Cloning and expression of a complementary DNA encoding a bovine adrenal angiotensin II type-1 receptor

Angiotensin II elicits different responses which affect cardiovascular, neuronal and electrolyte transport regulation. To understand the mechanisms responsible for its various actions, the receptor for angiotensin II has long been sought, but numerous attempts to purify the receptor have been unsuccessful owing to its instability and low concentration. We report here the expression cloning of a complementary DNA encoding a bovine angiotensin II receptor to overcome these difficulties. The receptor cDNA encodes a protein of 359 amino-acid residues with a transmembrane topology similar to that of other G protein-coupled receptors. COS-7 cells transfected with the cDNA expressed specific and high-affinity binding sites for angiotensin II, angiotensin II antagonist and a non-peptide specific antagonist for type-1 receptor. Dithiothreitol inhibited ligand binding. The concentration of intracellular Ca2+ and of inositol-1,4,5-trisphosphate increased in the transfected COS-7 cells in response to angiotensin II or angiotensin III, indicating that this receptor is the type-1 receptor for angiotensin II. Northern blot analysis revealed that the messenger RNA for this receptor is expressed in bovine adrenal medulla, cortex and kidney.

Structural analysis of repetitive DNA sequences in the goat growth hormone gene region

Two clones that contain goat growth hormone (gGH) genes were isolated from goat genomic library using goat growth hormone cDNA as a probe. One clone CgGH contained gGH1 gene, and another clone, EgGH, contained gGH2 and gGH3 genes. The clone EgGH contained 491 bp inserted sequence, just upstream of the gGH3 gene, which was not present in the clone CgGH. From the sequencing data of the flanking regions of these gGH genes, short interspersed repetitive sequences (SINES) were found. Four SINES's existed in the CgGH clone and eight SINES's existed in the EgGH clone. The number of the repetitive DNA sequences in the goat genome was estimated about 10(2) copies from the analysis of the reassociation rate. As the number of gGH genes (gGH1, gGH2, and gGH3) per genome was different among individual goats, DNA fragments containing gGH1 gene, and that containing gGH2 and gGH3 genes, were estimated to be allelic on the goat chromosome.

[Experimental study on methyl bromide poisoning in mice. Acute inhalation study and the effect of glutathione as an antidote]

The objectives of this study were to determine the LC50 of methyl bromide (MeBr) and the dose-response curve and to study the detoxication effect of reduced glutathione (GSH) on MeBr poisoning in mice. 1) The LC50 of 4-h exposure to MeBr was 405 ppm in male mice with 95% confidence limits of 386-425 ppm. 2) The mortality rates of mice exposed to 500 ppm MeBr for 105, 120, 130, 140, 150 and 180 min were 0, 0, 10.7, 15.0, 85.0 and 90.0%, respectively. 3) In contrast, the mortality rate of mice pretreated with GSH (i.p 500 mg/kg; GSH-group) was only 5.3% after exposure to 500 ppm MeBr for 150 min. 4) Metabolic substances (Br-, GSH, formaldehyde, formic acid and beta-glucuronidase) were analyzed after exposure to 500 ppm MeBr and compared with the GSH-group and the distilled water treated group (DW-group). Except for GSH, concentrations of all other substances were significantly lower in the GSH-group than in the DW-group. Erythrocyte osmotic fragility test showed a significant increase in fragility in the DW-group. These results suggested that the onset of symptoms or death due to MeBr poisoning suddenly occurs at some point of concentration and time exposure. It was also shown that pretreatment with GSH effectively reduced mortality due to MeBr exposure.

Outer membrane proteins responsible for the penetration of beta-lactams and quinolones in Pseudomonas aeruginosa

Porin-deficient mutants of Pseudomonas aeruginosa PAO1 were selected by isolating latamoxef-resistant mutants following chemical mutagenesis. Highly latamoxef-resistant mutants had alterations in both the outer membrane proteins and penicillin-binding protein 3, a lethal target of latamoxef. Both of these alterations may be essential for cells to acquire high resistance to latamoxef. Many of the latamoxef-resistant mutants were also resistant to new quinolones and chloramphenicol. Resistance to these compounds was simultaneously co-transduced from one mutant into strain PAO1 when selection was made for transduction of ofloxacin resistance. Study of these transductants indicated that decreased amounts of outer membrane proteins C, D2, E1, and E2 lowered the outer membrane permeability and resulted in resistance. Three of these proteins were apparently identical to proteins previously reported to function as small pores. The results suggested that at least one of the four proteins was functioning as a porin for the antibacterial agents studied.

