Dental fear in Japan: Okayama Prefecture school study of adolescents and adults

A total of 3,041 students and staff in middle school in Okayama Prefecture, Japan, were surveyed regarding dental fear. Over 88% reported fear, with 42.1% classified as having high fear. Almost 70% reported acquiring dental fear prior to junior high school. A majority reported being hurt at the last appointment. Delay of dental work was also reported for over 50% of the sample. Coping, pattern of physiological upset, nondental fears, and sex and age differences were also reported. Results suggest intervention is needed to address the major dental public health problems associated with dental fear.

Large scale production and characterization of lyophilized pyridoxalated hemoglobin-polyoxyethylene (PHP)

Lyophilized PHP as an oxygen carrier is prepared from outdated red cell and dicarboxymethylated polyoxyethylene. In order to apply PHP for a clinical use, a large scale production of high quality PHP has been studied. We have set up a 20 L scale production flow of PHP88. The product was tested to confirm the quality and lot-to-lot consistency. The blood group specific materials were weakly positive in stroma-free hemoglobin (SFH), however, were found negative in the PHP of this scale. The amount of phosphatidylethanolamine (PE) in purified SFH and PHP88 reconstituted solution was 0.19 +/- 0.04 and 0.03 +/- 0.01 ppm, respectively. Contamination of viruses such as HBV and Non A non B hepatitis virus could not be observed in the final product. Elimination and inactivation of HIV was validated through a spike test. The characterizations of the final products in 20 L scale were done through MW, P50, Hill coefficient, viscosity, and molecular weight distribution by SDS-PAGE and batch to batch consistency was also confirmed. The results show that production process is appropriate to eliminate the blood group materials, PE and virus, and produce PHP of high quality. Lyophilized PHP88 can be produced by addition of maltose and can be stored over 1 year.

Tissue-specific and non-tissue-specific heavy-chain isoforms of myosin in the brain as revealed by monoclonal antibodies

Four types of monoclonal antibody (BM-1, BM-2, BM-3 and BM-4) each having distinctive tissue specificity were obtained by immunizing mice with purified bovine cerebrum myosin. Both BM-1 and BM-2 reacted most efficiently with cerebrum myosin and less efficiently with myosins from other limited nonmuscle tissues, the tissue specificity of BM-1 being much narrower than that of BM-2. BM-3 reacted more efficiently with several other nonmuscle myosins than with cerebellar or cerebral myosin. BM-4 recognized various nonmuscle and smooth muscle myosins with a nearly equal efficiency. Cerebral myosin as well a cerebellar myosin contained two or more electrophoretic variants of the heavy chains. BM-1 and BM-3 as well as BM-2 and BM-3 were found to recognize selectively these distinct heavy-chain isoforms. The antigenic sites of the three tissue-specific antibodies (BM-1, BM-2 and BM-3) were all localized near the head/tail junction of the myosin molecules, while that of non-tissue-specific antibody BM-4 was near the center of the tail. These and additional results indicate that mammalian brain tissues as well as several other nonmuscle tissues contain multiple heavy-chain isoforms of myosin, the levels of which differed considerably from one tissue to another.

Erythrocyte deformability in workers exposed to lead

Erythrocyte deformability and other hematological indicators were determined in 17 male workers exposed to lead at a secondary lead refinery and 13 controls. Blood lead, urine lead, urine coproporphyrin, delta-aminolevulinic acid and erythrocyte zinc protoporphyrin were determined to evaluate the degree of lead exposure in the lead workers above. For the measurement of erythrocyte deformability, the microfilter method was used. The results were summarized as follows: 1. The mean values of blood lead, urine lead, urine coproporphyrin, urine delta-aminolevulinic acid and erythrocyte zinc protoporphyrin levels in lead workers were 53.5 micrograms/100g, 141.4 micrograms/l, 115.9 micrograms/l, 12.0 mg/l and 68.9 micrograms/dl respectively, suggesting a moderate influence of lead exposure. 2. The mean values of erythrocyte count, hematocrit and hemoglobin were significantly lower in lead workers than those in controls. No significant differences were found in the mean values of mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and corpuscular natrium and potassium between lead workers and controls. 3. Erythrocyte deformability was significantly reduced in lead workers compared with controls.

