylated chicken anti-HD antibody purified with affinity chromatography, expression of HD antigen was immunohistochemically investigated in formalin-fixed tissues of human malignant melanoma. HD antigen-positive melanoma cells were clearly demonstrated in 7 of 11 lesions of malignant melanoma. No HD antigen-positive cells were found in 8 lesions of melanocytic nevus, and no components of normal human skin including epidermal melanocytes were stained with the antibody. This study is the first that immunohistochemically demonstrates HD antigen in tissue sections of human malignant melanoma. The expression of the HD antigen in transformed human melanocytes may have great immunological significance because the antigen is absent from normal human tissues and is immunogenic in humans.

Primary structure of an alkaline ribonuclease from bovine liver

A pyrimidine base specific and most basic alkaline RNase named RNase BL4 was isolated from bovine liver as a protein showing a single band on slab gel-electrophoresis. The enzyme is most active at pH 7.5. The enzyme was immunologically distinguishable from the known bovine RNases such as pancreatic RNase (RNase A), seminal RNase, kidney non-secretory RNase (RNase K2), and brain RNase (RNase BRb). The primary structure of this pyrimidine base-specific RNase was determined to be less than EDRMYQRFLRQHVDPDETG- GNDSYCNLMMQRRKMTSHQCKRFNTFIHEDLWNIRSICSTTNIQCKNGQMNCHEGVVRV- TDCRETGSSRAPNCRYRAKASTRRVVIACEGNPEVPVHFDK. It consists of 119 amino acid residues, and is 5 amino acid residues shorter than RNase A. The sequence homology of RNase BL4 with RNase A is 46.2%, and optimal alignment of RNase A and RNase BL4 requires five deletions, one at the 24th position, two at the 75th and 76th positions, and two at the C-terminus in RNase BL4. The RNase BL4 was highly homologous with a porcine liver RNase (RNase PL3, 94.1% homology) studied by Hofsteenge et al. (personal communication from Hofsteenge, J., Matthies, R., and Stones, S.R.).

[Acute renal failure in patients with hematologic neoplasms]

The retrospective study of acute renal failure (ARF) in patients with hematologic neoplasms was carried out. ARF occurred in 32 (6.1%) of 526 patients with hematologic neoplasms. Twenty-one (66%) patients recovered from ARF, but only 7 (22%) survived and were discharged from the hospital and 25 (78%) died of ARF or other complications. In 17 patients with leukemia or malignant histiocytosis, sepsis and/or disseminated intravascular coagulation were the most common causes of ARF, and all 17 patients died. In 11 patients with multiple myeloma, ARF was always attributable to the underlying disease, and the clinical course improved with the initiation of blood purification therapy (hemodialysis, plasma exchange) and chemotherapy. Five patients in blast crisis of chronic myelogenous leukemia or non-Hodgkin's lymphoma developed ARF as a result of tumor lysis syndrome. In this group, renal function improved with hemodialysis but only 2 patients survived. Patients with oliguria had worse outcomes than those without oliguria. Survival appeared to depend not on renal function but on the underlying disease, the cause of ARF, and other complications. These findings suggest that, in patients with hematologic neoplasms complicated by ARF, early initiation of blood purification therapy will improve the prognosis.

[Megaloblastic anemia and platelet function--a qualitative platelet defect in pernicious anemia]

In order to know the entities of platelet defect in pernicious anemia, we investigated platelet functions in ten cases with pernicious anemia. Three of the cases had total gastrectomy. Five cases showed thrombocytopenia and four cases revealed prolongation of Ivy bleeding time. Decreased adhesiveness was observed in three cases. Various abnormalities in platelet aggregation were observed. However, almost all of the cases showed remarkable improvement of decreased platelet functions after the therapy of Vitamin B12 injection. The results of adenine nucleotides in platelets and the release of them following collagen or epinephrine aggregation were analysed in comparison with normal platelets. The ADP was definitely decreased and the ATP/ADP ratio was increased. In addition, the release of ATP and ADP at collagen or epinephrine induced aggregation was markedly decreased, and after the therapy of Vitamin B12, the decrease of adenine nucleotide release remarkably increased. In summary, the acquired defects of platelet function in pernicious anemia are regarded as a secondary storage pool disease, and its defects improve after Vitamin B12 therapy.

[Philadelphia chromosome positive acute mixed lineage leukemia with bcr (M-BCR-1) rearrangement]

We report two cases of Philadelphia (Ph1) chromosome positive acute mixed lineage leukemia (AMLL) with breakpoint cluster region (bcr) (M-BCR-1) rearrangement. A 31 year-old-man (case 1) and a 42 year-old-woman (case 2) were admitted to our hospital for further evaluation of leucocytosis with atypical blasts. Each case was diagnosed as having bilineal type of AMLL because: (1) blasts in each case consisted of larger myeloid cells positive for myeloperoxidase and small lymphoid cells positive for PAS, and blasts in case 2 were positive for TdT; (2) blasts in case 1 expressed B lymphoid associated antigen; (3) Southern analysis in each case showed clonal rearrangements of both the immunoglobulin heavy chain and the T cell receptor beta gene. These two cases demonstrated the Ph1 chromosome and rearrangement of the bcr (M-BCR-1) gene, but none of splenomegaly, basophilia, and additional chromosome abnormalities were observed. In addition, after achieving remissions, they didn't revert to chronic phase of chronic myelogenous leukemia (CML) and showed normal neutrophil alkaline phosphatase scores, and the Ph1 chromosome disappeared completely in case 1 and coexisted with the normal chromosome in case 2. These findings suggest that diagnosis of both cases should not be CML blast crisis (BC) but Ph1 positive acute leukemia, and Ph1 positive AMLL may be a distinct clinical entity to be distinguished from CML-BC.