[The relationship between alveolar apertures and alveolar size and smoking history in humans, and experimental studies on air pollutants]

Using surgical specimens from patients with lung tumor, alveolar apertures and alveolar sizes were quantitatively assessed using scanning electron microscopy. Compared with smoking habits, increased apertures, defined as alveolar destruction were observed in patients smoking more than 35 years, whereas alveolar size was increased in patients, with a 15-year smoking history. Experimental studies with exposure to NO2, O3 and H2SO4 mist showed that exposure of NO2 and H2SO4 could induce epithelial injury such as disappearance of cilia in the central airways.

[Cardiac tamponade as an initial manifestation of acute myeloblastic leukemia]

A 28-year-old man was admitted to our hospital because of cardiac tamponade and pleural effusion. Although his peripheral blood picture was normal, his pericardial fluid contained a lot of myeloblasts with Auer bodies and a diagnosis of acute myeloblastic leukemia (M2) was made from the finding of bone marrow smears. The pericarditis was successfully treated with instillation of mitoxantrone into the pericardial space after drainage. He responded well to the systemic chemotherapy and achieved a complete remission. Although 27 cases of leukemia complicated with cardiac tamponade have so far reported, only three cases gave normal findings of the peripheral blood on admission. Leukemic pericardial effusion with cardiac tamponade in very rare as an initial manifestation of AML. The efficacy and safety of pericardial infusion of mitoxantrone were demonstrated in this patient.

Hemodialysis-associated amyloidosis of bone of beta-2 microglobulin origin

A case of hemodialysis-associated amyloidosis in a patient who had been on hemodialysis for 10 years is described. Bone lesions were found in the humeral heads, carpal bones, and femoral heads and necks. Specimens obtained from the pathologically fractured left femoral neck revealed amyloid deposits histologically. Immunoperoxidase staining for beta-2 microglobulin was positive in the amyloid at the light-microscopic level. We reconfirmed that bone lesions associated with long-term hemodialysis are manifestations of amyloidosis of beta-2 microglobulin origin. Hemodialysis-associated amyloidosis should be considered in the treatment of long-term hemodialysis patients.

Detection of multidrug resistance (MDR1) gene RNA expression in human tumors by a sensitive ribonuclease protection assay

The human MDR1 gene encoding P-glycoprotein, an energy-dependent drug-efflux pump, was initially isolated from a multidrug-resistant KB carcinoma cell. When a 3 kb genomic sequence isolated from normal human tissue including the major downstream promoter and the first and second exons of the MDR1 gene was compared to the equivalent fragment from KB cells, the MDR1 gene from KB carcinoma cells was found to have a point mutation in the first exon. Although this mutation does not affect the downstream promoter sequence or the coding sequence of the MDR1 gene, it creates a single base mismatch between the 5' KB genomic fragment previously used for RNase protection analysis of MDR1 RNA expression in normal tissues and thereby reduces the sensitivity of this assay. Using the DNA fragment from normal tissues rather than KB cells, we have reanalyzed MDR1 mRNA levels in 12 renal carcinomas and 4 colon adenocarcinomas. By this RNase protection assay, MDR1 RNA levels are as high in these tumors as in the multidrug-resistant cell line, KB-8-5. The ribonuclease protection assay indicated that the major downstream promoter was mainly used in these clinical samples including two samples of RNA from metastatic renal cancer. This assay appears to be a very sensitive and specific assay for detecting MDR1 mRNA levels and mRNA initiation sites in clinical samples.

[A randomized phase II study of (2''R)-4'-0-tetrahydropyranyladriamycin and adriamycin in combination with vincristine and ACNU in small cell lung cancer--THP-ADM, VCR, ACNU vs ADM, VCR, ACNU]

Between April 1984 and March 1988, a comparative randomized phase II study was performed to compare the effects of (2''R)-4'-0-Tetrahydropyranyl-adriamycin (THP) and adriamycin in combination with vincristine (VCR) and ACNU in 60 previously untreated and evaluable patients with small cell lung cancer (SCLC). Arm AVA was constituted by adriamycin, VCR and ACNU, and arm TAVA by THP, VCR, ACNU. Of the 30 patients treated with AVA, there were 20 partial responses, 7 with no change and 3 with progressive disease, for an overall response rate of 66.7%. On the other hand, of the 30 patients on TAVA, one complete response and 22 partial responses were observed, for an overall response rate of 76.7% Median survival time of AVA was 10.0 M, that, of TAVA was 9.3 M. But significant differences between the two arms was not found. During induction therapy, leukopenia was the main side effect. Over WHO Grade 3 leukopenia was seen in 53.3% of patients on AVA and 70.0% of those on TAVA. Moderate hair loss (Grade 2) was significantly less frequent with TAVA than AVA. In conclusion, the results indicated that THP is active in SCLC with the same level of adriamycin, and has less toxicity. THP is a suitable drug as a first line combination chemotherapy for SCLC.