Myosin and actin from aortae of spontaneously hypertensive and normotensive rats

Contractile proteins were extracted from thoracic aortae of 9-month-old spontaneously hypertensive stroke-prone (SHRSP) and normotensive Wistar Kyoto rats (WKY). The average wet weight of the aortae from SHRSP was approximately 1.6-fold heavier than that of WKY. On polyacrylamide gel electrophoresis of the myofibrillar extracts prepared from normalized, equal weights of aortae of SHRSP and WKY, both the compositions and concentrations of major polypeptides including myosin heavy chains and actin were nearly identical in these extracts. The myosins purified from these extracts contained identical light chains of about 20- and 17 kDa. Proteolytic peptide maps of the heavy chains of myosin from SHRSP were also indistinguishable from those of WKY, suggesting that the same isoforms of myosin are expressed in both aortae. From these results it is suggested that the qualitative differences may be small, if any, between the major contractile proteins in the aortae of SHRSP and those of WKY.

Direct interactions between talin and actin

Talin was purified from chicken gizzard by a modification of the method of L. Molony et al. [J. Biol. Chem.(1987) 262, 7790-7795]. Unlike the talin purified by the previous method, the talin purified by the new method was found to bind to both F- and G-actin: Talin cosedimented with F-actin. On gel filtration of a mixture of talin and G-actin, a complex of talin and action was obtained. Talin stimulated the polymerization rate of G-actin. A major proteolytic fragment of talin that retained the binding ability to F-actin was also identified. These results indicate that talin can bind directly to actin and suggest that talin plays a key role in the organization of actin filaments at the actin-membrane attachment sites in vivo also.

Protein kinase C phosphorylates both the light chains and the head portion of the heavy chains of brain myosin

Protein kinase C phosphorylated both the 19/21-kDa regulatory light chains and heavy chains of bovine brain myosin. The major phosphorylation sites of the light chains were on their threonyl residues, while those for myosin light chain kinase were on their seryl residues. Whereas several non-muscle regular myosins have been reported to be phosphorylated by different types of protein kinases at the non-helical small segments at the tail ends of the heavy chains, the phosphorylation sites for protein kinase C were localized on the head portion of the heavy chains of brain myosin. The possible role of phosphorylation of brain myosin by protein kinase C in the regulation of motility of neural cells is discussed.

[A case of subdural effusion secondary to dural metastasis of prostatic cancer: case report]

The authors reported a case of subdural effusion secondary to dural metastasis of prostatic cancer. A 61-year-old man was referred for headache, vomiting and gait disturbance. He had undergone hormonal therapy for prostatic cancer. He showed a mild left hemiparesis and anemia without bleeding. CT-scan disclosed a multilobular crescent shaped low density area in the right hemisphere. Under the diagnosis of chronic subdural hematoma, burr hole irrigation therapy was performed. Xanthochromic fluid was evacuated from the subdural space, in which no tumor cells were shown to exist. CT-scan on the 21st day disclosed a low density area, which was diagnosed as recurrent chronic subdural effusion. Therefore, craniotomy was performed to evacuate the subdural fluid and to explore the dura mater. Removal of the red hemorrhagic tumor at the dura mater and the fluid was performed. The patient died of heart failure in the 16th month despite complete recovery after the second operation. Histopathological examination of the tumor revealed adenocarcinoma at the outer part of the dura mater and the adjacent skull bone, where capillaries were embolized with tumor cells. However, no tumor cells were found in the subdural fluid. The authors could find in the literature 30 cases of subdural hematoma or effusion secondary to dural metastasis of carcinoma. The pathogenesis of the subdural hematoma in this case might be due to circulatory disturbance at the dura mater brought about by the invasion of the tumor or tumor cells emboli in the capillaries.

