Effects of interocular blur suppression ability on monovision task performance

Suppression of anisometropic blur induced by monovision contact lenses was examined in 18 presbyopic subjects. Suppression ability was quantified by reducing the contrast of a bright test target, viewed by subjects wearing a monovision correction, until the blurred image was suppressed. Subjective success with monovision was evaluated using a patient survey and no correlation to blur suppression ability was found. Objective success was evaluated in terms of performance at three near work tasks, each requiring a different level of stereoscopic localization. A significant correlation was found between card filing performance (requiring a moderate level of stereopsis) and blur suppression ability. Correcting either the dominant or non-dominant eye for near in the monovision correction did not significantly affect blur suppression ability. There was no evidence for adaptation to monovision in terms of increasing blur suppression ability over time.

Surgical treatment of multiple aneurysms. Review of experience with 372 cases

We review the surgical results in 372 cases of multiple intracranial aneurysms over a 25-year period in which one of us (JS) performed 2,000 direct operations for aneurysms. All patients were classified into four groups according to the location of the aneurysm: Group 1: multiple aneurysms including anterior communicating artery aneurysm (157 cases); Group 2: multiple aneurysms of unilateral anterior circulation (72 cases); Group 3: multiple aneurysms of bilateral anterior circulation (110 cases); Group 4: multiple aneurysms including vertebro-basilar artery aneurysms (33 cases). In multiple aneurysm cases, our policy has been to treat all aneurysms, ruptured and unruptured, in a one-stage operation whenever possible. About 90% of patients in both Group 1 and 2 were treated by one-stage operations, while 60% of patients in Group 3 and 42% of patients in Group 4 were operated on in the same manner. Excellent and good results in from 73% to 81% of cases were obtained in patients in Group 1, Group 2 and Group 3. Morbidity was 14-19% and mortality was 6-8%. These results were comparable to the results with a single aneurysm of the anterior circulation. On the other hand, the surgical results in Group 4 were poor with a mortality of 27%. Poor results were attributable to the postoperative rebleeding from the untreated vertebro-basilar aneurysms, which were thought to be unruptured aneurysms preoperatively. Furthermore, it was clarified that the results of early one-stage operations (within one week from onset) in patients with multiple aneurysms were satisfactory. In this group, there was good recovery in 84% of patients, 7% were disabled and 9% died.(ABSTRACT TRUNCATED AT 250 WORDS)

[In vitro study on decolorization effect of argon ion laser]

Many experimental treatments for oral pigmented lesions with several kinds of lasers have been applied and consequently, the argon ion (Ar+) laser is used clinically as one of the most effective lasers for decolorizing. This in vitro study was carried out to clarify the depigmentation mechanism by low energy Ar+ laser irradiation. Each cultured human melanotic malignant melanoma cell colony was irradiated by the laser at 0.31 J/cm2. Each colony was fixed in time sequence and examined microscopy and ultramicroscopy. The present study disclosed the tyrosinase inactivation and decrease in the number of melanosomes of the laser melanoma cells. Subcellular degeneration was very mild and the mature melanin granules markedly decreased concomitantly with the increased secretion of the granules. These findings suggest that Ar+ laser irradiation evokes decolorization effect by the mechanism of 1) organelle-specific injury, 2) hypersecretion of melanosomes and 3) maturation arrest of melanosomes, related to its photoactivity.

Beta and alpha adrenergic reactivity elicitable stress study with special reference of electrocardiographic T-wave amplitude