Prong plate fixation for displaced intracapsular fractures of the femoral neck

The design and use of a prong plate for the treatment of displaced fractures of the femoral neck is described. The prongs hold the femoral head, and the plate is screwed to the anterior cortex of the femoral neck and trochanteric region. The new plate has been used in 32 patients with Garden stage III or IV fractures and 29 had a good result. Bony union was seen within 11 weeks in all patients in whom bleeding of the femoral head was noted at operation, but was much delayed in patients without bleeding. Late segmental aseptic necrosis was seen in four patients after follow-up of at least two years, and successfully treated. The prong plate allows accurate reduction, impaction and strong rigid fixation with less disturbance of the intramedullary blood flow than other fixation methods.

[A comparative randomized phase II study of CDDP, CDDP-carboquone (CQ) and CDDP-etoposide as second-line chemotherapy in small cell lung cancer (SCLC)]

51 SCLC patients who had received prior chemotherapies and had measurable lesions were randomized to CDDP, CDDP-CQ, and CDDP-etoposide treatment group. Prior chemotherapies of 49 complete cases were AVA (ADM, VCR, ACNU; 16 cases), TAVA (THP-ADM, VCR, ACNU; 17 cases), CAV (CPA, ADM, VCR; 4 cases) and others. The median period of 49 cases from prior chemotherapy to this chemotherapy was 4 weeks. In the CDDP alone group, CDDP was given at a dose of 80 approximately 100 mg/m2/4-5 weeks on Day 1, and in CDDP-CQ treatment group, patients were given the same dose of CDDP and CQ 6 mg/body on Day 1, 2. In CDDP-etoposide treatment group, the same doses of CDDP and etoposide 60 mg/m2 Day 1-5 (Total 300 mg/m2) were given. Response rate of the CDDP alone group was 6.7% (PR 1/total 15), that of CDDP-CQ group was 6.3% (PR 1/total 16), and in CDDP-etoposide group it was 16.7% (PR 3/total 18). In CDDP-CQ treatment, the main side effect was strong hematotoxicity (WBC; Grade 3, 5 patients, Grade 4, 2 Pl: Grade 3, 5 Grade 4, 3), and main hematotoxicity of CDDP-etoposide was leukopenia (W BC; Grade 3, 4 patients, Grade 4, 2 Pl; Grade 4, 1). In these patients, it was thought that CDDP was not useful in second chemotherapy, as not only CDDP alone but also the combination with CQ or etoposide.

Stress fracture of the body of pubis in a pregnant woman. Case report

A case with stress fracture of the body of the pubic bone which occurred in a 35-year-old pregnant woman is described. No underlying pathologic process was found and it would seem that the mechanical load acting on the pubic bone to cause stress fracture is brought about by both the muscle imbalance and ligament laxity. In a few weeks after delivery, the fracture showed a complete bony union.

Cloning and sequencing of cDNA that encodes goat growth hormone

The cDNA that encodes goat growth hormone (gGH) was isolated from a goat pituitary cDNA library. The cDNA, about 880 base pairs long, had a coding sequence, 5'- and 3'-untranslated regions and a poly(A) chain. The cDNA could encode a polypeptide of 217 amino acids. The amino acid sequence homology between gGH and the sequences of bovine GH, rat GH and human GH was 99, 83 and 66%, respectively. By Northern blot hybridization, we found that the possible gGH gene is transcribed in the goat pituitary.

