[A case of alveolar soft part sarcoma found by pulmonary metastasis]

A 34-year-old housewife presented to a hospital because of dry cough. Her chest radiograph showed bilateral multiple nodular lesions. Smaller but similar lesions had been seen on the chest radiograph 2 years earlier. Because the tissue taken during a trans bronchial biopsy was non-diagnostic, open lung biopsy was done and the diagnosis was pulmonary metastasis of alveolar soft part sarcoma. The primary tumor was found in her left calf by MRI. Malignant tumors are important for differential diagnosis of slow-growing multiple pulmonary nodules, and in some cases MRI is useful for finding the primary site.

Measures to control Toxocara egg contamination in sandpits of public parks

We investigated measures to prevent Toxocara egg contamination of sandpits. Replacement of contaminated sand was not effective because 1-9 new fecal deposits per sandpit were found daily, with eggs reappearing in the sand 6-9 weeks after the replacement. When the sandpit was covered with a clear vinyl sheet, the temperature of the sand to a depth of 3 cm was 42 degrees C or more for 3 hr when the air temperature was higher than 30 degrees C. This procedure prevented contamination by fecal deposits and also resulted in the destruction of existing eggs because the sandpit was kept dry on rainy days. The method seemed safe and inexpensive. The effectiveness of a fence around a sandpit depended on user behavior, which could not be relied upon. Therefore, a practical method for the prevention of Toxocara egg contamination of sandpits is to cover the sandpit with a clear vinyl sheet at night and on rainy days.

[Three interesting pediatric cases with penicillin-resistant Streptococcus pneumoniae infection]

Since penicillin-resistant Streptococcus pneumoniae first recognized in 1967, the rate of penicillin-resistant strains has been increasing worldwide. There have been up to 50% from pediatric specimens in Japan. We reported three pediatric cases with penicillin G resistant Streptococcus pneumoniae infection to show some important clue from these cases for clinical practice against resistant pneumococcal infection. The first case was a typical acute mastoiditis, although we have experienced only masked mastoiditis recently. The second case was meningitis with septicemia, which did not show any abnormality in the first obtained cerebrospinal fluid. The third case was recurrent bronchitis in a child with cerebral palsy. The minimum inhibition concentrations of these isolated strains were 0.25 microgram/ml in the second case an 2.0 microgram/ml in the first and third cases.

Cloning of a complementary DNA encoding an 80 kilodalton nuclear cap binding protein

It has been shown that the monomethylated cap structure plays important roles in nuclear events. The cap structure has been implicated in the enhancement of pre-mRNA splicing. More recently, this structure has also been suggested to facilitate RNA transport from the nucleus to the cytoplasm. We have previously identified and purified an 80kD Nuclear Cap Binding Protein (NCBP) from a HeLa cell nuclear extract, which could possibly mediate these nuclear activities. In this report, we describe cloning of complementary DNA (cDNA) encoding NCBP. The partial protein sequences of NCBP were determined, and the full-length cDNA of NCBP was isolated from HeLa cDNA libraries. This cDNA encoded an open reading frame of 790 amino acids with a calculated molecular mass of 91,734 daltons, which contained most of the determined protein sequences. However, the protein sequence had no significant homology to any known proteins. Transfection experiments demonstrated that the epitope-tagged NCBP, transiently expressed in HeLa cells, was localized exclusively in the nucleoplasm. Similar experiments using a truncated NCBP cDNA indicated that this nuclear localization activity is conferred by the N-terminal 70 amino-acid region.

