Considerations for Mean Upper Cervical Cord Area Implementation in a Longitudinal MRI Setting: Methods, Interrater Reliability, and MRI Quality Control

BACKGROUND AND PURPOSE

Spinal cord atrophy is commonly measured from cerebral MRIs, including the upper cervical cord. However, rescan intraparticipant measures have not been investigated in healthy cohorts. This study investigated technical and rescan variability in the mean upper cervical cord area calculated from T1-weighted cerebral MRIs.

MATERIALS AND METHODS

In this retrospective study, 8 healthy participants were scanned and rescanned with non-distortion- and distortion-corrected MPRAGE sequences (11-50 sessions in 6-8 months), and 50 participants were scanned once with distortion-corrected MPRAGE sequences in the Day2day daily variability study. From another real-world observational cohort, we collected non-distortion-corrected MPRAGE scans from 27 healthy participants (annually for 2-4 years) and cross-sectionally from 77 participants. Statistical analyses included coefficient of variation, smallest real difference, intraclass correlation coefficient, Bland-Altman limits of agreement, and paired t tests.

RESULTS

Distortion- versus non-distortion-corrected MPRAGE-derived mean upper cervical cord areas were similar; however, a paired t test showed incomparability (t = 11.0, P = <.001). Higher variability was found in the mean upper cervical cord areas calculated from an automatic segmentation method. Interrater analysis yielded incomparable measures in the same participant scans (t = 4.5, P = <.001). Non-distortion-corrected mean upper cervical cord area measures were shown to be robust in real-world data (t = -1.04, P = .31). The main sources of variability were found to be artifacts from movement, head/neck positioning, and/or metal implants.

CONCLUSIONS

Technical variability in cord measures decreased using non-distortion-corrected MRIs, a semiautomatic segmentation approach, and 1 rater. Rescan variability was within ±4.4% for group mean upper cervical cord area when MR imaging quality criteria were met.

MRI-Based Methods for Spinal Cord Atrophy Evaluation: A Comparison of Cervical Cord Cross-Sectional Area, Cervical Cord Volume, and Full Spinal Cord Volume in Patients with Aquaporin-4 Antibody Seropositive Neuromyelitis Optica Spectrum Disorders

BACKGROUND AND PURPOSE

Measures for spinal cord atrophy have become increasingly important as imaging biomarkers in the assessment of neuroinflammatory diseases, especially in neuromyelitis optica spectrum disorders. The most commonly used method, mean upper cervical cord area, is relatively easy to measure and can be performed on brain MRIs that capture cervical myelon. Measures of spinal cord volume (eg, cervical cord volume or total cord volume) require longer scanning and more complex analysis but are potentially better suited as spinal cord atrophy measures. This study investigated spinal cord atrophy measures in a cohort of healthy subjects and patients with aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders and evaluated the discriminatory performance of mean upper cervical cord cross-sectional area compared with cervical cord volume and total cord volume.

MATERIALS AND METHODS

Mean upper cervical cord area, cervical cord volume, and total cord volume were measured using 3T MRIs from healthy subjects (n = 19) and patients with neuromyelitis optica spectrum disorders (n = 30). Group comparison and receiver operating characteristic analyses between healthy controls and patients with neuromyelitis optica spectrum disorders were performed.

RESULTS

Mean upper cervical cord area, cervical cord volume, and total cord volume measures showed similar and highly significant group differences between healthy control subjects and patients with neuromyelitis optica spectrum disorders (P < .01 for all). All 3 measures showed similar receiver operating characteristic-area under the curve values (mean upper cervical cord area = 0.70, cervical cord volume = 0.75, total cord volume = 0.77) with no significant difference between them. No associations among mean upper cervical cord cross-sectional area, cervical cord volume, or total cord volume with disability measures were found.

CONCLUSIONS

All 3 measures showed similar discriminatory power between healthy control and neuromyelitis optica spectrum disorders groups. Mean upper cervical cord area is easier to obtain compared with cervical cord volume and total cord volume and can be regarded as an efficient representative measure of spinal cord atrophy in the neuromyelitis optica spectrum disorders context.

