A dynamic state of a closed ecosystem and its significance to the generation of the Earth's environment

The Earth forms a living-system composed of large materially closed ecosystems (CES). We are performing various experiments to study comparable living-systems, especially smaller samples we call "microcosmic type CES". CES have an ability to persist despite perturbation. We show experimental results of the behavior of CES mainly during the transition form a semi-open state to an entirely closed one. We report phenomena on CES instability which may be inherent in them. We suggest that CES possess some properties that may help elucidate the nature of the Earth as a living system. Climatic change on the Earth, such as oceanic anoxia and its consequences, may have been due to disturbances as modeled in a CES.

[The usefulness of induced sputum in the diagnosis of pulmonary tuberculosis]

This study was designed to compare the results of culture for tubercle bacilli using induced sputum by an ultrasonic nebulizer and gastric aspirates from same patients who were suspected of having active tuberculosis with little or no sputum and had received no prior chemotherapy. 22 patients included in this series were either culture positive for tubercle bacilli or showed unequivocal radiographic improvement after three months of therapy with three anti-tuberculosis drugs. Induced sputum from 17 patients and gastric aspirates from seven patients were culture positive for M.tuberculosis. This difference is significant (p < 0.01). Paired induced sputum and gastric aspirates were both positive for tubercle bacilli in seven patients. The finding of acid-fast bacilli on microscopy or tubercle bacilli in culture in four of the seven patients were available much earlier with induced sputum than with gastric aspirates. Positive gastric aspirates and negative induced sputum for tubercle bacilli was not seen. These results suggest that induced sputum by an ultrasonic nebulizer is superior to gastric aspirates in terms of high sensitivity and early finding for tubercle bacilli and induced sputum and gastric aspirates do not supplement each other.

[Outbreaks of pulmonary tuberculosis in a family and in a hospital. Analysis of restriction-fragment-length polymorphisms]

Restriction-fragment-length polymorphism, analysis was used to study two outbreaks of pulmonary tuberculosis, one in a family and one in a hospital. The DNA probe was derived from the insertion sequence IS 6110. Two groups of isolates were analyzed, both of which were suspected to be common sources of each infection. Both groups showed identical fingerprints within each group. These results suggest that analysis of restriction-fragment-length polymorphism is useful in epidemiological studies of pulmonary tuberculosis.

Relationship between grade of varicocele and the response to varicocelectomy

BACKGROUND

Although several studies indicate that larger varicoceles are associated with greater impairment of spermatogenesis, others suggest that the response to surgery is independent of varicocele size. In order to elucidate these seeming contradictions, correlations between the preoperative evaluation of varicoceles and improvement in semen quality after varicocelectomy were investigated.

METHODS

Forty men with left unilateral varicocele, followed for at least 6 months after varicocelectomy, were included in this study. The relationships between the grade of varicocele by palpation, Doppler examination, ultrasound, or scintigraphy were correlated with a postoperative improvement in sperm density or sperm motility.

RESULTS

Greater improvement in sperm density was observed in the patients with a large varicocele graded by palpation or measured by ultrasound, and greater improvement in sperm motility was observed in the patients with high uptake of radioactivity in the left side by scrotal scintigraphy.

CONCLUSION

An improvement in semen quality after varicocelectomy is greater in patients with a large varicocele than in the patients with a small one. The significance of surgical repair of a small varicocele should be reconsidered.

[Antituberculous drug-resistance among homeless peoples]

We studied on the prevalence of drug-resistance among 65 homeless cases who were admitted and treated for active tuberculosis at the Nakano National Chest Hospital during the period from 1990 to 1992 and at the International Medical Center of Japan during the period from 1993 to 1994. Resistance to one or more first line antituberculous drug were revealed in 14 cases out of 65 (21.5%) in initially treated cases 6 out of 43, and in retreated cases 8 out of 22. The prevalence of drug resistance in this study was significantly higher compared with 2 out of 39 cases (5.1%) in our previous report during the period from 1986 to 1988. In these drug-resistant cases, multidrug-resistant cases, namely, resistant to at least 2 drugs including both INH and RFP were founded in 6 cases (9.2%). Compared with drug-sensitive cases, the negative convertion rate of bacilli was lower and the number of defalters was significantly larger. It was suggested that higher prevalence of drug-resistance and defalting from the adequate treatment in homeless cases of tuberculosis possibly makes the prognosis of drug-resistant tuberculosis worse and treatment of such cases more difficult.

Transradial styloid, transtriquetral perilunate dislocation of the carpus with an associated fracture of the ulnar border of the distal radius

A rare case of transradial styloid, transtriquetral perilunate dislocation associated with an ulnar border fracture of the distal radius is described. The mechanism of injury is discussed, and the results of treatment are reported.