Preparation of highly purified porcine theca cells

A novel method for purifying dispersed porcine theca cells, with less than 3% granulosa cell contamination, was developed by the repeated use of mechanical and enzymatic procedures. The steroidogenic criteria used for the identification and purity evaluation of both theca and granulosa cells were also improved. Purified theca and granulosa cells from medium-sized follicles displayed steroidogenic differences when they were cultured in the presence of 10% fetal bovine serum: (1) the theca cells synthesized oestradiol (239.1 +/- 35.1 pg ml-1 per 2.5 x 10(5) cells in 40 h), but the granulosa cells did not synthesize it unless aromatizable androgens were added; (2) theca cells synthesized androstenedione (73.2 +/- 14.4 ng ml-1 per 2.5 x 10(5) cells in 40 h), but granulosa cells did not; (3) FSH did not affect progesterone production in theca cells; (4) the theca cells secreted androstenedione for up to 48 h; and (5) FSH significantly stimulated progesterone production in granulosa cells during a culture for 40 h (P < 0.05), but not during culture for 12 h. The lack of response to FSH was used as a reliable, functional indicator of the purity of porcine theca cells. However, this criterion proved not to be useful for cells cultured for 12 h; porcine FSH had no effect on the progesterone production of theca cells co-cultured for this time with as many as 20% granulosa cells. However, after co-culturing for 40 h, this criterion resulted in the detection of only 3% granulosa cell contamination.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of non-tuberculous mycobacterial lymphadenitis diagnosed with new skin tests and PCR

Non-tuberculous mycobacterial (NTM) cervical lymphadenitis has been rarely reported in Japan. We report on a case of a 15 month old child with NTM cervical lymphadenitis who was diagnosed with new skin tests containing NTM antigens and a polymerase chain reaction (PCR) method. These two diagnostic methods were highly useful in the present case, therefore we anticipate they will become available to other Japanese physicians to expedite the diagnosis of NTM lymphadenitis.

Changes of gonadotrophin surge inhibiting/attenuating factor activity in pig follicular fluid in relation to follicle size

The activity of GnSI/AF was measured in pig follicular fluid (pFF) from 58 individual follicles of various sizes, by bioassay using rat pituitary cells, to investigate the relationship between gonadotrophin surge inhibiting/attenuating factor (GnSI/AF) activity and follicular development. In addition, the correlation between GnSI/AF and inhibin activities and the content of sex steroids (oestradiol, progesterone and testosterone) of follicles was examined. The activity of GnSI/AF in pFF varied significantly (0.155-1.69 U microliter-1) with size of the follicle. The activities (mean +/- SEM) were intermediate and constant in follicles with diameters from 3 to 5 mm (0.583 +/- 0.080 U microliter-1, n = 24), were higher and reached the highest value in follicles with diameters between 6 and 8 mm (0.863 +/- 0.068 U microliter-1, n = 21), and were lower, reaching the lowest value in follicles with diameters of 9 and 10 mm (0.401 +/- 0.089 U microliter-1, n = 13). In contrast, inhibin activity was almost constant during the development of follicles, although individual values varied from 0.9 to 2.5 U microliters-1. For follicles with diameters of 4-8 mm, inhibin activity was 1.754 +/- 0.042 U microliters-1 (n = 39); activity was higher in the smallest follicles with diameters of 3 mm (2.063 +/- 0.015 U microliters-1, n = 6) and was lower in follicles with diameter of 9 mm, reaching the lowest value in follicles with diameter of 10 mm (1.176 +/- 0.068 U microliters-1, n = 7); inhibin activity was not significantly correlated with GnSI/AF activity.(ABSTRACT TRUNCATED AT 250 WORDS)

[Regional differences in seizure threshold following systemic and topical administration of penicillin in cats]

