Control of lymphatic filariasis by annual single-dose diethylcarbamazine treatments

It has long been stressed that diethylcarbamazine citrate must be given at a total dosage of 72 mg per kilogram of body weight in 12 divided doses of 6 mg kg(-1) to obtain maximum effect against Wuchereria bancrofti. However, recent studies revealed that only a single dose at 6 mg kg(-1) could reduce microfilaria (Mf) counts by 90%, and that the effect would persist for 12-18 months. The annual repeat of the single-dose mass treatment was shown to be effective in reducing Mf prevalence and density in large-scale, long-term field trials. The scheme is simple and economic, and could be sustainable in many endemic areas, where health manpower and resources are often not sufficient. Annual single-dose mass treatments can be an effective weapon against human lymphatic filariasis, as discussed here by Eisaku Kimura and Jona Mataika.

A chromatic-cancellation property of human pupillary responses

The pupil exhibits a response property somewhat analogous to perceptual red-green cancellation. Across a limited range of flash intensities near threshold, pupillary constrictions evoked by red flashes can be reduced, if not nulled, by the simultaneous addition of a green flash. The percentage of trials on which a stimulus-evoked response can be correctly discriminated from noise also falls to chance level as a green flash is added to the red flash. In terms of the quanta absorbed by L and M cones, the cancellation can be modelled as a function of magnitude of 0.65*L-M.

[Study on clinical effect of a continuous intravenous infusion of azasetron against nausea and vomiting induced by anticancer drugs including CDDP]

Azasetron, a selective 5-HT3 receptor antagonist, has been previously shown to be highly effective in the prophylaxis of nausea and vomiting induced by anticancer drugs and is widely used in the clinical setting in Japan. In order to improve the antiemetic effect of azasetron, we designed a continuous intravenous infusion method of this drug and compared the antiemetic effect of this method with that of standard bolus intravenous injection on nausea and vomiting associated with anticancer drugs including 75 mg/m2 cisplatin (CDDP). A continuous group is intravenous bolus injection of 2.5 mg azasetron followed by 7.5 mg continuous intravenous infusion for 24 hrs, and a bolus group is intravenous bolus injection of 10 mg azasetron. The inhibitory effect on nausea of the continuous group was significantly superior to those of the bolus group on day 3 and 4 (p < 0.05) and inhibitory effect on vomiting of the continuous group was significantly superior to those of bolus group on day 2 (p < 0.05). No adverse effects were observed in either group of this study. From these data, continuous intravenous infusion of azasetron was considered to be highly effective in prophylaxis of nausea and vomiting induced by anticancer drugs.

Differential contribution of metal complexation and dimerization to the chemotherapeutic potential of bicyclen-Zn2II complex against human immunodeficiency virus

1,1'-(m-Xylenediyl)-bis(1,4,7,10-tetraazacyclododecane)-Z n2II complex (m-xylenediyl-bicyclin-Zn2II), a potent inhibitor of human immunodeficiency virus (HIV), was obtained from cyclin by a combination of dimerization and metal complexation. The ratio of median cytotoxic concentration against host cells (CC50) and median effective concentration against HIV cytopathogenicity (EC50), referred to as the selectivity index (SI), was regarded to be a measure of anti-HIV activity. These two chemical modifications contributed to a potent, in vitro anti-HIV activity of m-xylenediyl-bicyclin-Zn2II by respectively increasing the CC50 and decreasing the EC50 in comparison with those of cyclin.

[Late pericardial effusion after open-heart surgery: usefulness of pericardiocentesis under echocardiographic guidance]

Late pericardial effusion (PE) after open heart surgery has a potential for serious complications, including tamponade necessitating urgent drainage. From October 1990 to March 1995 moderate to massive PE developed following 9 of 359 (2.5%) cardiac procedures between 11 and 55 days postoperatively (mean, 18.6 days). Only one of these nine patients had evidence of cardiac tamponade; the other 8 patients had moderate symptoms including malaise, weight gain, and dyspnea on exertion. All patients except one were being treated with warfarin and anti-platelet agents. Echocardiography detected posterior PE of variable magnitude in all 9 patients; anterior PE was present in only one of these patients. Pericardiocentesis under echocardiographic guidance using an echo transducer with a built in puncture needle was performed in all patients. A flexible catheter was left in place for 24 to 72 hours for suction. In each case, 300 to 712 ml of old bloody fluid (mean, 475 ml) was evacuated, with relief of symptoms. Despite continuing anticoagulant therapy, there was no recurrence of pericardial effusion. The technique we have described simplifies pericardiocentesis and helps to avoid complications in this procedure.