[Evaluation of the streptomycin twice weekly with INH and RFP for initial therapy of pulmonary tuberculosis]

For the purpose to compare the effectiveness of SM and EB as a third drug in the standard regimens and to know whether the addition of SM twice weekly to INH and RFP could be acceptable for the treatment of pulmonary tuberculosis, the efficacy, adverse effects and results of long-term follow-up of the groups consisting of 105 patients treated with SM twice weekly for 6 months in addition to INH and RFP for 9 months (S2 group) and 107 patients treated with EB for 6 months in addition to INH and RFP for 9 months (E group) were observed. The speed of negative conversion of sputum and that of X-ray findings improvement were slightly faster in S2 group than E group but the difference was statistically not significant. The incidence of adverse effects such as elevation of serum transaminase values, gastrointestinal troubles, drug allergy and others was not similar in two groups. The relapse was observed in 2 cases of S2 group and 5 cases of E group. We concluded that SM twice weekly to INH and RFP is similarly effective as EB in combination with INH and RFP, and the this regimen could be used as standard regimen for pulmonary tuberculosis.

[Evaluation of factors aggravating and delaying recovery from postoperative hypercoagulable state in patients operated on for esophageal cancer]

When a living body is invaded to a high degree, a hypercoagulable state develops. The radical operation for esophageal cancer is known as a very high risk operation. The purpose of this study is to evaluate in detail the postoperative changes in platelet, coagulation and fibrinolytic systems, in 34 patients operated on for esophageal cancer, and to clarify the factors contributing to both the aggravation and delay of recovery from the postoperative hypercoagulable state. Operating time and blood loss during surgery were factors aggravating the postoperative hypercoagulable state. The mechanism of coagulation progressed significantly in those patients requiring 500 minutes or more operating time and having a blood loss of 600 ml or more during surgery. Age was seen as an important factor delaying recovery, as the recovery of the coagulative parameters was delayed significantly in patients aged 70 or above. Hepatic function was the most important of post operative organ functions. Renal, cardiac and respiratory functions were unrelated to the postoperative hypercoagulable state.

Correlation between histopathologic features and magnetic resonance images of spinal cord lesions

The authors report a correlation between histopathologic features and magnetic resonance images of spinal cord lesions in 19 human spinal cords with various types of lesions. Abnormally high T2-weighted image signal intensities appeared nonspecifically in mildly altered lesions or areas with edema. In the gray matter, a low T1-weighted image in addition to a high T2-weighted image signal intensity appeared in severely altered lesions with necrosis, myelomalacia, or spongiform change. In the white matter, abnormally high T1-weighted image intensities appeared in severely altered lesions. Based on these preliminary results, it appears that a correlation between the degree of histopathologic alteration of the spinal cord and magnetic resonance images in clinical cases can be made. This is the first study to clarify the correlation between histopathologic features and magnetic resonance images of the diseased human spinal cord.

Klinefelter's syndrome with prepenile scrotum

Two cases of Klinefelter's syndrome with prepenile scrotum were presented. They underwent the operation for prepenile scrotum according to Glenn and Anderson's method. Thereafter urethroplasty was performed in each case. The decrease in response to testosterone in the target organ was noticed in 1 patient, suggesting that some androgen resistance in this case was attributable in part to anomaly of genitalia.

[A telescopic system for distance consisting of contact lens and spectacle lens for low vision patients]

A telescopic system for distance consisting of a negative contact lens (-10.0 - -20.0 D) as the eye piece and a positive spectacle lens (+8.0 - +16.0 D) as the objective, a modification of the Galilean telescope was examined. First the system was tried in 15 normal subjects, whose visual acuity was reduced to 20/200 or less by providing several occlusion membranes, and results were compared with customary full correction for distance. The best improvement of their vision by this system was achieved when the dioptric power of the spectacle was between +11.0 D and +13.75 D. This system was then applied to 78 eyes (61 patients) with visual acuity of 20/100 or less. Subjective improvement of vision was found in 55% of those patients' eyes. Eight patients out of 26 patients whose better eye acuity was 20/100 or less wanted to use this system and received prescription to result in the visual improvement, as evidenced by their continued use. This system can provide aid for low vision correction for distance.

[Sexual disturbance caused by endocrine dysfunction]

Nineteen cases of sexual disturbance caused by endocrine dysfunction were surveyed for the clinical features. In hypogonadotropic hypogonadism ejaculatory failure was observed in 12 out of 13 cases. On the contrary, 2 of three hypergonadotropic patients preserved their ejaculation. The serum testosterone levels of hypogonadotropic and hypergonadotropic hypogonadism were less than 200 ng/dl. When the testosterone level decreased to less than 100 ng/dl, nine patients out of 13 complained loss of libido and 12 patients complained loss of ejaculation, but six patients preserved erectile function. Hyperprolactinemic patients showed loss of libido in 4, erectile failure in 4 and loss of ejaculation in 2. When good response to hCG test was present or the testicular volume was more than 4 ml, patients with hypogonadotropic hypogonadism showed good response to hCG therapy.

[Fertility after orchiopexy for unilateral retention testis]

The testicular function after orchiopexy for unilateral cryptorchism was examined for fertile state with the relation to the age at operation and the testicular size. Sperm concentration decreased with the age at operation, accompanying a rise of gonadotropins and a decrease of the testicular size. The testicular size decreased with the age at operation. sperm deterioration was correlated more with the testicular size in the normally descending side than that of the operated one. The gonadotropin level was inversely correlated with the size of the contralateral normally descending testis. These results indicate that fertility after unilateral orchiopexy is influenced by the age at operation as well as the development of the normally descending contralateral testis.