The regional differences of epileptic seizure susceptibilities in various brain structures were investigated by using the feline model of systemic and local applications of penicillin (PC). After PC application, "repetitive isolated discharges" (RIDs) were observed and thereafter, it developed to "sustained high-frequency discharge" (SHD). The following results were obtained. 1. After the intraperitoneal application of PC, the areas involved by RIDs in order of frequency were cerebral cortex, hippocampus, mesencephalic reticular formation, centro-median nucleus of thalamus, amygdaloid nucleus, dorsal median nucleus of thalamus and globus pallidus. SHD was firstly arising from cerebral cortex (100%), especially from suprasylvian gyrus of 13 out of 16 cats (18.2%). SHD immediately propagated to either the other cortical areas or subcortical structures. Hippocampus, centro-median nucleus and dorsal median nucleus of thalamus were rapidly involved by SHD from cerebral cortex in comparison with the other subcortical structures. 2. PC was applied topically on the surface of several different cortical areas. RIDs tended to appear in posterior suprasylvian gyrus. On the other hand, SHD arose from posterior ectosylvian gyrus in most cases. The mechanisms of initiation and propagation of epileptic discharge were discussed in conjunction with epileptic seizure susceptibility in various neuronal structures.

Chronological SPECT studies of a patient with subacute sclerosing panencephalitis

We describe here chronological single photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) of a patient with subacute sclerosing panencephalitis (SSPE) from the early clinical stages. The case, an 8-year-old Japanese girl, was in clinical stage I of the disease on admission. A SPECT study with 99mTc-hexamethylprophyleamine oxime (99mTc-HM PAO) and 123I-IMP revealed hypoperfusion of cerebral blood flow in the bilateral occipital areas and a part of the cerebellum. Initially, no abnormal findings were observed on CT and MRI. Subsequently, however, MRI indicated abnormal signal intensity dominantly in the area of the occipital white matter where hypoperfusion of cerebral blood flow was found by the initial SPECT studies. This abnormal cerebral hypoperfusion appeared to improve after treatment with oral inosiplex and intrathecal interferon-alpha over 6 months of the clinical course. The abnormal signal intensity on the MRI also decreased, but simultaneous cranial CT demonstrated diffuse cortical atrophy and slight ventricular dilatation.

Heat treatment of nuclear extract alters selection of the 3' splice site in pre-mRNA splicing

We investigated in vitro splicing reaction using an artificially created mRNA precursor containing a single 5' splice site and tandemly duplicated 3' splice sites. We found that the 3' splice site proximal to the 5' splice site is predominantly used under the standard splicing conditions. However, when the preheated nuclear extract was employed, the intermediate in which the distal 3' splice site was selected accumulated exclusively. This shows that heat treatment of nuclear extract abolishes the activity involved in the selection of the 3' splice sites that are in cis-competition for the common 5' splice site. The results presented here suggest the presence of a factor(s) required for the selection of the proximal 3' splice site.

[Clinical long-term studies of the treatment of chronic complicated urinary tract infections. Utility and recurrence after 14-day treatment by cefditoren pivoxil]

In this study, cefditoren pivoxil (ME 1207, CDTR-PI), a new oral cephem antibiotic, was given to 72 patients with non-catheterized complicated urinary tract infections (UTI) to evaluate clinical efficacy and safety, and also to investigate the rate of recurrence after completion of treatment. Daily dose of CDTR-PI was 100 mg t.i.d., and CDTR-PI was administered for 14 days. According to the criteria proposed by the Japanese UTI Committee, clinical efficacy of CDTR-PI was evaluated at day 7 and day 14. The rate of recurrence was assessed by bacterial count in urine as the marker. The following results were obtained. 1. Overall clinical efficacy rates were 68.4% on day 7 and 81.6% on day 14. The efficacy rate at day 14 was higher than the rate at day 7. 2. Bacteriologically, eradication rates were 75.5% at day 7 and 79.6% at day 14. 3. As to side effects, abdominal discomfort was observed in 1 case and its incidence was 1.6%. Incidence of abnormalities of laboratory findings was 10.4%, and these abnormalities were slight and transient. 4. Thirty-one patients were assessable to the recurrence of infections, 60% of them were judged as "cured" at 1-2 weeks and 3-7 weeks after completion of treatment. In this study, "relapsed", reappearance of causative organisms, was observed much more frequently than "reinfection". These results suggest that sufficient clinical efficacy and safety of CDTR-PI in non-catheterized complicated UTI were effected by 14 days treatment.

