Specific microbial colonizations in the periodontal sites of HIV-infected subjects

The purpose of this study was to examine colonization by specific organisms at periodontal sites in HIV-seropositive [HIV(+)] subjects. A total of 67 HIV(+) and 32 HIV(--) subjects were investigated. The specific pathogens included black-pigmented anaerobic rods (BPAR), Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Candida albicans and mycoplasma species. P. gingivalis was present in the HIV(+) subjects more frequently than in the HIV(--) periodontitis patients (P < 0.01). The cell numbers of BPAR and P. gingivalis and percentages as the total of CFUs on blood agar cultured in an anaerobic chamber were statistically higher in periodontal pocket samples from HIV(+) than from HIV(--). A. actinomycetemcomitans was also detected at a high rate (41.8%) in HIV(+) patients. The average cell numbers of C. albicans were higher in samples from the HIV(+) group (P < 0.05). The detection rate of mycoplasma species in the HIV(+) patients was significantly lower than that in HIV(--) subjects (P < 0.05), and most isolated mycoplasma strains were Mycoplasma salivarium.

Serum carotenoids and vitamins and risk of cervical dysplasia from a case-control study in Japan

The relationships between risk of cervical dysplasia and dietary and serum carotenoids and vitamins were investigated in a case-control study. Cases were 156 women who attended Papanicolaou test screening in nine institutes affiliated with Japan Study Group of Human Papillomavirus (HPV) and Cervical Cancer and had cervical dysplasia newly histologically confirmed. Age-matched controls were selected from women with normal cervical cytology attending the same clinic. Blood sample and cervical exfoliated cells were obtained for measuring serum retinol, alpha-carotene, beta-carotene, zeaxanthin/lutein, cryptoxanthin, lycopene and alpha-tocopherol and for HPV detection. Higher serum level of alpha-carotene was significantly associated with decreased risk of cervical dysplasia after controlling for HPV infection and smoking status (odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.04-0.62 for the highest as compared with the lowest tertile). Decreased risk for the highest tertile of serum lycopene (OR = 0.28) was marginally significant. Decreased risks observed for the highest tertiles of beta-carotene (OR = 0.65) and zeaxanthin/lutein (OR = 0.53), were not statistically significant.

Utility of the monoclonal antibody HIK1083 in the diagnosis of adenoma malignum of the uterine cervix

OBJECTIVES

The aim of this study was to qualify a staining technique for the diagnosis of adenoma malignum.

METHODS

The gastric mucin expression of adenoma malignum, ordinary endocervical adenocarcinoma, and normal cervical glands was immunohistochemically compared using the monoclonal antibody HIK1083.

RESULTS

The three categories were clearly distinguished, with 90% (9/10) of cases with positive adenoma malignum, 30% (3/10) of cases with weakly positive ordinary cervical adenocarcinoma, and no (0/10) cases of positive normal cervical glands.

CONCLUSIONS

This preliminary report indicates that the use of HIK1083 is valuable in the diagnosis of adenoma malignum.

[Surgical management of pulmonary disease due to nontuberculous mycobacteria]

Between 1983 and 1998, 9 patients with nontuberculous mycobacteriosis (NTM) underwent pulmonary resection. 8 patients were men and 1 was woman. Mean length of preoperative period was 20.3 months (range 6 months to 51 months). Most operative indication was localized NTM resistant to multidrug therapy. Lobectomy was performed in 7 patients, segmentectomy in one, partial resection in one. We have no operative mortality but air leaks occurred in one and he needed thoracoplasty. Mean postoperative follow up period was 67.7 months. Only one patients relapsed 34 months after the first operation. For localized NTM, early surgical management results good outcome.

[Relationship between epidemiological data of adenovirus type 7 in Kawasaki City and restriction enzyme assay pattern of the virus]

Since April 1995 increased number of type 7 were isolated in Japan and also in Kawasaki city. From May 1996 to March 1999, Adenovirus type 7 (Ad7) were isolated from 49 patients with high body temperature, and longer febrile period were observed in infants and younger children. Lower respiratory tract infection occurred and a young child developed fatal pneumonia. Ad7 were isolated not only in summer but in winter. They were prevalent all season. We analyzed 27 strains of Ad7 genetically using restriction enzyme and compared the results with epidemiological and clinical data. Consequently we can not found any difference in genetic pattern between these Ad7 regardless of age or symptom. The pattern was all the same as Ad7d that of already issued in Japan.