A new surgical approach to Dupuytren's disease

We present a new surgical approach for Dupuytren's disease which overcomes some of the problems seen with traditional approaches. The approach is simple but allows full exposure and accommodates all options for closure. It comprises transverse incisions at the skin creases of the digit joined by oblique incisions at 45°. The transverse incisions can be extended to the mid-axial line for improved exposure and skin release and to lateralize the apices of the scar. After excision of the disease and correction of the contracture the wound can be assessed and closed primarily, with advancement flaps or skin grafts, or left partially open. This study includes surgery on 105 rays in 75 patients with excellent results in 80 rays, good results in 20 rays, fair results in four rays and a poor result in one ray. There was only one significant complication.

Long-Range Coherency Strain and Tilted Ipitaxy in Ag-Fe-Ag Sandwich Structures on Gaas(001) Substrates

We find that epitaxial Fe films sandwiched between epitaxial Ag films grown on GaAs (001) substrates possess residual coherency strain at a thickness of 2000Å. The [001] directions of the Fe and Ag films are tilted with respect to the GaAs [001] axis. The tilts are coplanar with the tilt of the substrate surface normal to the [001] axis of GaAs and are qualitatively consistent with a recently proposed modol for tilted epitaxy.

Dynamic evaluation of [18F]-FDG uptake in the rat brain by microPET imaging

This study aims to acquire the functional image of the rat brain, small animal positron emission tomography (microPET) with high resolution and sensitivity is adopted to assess the metabolic activity corresponding to the neuronal activity induced by the electrical stimulation of the rat tail using [18F] fluorodeoxyglucose (FDG) as the radiotracer. The microPET imaging technology can provide anatomical and functional information on neuronal activity used to analyze responses in pathway sequence relationships between the thalamus and the cerebral cortex.

In vitro metabolism of the epoxide substructure of cryptophycins by cytosolic glutathione S-transferase: species differences and stereoselectivity

The enzyme kinetics of the glutathione (GSH) conjugation of cryptophycin 52 (C52, R-stereoisomer) and cryptophycin 53 (C53, S-stereoisomer) by cytosolic glutathione S-transferases (cGSTs) from human, rat, mouse, dog and monkey liver were studied. Vmax, Km, and CLint values for glutathione conjugation of C52 (R-stereoisomer) were 0.10 +/- 0.01 nmol min-1 mg-1, 3.24 +/- 0.23 microM, and (3.15 +/- 0.09) x 10(-2) ml min-1 mg-1, respectively, in human cytosol. Due to limited solubility relative to the Km, only CLint values were determined in rat ((7.76 +/- 0.10) x 10-2 ml min-1 mg-1) and mouse ((7.61 +/- 0.50) x 10(-2) ml min-1 mg-1) cytosol. Enzyme kinetic parameters could not be determined for C53 (S-stereoisomer). Microsomal GSH conjugation in human, rat, and mouse was attributed to cytosolic contamination. No GSH conjugation was seen in any biological matrix from dog or monkey. There was little GSH conjugation of C53 by cytosol or microsomes from any species. The metabolism of C52 and C53 by epoxide hydrolase was also investigated. No diol product was observed in any biological matrix from any species. Thus, cGSTs are primarily responsible for C52 metabolism.