[Cases of severe methyl bromide poisoning residing above a warehouse]

Methyl bromide has been widely used in Japan to fumigate grains and wood. One death and 3 cases of hospitalization resulted from exposure to methyl bromide at place of residence. These 4 cases were not employed and were members of one family living above a warehouse, the ground level of this building was a warehouse where herbs were stored and the second floor was their living area. On the 13th of May 1978 at 7:00 p.m., the herbs were fumigated with methyl bromide gas. The fumigator used 15 kg of methyl bromide (2 cylinders), a quantity far greater than usual. It is assumed that the concentration in the warehouse was between 10,000-15,000 ppm. Early in the morning on the 16th of May (3 days later), one of the family members, a 12-year-old girl, developed severe convulsions, and later 2 others also had severe convulsions, while the other suffered from marked mental confusion. The serum or plasma bromide ion level ranged from 280 to 600 ppm. The results of the clinical laboratory test showed that GOT exceeded the normal level in 3 out of the 4 cases. Moreover, LDH activity was above the normal range in 3 cases and CPK activity was increased in all the cases.

Aplastic anemia associated with type A viral hepatitis--possible role of T-lymphocytes

Posthepatitic aplastic anemia (PHAA) is rather uncommon. Most reported cases have developed after non-A, non-B or B type hepatitis. The only case of PHAA occurring after hepatitis A reported so far, was described by Smith et al., who diagnosed it by the long-term elevation of IgG-class antibody in response to hepatitis A virus. Recently, the detection of IgM-class antibody specific against hepatitis A virus (IgM anti-HAV) has been commonly employed for precise diagnosis of hepatitis A. The case reported here is the first case of PHAA occurring after hepatitis A to be diagnosed by radioimmunoassay of IgM anti-HAV. Furthermore, evidence is presented suggesting that the PHAA may have been an immune-related response. Addition of the patient's peripheral T-lymphocytes to cultures of her own bone marrow cells resulted in a reduction in the number of colony-forming units in culture (CFU-C).

[A simple determination method of bromide ion in plasma of methyl bromide workers by head space gas chromatography]

An improved method for the simple determination of bromide ion in plasma is described. It was modified from the method by Kawai, Sugiyama et al. (1985). In the improved method, 200 microliters of plasma and 800 microliters of distilled water were placed in a reaction vial to which 100 microliters of dimethyl sulfate was added. The reaction vial was immediately sealed, placed in an incubator at 85 degrees C, and shaken for 10 min. At the end of the reaction, a gas-tight syringe was used to draw out the head space gas of 1 ml. The methyl bromide gas was then injected into a gas chromatograph and methyl bromide was determined with F.I.D. A good linear relationship was obtained between the peak area of methyl bromide and the concentration of bromide ion within the range of 0.5 to 500 ppm. Bromide ion in the range of 0.5 to 500 ppm in standard solution was added to the plasma samples. After 10 repeated measurements, the relative standard deviation was found to be in the range of 2.8-3.6% and recovery was over 96%. The analytical results of this method were compared with those obtained by spectrophotometry. The analytical results obtained by the two methods were in good agreement (r = 0.9669) in plasma samples of 10 methyl bromide workers. A study to determine bromide ion concentration in 39 methyl bromide workers was made and the results were compared with those observed in 100 workers (control group) not exposed to methyl bromide.(ABSTRACT TRUNCATED AT 250 WORDS)

Comminuted fractures of the proximal humerus treated with hook plate

Good results were obtained using a hook plate to fix bone in 18 cases of fracture of the proximal humerus in which the bone was greatly comminuted or dislocated. The hook plate protects the fixed area against rotation, shear stress and flexion much better than other fixation methods.

The nucleotide sequence of the gene for gamma-glutamylcysteine synthetase of Escherichia coli

The nucleotide sequence of the gsh I gene for gamma-glutamylcysteine synthetase(GSH I) of Escherichia coli B has been determined. The gsh I structural gene contains 1557 bases in length and predicted a ploypeptide of 518 amino acids with a calculated molecular weight of 58,251. The value is in good agreement with that obtained from gel filtration and SDS/PAGE of GSH I. The initiation codon 5 bp downstream of putative Shine-Dalgarno sequence was an unusual TTG, which encoded methionine. For transcription, two sets of consensus promoter signals(-10 and -35 regions) overlapping each other were identified. The terminator signal shows the favored stem-loop structure with an adequate free energy delta G = -22.80 kcal/mol.