Low-grade endometrial stromal sarcoma with cardiovascular involvement--a report of three cases

BACKGROUND

In low-grade endometrial stromal sarcoma, it has been reported that vascular space involvement in surgical specimens is found in over 50% of patients. However, in contrast to intravenous leiomyomatosis, it has been thought that further tumor extension to large vessels is rarely observed.

CASES

We present three cases of low-grade endometrial stromal sarcoma with cardiovascular involvement by recurrent tumors observed on imaging studies. Two cases demonstrated tumor infiltration inside the inferior vena cava while the other case showed tumor growth in the left ventricle.

CONCLUSION

This report suggests that attention should be paid to the possibility of cardiovascular invasion during the entire course of this disease.

Inhibitory activities of 2-pyridinecarboxylic acid analogs on phytogrowth and enzymes

Five 2-pyridinecarboxylic acid-related compounds (1, 2 and 5-7) showed germination inhibition against the seed of Brassica campestris L. subsp. rapa HOOK fil et ANDERS at a concentration of 5.0 x 10(-4) M. These compounds also demonstrated inhibitory activity on the growth of the root of this plant at a concentration of 3.0 x 10(-4) M; among these compounds, 2-pyridylacetic acid (5) showed the strongest inhibitory activity, and the effect was slightly stronger than that of sodium 2,4-dichlorophenoxyacetate (2,4-D) used as a positive control. The amounts of chlorophyll in the cotyledons of this plant treated with these active compounds was lower than that of the control group. Four compounds (1 and 5-7) with germination inhibition also showed inhibitory activities against alpha-amylase and carboxypeptidase A, and 5 was the strongest inhibitor toward both enzymes.

[Optical immunoassay test for rapid detection of influenza A and B viruses: an evaluation]

The optical immunoassay test (FLU OIA, BioStar, USA) for rapid detection of influenza A and B viral antigens was compared with viral isolation in cell culture. A total of 103 respiratory specimens were tested on 75 pediatric patients with acute respiratory illnesses. Influenza viruses were recovered in 40 specimens (type A: 5, Type B: 35). FLU OIA demonstrated 80.0% sensitivity and 68.8% specificity for nasopharyngeal aspirates and 36.7% sensitivity and 83.9% specificity for throat swabs. We also tested FLU OIA, retrospectively, using 78 supernatant samples from pediatric patients with influenza A virus infection frozen after cell culture. FLU OIA demonstrated 91.4% sensitivity and 92.3% specificity for nasopharyngeal aspirates and 50.0% sensitivity and 91.7% specificity for throat swabs diluted in viral transport media. Nasopharyngeal aspirates showed higher sensitivity than throat swabs for detection of influenza virus by FLU OIA. We believe this rapid test kit is useful for the detection of influenza A and B viruses.

Association of Helicobacter pylori with gastroduodenal diseases

Helicobacter pylori was first cultured in vitro in 1982. This bacterium is a spiral gram-negative rod which grows under microaerophilic conditions. The ecological niche is the mucosa of the human stomach which had been thought to be aseptic before the discovery of this bacterium. This organism causes a long-lasting infection throughout a person's life if there is no medical intervention. Numerous persons are infected with the organism around the world, and the rate of infection in Japan is nearly 50% of the population. However, the route of infection remains unclear because the organism has not been isolated from any environment other than several animals. H. pylori is now recognized as a causative agent of gastritis and peptic ulcers. Though gastritis, and especially chronic active gastritis, is observed at least histologically in all persons with H. pylori, peptic ulcers develop in only some infected persons. Specific factors in the host and/or the bacteria are needed for the development of peptic ulcer disease. Furthermore, H. pylori is considered to be related to the development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma, especially those of low grade. Also, H. pylori infection is a major determinant for initiating the sequence of events leading to gastric cancer. In some patients with low-grade gastric MALT lymphoma, the eradication of H. pylori led to a regression of lesion. Gastric cancer has been induced in Mongolian gerbils with long-term H. pylori infection. The combinations of drugs, which consist of an antisecretory agent (acid-suppressing agent) and antimicrobial agents, are used for the eradication of the organism. Eradication therapy is recommended at least for patients with peptic ulcers.