Twenty-six healthy young Caucasian males were defined into high hostile (Hi-Ho) group and low hostile (Lo-Ho) group assessed by Cook-Madley's Hostility (Ho) scale. Mental arithmetic task (MA) and forehead cold stimulus task (FCS) were loaded to both Hi-Ho and Lo-Ho groups. Electrocardiographic T-wave amplitude (TWA), heart rate (HR) and coefficient of variance of 100 R-R intervals (CVR-R) were measured continuously during MA and FCS task periods. Greater TWA attenuation was found in Hi-Ho group (p less than 0.05). Although no significant intergroup difference was represented in HR and CVR-R, HR increased significantly (p less than 0.01) in whole subjects and CVR-R was tend to be suppressed during MA period. In addition, comparison of these physiological responses were performed between Type-A and Type-B groups classified by Jenkins' Activity Survey Form-T (JAS-T). There was no significant difference in reactivity of TWA, HR and CVR-R to both two tasks between high and low Type-A scored groups. Previous data suggested that the TWA reactivity in Hi-Ho subjects to cognitive stress showed similar pattern in Type-A individuals. However, autonomic nervous interaction could not be clarified in Hi-Ho subjects. The differentiation of method for assessment of behavioral pattern was also discussed.

[A case of intramedullary spinal cavitation after minor trauma]

A case of surgically treated intramedullary spinal cavity which appeared 1 year after a minor injury was presented. A 15 year-old boy developed nuchalgia and muscle weakness of his right arm and leg. On admission, he had right hemiparesis and sensory disturbances in the right C6-C8 and left T1-S5 dermatomes. Metrizamide-CT scan and MRI disclosed an intramedullary spinal cavity between C4-C5 vertebral levels. A myelotomy and a biopsy of the cavity wall were carried out in order to communicate the cavity with the subarachnoid space, and to make a definite diagnosis. The microscopic examination of a biopsy specimen revealed no tumor findings but inflammation. Taking into account the location of the cavity, a site corresponding with the site of a previous trauma, the authors finally diagnosed the cavity as intramedullary spinal cavitation after minor trauma. His symptoms improved remarkably after the operation.

Analysis of optokinetic nystagmus in patients with localized lesions of unilateral visual cortices

Optokinetic nystagmus (OKN) asymmetry in 4 patients with localized lesions of the unilateral visual cortices (2 in the right hemisphere and 2 in the left hemisphere), confirmed at autopsy or by CAT scan, was detected by computer analysis. The ENG recordings showed typical asymmetry of OKP: lower amplitude in the contralateral optokinetic pattern (OKP) than on the side with the visual cortex lesion. Analysis of this asymmetry revealed lower amplitude, remarkably impaired slow-phase velocity, and mildly impaired fast-phase velocity, with a slight difference in number of OKN. The findings suggested that asymmetry of OKP in patients with localized lesions of the unilateral visual cortices is primarily caused by the impaired slow-phase velocity of the contralateral OKN because of a slight change in number of OKN.

High-incidence of C9 deficiency throughout Japan: there are no significant differences in incidence among eight areas of Japan

From 92,686 sera sent from hospitals throughout Japan to the Special Reference Laboratories for CH50 assay, we were able to classify 80 patients as C9-deficient using a sensitive screening test, as well as hemolytic and immunochemical C9 assays. The incidence of C9 deficiency was determined to be 0.086%, and there were no distinct differences among the eight areas of Japan tested. Serum CH50 levels of these C9-deficient patients varied widely (9.4-63.8 U/ml), and exhibited a higher value (average: 34.1 U/ml) than that of healthy C9-deficient individuals, probably due to elevated C3, C4, and C5 levels. These patients suffered from a variety of autoimmune, renal, and infectious diseases, which, however, are thought to be only incidentally associated with C9 deficiency.

IL-2 receptor subunit, p75: direct demonstration of its IL-2 binding ability by using a novel monoclonal antibody

A new monoclonal antibody (mAb), TU11 mAb, was found to be specific for the p75 subunit of human interleukin 2 receptor (IL-2R). TU11 mAb reacted with human and Gibbon ape cell lines positive for IL-2Rp75 but not with cell lines negative for IL-2Rp75 tested. TU11 mAb specifically detected a single cell surface molecule with a molecular weight of 75 kd. The 75 kd molecule was identical to p75 detected by TU27 mAb specific for human IL-2Rp75 in sequential immunoprecipitation. TU11 mAb did not block IL-2 binding to the high-affinity IL-2R at all and precipitated p75 bound with IL-2. Using TU11 mAb, we have demonstrated here that solubilized p75 has an IL-2 binding site.