Techniques of nasotracheal intubation with the fiberoptic bronchoscope

When nasotracheal intubation with a fiberoptic bronchoscope is performed, the tube may be blocked in the nasal cavity or larynx, resulting in several complications including epistaxis and hoarseness. We review the causes and complications of tube blockage and discuss optimal techniques for minimizing it.

Examination of Bacterial Characteristics of Anaerobic Membrane Bioreactors in Three Pilot-Scale Plants for Treating Low-Strength Wastewater by Application of the Colony-Forming-Curve Analysis Method

Characteristic sludge ecosystems arising in anaerobic membrane bioreactors of three pilot-scale plants treating low-strength (less than 1 g of biological oxygen demand per liter) sewage or soybean-processing wastewater were examined by analysis of the colony-forming-curves (CFC) obtained by counting colonies at suitable intervals. The wastewaters, containing high amounts of suspended solids (SS) (SS/chemical oxygen demand ratio, 0.51 to 0.80), were treated by using two types of bioreactors: (i) a hydrolyzation reactor for solubilization and acidification of SS in wastewater and (ii) a methane fermentation reactor for producing methane. The colony counts for the two sewage treatment plants continued to increase even after 3 weeks of incubation, whereas those for soybean-processing wastewater reached an approximately constant level within 3 weeks of incubation. The CFCs were analyzed by correlating the rate of colony appearance on roll tubes with the physiological types of bacteria present in the bioreactors. It was found that there were large numbers of slow-colony-forming anaerobic bacteria within the bioreactors and that the viable populations consisted of a few groups with different growth rates. It is considered that the slow-growing colonies appearing after 10 days of incubation were the dominant microflora in the sewage treated by hydrolyzation reactors. In particular, highly concentrated sludge (30.0 g of mixed-liquor volatile SS per liter) retained by the membrane separation module contained a large number of such bacteria. Slow-growing colonies of these bacteria could be counted by using a sludge extract medium prepared from only the supernatant of autoclaved sludge. In addition, the highest colony counts were almost always obtained with the sludge extract medium, meaning that most of the anaerobic bacteria in these sludges have complex nutrient requirements for growth. This report also indicates the usefulness of application of the CFC analysis method to the study of bacterial populations of anaerobic treatment systems.

The origin of myoclonus and periodic synchronous discharges in subacute sclerosing panencephalitis

We report here a case of a patient with subacute sclerosing panencephalitis (SSPE) and we have analyzed periodic events using dipole tracing methods to clarify the origin of periodic synchronous discharges and myoclonus. Both source generators were located in the subcortical part of the cerebrum, an area adjacent to the thalamus. Although the pathophysiology of periodic events in SSPE has been controversial, dipole tracing methods may contribute to clarify the origin of periodic events in SSPE.

A case of bronchiolitis obliterans organizing pneumonia associated with primary Sjögren's syndrome who died of superimposed diffuse alveolar damage

Bronchiolitis obliterans organizing pneumonia (BOOP) developed in association with primary Sjögren's syndrome in a 69-year-old female. She died of diffuse alveolar damage superimposed on BOOP in spite of corticosteroid therapy.

Improved Technique for Identification and Enumeration of Methanogenic Bacterial Colonies on Roll Tubes by Epifluorescence Microscopy

Methanogenic fluorescent colonies can be clearly identified on roll tubes by using an epifluorescence microscope equipped with a × 2 objective. Methanogenic and nonmethanogenic colonies could be counted in roll tubes prepared from methanogenic enrichment cultures. Late-developing colonies appearing after 25 days of incubation were mainly methanogenic.