Synthesis of Escherichia coli heat-stable enterotoxin STp as a pre-pro form and role of the pro sequence in secretion

Escherichia coli heat-stable enterotoxin STp is presumed from its DNA sequence to be synthesized in vivo as a 72-amino-acid residue precursor that is cleaved to generate mature STp consisting of the 18 carboxy-terminal amino acid residues. There are two methionine residues in the inferred STp sequence in addition to the methionine residue at position 1. In order to confirm production of the STp 72-amino-acid residue precursor, we substituted the additional methionine residues by oligonucleotide-directed site-specific mutagenesis. Since these substitutions did not cause a significant change in STp production, it can be concluded that STp is normally synthesized as the 72-amino-acid residue precursor. The length of the STp precursor indicated the existence of a pro sequence between the signal peptide and the mature protein. In order to identify the pro sequence and determine its role in protein secretion, deletion and fusion proteins were made. A deletion mutant in which the gene fragment encoding amino acid residues 22 to 53 of STp was removed was made. STp activity was found in the culture supernatant of cells. Amino acid sequence analysis of the purified STp deletion mutant revealed that the pro sequence encompasses amino acid residues 20 to 54. A hybrid protein consisting of STp amino acids 1 to 53 fused in frame from residue 53 to nuclease A was not secreted into the culture supernatant. These results indicate that the pro sequence does not function to guide periplasmic protein into the extracellular milieu.

Measurement of testicular volume by ultrasonography

To measure testicular volume accurately, an ultrasonographic method was developed and the results obtained from this compared with those obtained by conventional measurements, namely (1) comparison with testis models, (2) an orchidometer, and (3) measurement of testicular volume by calipers through the scrotal skin. Data from these methods were compared with the actual volume measured at operation by slide calipers placed directly on the testis. The volume obtained by comparison with testis models or with an orchidometer tended to over-estimate the actual volume. The volume measured by slide calipers on scrotal skin was also found to be incorrect. On the other hand, the volume measured by ultrasonography proved to be closer to, and to correlate well with, the actual volume, and was considered to be the best method.

Therapeutic embolization of oral hemangiomas with absolute ethanol

Two patients, one with a high-flow arteriovenous hemangioma and the other with a low-flow capillary-venous type, were treated by injection of ethanol, and excellent results were obtained.

[Ultrasonography of ganglions in the extremities]

Ultrasonography of 8 cases of cystic mass in extremities (7 ganglions, 1 popliteal cyst) were reviewed and evaluated. The lesions were demonstrated as round, oval or flattened shaped masses with no echo signal. However, in most cases, there was no sign of posterior echo enhancement, which may be the effect of posterior bony structure. It seemed important to handle probe with adequate palpation, which enables examiner to get further anatomical information.

[Continuous subcutaneous infusion of peplomycin in oral squamous carcinoma]

To determine the effect of continuous subcutaneous infusion of peplomycin on both antitumor activity and pulmonary toxicity, thirty-two patients with previously untreated oral squamous carcinoma were given peplomycin via osmotic microinfusion pump (SP-5, Nipro Co., Ltd.) at a daily dose of 5.0 mg subcutaneously. The mean dosage of peplomycin given was 79.8 mg. An overall response rate of 62.5% was achieved, with 21.9% complete response, and 40.6% partial response. The maximum reduction of tumor volume for responder could be generally observed when peplomycin was given at about 60 mg continuously. The most frequently encountered toxicity was a mucocutaneous reaction, manifested by stomatitis (34.4%) and skin eruption (18.8%), but they were mild and tolerable. A local skin reaction also occurred at the site of drug injection, and an ulcer formation developed in 12.5% of patients. Monitoring of pulmonary function by means of PaO2 revealed that 32.0% of patients had a decrease over 10% after peplomycin administration. However, interstitial pneumonitis eventually occurred in only one patient (3.1%). In conclusion, the regimen of continuous infusion of peplomycin is a useful method to administer peplomycin safely without reducing the antitumor effect compared to conventional intermittent injection.

[Tumor factors influencing the prognosis of renal cell carcinoma]

Fifty six patients, 40 males and 16 females, received radical nephrectomy and were diagnosed to have renal cell carcinoma pathologically at Asahi General Hospital between January, 1972 and September, 1984. The five and ten year survival rates were 44.2 and 35.7% respectively. The cancers were classified according to pTNM category and their cell type and grade were estimated. The relationship between these factors and the patient's prognosis was studied. We recognized a close correlation among pT, cell type and grade, and found that they had a serious influence on prognosis. There was a close correlation between grade and pV, but no relationship between pN, pM and grade. Cases with a positive lymph node or distant metastasis had poor prognosis. Therefore, we suggest the possibility of false negative evaluation of pN and pM, because pN and pM were estimated clinically. Consequently, we believe that the pTNM category is a good classification for evaluation tumor expansion and the prognosis.