Epidemiological and clinical characteristics of Menière's disease in Japan

From 1975 to 1990, nationwide surveys on Menière's disease were performed three times by the Research Committee of Menière's disease (1975-76) and the Research Committee of Peripheral Vestibular Disorders (1982-84 and 1990) in Japan. Nine hundred and fifty-eight definite Menière cases, 520 in the 1st, 230 in the 2nd and 148 in the 3rd survey, were sampled by the members of the Committees. The epidemiological and clinical characteristics of Menière's disease were analyzed and compared with such control cases as other vertiginous patients, ENT patients without vertigo, and healthy subjects. In Menière's disease, the male to female ratio has changed from even to female predominance over the 15 years the study ran. The age distribution at onset peaked in the forties for males and thirties for females. Significant epidemiological results are summarized as follows: Definite Menière's disease has a higher incidence in married persons and in people with a nervous and precise character, whereas the incidence is lower in obese people. Physical and mental fatigue induced the onset of attacks. Menière's disease happened in day time in many cases, especially during the afternoon. As these epidemiological findings were commonly observed in all the surveys, the results are considered to be universal epidemiological characteristics of Menière's disease in Japan. In the same period, regional investigations were performed by Toyama Medical Association and our University. The male to female ratio in Toyama indicated a more significant female predominance than in the nationwide surveys. The prevalence of Menière's disease in Toyama Prefecture has been almost constant in all surveys, about 17/100,000 since 1974.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in folate concentration in Yoshida sarcoma after administration of leucovorin or cisplatin

Both leucovorin (LV) and cisplatin (cis-dichlorodiammine platinum II, CDDP) act as modulators of 5-fluorouracil (5-FUra) by increasing the intracellular concentration of reduced folate. We measured intracellular folate levels following the administration of LV or cisplatin in tumor-bearing rats to determine the optimal schedules for their use as 5-FUra modulators. Donryu rats were inoculated with Yoshida sarcoma cells on the right flank. Seven days after tumor inoculation, the animals were injected with LV or CDDP. The kinetic and dose-related changes in intracellular folate concentration were analyzed by means of a binding assay. Folate levels in the tumor tissues were significantly higher than baseline 1 and 2 h after administration of LV and remained significantly high until 8 h after administration. Folate levels in the tumor tissues were significantly higher than baseline 1 and 2 h after cisplatin administration, then decreased to a rather low level 8 h after, and to a significantly lower level than baseline 24 h after administration. The folate levels in the tumor tissue increased in proportion to the dose of LV, but did not increase when the dose of cisplatin was increased from 1 mg/kg to 8 mg/kg. Repeat high-dose administration of LV and repeat low-dose administration of cisplatin are advocated when they are used as modulators of 5-FUra.

Clinicopathological study of primary malignant tumors of the lung: an analysis of 993 tumors resected at the Kanazawa University Hospital between 1979-1993

A retrospective study was conducted of 993 malignant tumors of the lung in 977 patients. The male-female sex ratio was 2.6:1. The age distribution of the males did not differ from that of the females and the overall mean age was 64.3 +/- 9.5 years (range, 13-85 years). Forty-three percent of the patients were in their seventh decade. The location was peripheral in 81% of the tumors and central in 19%. Of the central tumors, 85% were squamous cell (epidermoid) carcinoma (SCC), while 58% of the peripheral tumors were adenocarcinoma (ADENO). In males, 49% of all tumors were SCC and 36% ADENO, while in females 76% were ADENO. The incidence of positive lymph node metastasis increased in parallel with the pT status in both central and peripheral carcinomas. However, it was noted that, of peripheral lung carcinomas, no SCC with a diameter of 15 mm or less had lymph node metastasis, whereas 18.9% of the ADENO of this size were positive for lymph node metastasis. These results indicate that lymph node metastasis can occur even in small-sized peripheral ADENO less than 15 mm. Thus, early detection and surgery together with mediastinal lymph node dissection are necessary even for small-sized tumors to improve the prognosis in patients with peripheral ADENO of the lung.