Facioscapulohumeral muscular dystrophy with chromosome 9p deletion

We report a 31-year-old man with facioscapulohumeral muscular dystrophy who had congenital anomalies and mental retardation. Southern blot analysis, using the probe p13E-11, displayed an abnormal EcoRI DNA fragment that reflect DNA rearrangements in facioscapulohumeral muscular dystrophy. In addition, high-resolution cytogenetic study revealed an interstitial deletion of the short arm chromosome 9: 46,XY,del(9)(p.22.1p24.1).

A pupillometric correlate of scotopic visual acuity

While not easily fit into the classic descriptions of the pupillary light reflex, previous studies reported that changes in the spatial composition of the retinal image can evoke a pupillary response. The present study extends this observation by showing that the pupil constricts in response to scotopic as well as photopic spatial patterns. Moreover, the amplitude of the scotopic response decreases with increasing spatial frequencies suggesting a pupillary spatial acuity of about 3 c/deg. The scotopic pupil acuity is similar to the scotopic perceptual visual acuity measured in the same observers.

Effect of piroxicam beta-cyclodextrin complex on experimental inflammation

1. The effectiveness of the inclusion product of piroxicam with beta-cyclodextrin was compared to that of free piroxicam on inflammatory reactions by using three experimental inflammatory models in rats. 2. The inclusion compound showed anti-inflammatory effects similar to those of simple piroxicam on granuloma tissue formation and arthritis induced by complete Freund adjuvant. 3. In carrageenin-induced pleurisy, the piroxicam beta-cyclodextrin reduced leukocyte mobilization more intensely than non-complexed piroxicam. 4. These results suggest that beta-cyclodextrin is a useful tool for improving the efficacy of piroxicam.

[Newly developed detection system for serum Helicobacter pylori antibodies using ELISA and its clinical significance]

Using ELISA, a specific and sensitive system that detects serum immunoglobulin G antibodies against all soluble antigens of Helicobacter pylori (Hp) has been developed. This system is used at three different concentrations of Hp antigens coated on the solid phase of the ELISA. Anti-Hp antibodies were judged positive when the difference in the ELISA values between high and middle or middle and low concentrations of antigen were over the specific values. For the ELISA system, called the three point antigen method, sensitivity and specificity of urease activity were 86.9% and 70.8%, respectively. Positive rate for antibodies to serum Helicobacter pylori in dyspeptic patients was higher than that in healthy subjects.

Nature of the pupillary responses evoked by chromatic flashes on a white background

Color flashes on a steady-white background are classically used to isolate the response of the chromatic (color-opponent), as opposed to achromatic (luminance), channel in psychophysical investigations. The present study shows that pupillary responses evoked by such stimuli behave as if they are composed of functionally separable components. One component has a temporally transient waveform and has an action spectrum that is similar to the spectral sensitivity curve of the psychophysical chromatic channel. The present study discusses the possibility that the pupillary response is mediated by phasic (M-like) neurons and/or by tonic (P-like) neurons.

Facilitation in Anopheles and spontaneous disappearance of filariasis: has the concept been verified with sufficient evidence?

The validity of recently much argued phenomenon of facilitation in the transmission of filariasis was considered by examining previously published papers. It was concluded that there was no clear evidence to support the existence of facilitation and facilitation-based unstable equilibrium in relation to microfilaria prevalence and density in human population below which filariasis would spontaneously disappear, even when the vector was Anopheles mosquitoes. Instead, the existence of a critical level of man/mosquito contacts for the disappearance of filariasis was suggested.

Parasitological and clinical studies on Wuchereria bancrofti infection in Chuuk (formerly Truk) State, Federated States of Micronesia

A total of 2193 people in 14 villages on 9 islands was examined for microfilaria (mf). The average mf rate of those examined was 2.6%. High mf rates of 7-10% were obtained in 3 villages on 3 islands. Analysed by sex and age, the highest mf rates were observed among males of age > or = 20 years (6-10%). A clinical study conducted on 466 adult males of age > or = 15 years showed that the average hydrocele rate was 3.4% and that of elephantiasis 0.4%. For the ages > or = 50 years the hydrocele rate was nearly 10%, indicating that filariasis is an important public health problem. Filariasis in Chuuk seems to be decreasing, but some endemic villages found in the study imply the existence of many unknown and thus unattended foci of filariasis in Pacific islands.

Treatment of a Japanese patient with familial amyloidotic polyneuropathy with orthotopic liver transplantation

A 28-year-old male patient with familial amyloidotic polyneuropathy (FAP) underwent a liver transplantation from a heart-beating cadaveric donor in Sweden. He had suffered from the disease for 2.5 years. It took 5.5 hours to carry out the operation without blood transfusion. After the liver transplantation, serum amyloidgenic variant transthyretin (TTR) levels became extremely low and diarrhea stopped after the 7th day. On day 13, the patient was discharged from the hospital and one month after the transplantation, his general condition remained quite good. This is the first case of a Japanese patient with congenital metabolic disorders as well as FAP to receive a liver transplantation from a heart-beating cadaveric donor.