[Elevation of intracranial pressure during hemodialysis--continuous measurement of cerebrospinal fluid pressure in a patient with acoustic neurinoma]

Intracranial pressure (ICP) was continuously monitored in a thirty-two-year-old female of acoustic neurinoma complicated with chronic renal failure. Severe headache with vomiting has begun to appear during hemodialysis for several months, prompting a diagnosis of an obstructive hydrocephalus. Continuous ventricular drainage was placed after admission and changes of ICP were monitored during hemodialysis. Dynamic changes of electrolytes, protein, sugar, urea nitrogen, and creatinine levels in the cerebrospinal fluid (CSF) as well as osmolarity were measured every one hour during the hemodialysis. An increment of ICP started to occur gradually after initiation of hemodialysis reaching the maximum value 23 minutes later. It was spontaneously decreased to the initial level 8 minutes later followed by fluctuations thereafter consisting of the changes of 20 to 30 mmHg. A remarkable rise in osmotic pressure in CSF has been observed corresponding to the rise of ICP which created a large difference from the blood osmotic pressure that consistently decreased following the onset of hemodialysis. Whereas, the absolute values of all measured factors including electrolytes and urea nitrogen in CSF have decreased consistently which did not seem to contribute intermittent increment of osmotic pressure of CSF. The cause of ICP increment in our case was considered mainly due to increase of water content in the brain tissue caused by the widening of osmotic gradient between the CSF and blood, although the substances responsible to the actual increase of CSF osmotic pressure remained unclear.

[Experience of carotid endarterectomy]

The clinical course of 45 patients treated by carotid endarterectomy over the past 5 years is described with emphasis on the following three points: 1) Diagnostic methods, namely digital subtraction angiography (DSA) and B-mode Doppler imaging technique; 2) surgical procedure using an improved shunt tube and surgical instruments; and 3) monitoring before and during surgery. All operations were conducted using a shunt. Morbidity and mortality rates were both 0%. Postoperative transient hemiparesis lasting for 6 hours was recognized in only four cases. The total percentage of correct diagnoses using intravenous DSA compared with conventional angiography was approximately 80%. The accuracy of the non-invasive B-mode Doppler technique in measuring the degree of constriction compared with conventional angiography was 84%. The shunt was made of silicone tubing and was based on a tube 30 cm in length and 3.5 mm in diameter which was a T-shaped loop. Different sized bulbs were fixed to each end of the tube to prevent extravascular deviation. Modified bulldog clamps and Sugita clips were used for fixation in the vessel. Regional cerebral blood flow (rCBF) measurement and electroencephalography (EEG) under contralateral Matas procedure were conducted before surgery, and cross circulation during short-term occlusion of the common carotid artery was evaluated. The emergence or increase of delta waves in EEG during occlusion was observed in six cases. The rCBF of the affected middle cerebral artery territory in these patients was lower than that in patients with no increase of delta waves. Furthermore, the mean stump pressure during surgery in cases with preoperative EEG changes was 40 mmHg and that in cases without changes was 63 mmHg; these values were significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

[Intraoperative monitoring of cerebral function and carotid hemodynamics during carotid endarterectomy]

The authors investigated the hemodynamics and monitored the cerebral function to perform the carotid endarterectomy (CEA) safely. The hemodynamics were investigated by measurements of carotid arterial blood flow by an electromagnetic flow meter before and after CEA. And a doppler flow meter applied directly to the carotid arteries to analyze the flow parameters such as peak frequencies (PF), mean frequencies (MF), mode frequencies (Mo F) and % window. We used routinely our specially designed shunt system during surgery, by which stump pressure of the ICA could be measured easily. The cerebral function was evaluated by the amplitude of N20-P25 component of somatosensory evoked potential (SEP). Flow parameters of doppler sounds demonstrated significant changes such as inversion of MF and Mo F, decrease in % window at the poststenotic ICA in the severe stenosis group. By these doppler sounds the extension of stenotic lesion could be detected clearly. The ICA flow showed evidently low values in patients with more than 80% stenosis, which was improved by CEA. With our specially designed T-tube shunt system, stump pressure, side pressure and direct pressure of the ICA could be monitored easily. The mean stump pressure was 52 mmHg and systemic arterial blood pressure was 99 mmHg on the average. SEP revealed evident changes during temporary occlusion in 10 out of 41 patients, which improved following the reflow with the shunt system. Mean stump pressure in the 11 patients was 33 mmHg, and that in the remaining patients were 59 mmHg on the average.(ABSTRACT TRUNCATED AT 250 WORDS)