[New index for prediction of the patients prone to ventricular arrhythmias after acute myocardial infarction]

Recently late potential (LP) has been evaluated using signal averaged electrograms in order to predict the patients prone to the ventricular arrhythmias such as ventricular tachycardia (VT) or ventricular fibrillation (VF). However, the predictive accuracy was not satisfactory in clinical use. Therefore some new approach was expected. We tried to find a new index to predict the susceptibility to ventricular arrhythmias using frequency analysis by fast Fourier transformation technique (FFT). Fragmented electrograms are elucidated to be present through QRS complex beside the terminal portion of QRS and ST segment by Cain et al. Eighty-seven body surface electrograms were analyzed by FFT, and the power spectral distribution of specific band width of 25-50 Hz was evaluated. Late potential was also obtained by ordinary technique. The patients after acute myocardial infarction were classified into 5 groups according to Lown's grade; group 1 (grade 0.1), group 2 (grade 2), group 3 (grade 3,4A) and group 4 (grade 4B, non sustained VT), and group 5 (grade 4B, sustained VT/VF). The body surface distribution of 25-50 Hz were classified into 3 types; type A (almost equal two maxima), type B (unequal two maxima) and type C (single maximum). Types A & B were frequently observed, but type C was never seen in high risk group (group 4 and 5). Predictive accuracy of VT/VF was 89.2% by type A and 66.7% by LP. The combination of the two criteria improved the predictive accuracy of VT/VF up to 92.9%.(ABSTRACT TRUNCATED AT 250 WORDS)

Genotyping of hepatitis C virus by a simple ELISA method

BACKGROUND

Hepatitis C virus (HCV) has been classified into five distinct types by nucleotide sequence analysis of the genome. The correlation between genotypes of HCV and sensitivity to treatment or prognosis is still controversial.

OBJECTIVES

We tried to establish a simple antibody assay to determine the HCV serotype instead of genotype determined by PCR or nucleotide sequence.

STUDY DESIGN

We made an enzyme-linked immunosorbent assay (ELISA) system by using synthetic oligopeptides of NS4 regions of types 1 (CH) and 2 (KN) HCV, and examined sera of various stages of hepatitis C patients.

RESULTS

Among 13 HCV RNA-positive sera, serotyping was consistent with genotyping. Four sera of type 1 and 7 sera of type 2 were positive to anti-CH and anti-KN antibodies, respectively. Two sera of patients mixedly infected with type 1 and 2 HCV were positive to both antibodies. The number of type 1 and 2 in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma was 27 and 18, 28 and 15, and 46 and 12 respectively.

CONCLUSIONS

Our result suggests that this simple ELISA method is useful for typing of HCV, and there is no significant relationship between HCV type and liver failure.

Preliminary guidelines for reporting treatment results in Menière's disease conducted by the Committee of the Japanese Society for Equilibrium Research, 1993

In order to draft guidelines for reporting treatment results in Menière's disease (MD) in Japan, 17 committee members elected from the Japanese Society for Equilibrium Research (JSER) have met for about two years. The preliminary guidelines obtained from their discussions are summarized as follows. i) Evaluations of symptoms: Only definitive vertiginous spells with spontaneous nystagmus should be evaluated (AAOO, 1972). The parameter for the assessment of hearing levels should be evaluated using four-frequency pure-tone averages (PTA) at 250 Hz, 500 Hz, 1 kHz and 2 kHz. ii) Evaluation period: Valid results for the evaluation should be based on observations at least six months before treatment and over at least 12 months after initiation of therapy. iii) Evaluation criteria The formula expressing the effects of treatment on vertiginous spells should adopt a numeric vertigo score, which is shown in the AAO-HNS (1985) guidelines. If the duration of pre-treatment evaluation period is less than 6 months, the divisor is replaced by the average of definitive spells per month for the period of observation. iv) Global judgment: For a global judgment, patients and doctors should jointly evaluate the treatment results from the standpoints of their subjective and objective symptoms respectively.