Excellent survival of pediatric dermatofibrosarcoma protuberans in Taiwanese

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Background: Pedicatric dermatofibrosarcoma protuberans (PDFSP) was a rare disease. We reported our institutional experience with PDFSP treated from 1977–2002. Methods: Twelve patients with PDFSP diagnosed before age 18 years were treated in our institute from 1977–2002 according to institutional cancer registry. After approved by institutional research ethic committee (ClinicalTrials.gov Identifier: NCT00173355 ), active patient contact and linkage with National Residency Registry was done to survey the disease status. Results: There were 6 boys and 6 girls in this study. The median age at diagnosis were 16 years (range: 3 months ∼18 years). The disease sites were diverse, from scalp to knee. Nine of them underwent wide excision in our hospital for their primary disease; the other 3 patients underwent wide excision in our hospital for local recurrent disease. None of them underwent neoadjuvant or adjuvant therapy. All of them had low grade T1a (≤ 5cm in size, superficially located) disease except T staging was not available in two patients. Negative margin was obtained in all in the operation of our instituion except close margin in one patient, who had uncontrolled recurrence and died of progressive disease later. The clinical follow-up (FU) period range from 1 to 214 months (median: 30). Active patients contact via telephone followed by twice postcard invitation was done. No evidence of disease (NED) was revealed by medical FU for three patients and by telephone FU for three patients. For the remaining six patients who had no response after telephone and postcards contact, data from linkage with National Residency Registry was used. Death was noted in one patient and aliveness was noted in five patients (all of them were NED in their last FU in our hospital). The 10-year/15-year progression free and overall survival rates were 100%/75% and 100%/83% respectively without obvious complications. Conclusion: The prognosis of PDFSP in Taiwanese was excellent when adequate surgical margin was obtained.

No significant financial relationships to disclose.

Reducing the expression of glutathione transferase D mRNA in Drosophila melanogaster exposed to phenol and aniline

Phenol and aniline are toxic to animals. The purpose of the present study was to examine the expression of glutathione transferase D mRNA in fruit flies altered by long-term exposure to phenol and aniline. Changes in the amount of mRNA were measured by a semiquantitative reverse-transcription polymerase chain reaction assay. The level of each glutathione transferase D mRNA expressed in the phenol-treated and aniline-treated strains of adult fruit flies differed after chemical treatment. Aniline was more potent than phenol in suppressing the expression of cytosolic glutathione transferase D mRNA. Aniline reduced the level of glutathione transferase mRNA expressed in the aniline-treated strain to less than a 0.5 fraction as compared to that measured in the wild-type strain. But phenol was only able to suppress the GstD7 and GstD4 mRNAs expressed in the phenol-treated strain. Neither aniline nor phenol reduced the expression of microsomal glutathione transferase mRNA in fruit flies.

Induction of glutathione S-transferases activities in Drosophila melanogaster exposed to phenol

Studying the toxic effects of long-term exposing fruit flies to phenol is the object of this study. The induction of the glutathione S-transferases enzymatic activities, the change in the amount of mRNA related to phenol exposure, the change in survival rate of adult fruit flies, and the chemical interaction between phenol and benzene were the problems to be investigated. Glutathione S-transferases were separated by affinity chromatography and the mRNAs levels were quantified by reverse-transcription polymerase chain reaction. Long-term feeding phenol to wild type fruit flies had caused some toxic effects included increasing the resistance to phenol toxicity, lowering the benzene toxicity, and induction of glutathione S-transferases enzymatic activities. But no significant change in the amount of glutathione S-transferases GstD1 and GstD5 mRNAs had occurred. From these results, we concluded that fruit flies could develop resistance to phenol by decreasing its toxicity; phenol was a inducer of glutathione S-transferases; phenol could increase the glutathione S-transferases enzymatic activities by increasing the amount of proteins; phenol exposure could decrease the benzene toxicity; no new glutathione S-transferase isozyme subunit was induced; and the level of GstD1 and GstD5 mRNAs did not significantly increase in phenol-treated strain.

Unintentional ingestion of over the counter medications in children less than 5 years old

OBJECTIVE

Childhood ingestion of medications remains a substantial problem. Medication available over the counter (OTC) is widely used and has significant toxicity. The present study aims to investigate the nature and extent of unintentional ingestion of OTC medication in children < 5 years old in Victoria, Australia, during the period 1996-2000, in order to highlight critical factors.