[Primary interhemispheric subdural abscess: report of a case]

We reported a rare case of primary interhemispheric subdural abscess. Twenty-three cases of this pathological condition have been reviewed. In those reports, however, findings of magnetic resonance imaging (MRI) were not referred to. In this report, MRI findings in this pathological condition, in addition to X-ray computed tomography (CT), is mentioned. A 22-year-old man, who had suffered from headache and vomiting for 2 weeks, suddenly became drowsy and left-hemiparetic. The X-ray CT scan on admission showed a well-circumscribed low density area in contact with the falx in the right parieto-occipital region. This lesion had so called "ring enhancement". MRI in the sagittal view revealed that, along the falx, the long T1 and T2 areas extended from the right cerebellar tentorium to the right frontal region. The operation demonstrated the capsular formation of the abscess. After pus aspiration, continuous drainage was performed from the cavity of the abscess. The patient fully recovered postoperatively. In the diagnosis of interhemispheric subdural abscess, it is said that conventional X-ray CT sufficiently reveals the quality of the lesion, the precise site, and the anatomical relation to the surrounding edema. In our case, MRI was able to confirm the diagnosis made by the X-ray CT. Furthermore, MRI was thought to be superior to the X-ray CT in the evaluation of the extension of the abscess and in the delineation of the surrounding edema. Combined use of X-ray CT and MRI in cases of interhemispheric abscess was considered to make the diagnosis more precise in both qualitative and quantitative aspects.(ABSTRACT TRUNCATED AT 250 WORDS)

Study of temperature factors in cubic crystals by high-voltage electron diffraction

The critical voltages for systematic reflections and splits of Kikuchi lines were measured using a high-voltage electron microscope to investigate the atomic temperature factors in cubic crystals. The split of the Kikuchi line at the intersection with the forbidden 222 Kikuchi line as well as the critical voltage of the 333 reflection for Si and Ge decreased steeply with temperature. The temperature dependence showed that the anharmonic contribution to the atomic-temperature factor for Si and Ge is extremely weak in the temperature range 300 approximately 1078 K. On the contrary, the B factors obtained from the measured critical voltages for Al, Cu, and Fe varied nonlinearly with temperature, suggesting the importance of the anharmonic effect in the vibration of atoms. The observed temperature dependence of the critical voltages for the metals were compared with calculations based on harmonic, quasi-harmonic, and anharmonic approximations. The quasi-harmonic approximation that takes into account the thermal expansion modification reproduces well the observed values for Fe but not those for Al and Cu. The effect of intrinsic anharmonic vibration should be considered for reproducing the results for Al and Cu. Fitting the measured critical voltages with the calculated ones, we estimated the values for coefficients of the isolated atom potentials. The results are in good agreement with those obtained by neutron and X-ray diffraction.

Physical, enzymatic, and contractile properties of brain myosin with anti-brain myosin Fab fragment bound on its tail