Impact of stress on alcoholic liver injury; a histopathological study

Certain behaviors can have an influence on the cause and progression of liver disorders. To clarify the relation between histopathological change of the liver and psychosocial stress, behavioral traits, and psychological state, patients with fatty liver (n = 14) were compared with patients with chronic hepatitis (n = 16). Both groups were alcohol-induced without other causes and consumed the same dose of alcohol. By morphometric methods, fat deposit ratio (FDR) and degree of liver damage (DLD) which reflects lobular fibrosis, inflammatory cell infiltration, and necrosis were evaluated. Life Change Unit scores from the Social Readjustment Rating Scale were significantly higher in chronic hepatitis than in fatty liver (p less than 0.001). DLD was significantly correlated with Life Change Unit (r = 0.59, p less than 0.01). It is suggested that psychosocial stress is one of the aggravating factors of fibrosis and inflammatory change of the liver which is previously damaged by alcohol in man just like the rat liver following stress.

How could canal-pluggings result in intensive direction changing type of positional nystagmus?

The objectives of this study in Rhesus monkeys is to observe the sequences which appear in the oculo-spinal-motor system after selected semicircular canals had been plugged. The left anterior and the right posterior canals in a monkey "LARP", the left anterior and posterior canals in "LALP", and the left lateral canal in "LL" were plugged under intubation general anesthesia. Three-dimensional eye recordings were performed, using two scleral coils. Behavior, posture, and vestibulo-ocular reflex were studied. Compensation was established in the light within 2 days. In darkness, no spontaneous nystagmus was recorded in the sitting position. The monkey "LALP" developed marked positional nystagmus. When the head position was changed up to 360 degrees in 15 degrees steps, horizontal, vertical and torsional eye movements showed remarkable changes. Spontaneous direction changing nystagmus in darkness was also recorded in "LALP". To conclude, direction changing positional nystagmus, which was seen for several months after the canal plugging, was difficult to explain by the damage to the adjacent ampullary and/or otolithic endorgans, but may be explained by the limited otolithic compensation in the earth parallel plane for the defective dynamic canal inputs. These observations and conclusions were from experiments using three monkeys only and should still be confirmed in more extended experiments.

Cloning, nucleotide sequence, and expression in Escherichia coli of the gene for poly(3-hydroxybutyrate) depolymerase from Alcaligenes faecalis

The extracellular poly(3-hydroxybutyrate) depolymerase gene from Alcaligenes faecalis T1 was cloned into Escherichia coli DH1 by using the plasmid pUC8. An A. faecalis T1 genomic library was prepared in E. coli from a partial Sau3AI digest and screened with antibody against the depolymerase. Of the 29 antibody-positive clones, 1 (pDP14), containing about 4 kilobase pairs of A. faecalis T1 DNA, caused expression of a high level of depolymerase activity in E. coli. The enzyme purified from E. coli was not significantly different from the depolymerase of A. faecalis in molecular weight, immunological properties, peptide map, specific activity, or substrate specificity. Most of the expressed enzyme was found to be localized in the periplasmic space of E. coli, although about 10% of the total activity was found in the culture medium. Results of a deletion experiment with pDP14 showed that a large SalI fragment of about 2 kilobase pairs was responsible for expression of the enzyme in E. coli. The nucleotide sequence of the large SalI fragment has been determined. Comparison of the deduced amino terminus with that obtained from sequence analysis of the purified protein indicated that poly(3-hydroxybutyrate) depolymerase exists as a 488-amino-acid precursor with a signal peptide of 27 amino acids.

Further clinical experiences with middle-ear implantable hearing aids: indications and sound quality evaluation

Since 1983, when the 5-year project on the middle-ear implantable hearing aids (MEI) was completed, we have been concentrating our studies on the clinical application of the partially implantable MEI (PMEI). The study was on the indication of implantation, improvement of the implantation operation, follow-up of the implanted patients, minor modification of the MEI, preparation of necessary surgical tools, and so on. Clinical study was also necessary for our team to finally confirm the clinical usefulness of this device. The present report is focussed mostly on the problem of indication for the application of PMEI.