Adrenal steroid regulation of neuropeptide Y (NPY) mRNA: differences between dentate hilus and locus coeruleus and arcuate nucleus

Regulation by adrenal steroids of neuropeptide Y (NPY) mRNA was investigated in hilus of the dentate gyrus, arcuate nucleus of hypothalamus and locus coeruleus (LC) of the adult rat brain. Adrenalectomy (ADX) increased NPY mRNA in hilus but decreased NPY mRNA levels in arcuate nucleus and LC. Using a steroid replacement paradigm previously shown to discriminate between Type I and Type II adrenal steroid receptor mediated effects, it was shown that Type I receptor stimulation by aldosterone prevented the ADX-induced increase of NPY mRNA in hilus, whereas Type II receptor stimulation by Ru28362 prevented the ADX-induced decrease in NPY mRNA in arcuate nucleus and LC. The results for hilus are consistent with evidence for a role of Type I receptors in maintaining levels of a number of gene products associated with neurotransmission. The different regulation in hilus from that in arcuate and LC indicate, along with evidence for regulation of NYP expression by insulin, NGF and cyclic AMP and phorbol esters, that the adrenal steroid regulation of NPY gene expression is part of a complex set of regulatory mechanisms that depend on the brain region and cell type.

Molecular characterization of a gene encoding extracellular serine protease isolated from a subtilisin inhibitor-deficient mutant of Streptomyces albogriseolus S-3253

An extracellular serine protease produced by a mutant, M1, derived from Streptomyces albogriseolus S-3253 that no longer produces a protease inhibitor (Streptomyces subtilisin inhibitor [SSI]) was isolated. A 20-kDa protein was purified by its affinity for SSI and designated SAM-P20. The amino acid sequence of the amino-terminal region of SAM-P20 revealed high homology with the sequences of Streptomyces griseus proteases A and B, and the gene sequence confirmed the relationships. The sequence also revealed a putative amino acid signal sequence for SAM-P20 that apparently functioned to allow secretion of SAM-P20 from Escherichia coli carrying the recombinant gene. SAM-P20 produced by E. coli cells was shown to be sensitive to SSI inhibition.

Pharmacokinetics and pharmacodynamics of recombinant human granulocyte colony-stimulating factor (rhG-CSF) following intranasal administration in rabbits

The objective of this study was to evaluate the pharmacokinetics and pharmacodynamics of G-CSF as well as their relationship following intranasal (i.n.) administration of aqueous rhG-CSF preparations with or without additives. In order to achieve a better understanding of the dosage regimen and the effectiveness of intranasally administered rhG-CSF in inducing leukopoiesis, we investigated rhG-CSF absorption and blood leukocyte dynamics with respect to dose in rabbits. RhG-CSF could be absorbed through the nasal cavity of rabbits when rhG-CSF aqueous preparations, especially those containing alpha-cyclodextrin (alpha-CyD) were intranasally administered. We found that serum G-CSF levels and the total count of leukocytes in peripheral blood (total blood leukocyte count) showed a dose-dependent increase with rhG-CSF. The area under the serum G-CSF concentration-time curve (AUC, a pharmacokinetic parameter) and the area under the increased total blood leukocyte count-time curve (AUL, a pharmacodynamic parameter) increased with increase of dose of rhG-CSF administered intranasally. Good agreement was observed between log AUC and AUL; thus, it is concluded that an increase of AUC leads to an increase in effectiveness of rhG-CSF in inducing leukopoiesis in rabbits. A novel rhG-CSF delivery system in the form of i.n. administration of rhG-CSF was thus achieved.

Locus coeruleus lesions potentiate neurotoxic effects of MPTP in dopaminergic neurons of the substantia nigra

The observation that Parkinson's disease (PD) is associated with locus coeruleus (LC) noradrenergic neuronal degeneration suggests that the LC noradrenergic system may be involved in the pathogenesis and natural progression of the destruction of the substantia nigra (SN) dopaminergic neurons in Parkinson's disease. The relationship of these two systems was examined by injection of subtoxic doses of MPTP into unilateral LC 6-hydroxydopamine (6-OHDA) lesioned mice. A significant loss of dopaminergic cells was only found in the SN on the side of the LC lesions. These results suggest that the LC may have protective effects on SN dopaminergic neurons.