[A successful repair of acquired left ventricular-right atrial communication due to infective endocarditis]

A 17-year-old boy, who had suffered from streptococcal infective endocarditis, was referred to our hospital because of the uncontrolled infection and severe right ventricular failure despite 2 months of vigorous antimicrobial therapy. Preoperative two-dimensional and Doppler echocardiography revealed a shunt from the left ventricule or aorta to the right atrium. Both aortic and tricuspid valves had vegetations and severe regurgitations. He underwent an operation because of the persistent infection and worsening heart failure. Intraoperatively, the aortic valve was found to be severely damaged and to have numerous vegetations on both surfaces. The tricuspid valve had multiple vegetations on the atrial surface only, and its annulus was markedly dilated. There was a perforation in the septal leaflet of the tricuspid valve, and an exploration of the focal site disclosed a perimembranous ventricular septal defect (VSD) communicating directly between the left ventricle and right atrium. Aortic and tricuspid valve replacements and patch closure of the VSD were done successfully and his postoperative course was uneventful except for the episode of ventricular tachycardia, torsade de pointes, on the fifth postoperative day.

Inactivation of bleomycin by an N-acetyltransferase in the bleomycin-producing strain Streptomyces verticillus

Bleomycin-producing Streptomyces verticillus ATCC15003 possesses a bleomycin acetyltransferase which inactivates the drug in the presence of acetyl coenzyme A. The site of acylation in enzymically prepared acetylbleomycin A2 was determined by nuclear magnetic resonance analysis; the primary amino group of the beta-aminoalanine moiety of bleomycin was acetylated Acetylbleomycin A2 had no detectable antibacterial activity and did not induce in vitro DNA degradation.

[Coronary artery bypass grating 13 years after pneumonectomy]

Coronary artery bypass grafting (CABG) in a patient who had undergone left pneumonectomy for lung cancer 13 years earlier is described. Preoperative pulmonary function was reduced; percent vital capacity was 55% and percent forced expiratory volume in 1 second was 77%. Triple CABG was performed with saphenous vein grafts. A retractor designed for use in harvesting of the internal thoracic artery was useful to obtain a good operative view because the heart had shifted to the left. Oxygen tension of the arterial blood decreased transiently after extracorporeal circulation. The early postoperative course was uneventful and the patient was discharged on day 57 after the operation. This is the first report, to the best our knowledge, of CABG after pneumonectomy for lung cancer in Japan. We think it possible, with careful management, to perform open heart surgery on a patient after pneumonectomy if pulmonary function is adequate.

Hourly change in cercarial densities of Schistosoma haematobium and S. bovis at different depths in the water and distances from the shore of a dam in Kwale District, Kenya

Hourly change in cercarial densities was studied at different depths in the water and distances from the shore at a dam in Kwale District (Kenya), where Schistosoma haematobium is highly endemic, by using a filtration apparatus for detecting cercariae. The peak of cercarial density at the surface of water (2-3 cm deep) was at 11:00 hours. Those at the middle point (25 cm deep) and the bottom (50 cm deep) were at 12:00 and 13:00 hours respectively. In the morning, the majority of cercariae (79% of the total detected) was obtained at the surface of water, but none at the bottom. After midday, 40% of the cercariae were obtained at the bottom. Cercariae seemed to sink with time resulting in a wider distribution in the water. The numbers of cercariae obtained at a sampling point 20 cm from the shore, which was inside the wire-screened snail-free area, were 3.4-23 times more than those obtained at a sampling point 340 cm from the shore, indicating that cercariae were accumulating immediately near the shore. Winds might cause the accumulation.

[Surgical treatment for cardiac diseases in patients with concomitant malignant tumor]

Between April 1984 and December 1992, 8 patients with concomitant malignant tumor were treated surgically for cardiac disease. The mean age was 58 years (range: 51 to 69), and there were 6 males and 2 females. There were 2 cases of ischemic heart disease, 3 cases of valvular heart disease, and 1 case of atrial septal defect (ASD). Gastric cancer was present in 4 cases, malignant tumor of hepatobiliary tract in 2, rectal cancer in 1, and lung cancer in 1. All patients were operated on in a two-stage fashion. In 6 cases, cardiac surgery including coronary artery bypass grafting (4 patients) and valve replacement (2 patients) were performed with an average of 58 days prior to the tumor resection. The other 2 patients underwent radical operation for a gastric or rectal cancer, followed by cardiac surgery for ASD or mitral stenosis about 2 months later. One patient died of respiratory failure 56 days after lobectomy following coronary artery bypass. There was one late death of local recurrence of rectal cancer 2 years after the operation. In conclusion, good surgical result can be expected with sequential operations for cardiac disease and malignant tumor, if curative resection of the tumor is possible.