[Clinical evaluation of terodiline hydrochloride in patients with urinary frequency or incontinence]

A clinical trial with the collaboration of 15 department of urology was performed to determine the usefulness of terodiline hydrochloride in 99 patients whose chief complaints were of pollakisuria or incontinence due to neurogenic bladder, psychogenic disease or chronic cystitis. The patients were orally given 24 mg once daily for 4 weeks. The final global improvement rate was 88.5% and the effective rates on subjective symptoms were; 66.2% for diurnal urinary frequency, 68.0% for nocturnal urinary frequency, 68.8% for urinary incontinence and 78.3% for nocturnal enuresis. Even for the cases having mild bladder outlet obstructive disease, the clinical effective rates were good. Mild side effects were observed in 10 patients, which were dry mouth and others. The results obtained from this trial suggest that terodiline hydrochloride may be useful for the treatment of urinary frequency and incontinence caused by detrusor instability.

A nuclear cap binding protein from HeLa cells

We have identified a cap binding protein in a HeLa nuclear extract using a gel mobility shift assay probed with capped RNA. Subcellular fractionation of HeLa cells revealed that the majority (about 70%) of the cap binding activity is present in the nuclear extract, about 20% is in the cytoplasmic S100 fraction, and almost none in the ribosome-high salt wash fraction, indicating that the protein in active form localizes mainly in the nuclei. Competition experiments with various cap analogues showed that the G(5')ppp(5')N-blocking structure as well as the methyl residue at the N7 position of the blocking guanosine is important for the binding of this protein, and that the trimethylguanosine cap structure which exists at the 5' termini of many snRNAs is not recognized by this protein. Immunoprecipitation experiments using various anti-snRNP antibodies suggested that this protein is partially associated with U2 snRNP. We purified this protein to near homogeneity from a HeLa nuclear extract by several chromatographic procedures including capped RNA-Sepharose chromatography. The purified protein shows molecular weight of 80 kilodaltons, as judged by SDS gel electrophoresis, and binds specifically to the cap structure.

[CA 19-9 in patients with benign pulmonary diseases]

Although serum CA 19-9 is considered to be a useful and specific tumor marker for pancreatic cancer, some patients with benign pulmonary diseases show elevated serum CA 19-9 levels. We measured serum CA 19-9 levels of 156 patients with benign pulmonary diseases (55 with asbestosis, 11 with bronchial asthma, 32 with bronchiectasis, 16 with idiopathic pulmonary fibrosis (IPF), 13 with healed pulmonary tuberculosis (HPT) and 29 other benign diseases). The percentage of patients with positive serum CA 19-9 was 42.3% (14.5% in asbestosis, 27.3% in bronchial asthma, 59.4% in bronchiectasis, 81.3% in IPF, 61.5% in HPT and 51.7% in others). In some patients, serum CA 19-9 levels were as high as those found in malignant gastrointestinal diseases. Serum CA 19-9 levels correlated well with disease activity. Immunohistochemically, CA 19-9 was expressed in mucous cells of the bronchial gland and surface of the bronchiolar surface epithelium cells in benign pulmonary disease. Gel filtration study suggested some difference in molecular weight between the serum CA 19-9 antigen of lung cancer and that of benign pulmonary diseases. It is suggested that serum CA 19-9 increases in the case of hyperplasia of the bronchiolar epithelium cells or the mucous cells of the bronchial gland. We conclude that benign pulmonary disease is one of the factors that affect serum CA 19-9 levels.

[A case of atonic partial seizure]

This report presented a 4-year-old girl who had atonic partial seizure of the right leg accompanied by impaired equilibrium. This patient had a generalized tonic-clonic seizures before, and had been on anticonvulsant medication. Mild cataplexy of the right leg and flail trunk while standing occurred abruptly. Based on clinical symptoms, physiological findings, and an electroencephalogram taken at the time of seizure, the cataplexy of the right leg was diagnosed as epileptic seizures. After the dosage of anticonvulsant drug was increased, all symptoms disappeared completely. Cases of atonic partial seizure have been reported only rarely. In our case, atonic partial seizure was associated with nonepileptic equilibrium impairment, probably due to cerebral cortex dysfunction. This is an extremely rare occurrence.