D-myo-inositol 1,4,5-trisphosphate binding domain of phospholipase C-delta 1

D-myo-Inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) binding domain of phospholipase C-delta 1 (PLC-delta 1) was determined by examining binding activity of the synthetic peptide corresponding to residues 30-43 of PLC-delta 1. The peptide coupled with carrier proteins such as keyhole limpet hemocyanin or bovine serum albumin bound Ins(1,4,5)P3, whereas a scrambled peptide with the same amino acids did not do so. Polyclonal antibody against the peptide was examined to determine whether it would cause inhibition of the Ins(1,4,5)P3 binding to PLC-delta 1. Fab fragment of antibody to the peptide did inhibit binding to PLC-delta 1, in a dose-dependent manner. Thus it seems likely that the region of residues 30-43 of PLC-delta 1 is responsible for the binding of Ins(1,4,5)P3.

Regulation of low density lipoprotein receptor activity in Chinese hamster ovary cells transfected with the c-fms gene

Chinese hamster ovary (CHO) cells were transfected with the human c-fms gene, which encodes the receptor for macrophage colony-stimulating factor, to examine the effects on the low density lipoprotein (LDL) receptor activity. Degradation of [125I]LDL was significantly reduced in the transfected CHO cells as compared to non-transfected cells when incubated in lipoprotein-deficient serum. Quantitative analysis of LDL receptor mRNA using a competitive PCR method demonstrated that LDL receptor suppression occurred at transcription. These findings suggest that expression of the c-fms gene is involved in the regulation of LDL receptors on macrophages.

Higher-order structure of bovine mitochondrial tRNA(SerUGA): chemical modification and computer modeling

On the basis of enzymatic probing and phylogenetic comparison, we have previously proposed that mammalian mitochondrial tRNA(sSer) (anticodon UGA) possess a slightly altered cloverleaf structure in which only one nucleotide exists between the acceptor stem and D stem (usually two nucleotides) and the anticodon stem consists of six base pairs (usually five base pairs) [Yokogawa et al. (1991) Nucleic Acids Res. 19, 6101-6105]. To ascertain whether such tRNA(sSer) can be folded into a normal L-shaped tertiary structure, the higher-order structure of bovine mitochondrial tRNA(SerUGA) was examined by chemical probing using dimethylsulfate and diethylpyrocarbonate, and on the basis of the results a tertiary structure model was obtained by computer modeling. It was found that a one-base-pair elongation in the anticodon stem was compensated for by multiple-base deletions in the D and extra loop regions of the tRNA(SerUGA), which resulted in preservation of an L-shaped tertiary structure similar to that of conventional tRNAs. By summarizing the findings, the general structural requirements of mitochondrial tRNAs necessary for their functioning in the mitochondrial translation system are considered.

Hypothalamic neuropeptide Y, its gene expression and receptor activity: relation to circulating corticosterone in adrenalectomized rats

Previous evidence has suggested a possible relationship between the adrenal steroid, corticosterone (CORT) and neuropeptide Y (NPY) in the brain. To provide a more systematic analysis of this interaction, the present study employed a variety of techniques, including in situ hybridization to measure NPY gene expression, radioimmunoassay to examine peptide levels and radioligand [125I]peptide YY (PYY) binding for analysis of peptide receptors. The results show that adrenalectomy (ADX), which caused a decline in CORT to levels < 0.3 micrograms %, has generally little impact on the hypothalamic NPY projection system under normal, basal conditions. This includes peptide gene expression or content in the area of its cell bodies (arcuate nucleus, ARC), in addition to peptide binding at its receptor sites. While it also includes peptide content at most hypothalamic terminal sites, there are three notable exceptions, namely, the medial paraventricular (PVN) and dorsomedial nuclei and medial preoptic area, where NPY nerve terminals and glucocorticoid receptors are particularly dense and the decline in CORT through ADX markedly reduces NPY content. In contrast, evidence obtained from CORT replacement in ADX rats shows that this steroid has profound impact on all components of the hypothalamic NPY system. This peptide-steroid interaction is apparent at the level of the cell body (ARC), as well as at the nerve terminal or receptor site (PVN and ARC), where CORT levels > 10 micrograms % strongly potentiate NPY gene expression, peptide content and radioligand binding. These and other findings suggest that this CORT-NPY interaction in the hypothalamus occurs physiologically under conditions, e.g., at the onset of the active feeding cycle, when circulating CORT normally rises.