Correlation among lipid peroxidation, brain energy metabolism and brain oedema in cerebral ischaemia

In order to study the involvement of lipid peroxidation in the generation of ischaemic cell damage, sequential measurements were made on the chemiluminescence, energy metabolism, water content and the volume of Na+ and K+ in the cerebral cortex using a rat model for severe cerebral ischaemia. It was found that the amount of chemiluminescence increased due to ischaemia and increased further following recirculation. In chemiluminescence spectral analysis, peaks were found at 480, 520-530, 570, 620-640, 680-700 nm. It is thought that these wavelengths reflect the release of energy due to the reduction of active oxygens to more stable states during the breakdown of lipid hydroperoxide. The recovery of ATP in the 5 min ischaemic brain after reflow with ATP stopped at approx. 60% of the pre-ischaemia level, whereas the water content of the cortex showed an increase after 5 min of recirculation, and a gradual recovery thereafter for 30 min. There was a strong correlation between the increase in cortical water content after recirculation and the amount of chemiluminescence. It is concluded that causes of the ischaemic cerebral oedema include not only decreased activation of ATP-dependent Na+, K+-ATPase, but also functional changes in ion channels due to an increase in free radicals following recirculation.

[Computed tomographic evaluation due to ruptured intracranial aneurysms in the posterior fossa]

From April, 1978 through December, 1984, computed tomographic (CT) findings were carefully examined in 34 cases of initial subarachnoid bleeding due to a single ruptured aneurysm in the posterior fossa. All of the patients were hospitalized within 3 days of the onset of symptoms. High-density areas, which indicate the presence of subarachnoid clots, were evaluated in the interhemispheric and Sylvian fissures and the interpeduncular, prepontine, ambient, and quadrigeminal cisterns. The CT data suggest that hematomas in the four cisterns are thicker than those in the supratentorial subarachnoid spaces. Only one patient had an intracerebral hematoma. Hydrocephalus accompanied aneurysms of the posterior fossa more frequently than those of the anterior circulation.

[The effect of phenytoin on free fatty acid liberation and mononucleotide metabolism in transient ischemia]

Ischemia gives rise to severe energy depletion and influx of Ca from the extracellular space, and it is suggested that increased intracellular Ca leads to the activation of phospholipase C and A, and to liberation of free fatty acids (FFA) in particular arachidonic acid. Phenytoin has been reported not only to maintain the intra- and extracellular cation balance but blockade the Ca channel. The purpose of the present study is to investigate the effect of phenytoin on the liberation of FFA, energy metabolism and mononucleotide metabolism in ischemic brain. Male Wistar rats were subjected to global cerebral ischemia induced by the occlusion of basilar and bilateral common carotid arteries. The brains were frozen in situ by the funnel technique after 5 or 30 min of ischemia or after 10, 30, or 60 min of recirculation following 30 min of ischemia. Purine and pyrimidine nucleotides, FFA, and glycolytic intermediates were measured by HPLC, GLC, and fluoro-enzymatic method. In non-treated rats, ATP reached a nadir after 5 and 30 min of ischemia. Phenytoin significantly attenuated ATP depletion after 5 and 30 min of ischemia. And also E.C. is higher in phenytoin treated rats than in non-treated rats in ischemia. After 60 min of recirculation, ATP recovered to 1.93 +/- 0.02 mumol (72.3% of pre-ischemia) in treated rats but 1.60 +/- 0.07 mumol/g (60% of pre-ischemia) in non treated rats. In E.C., there are significant differences between non-treated and treated rats after 10 and 30 min of recirculation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Protective effect of various agents against ischemic neuronal damage in guinea pig hippocampal neurons studied in vitro]