Inhibition of human immunodeficiency virus proliferation by macrocyclic polyamines and their metal complexes

The macrocyclic polyamines, cyclen and cyclam, and their derivatives have been tested for inhibitory activity against the cytopathogenic effect (CPE) of human immunodeficiency virus type 1 strain HTLV-IIIB (HIV-1IIIB) on CD4+ human lymphoblastoma MT-4 cells. Cyclam and its derivatives were complexed with a variety of transition metal ions NiII, ZnII, CuII, FeIII and CoIII. The divalent metal complexes effected lower toxicity and greater anti-HIV-1 activity, while the trivalent metal complexes had no effect on HIV-1-dependent CPE. When dimerized, the anti-HIV activity of monomers was significantly enhanced. A potent inhibition of CPE by biscyclam was transiently observed 4 d after the virus infection, but was not seen at 6 d due to severe toxicity. The toxicity of biscyclam, referred to as delayed toxicity, could be overcome by a metal complexation. The strain specificities of biscyclams were further studied by testing their effects on syncytium formation between HIV-infected and uninfected human acute lymphoblastic leukemia MOLT-4 cells. The 50% inhibitory concentrations of biscyclams against HIV-2GH-1-dependent syncytium formation were less than one hundredth those for the other HIV strains (HIV-1IIIB, HIV-1RF and HIV-1SF-2).

Induction of FOS and JUN proteins by adrenocorticotropin and phorbol ester but not by 3',5'-cyclic adenosine monophosphate derivatives

We report the results of an extensive kinetic analysis of the effects of ACTH, cAMP derivatives (dibutyryl cAMP and 8-bromo-cAMP) and phorbol ester (phorbol-12-myristate-13-acetate) on the expression of fos and jun gene family members at the mRNA (Northern hybridization) and protein levels (immunoprecipitation and indirect immunofluorescence) in the mouse Y-1 adrenocortical cell line. FOS and JUN proteins are induced by ACTH independently of cell cycle stage. c-Fos, fos-B, fra-1, fra-2, c-jun, and jun-B genes are induced by ACTH, the kinetic profiles for mRNAs and respective protein products being similar, except for a 1-h protein delay. Jun-D mRNA is an exception, being constitutively expressed. However, JUN D protein is induced by ACTH. phorbol-12-myristate-13-acetate closely mimics these inductive effects of ACTH. On the other hand, cAMP derivatives are not effective in inducing the fos and jun genes, except for fra-2 mRNA, JUN D protein, and to some extent JUN B protein. Clearly, ACTH is endowed with the versatile capability of modulating fos and jun gene expression, suggesting that AP-1 transcription factors play a role in ACTH mechanisms of action. ACTH receptors are likely to activate signaling routes other than the classical cAMP/protein kinase A in order to induce FOS and JUN proteins.

[Pathologic changes at the coronary artery-bypass graft anastomosis--an immunocytochemical study]

We have performed immunocytochemical investigations on proliferative tissues observed in anastomotic sites of the saphenous vein aortocoronary bypass grafts to the coronary arteries. Nine anastomotic sites were obtained from 5 necropsy patients who had died after bypass grafting. Interval between the operation and death in these patients varied from 5 days to 9 months. The anastomotic sites were fixed in methanol-Carnoy's fixative, and embedded in paraffin. Six monoclonal antibodies specific for muscle cell actin (HHF35), smooth muscle cell actin (CGA7), vimentin, desmin, macrophages (HAM56) and endothelial cells were used for the immunocytochemical study. Of the 9 anastomotic sites, 4 were totally occluded, while the remaining 5 were patent. The occluded sites were characterized by a presence of fresh or organized thrombus. Immunocytochemically, the latter was composed of macrophages, smooth muscle cells and neovascularization. In contrast, a patent site at 5 days after grafting showed an early stage of intimal proliferation composed of macrophages and spindle-shaped cells. Two patent sites at 33 days after grafting revealed a distinct intimal thickening consisting almost entirely of smooth muscle cells. At this stage, smooth muscle cells at a deeper intima were stained positive with both HHF35 and CGA7, whereas the cells at the luminal site were stained positive with HHF35 but negative with CGA7. In older lesion at 9 months after grafting, almost all smooth muscle cells within intimal thickening showed positive with HHF35 and CGA7. Moreover, these smooth muscle cells were stained positive with vimentin but were negative with desmin, irrespective of the lesion's age.(ABSTRACT TRUNCATED AT 250 WORDS)