METHODS

Numbers of enquiries relating to unintentional ingestion of OTC medication in children < 5 years old and medication types were obtained from the Victorian Poisons Information Centre for 1998-2000. Emergency Department presentations involving poisoning of children < 5 years old, the medication types and subsequent admissions were obtained from the Victorian Emergency Minimum Dataset for 1996-2000.

RESULTS

Numbers of enquiries and Emergency Department attendances for poisoning were substantially higher for OTC medication than for prescription medication; however, a lower proportion of cases involving ingestion of OTC medication (24.8%) required hospital admission during the study period compared with cases involving ingestion of prescription medications (33.8%). Overall, the peak incidence was at 2 years of age, with a slight male over-representation. Paracetamol and cough/cold preparations were the most common agents.

CONCLUSIONS

The causes of unintentional ingestion of OTC medications by children might include lack of child-resistant closure (CRC), inadequate design of CRC, attitudes concerning the toxicity of OTC medications, or lack of vigilance by parents and carers in the storage and administration of OTC medications. Consideration should be given to restricting sales of toxic OTC medications to pharmacies, and increasing counselling of consumers concerning the toxicity and safe storage of OTC medications and the correct usage of CRC. The adequacy of CRC design and OTC medications warranting CRC should be reviewed by the relevant authorities.

Fetal behavioural state changes following maternal fluoxetine infusion in sheep

Clinical depression is diagnosed in 5-15% of women during pregnancy, increasing the risk of negative outcomes. Fluoxetine (FX), a selective serotonin reuptake inhibitor, is prescribed during pregnancy. In adults, FX alters sleep patterns with single doses decreasing total sleep time and rapid eye movement sleep. The effects of FX on sleep in the fetus are unknown. However, 5-hydroxytryptophan, the precursor of serotonin, has been reported to prolong high-voltage (HV) electrocortical (ECoG) activity and increase the incidence of fetal breathing movements (FBM) in the sheep fetus. We hypothesize that FX exposure will decrease the incidence of LV ECoG in the fetus. Twenty-one pregnant sheep were surgically prepared for chronic study of blood gases, ECoG activity, eye movements and FBM. After 3 days of recovery, ewes received a 70-mg bolus i.v. infusion of FX or sterile water followed by continuous infusion at a rate of 0.036 mg/min for 8 days. The incidence of low-voltage (LV) ECoG decreased from 54+/-4% on the preinfusion day to 45+/-5% on infusion day 1 in the FX group and remained decreased throughout the infusion period. In addition, the incidence of both eye movements and FBM was decreased on infusion day 1 compared to preinfusion day in the FX group. HV ECoG increased from 39+/-3% on preinfusion day to 68+/-14% on FX infusion day 1 and remained elevated throughout the infusion period. These data show that maternal FX administration alters fetal behavioural state.

Mechanisms of bradykinin-mediated Ca(2+) signalling in canine cultured corneal epithelial cells

Experiments were designed to differentiate the mechanisms of bradykinin receptors mediating the changes in intracellular Ca(2+) concentration ([Ca(2+)](i)) in canine cultured corneal epithelial cells (CECs). Bradykinin and Lys-bradykinin caused an initial transient peak of [Ca(2+)](i) in a concentration-dependent manner, with half-maximal stimulation (pEC(50)) obtained at 6.9 and 7.1, respectively. Pretreatment of CECs with pertussis toxin (PTX) or cholera toxin (CTX) for 24 h did not affect the bradykinin-induced [Ca(2+)](i) changes. Application of Ca(2+) channel blockers, diltiazem and Ni(2+), inhibited the bradykinin-induced Ca(2+) mobilization, indicating that Ca(2+) influx was required for the bradykinin-induced responses. Addition of thapsigargin (TG), which is known to deplete intracellular Ca(2+) stores, transiently increased [Ca(2+)](i) in Ca(2+)-free buffer, and subsequently induced Ca(2+) influx when Ca(2+) was readded to this buffer. Pretreatment of CECs with TG completely abolished bradykinin-induced initial transient [Ca(2+)](i), but had slight effect on bradykinin-induced Ca(2+) influx. Pretreatment of CECs with 1-[beta-[3-(4-methoxyphenyl)propoxy]-4-methoxyphenethyl]-1H-imidazole (SKF96365) and 1-(6-((17beta-3-methoxyestra-1,3,5(10)-trien-17-yl)amino)hexyl)-1H-pyrrole-2,5-dione (U73122) inhibited the bradykinin-induced Ca(2+) release and Ca(2+) influx, consistent with the inhibition of receptor-gated Ca(2+) channels and phospholipase C (PLC) in CECs, respectively. These results demonstrate that bradykinin directly stimulates B(2) receptors and subsequently Ca(2+) mobilization via a PTX-insensitive G protein in canine CECs. These results suggest that bradykinin-induced Ca(2+) influx into the cells is not due to depletion of these Ca(2+) stores, as prior depletion of these pools by TG has no effect on the bradykinin-induced Ca(2+) influx that is dependent on extracellular Ca(2+) in CECs.