An antibody obtained by immunizing a rabbit with purified bovine brain myosin was found to react with the tail portion of the myosin heavy chain. An Fab fragment obtained by limited papain digestion of the antibody was allowed to bind to brain myosin, and the complex of the Fab fragment and brain myosin (Fab-myosin) was isolated. On examination of the rotary-shadowed Fab-myosin by electron microscopy, most of the Fab fragment was located on the middle to C-terminal regions of the tails of the myosin molecules. The solubility of Fab-myosin in low salt solutions was higher than that of control brain myosin. Fab-myosin was found to form small irregular aggregates in low salt solutions instead of regular bipolar filaments, and the relative population of the monomeric form of myosin molecules observed for the Fab-myosin was much larger than that observed for the control myosin. The actin-activated Mg2+-ATPase activity of Fab-myosin was stimulated two- to threefold by phosphorylation of the light chains with myosin light chain kinase, as observed for the control brain myosin. Furthermore, the levels of the ATPase activity of the phosphorylated and dephosphorylated Fab-myosins were similar to those of the phosphorylated and dephosphorylated control myosins, respectively. The superprecipitation activity of Fab-myosin was also highly dependent on phosphorylation of the light chains. Although control brain myosin formed a large superprecipitate network which contracted to a dense particle, Fab-myosin generated only numerous tiny superprecipitates under the same conditions. From these results it was deduced that a regular filamentous state of brain myosin was not prerequisite for its actin-activated Mg2+-ATPase and superprecipitation activities but was indispensable for the formation of a large and well contractible superprecipitate.

[Enlarging of intracranial hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients]

The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. Four cases out of these five were in a state of hemorrhagic shock. All these five cases showed a subsequent enlargement of intracranial hematoma. Four cases died. Two of them, who had low initial Glasgow Coma Scale (G.C.S) died of uncontrollable increase of intracranial pressure. The other two, who had high initial G.C.S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity.

[Comparison of two dimensional and three dimensional CBF measurements in stroke patients]

The purpose of this study is to compare the detectability of the reduction in cerebral blood flow (CBF) using the two versus the three dimensional technique of CBF measurement. Both techniques were simultaneously carried out 85 times on 52 stroke patients. In the two dimensional technique, CBF was measured by the Xe-133 inhalation method and the value was calculated by the initial slope index. In the three dimensional technique, CBF was measured by single photon emission CT with Xe-133 inhalation method. CBF reduction was studied in the middle cerebral artery (MCA) territory on a CBF map in both techniques. Additionally, mean CBF was also calculated for the same territory. On the CBF map, the CBF reduction was shown in 25 of 85 measurements with the two dimensional technique and in 41 of 85 with the three dimensional technique. In comparing the imagings of both techniques, the CBF reduction seen extensively along the cortical surface and in the entire MCA territory with the three dimensional technique was also detected with the two dimensional technique. However, focal CBF reduction observed at the cortical surface and in the deep cerebral tissue with the three dimensional technique was not detected with the two dimensional technique. In order to evaluate both techniques quantitatively, we calculated the ratio of the mean CBF difference between the MCA territories of both hemispheres to mean CBF in the non-affected MCA territory. This ratio represented the asymmetry index. Firstly, the relationship between asymmetry index and the imaging of CBF reduction on the CBF map was studied.(ABSTRACT TRUNCATED AT 250 WORDS)

A basic protein from bovine brain that co-precipitates with tubulin in vitro

A 193 kDa protein consisting of 58 kDa subunits, which has pI values of 8.50 and 8.65, was purified from bovine brain cytosol. It formed heavy precipitates with tubulin, and the molar ratio of tubulin dimer to this protein in the precipitate was 3.2. In contrast to microtubules containing ordinary microtubule-associated proteins, these complexes remained stable against cold and 1 mM CaCl2.

Cystic cavernous hemangioma in the frontal lobe in an infant--case report

A 4-month-old infant was hospitalized following a generalized convulsion. Computed tomography showed a lesion of heterogeneous high density and a large low-density area in the right frontal lobe. At surgery, an angiomatous tumor was found within a large cyst containing bloody fluid. Histopathological diagnosis was a cavernous hemangioma. Only eight other cavernous hemangiomas in infants have been reported. The characteristic clinical features and computed tomographic findings of these cases are discussed.