[Quantitative hemodynamic assessment of internal thoracic artery grafts using transthoracic duplex imaging]

The hemodynamics of blood flow in internal thoracic artery (ITA) grafts were studied using transthoracic duplex imaging prior to and following coronary artery bypass grafting (CABG) in 37 patients. Transthoracic images of the ITA were obtained through the first intercostal space using a 7.5 MHz probe, and their diameter and area were measured by B-mode imaging. Systolic, diastolic, mean and end-diastolic blood flow velocity (Vs, Vd, Vm, and Ved) were determined based on Doppler signals and systolic, diastolic, and total blood flow (Fs, Fd, and Ftotal) were calculated by the following formula: Flow = Vm x area x 60/10(3). The diameter of the ITA increased following CABG. Prior to CABG, Vs, and Fs, were dominant, while following CABG, the hemodynamic pattern was diastolic dominant, although individual variation existed. The ITA blood flow was measured in 4 groups, in patients who had had a previous anterior myocardial infarction and no redistribution on myocardial scintigraphy (group I), in patients with 99-100% coronary artery stenosis who had not had an anterior myocardial infarction or who had an anterior myocardial infarction and had redistribution (group IIa), in patients with the same criteria as group IIa but who had 90% coronary stenosis (group IIb), and in patients with 75% coronary stenosis who had not had anterior myocardial infarction (group IIc). Blood flow was 57, 73, 44mL and 34 mL/min, and the percentage of diastolic flow was 72, 69, 61, 59% respectively. These results show that ITA blood flow competes with native coronary artery flow in patients with moderate coronary stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

[Efficacy of oral midazolam as premedication in adult]

Midazolam was administered as a premedicant to 90 patients aged from 20 to 55 years with ASA status 1 or 2. The patients were divided into 3 groups: group I 10 mg orally, group II 20 mg orally, group III 5 mg intramuscularly. All premedications were given 30 minutes before entering the operating room. The perioperative effects of midazolam on blood pressure, pulse rate, respiratory rate and SpO2 as well as sedative, hypnotic and amnemonic effects were evaluated in these patients. There were no remarkable changes in the blood pressure, pulse rate or respiratory rate. There was no problem on the upper airway tract, but a slight decrease in SpO2 was observed in a few patients. In this study, sedative and hypnotic effects were almost satisfactory. Midazolam produced significant anterograde amnesia, and the amnemonic rate was 66.7% in group I and 86.7% in group II and III. In conclusion, oral midazolam is an effective preanesthetic medication in adult.

Effect of "Megafiller" insertion on the wear of composite resins

We have previously reported that insertion of coarse particles of beta-Quartz Glass Ceramic Insert (Megafiller) into a composite resin markedly reduced the polymerization shrinkage of resin restorative materials. In this study, we examined the effects of Megafiller insertion on wear resistance evaluated by the glass beads abrasion test, and the conventional toothbrushing abrasion test. The depth of wear was determined by measuring the thickness of the specimen before and after the wear tests using a profile projector accurate to 1 micron. In general, the depth of wear of the composites was reduced by Megafiller insertion, but the differences in the depth of wear between composites with and without the Megafiller were not significant except for a few materials. There were slight differences in the wetness of Megafiller in some composite resins.

The effects on blood flows of coronary artery by-pass grafts during intra-aortic balloon pumping

The internal thoracic artery (ITA), as well as aorto-coronary by-pass grafts, has been used for widely coronary artery by-pass grafting. Intra-aortic balloon pumping (IABP) is the first choice for left ventricular support when low output syndrome occurs during coronary artery by-pass surgery. However, the effect of diastolic augmentation by IABP may vary to the type of grafts. Graft flow with and without IABP support were measured in six patients undergoing elective coronary artery bypass surgery requiring IABP at Kanazawa National Hospital. The patients ranged in age from 59 to 67 years, with a mean age of 63 years, and included one woman and five men. In all cases, the left ITA was dissected from the thoracic wall as pedicle, and anastomosed in situ to the left anterior descending artery. Saphenous vein grafts (SVGs) were used for aortocoronary by-pass to the obtuse marginal branches, the first diagonal branches, the left circumflex branches, and/or the right coronary artery. Blood flow in 6 ITAs, 11 SVGs to the left coronary artery systems, and three SVGs to the right coronary artery was measured by ultrasound transit-time flowmeter simultaneously with the electrocardiogram. Blood flows in ITA grafts and SVGs were measured during IABP assist and unassisting under hemodynamically stable conditions after discontinuing cardiopulmonary by-pass. The systolic and diastolic flows of each graft were measured using the peak of the R wave and the end of T wave on the electrocardiogram as the references for systole. Systolic flow during IABP were similar to unassisted flow in both ITA and SVGs.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro and in vivo anti-herpes viral activities and biological properties of CV-araU