A study was made of protective effect of several drugs (mannitol, phenytoin, vitamin E and dexamethasone) against the deprivation of both glucose and oxygen from the bathing medium on electrical activities of guinea-pig hippocampal neurons in vitro. Using guinea-pig hippocampal slice, we recorded antidromic field potentials in the granular cell layer of the dentate gyrus with stimulating mossy fibers. "Ischemia" of a slice was achieved by substracting both glucose and oxygen from the perfusing medium. In standard medium, after 10 minutes of ischemia, field potentials had minimum recovery with an amplitude of 5% of control after 60 minutes in the standard medium. Mannitol treatment had no protective effect, but phenytoin, vitamin E and dexamethasone had clear dose-dependent effect. The protective effect was evaluated by recovery of field potential amplitude of the 60 minutes postischemic response and histological examination of the brain slice tissue. The degree of the histological damage was correlated with recovery of field potential. In this experiment we have demonstrated that phenytoin and vitamin E obviously have the protective action against ischemic neuronal damage in the guinea-pig hippocampal slice and the combined application of these drugs were more effective.

Experimental retrograde adriamycin trigeminal sensory ganglionectomy

Direct destruction of the sensory ganglion or its root, by either surgical transection or injection of phenol, has been employed as preferred treatment for a variety of neuralgic pain syndromes. In this report, the suicide axoplasmic transport of adriamycin is described as a novel approach to sensory ganglionectomy. When injected into a branch of the trigeminal nerve in the cat, adriamycin was swiftly transported by way of retrograde axoplasmic flow to the sensory neurons parental to the injected nerve, where adriamycin-specific autofluorescence was observed. Trigeminal sensory evoked potentials became unobtainable 24 to 48 hours after injection of adriamycin in concentrations of 1% to 10%. The sensory neurons underwent subacute degeneration within a week due to the delayed action of adriamycin, and consequently the primary afferents degenerated in a restricted projection field of the brain-stem trigeminal sensory nuclei. These results indicate that retrograde axoplasmic transport of adriamycin is a unique approach to noninvasive sensory ganglionectomy with strict, albeit simple, safe targeting of sensory neurons and little likelihood of regeneration.

Assessment of the thickness of the right ventricular free wall by magnetic resonance imaging in patients with hypertrophic cardiomyopathy

Electrocardiogram gated magnetic resonance imaging was performed in nine healthy volunteers, in four patients with pulmonary hypertension, and in 16 patients with hypertrophic cardiomyopathy. Fifty two short axis images in diastole were examined to assess the usefulness of magnetic resonance imaging for the measurement of the thickness of the free wall of the right ventricle and the degree of hypertrophy of the right ventricular free wall in hypertrophic cardiomyopathy and pulmonary hypertension. Magnetic resonance imaging gave a clear image of 68% of the length of the right ventricular free wall, showing both the endocardial and epicardial margins. The mean (1 SD) thickness of the right ventricular free wall measured at a total of 512 points was 0.44 (0.12) cm in patients with hypertrophic cardiomyopathy, 0.29 (0.08) cm in healthy individuals, and 0.73 (0.27) cm in patients with pulmonary hypertension.

Cerebral protective effect of flunarizine in a canine model of cerebral ischaemia

To test the effect of flunarizine on cerebral ischaemia, 15 dogs were subjected to ischaemia, using the 'canine model of the completely ischaemic brain regulated with a perfusion method' in which the cerebral blood flow (CBF) can be fully regulated. Five animals served as untreated controls, 10 received flunarizine, a calcium antagonist (1 mg/kg in 5 dogs and 3 mg/kg in 5 dogs), before the ischaemic period. After 1 h CBF was restored and recovery of the electrical activity of the brain and the degree of brain swelling were observed for 3 h. At the end of the experiments, the degree of extravasation of Evans blue was examined. Remarkable recovery of EEG was found in the groups given flunarizine when compared with untreated controls. However, no significant difference was found between untreated controls and flunarizine treated groups for the degree of brain swelling and the degree of extravasation of Evans blue. These results suggest that the treatment of flunarizine is of benefit for functional recovery against cerebral ischaemia, but does not suppress ischaemic brain oedema.