Gastric ulcers in SCID mice induced by Helicobacter pylori infection after transplanting lymphocytes from patients with gastric lymphoma

BACKGROUND & AIMS

Several studies have indicated that host factors are important in Helicobacter pylori-induced gastroduodenal diseases. We examined the pathological role of host immune responses in H. pylori infection by reconstituting components of the human immune system into severe combined immunodeficient (SCID) mice by transplantation of peripheral blood mononuclear cells (PBMCs) from H. pylori-infected patients.

METHODS

PBMCs obtained from patients with mucosa-associated lymphoid tissue (MALT) lymphoma were injected intraperitoneally into SCID mice, designated MALToma-hu-SCID mice. One month after transplantation, H. pylori was administered orally to the mice. The mice were killed and examined for pathological changes and immunologic features.

RESULTS

Human lymphocytes were detected in hu-SCID mice, and T- and B-cell functions were preserved for 1 month. Administration of H. pylori led to gastric ulcers with bleeding in the MALToma-hu-SCID mice. The gastric mucosa of control mice injected with Escherichia coli or transplanted with PBMCs from patients with peptic ulcers or gastritis or from healthy volunteers showed no pathological changes.

CONCLUSIONS

Host immune responses against H. pylori appear to be involved in the development of gastric ulcers in patients who have MALT lymphoma.

Morphologic analyses of positive peritoneal cytology in endometrial carcinoma

OBJECTIVE

To investigate the relationship between the morphologic features of endometrial adenocarcinoma cells in peritoneal fluids (effusions and washings) and macroscopic intraabdominal adenocarcinoma at laparotomy as well as prognosis.

STUDY DESIGN

Seventy-one patients with endometrial adenocarcinoma who showed positive peritoneal cytology at laparotomy were clinically divided into three groups: 25 patients with macroscopic neoplastic seeding in the peritoneal cavity (type 1), 38 patients without macroscopic peritoneal metastasis who survived with no evidence of disease (type 2) and 8 patients without macroscopic peritoneal metastasis who later developed recurrence of adenocarcinoma (type 3). Morphologic features of the adenocarcinoma cells in smears of peritoneal fluids were examined.

RESULTS

Most of the smears from type 1 patients showed moderate to high cellularity, scalloped edges of cell clusters and isolated adenocarcinoma cells, whereas these features were seldom observed in type 2 patients. Although not all type 3 patients demonstrated these three features, patients in the series whose specimens exhibited none of the three features did not show any peritoneal lesions or have a recurrence of their disease.

CONCLUSION

The finding of endometrial adenocarcinoma cells exhibiting high cellularity, scalloped edge of cell clusters and isolated cells in smears of peritoneal fluid is associated with the presence of intraabdominal macroscopic metastatic lesions and could be regarded as a risk factor for intraabdominal recurrence of carcinoma.

Assessment of the revised International Federation of Gynecology and obstetrics staging for early invasive squamous cervical cancer

OBJECTIVE

The aim of this study was to investigate the value of the International Federation of Obstetrics and Gynecology (FIGO) classification (1995) for early invasive cervical cancer. Methods. Clinico-pathological analysis was performed in 402 patients with invasive squamous cervical cancer in whom the depth of stromal invasion was 5 mm or less.

RESULTS

The incidence of lymph node metastasis was 1.2% (1/82) in patients with 3 mm or less depth of invasion; the node-positive patient was in stage IA1. The incidence of lymph node metastasis was 6.8% (5/73) in patients with 3-5 mm depth of invasion; this increased with increasing horizontal spread from 3.4% for 7 mm or less to 9.1% for more than 7 mm. None of the patients in this series had metastasis to the parametrial tissues. Of 4 patients with recurrence, 3 had horizontal spread of more than 7 mm and the remaining patient was in stage IA2.

CONCLUSION

The FIGO definition of early squamous cervical cancer is generally acceptable in its present form.

Molecular typing of enterohemorrhagic Escherichia coli O157:H7 isolated in Okayama Prefecture using pulsed field gel electrophoresis and random amplification of polymorphic DNA

Three outbreaks and many isolated cases of enterohemorrhagic Escherichia coli O157:H7 occurred in 1996 and 1997 in Okayama Prefecture, Japan. In an attempt to investigate the route of these infections, the strains isolated from the 3 outbreaks (total 33 strains) and 15 isolated cases (total 15 strains) were investigated using random amplification of polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE). In addition, 10 strains from an outbreak in Tojo Cho, Hiroshima Prefecture (June 1996), 2 strains from the particular types of meat in Kochi Prefecture, and 42 strains isolated from bovine feces in a farm in Okayama Prefecture were also investigated in the same manner. PFGE was much more useful than RAPD for molecular typing of the clinical isolates, in that it allowed us to classify them into 10 PFGE groups. We noted that the strains differed according to the time and place of the outbreaks (or isolated cases). This indicates that O157:H7 infections in Okayama Prefecture were caused by different strains (although some cases were aggravated by the same strains as were found in other areas). The isolates from bovine feces were classified into 5 groups by PFGE profiles, but none of them were identical to those of the clinical isolates.