[Clinical investigation of the therapeutic effects of cefmenoxime in the treatment of infections complicated by hematological diseases]

Therapeutic effects on cefmenoxime hemihydrochloride (CMX, Bestcall), a new synthetic cephem antibiotic, were examined in the treatment of various infections complicated with hematological diseases. The number of patients treated with CMX was 37 including 5 cases of sepsis or suspected sepsis, 14 cases of pneumonia or suspected pneumonia, 5 cases of upper respiratory diseases, 2 cases of urinary tract infections and 11 cases of other infections. All of these infections were complicated with hematological diseases: Acute leukemia, 13 cases; chronic myelocytic leukemia, 1 case; adult T cell leukemia, 3 cases; malignant lymphoma, 8 cases; Hodgkin's disease, 2 cases and myeloma, 3 cases. CMX were administered by a single intravenous injection or by a drip infusion. The dose was between 2 and 6 grams per day. Good to excellent clinical results were obtained in 25 out of 37 cases, total effective rate of 67.6%. No clinical side effects or abnormal laboratory findings attributable to CMX were observed except for light diarrhea in 2 cases. By the clinical investigation, it was demonstrated that CMX was one of safe and effective antibiotics for treating infections in the compromised hosts complicated with hematological diseases.

Soft disc herniation of the cervical spine

The definition of soft disc hernia of the cervical spine is not always clear, so we have studied 34 cases where soft disc material was extruded or had migrated outside the intervertebral space. There were 22 cases of the paracentral-central type and 12 cases of the posterolateral type. The diagnosis was made by discography using anteroposterior, lateral and both oblique radiographs. All the patients complained of pain or discomfort in the neck or the interscapular region which was increased by the neck compression test and reproduced during discography. Severe pain in the area was present in all the cases of the posterolateral type and in about half of the paracentral-central type. Cord signs, such as increased reflexes in the lower limbs, were found in 15 cases of the paracentral-central type and in 5 cases of the posterolateral type. These signs correlated with the width of the spinal canal and the amount of prolapsed disc material. Discography and reproduction of pain were most useful for the diagnosis of this type of hernia. It has now become possible to differentiate the paracentral type from the central type by performing computerised tomography scanning after discography. We treated 12 cases conservatively and 22 cases surgically, and obtained good results in both groups.

Replantation of the amputated distal part of the fingers

Microsurgical replantation has been attempted in the distal phalanx of the finger regardless of whether zones I and II were involved. There were 70 patients with 87 amputated fingers. The patients' ages ranged from 14 months to 71 years. Fifty-one fingers were completely amputated. Five of the 87 replants failed. Seven fingers showed partial necrosis, but all others had no necrosis. Of the 74 fingers that had partial or no necrosis more than 6 months after surgery, 60 fingers (81.1%) are in excellent condition and have good daily use, and 14.8% have at least partial use. The patients were satisfied with the cosmetic appearance in all of the replanted fingers that survived.

Superoxide anion generation by polymorphonuclear leukocytes enhanced in a patient with colony-stimulating activity-producing lung cancer

We examined superoxide (O-2)-generating activity of polymorphonuclear leukocytes (PMN) from a patient with lung cancer in whom there was a marked granulocytosis. There was a high level of colony-stimulating activity (CSA) in both the serum and the supernatant of the culture of the primary tumor. The PMN from the patient produced almost three times more O-2 than did the PMN from healthy donors and other patients with lung cancers but with no granulocytosis. The binding of wheat germ agglutinin (WGA), used as a stimulus for O-2 generation, to the surface membrane of cells and the protein content in the cells were about double that noted in the case of healthy donors. Following total extirpation of the tumor, the level of CSA in the serum decreased, as did activity of PMN for O-2 generation, and the binding of WGA to the cells reverted to normal levels.

Enhancement of erythroid progenitor cell growth in medium conditioned by a human cancer cell line, KONT

Erythroid-potentiating activity (EPA) was detected in culture medium conditioned by a human cancer cell line (KONT) that produces colony-stimulating activity (CSA), using erythroid colony formation in vitro. EPA in the medium conditioned by the KONT cells (KONT-CM) was markedly heat stable. After treating KONT-CM at 80 degrees C for 30 min, 30% EPA remained, while CSA was completely inactivated. Both EPA and CSA appeared in approximately the same fractions of the gel filtration, indicating a molecular weight of approximately 30,000 daltons. EPA bound partially to Concanavalin-A Sepharose, whereas CSA almost did not bind. Our results indicate that EPA can be separated from CSA based on heat stability and binding to Concanavalin-A Sepharose.