We compared the in vitro and in vivo antiviral effects against herpes simplex virus type 1 (HSV-1) and other biological properties of 1-beta-D-arabinofuranosyl-5-[(E)-2-chlorovinyl]uracil (CV-araU) and 1-beta-D-arabinofuranosyl-5-[(E)-2-bromovinyl]uracil (BV-araU, sorivudine). Both CV-araU and BV-araU exhibited antiviral activities against HSV-1 in the cell culture derived from mouse, though the activities were lower than those seen in human cells. For intraperitoneal and intracerebral infections in mice with HSV-1 strain WT-51, both compounds, administered twice daily, were effective in increase in the survival rate at doses of 15 mg/kg and 30 mg/kg, respectively. In pharmacokinetic analysis, both drugs were absorbed well in the rat gastrointestinal tract following oral administration. There was no difference between the metabolism of orally administered CV-araU and BV-araU in rats. High levels of the corresponding base were found in plasma after oral administration of CV-araU and BV-araU, but much lower base levels were seen after intravenous doses. Both drugs were resistant to degradation by rat liver enzymes.

Highly efficient transfection into primary cultured mouse hepatocytes by use of cation-liposomes: an application for immunization

Transfection methods for primary cultured mouse hepatocytes were examined. Of four conventional transfection methods examined, involving use of DEAE-dextran, calcium phosphate, cation-liposomes (lipofection), and cation-multilamellar liposomes, only cation-liposomes induced highly efficient transfection into primary cultured mouse hepatocytes. The highest transfection rate reached more than 60% of the total cells. Three other commonly used cell types (CHO-K1, COS-1, 3T3-L1) were also tested as target cells, but highly efficient transfection was observed specifically in primary cultured mouse hepatocytes. The transfection remained at a high level from 6 to 48 h after the start of incubation with the cation-liposome-DNA complex in the absence of serum, and the transfection rate decreased in inverse relation to the increase in cell density. The transfection was inhibited by free low density lipoprotein (LDL), EDTA, and an endocytosis inhibitor, cytochalasin B. These data suggest that the transfection is mediated not only by membrane fusion, as is generally accepted, but also by endocytosis. This information should be useful for research in hepatocyte biology and the development of gene therapy. As one of the applications, simple and successful immunization was achieved by administration of hepatocytes transfected with murine adhesion molecule, integrin VLA beta 1 subunit, genes into a Syrian hamster.

Assessment of frequency shifts in R-R interval variability and respiration with complex demodulation

A complex demodulation (CDM) method for continuous assessment of frequency shifts and time-dependent changes in amplitude in the rhythmic components existing in predefined frequency bands was proposed and applied to the analysis of high-frequency (HF) and low-frequency (LF) components of the R-R interval and to the analysis of respiration via impedance spirogram. Simulation studies revealed that this CDM technique furnishes mathematical features well suited to the investigation of non-stationary R-R interval signals and can delineate time-dependent fluctuations in both amplitude and frequency, accurately differentiating between HF and LF components. Analysis of data during paced breathing at different respiratory frequencies revealed that the estimated frequency of the HF component and respiration faithfully reflected the frequency of paced breathing. Analysis of data during dynamic exercise with increasing workload (20 W/min) showed that the frequency of the HF component was elevated with exercise and that both HF and LF amplitudes were reduced progressively with advancing load. CDM-derived frequency and amplitude of respiration were highly correlated to direct breath-by-breath respiratory frequency and tidal volume measurements. We conclude that this method could provide a powerful means for continuously assessing time-dependent changes in both cardiovascular and respiratory variations.