Efficacy of aquatic exercises for patients with low-back pain

We have studied 35 patients (25 female and 10 male) with low-back pain who were managed with aquatic exercises after an appropriate period of treatment for their condition in the medical institution. The exercises employed consisted of strengthening exercises for the abdominal, gluteal, and leg muscles, stretching of the back, hip, hamstrings, and calf muscles, walking in water, and swimming. All the patients had been participating in the exercise program for more than 6 months. The frequency of performing exercises was once a week for 7 patients, twice a week for 19, and 3 or more times a week for the remaining patients. The method used in this study was a survey questionnaire which was composed of questions about the patient's physical and psychological condition. Those patients who had performed exercises twice or more in a week showed a more significant improvement in the physical score than those who performed exercises only once a week. More than 90% of the patients felt they had improved after 6 months of participation in the program. The improvement in physical score was independent of the initial ability in swimming. The results obtained suggested that exercises in water may be one of the most useful modes of exercise for a patient with low-back pain.

Antibodies to human gastric epithelial cells and heat shock protein 60 in Helicobacter pylori positive mucosa associated lymphoid tissue lymphoma

BACKGROUND

Development of gastric mucosa associated lymphoid tissue (MALT) lymphoma is thought to be closely associated with host immune reactions to Helicobacter pylori.

AIM

To investigate humoral immune responses in patients with MALT lymphoma to antigens shared by H pylori and human gastric epithelial cells.

METHODS

Sera were obtained from H pylori positive patients with MALT lymphoma (n = 11) or other gastroduodenal diseases (peptic ulcer, n = 40; non-ulcer dyspepsia, n = 20) and from H pylori negative healthy control subjects (n = 10). Antibodies to HGC-27 human gastric epithelial cells and human recombinant heat shock protein (Hsp) 60 were examined using an enzyme linked immunosorbent assay (ELISA) and immunoblotting.

RESULTS

Antibody titres to HGC-27 cells were significantly elevated in H pylori positive patients with MALT lymphoma when compared with titres in patients with other gastroduodenal diseases and in healthy subjects. Immunoblotting of sera from patients with MALT lymphoma often detected a band with a molecular mass corresponding to Hsp60, and both ELISA and immunoblotting showed elevated antibody titres to the recombinant human Hsp60. Antigenic similarity between Hsp60 and H pylori HspB was documented by immunoblotting experiments.

CONCLUSIONS

Autoantibodies reactive with host gastric epithelial cells are often increased in MALT lymphoma, and Hsp60 is a major target antigen. Immune responses induced by immunological cross reactivity between H pylori HspB and human Hsp60 in gastric epithelium may be involved in the development of MALT lymphoma.

Selective cone suppression by the L-M- and M-L-cone-opponent mechanisms in the luminance pathway

We investigated how transient changes of background color influence the L- and M- (long- and middle-wavelength-sensitive-) cone signals in the luminance pathway. Motion identification thresholds were measured for a drifting sinusoidal grating (1 cycle/deg) modulated along different vector directions in L- and M-cone contrast space. The color of a central 4-deg-diameter region was briefly altered (500 ms) by incrementing or decrementing either L- or M-cone excitation. Incrementing L-cone and decrementing M-cone excitation produced a field that appeared reddish relative to the yellow surround. Likewise, incrementing M-cone and decrementing L-cone produced a field that appeared greenish. Motion identification thresholds were obtained on the yellow field following the brief color transitions. The results show that the threshold for the L-cone direction was selectively elevated by the background substitution of incrementing L-cone and decrementing M-cone excitation (shift toward reddish color). The same substitution, however, did not affect the threshold in the M-cone direction. Similarly, the threshold for the M-cone direction was selectively elevated by the background substitution of incrementing M-cone, decrementing L-cone excitation (shift toward greenish) without affecting the threshold in the L-cone direction. Experiments using the motion quadrature paradigm confirmed that these effects occur within the luminance mechanisms. These results indicate that the activation of L-on plus M-off signals suppresses the L-cone signal and that the activation of L-off plus M-on signals suppresses the M-cone signals in the luminance pathway. We propose a retinal model based on the experimental results.