A case of adult T-cell leukemia initiated with central nervous system symptoms

We treated a 52-year-old Japanese woman with adult T-cell leukemia (ATL) initiated with central nervous system (CNS) symptoms. Her chief complaints were paraplegia and left facial palsy. CNS-ATL was diagnosed because of the following three features. 1) Various sized lymphoid cells with marked nuclear convolution were numerous in her cerebrospinal fluid. 2) These cells were a monoclonal proliferation of T lymphocytes with OKT 4 marker. 3) The patient's serum was positive for anti-ATL associated antigen (ATLA). Although the neurological signs and symptoms improved markedly after intrathecal administration of combined chemotherapy (methotrexate, cytarabine and corticosteroid), these ATL cells were highly resistant to radiation therapy. The abdominal mass which developed in the course of the disease was diagnosed as a tumor formed of ATL cells, and VEPA (vincristine, endoxan, prednisolone and adriamycin) was administered with marked success.

Nucleotide sequences of chloroplast 5S ribosomal RNA from cell suspension cultures of the liverworts Marchantia polymorpha and Jungermannia subulata

The nucleotide sequences of chloroplast 5S rRNAs from cell suspension cultures of the liverworts Marchantia polymorpha and Jungermannia subulata were determined. Their nucleotide sequences, 119 nucleotides long, were highly homologous to each other (96% identity) and had high homology with those from chloroplast 5S rRNAs of two higher plants, tobacco (92% identity) and spinach (92-91% identity), but less homology (87-85% identity) with that from a lower plant, the fern Dryopteris acuminata.

Replantation of a completely amputated penis by the microsurgical technique: a case report

A case is reported of a 43 year old who performed a self amputation of his penis. Reimplantation was successfully performed.

Safe method of supraclavicular brachial-plexus anesthesia

Using the needle direction we devised, we applied brachial-plexus anesthesia in the supraclavicular approach originated by Kulenkampff to 561 patients 6 to 85 years of age. In this method, 20 ml of anesthetic was enough to obtain more than 95% anesthetic effect without any complications such as pneumothorax. Moreover, by using a long-acting drug (bupivacaine), we could get an effect lasting for more than 10 h, so that it was useful for long operations such as digital replantations, or for operations with severe postoperative pain.

Multipotent hemopoietic progenitors (CFUMIX) in human fetal liver

Colony formation by multipotent hemopoietic precursors (CFUMIX) from human fetal liver was studied in a methylcellulose culture system containing erythropoietin (Ep) and media conditioned by leukocytes in the presence of phytohemagglutinin (PHA-LCM). The 15 fetal livers used were obtained from 13-23-week-old abortuses. Morphologic characteristics of the fetal mixed colonies were similar to those of colonies derived from adult marrow cells. The number of colonies reached a maximum at about 15-17 days. Fetal liver CFUMIX was apparently more sensitive to added Ep than progenitors from adult bone marrow. Frequency of fetal liver precursors was higher than frequency of adult marrow precursors. Number of mixed colonies tended to increase with fetal age from 13 to 23 weeks of gestation (r = 0.547, P less than 0.05).

Electrophysiological study of nerve grafting

After using the sural nerve for cable grafting in three children with nerve defects of the upper limb, we conducted electrophysiological studies on the regeneration of the nerve. After nerve grafting, nerve regeneration was delayed as compared to that of the end-to-end suture, but muscle power recovered to 80% of normal. Electromyography showed isolated motor unit potentials with high amplitude and polyphasic waves at maximum voluntary contraction. The motor conduction velocity recovered to about 70% of the normal level, but the sensory conduction velocity was less than this. The motor conduction velocity was delayed in the graft site, which, for measurement purposes, included the two suture lines.

Digital nerve grafts in replanted digits

In most cases where digits have been amputated by avulsion and the digital nerve extensively injured, primary nerve suture cannot be performed. For such a digit when replanted, secondary nerve grafting was done under the operating microscope using a lateral femoral cutaneous nerve. Two years after operation, two-point discrimination of these cases proved to be 10.5 mm on average. And in the case of the transplanted three strand cable graft, using a lateral femoral cutaneous nerve yielded the most favourable results. The replacement was superior to the side receiving primary crushed nerve suture. Sensory nerve action potentials indicate that the regenerated nerve does not necessarily mature sufficiently. The recovery of sensitivity even to this degree however was sufficient for the replanted digits to be useful in all cases.

Some methods for bone fixation for digital replantation

Solid bone fixation constitutes one of the important factors in obtaining good function after replantation of amputated digits. Comparison has been made of various methods of bone fixation including a newly designed ceramic intramedullary screw which we have found useful for cases of amputation of a middle or proximal phalanx around its middle.