Studies on the physical states of human platelet myosin in crude extracts

The physical properties of human platelet myosin in crude extracts were studied by means of Sepharose 4B gel filtration and sucrose density gradient centrifugation in the presence or absence of Mg-ATP. Platelet myosin extracted with a buffer containing 0-0.15 M KCl gave a Stokes radius of about 12.0-12.5 nm irrespective of the presence or absence of Mg-ATP. The sedimentation coefficients obtained in the presence of Mg-ATP were about 10-11 and 8.5S at 0.05-0.10 and 0.15 M KCl, respectively, whereas the values obtained in the absence of Mg-ATP were about 16, 9-12, and 8.5S at 0.05, 0.10, and 0.15 M KCl, respectively. The apparent molecular weight in the presence of Mg-ATP, therefore, was about 500,000 and 420,000 at 0.05-0.10 and 0.15 M KCl, respectively, while the molecular weight in the absence of Mg-ATP was about 790,000, 460,000-620,000, and 440,000 at 0.05, 0.10, and 0.15 M KCl, respectively. The purified monomeric platelet myosin that had been solubilized with Mg-ATP at 0.10 M KCl had a Stokes radius of about 12.5 nm, a sedimentation coefficient of about 9S, and an apparent molecular weight of 460,000. On the other hand, while crude platelet myosin extracted at 0.6 M KCl with Mg-ATP gave a Stokes radius of about 20 nm, a sedimentation coefficient of about of 6S, and an apparent molecular weight of about 490,000, each of these physical parameters obtained in the absence of Mg-ATP was much larger than that obtained in the presence of Mg-ATP because the myosin was associated with F-actin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pathophysiological studies in moyamoya disease by rCBF and cortical artery pressure measurements in comparison to those in ICA or MCA occlusion]

The authors measured preoperative rCBF and intraoperative cortical artery pressure (CAP) during STA-MCA anastomosis to investigate cerebral hemodynamics in moyamoya disease. Six of 13 patients including 3 children showed ischemic attack and the remaining presented hemorrhagic attack. rCBF was measured by single photon ECT with Xe-133 inhalation technique. CAP's and rCBF's in moyamoya disease were compared to those in the 22 internal carotid artery (ICA) and 8 middle cerebral artery (MCA) occlusion. Systemic arterial blood pressure (SABP) was obtained at the radial artery. Mean rCBF in the MCA territory in moyamoya disease, ICA occlusion, and MCA occlusion were 39, 37, and 33 ml/100 g/min respectively. Mean SABP and CAP in moyamoya disease were 103 and 28 mmHg, respectively. In ICA occlusion, mean SABP and CAP were 98 and 45 mmHg, respectively. In MCA occlusion, mean SABP and CAP were 89 and 36 mmHg, respectively. To clarify the hemodynamics, vascular resistance was obtained from the following equations: The proximal vascular resistance (Rp), which was produced from the cervical ICA to cortical artery, was obtained by (mean SABP - mean CAP)/(rCBF). And distal vascular resistance (Rd) which was produced from the cortical artery to jugular vein, was obtained by (mean CAP)/(rCBF). Mean Rp in moyamoya disease ICA occlusion and MCA occlusion were 2.01, 1.21 and 1.70, respectively. Rd in moyamoya disease, ICA occlusion and MCA occlusion were 0.79, 1.37 and 1.22, respectively. There were significant differences in Rp and Rd between moyamoya disease and ICA or MCA occlusion. In ischemic group in moyamoya disease, rCBF, SABP, CAP, Rp and Rd were 41 ml/100 g/min, 111 mmHg, 28 mmHg, 1.92 and 0.70, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Results of a dental fear survey in Japan: implications for dental public health in Asia

The purpose of this investigation was to initiate the study of dental fear in Japan. 415 college students, aged 18-22 yr were surveyed. A standardized questionnaire which has been used in the United States was translated into Japanese and was administered to the students. More than 80% of those surveyed reported some dental fear. Six to 14% of the students reported extreme fear of the dentist. The majority of the subjects admitted that they delayed making dental appointments due to fear. Muscle tension was the most common physiological symptom reported. The dental drill and needle were the most fear-provoking stimuli.