Human papillomavirus infection and other risk factors for cervical intraepithelial neoplasia in Japan

Various risk factors were investigated in 167 cervical intra-epithelial neoplasia (CIN) case and control pairs in Japan. CIN cases showed evidence of nine known risk factors including smoking and sexual behaviour. However, after adjustment for papillomavirus infection, the highest determinant, the only remaining risk factors were: being married, early age at first pregnancy and multiparity.

Triterpenoid saponins of Acanthopanax nipponicus leaves

Five new triterpenoid saponins, nipponosides A-E (1, 3-6), were isolated from Acanthopanax nipponicus leaves, along with a known saponin, kalopanaxsaponin G (2). Nipponosides A-E were characterized as the 28-O-alpha-L-rhamnopyranosyl(1-->4)-beta-D-glucopyranosyl(1-->6)-beta -D-glucopyranosyl ester of 3-oxohederagenin, oleanolic acid 3-O-beta-D-glucopyranoside, gypsogenin 3-O-beta-D-glucopyranoside, 3beta,23,29-trihydroxyolean-12-en-28-oic acid, and 3beta,20alpha, 23-trihydroxy-30-nor-olean-12-en-28-oic acid, respectively. The structures of these new compounds were based on chemical and spectral methods.

Microhardness evaluations of resin-dentin bonding areas by nano-indentation

The purpose of this experiment was to determine the hardness values of the hybrid layer and its surroundings through the continuous use of a microhardness measuring device. Black's Class V cavities were prepared in nine dog teeth. The cavities were divided into four groups according to the dentin adhesive system applied. The adhesive systems were: "Bond One System", "Liner Bond II sigma System", "One Step System", and "Single Bond System". The treated teeth were observed at seven days post-application. Specimens were cross-sectioned perpendicularly or horizontally to the resin-dentin interface and embedded in epoxy resin. Their surfaces were polished. The microhardness of the resin-dentin bonding area was measured with a nano-indentation tester. The hardness values at a point of 10 microns distant from the interface in the direction of the dentin differed between systems. It appeared that this was influenced by the presence of the decalcified dentin not impregnated by resin, differences in the chemistry forming the hybrid layer, and the composition of the bonding resin. The hardness of the dentin-bonding interface and its surroundings was determined, and these areas were observed using SEM. Three layers were confirmed the healthy dentin layer, the composite resin layer, and the hybrid layer, (in which decalcified dentin impregnated by resin and that not impregnated by resin are considered to be mix). In the hybrid layer, no impression was found by SEM although the hardness in the bonding interface was significantly different. These layers appear to be more elastic and softer than the healthy dentin.

[Evaluation on the clinical background on early death in patients with pulmonary tuberculosis during the past five years]

We evaluated the clinical background of early death (within 3 months after admission to our hospital) in patients with active pulmonary tuberculosis during the past five years (1992-1996). Among 65 active pulmonary tuberculosis patients who died during the past five years, 32 (49%) died directly of tuberculosis. Thirteen (41%) of those 32 patients died of acute respiratory failure and 9 patients (28%) died in emacitation state. Twenty two patients (69%) died within 3 months after admission to our hospital (the early death group) and 10 patients (31%) died after 3 months (the late death group). Thirteen patients (59%) in the early death group died of acute respiratory failure. On the other hand, none in the late death group died of acute respiratory failure but 4 patients died of chronic heart and/or respiratory failure and 4 patients died in emarciation state. Compared to the patients in the late death group, more patients in the early death group had long total delays (patient's and doctor's delays), had coexisiting diseases, had fallen into acute respiratory failure, and were under malnutrition. We evaluated the nutritional condition of patients using the Onodera's PNI (Prognostic Nutritional Index; 10 x serum almumin concentration + 0.005 x peripheral lymphocyte count) and the PNI value was lower among the patients in the early death group than among those in the late death group. To prevent death due to tuberculosis, we emphasize that it is important to start anti-tuberculosis therapy before patients fall into acute respiratory failure and/or malnutrition.