Antimicrobial characteristic of insoluble alkylpyridinium iodide

Insoluble and soluble alkylpyridinium iodides (C8 to C18) were synthesized. The insoluble agents were quaternized 4-vinylpyridine-divinylbenzene copolymers. The insoluble agent [C12(50)] that contained 50% divinylbenzene and had a C12 alkyl chain was selected as the most suitable insoluble agent. C12(50) showed poor durability of the antibacterial activity, but C12(50), which had lost the activity, was refreshed by washing with ethanol. This washing became ineffective after a few cycles of antibacterial treatment and refreshment. Such C12(50) recovered the activity upon 1.0 N NaOH treatment. The antibacterial activity of C12(50) depended on its surface area. It showed high antimicrobial activity against gram-positive bacteria and also showed activity against gram-negative bacteria and yeasts. But the activities of C12(50) and laurylpyridinium iodide solution were different against some microbes. The antibacterial activities of the agents were investigated against Escherichia coli and Micrococcus luteus under various conditions. The activity of C12(50) was higher at a higher temperature or at a lower cell concentration. The activity of C12(50) decreased on addition of NaCl, glucose, or bovine albumin to the cell suspension or in 0.01 M sodium-potassium phosphate buffer. C12(50) showed less activity when cells were mixed with dead cells or the supernatant of dead cells killed in an autoclave. The mode of action of the laurylpyridinium iodide solution against E. coli and M. luteus was similar to that of C12(50) except for the influence of E. coli cell concentration.

Experimental study of interfascicular grafts in the peroneal nerve of the rabbit

To elucidate the nerve, especially motor nerve, regeneration after interfascicular grafting, the method most often used clinically, the nerve grafting was performed on 40 adult rabbits. By resecting 2.0 cm of the right peroneal nerve, the sural nerve was made into 4 interfascicular grafts under a operating microscope. The cross section area of the grafts was about the same as that of peroneal nerve. Histological and evoked electromyographic observations were conducted on the maturation of regenerating nerves of up to 24 post-operative months, when the maturation would have been completed. The present histological and evoked electromyographic observations revealed that about 70% of nerve, especially motor nerve, recovery was attained after interfascicular grafts as compared with normal nerve. In the nerve regeneration after interfascicular grafts, several factors differing from the case of suture are involved, and these factors were considered from the experimental findings.

Diagnosis and operative treatment for the brachial plexus injury

It is shown that the electrophysiological diagnosis of brachial plexus injury is becoming more precise than ever. The intraoperative use of electrodiagnosis especially aids the obtaining of better results for brachial plexus injuries. When nerve transfer is undertaken, biceps function is more usefully restored by the accessory nerve than by the intercostal nerves. Protective sensation was achieved in almost all cases by intercostal nerve transfer. When nerve grafting was undertaken, functional motor restoration was regained in the upper arm muscles in one case, but not in the forearm.

Disc herniation of cervical spine

The so-called soft disc herniation (the extruded or sequestered type) of cervical spine is relatively rare. For such a diagnosis precise neurological examination, myelography and discography are employed, but among them the specific reproduction of the patient's symptoms and the radiographic appearance of the disc by discography are especially important. Our 8 cases of soft disc herniation have been classified into central-paracentral and posterolateral types by the direction of extruded material from discographic pictures. Every type shows the complications of root pain. Discussion relates to the pain that accompanies this soft disc herniation. In half of the cases extruded disc material has been removed but others have been improved by conservative treatment.

Electrodiagnosis of compression of individual nerve roots of the cauda equina

Segmental electrodiagnosis of compression of individual nerve roots of the cauda equina has been attempted in 45 patients, including cases of disc hernia, spondylsis and spondylolisthesis. The needle electrode was inserted into the nerve root either just lateral to the intervetebral foramen or through the posterior sacral foramen. The recordings made on stimulating a single nerve root were somatosensory evoked potential, the cauda equina action potential and the M and H waves. Mixed spinal nerve root action potentials were also recorded by stimulating the sciatic, peroneal and tibial nerves. It was shown that a diagnosis could be made from the somatosensory evoked potential, the H wave and root pain reproduction, and also the diagnosis of a subclinical compression involvement. In other words, the neurophysiological state of dysfunction of individual roots in each aspect of compression can be expressed.