A preliminary study on comparison and fusion of metabolic images of PET with anatomic images of CT and MRI

OBJECTIVE

To compare and match metabolic images of PET with anatomic images of CT and MRI.

METHODS

The CT or MRI images of the patients were obtained through a photo scanner, andthen transferred to the remote workstation of PET scanner with a floppy disk. A fusion method was developed to match the 2-dimensional CT or MRI slices with the correlative slices of 3-dimensional volume PET images.

RESULTS

Twenty-nine metabolically changed foci were accurately localized in 21 epilepsy patients' MRI images, while MRI alone had only 6 true positive findings. In 53 cancer or suspicious cancer patients, 53 positive lesions detected by PET were compared and matched with the corresponding lesions in CT or MRI images, in which 10 lesions were missed. On the other hand, 23 lesions detected from the patients' CT or MRI images were negative or with low uptake in the PET images, and they were finally proved as benign.

CONCLUSIONS

Comparing and matching metabolic images with anatomic images helped obtain a full understanding about the lesion and its peripheral structures. The fusion method was simple, practical and useful for localizing metabolically changed lesions.

Morphological, immunohistochemical and quantitative studies of murine brain mast cells after mating

The mast cell is one of the immune cells, and can be triggered behaviorally to increase in the CNS of the sexually active dove. In the present study, we used ICR mice to investigate the number of brain mast cells in mated (one male with three female mice), non-mated (housed with female mice, but no mating) and control (four male mice housed together in one cage) male mice. We found that at least 40% of mated male mice had significant more mast cells than the maximum value seen in the controls, and that a significant correlation existed between the distribution index of mast cells and the postcoitum date. These mast cells were especially numerous in the thalamus and velum interpositum (VIP). Morphological observations showed that the increased mast cells were ultrastructurally similar to those in the controls, and displayed gonadotropin-releasing hormone (GnRH)-like immunoreactivity. Based on the facts that the number of brain mast cells in the male mice increased significantly after mating and that the change in the distribution of mast cells in the VIP and the thalamic parenchyma correlated well with time postcoitum, we speculate that, after mating, mast cells may migrate from the VIP to the thalamic parenchyma along the vascular tree of the brain. These results strongly suggest that mast cells are involved in the interaction among the immune, endocrine, and nervous systems in the mated male mouse brain.

Taurine-sulfur assimilation and taurine-pyruvate aminotransferase activity in anaerobic bacteria

We demonstrated the ability of strictly fermentative, as well as facultatively fermentative, bacteria to assimilate sulfonate sulfur for growth. Taurine (2-aminoethanesulfonate) can be utilized by Clostridium pasteurianum C1 but does not support fermentative growth of two Klebsiella spp. and two different Clostridium spp. However, the latter are able to assimilate the sulfur of a variety of other sulfonates (e.g., cysteate, 3-sulfopyruvate, and 3-sulfolactate) anaerobically. A novel taurine-pyruvate aminotransferase activity was detected in cell extracts of C. pasteurianum C1 grown with taurine as the sole sulfur source. This activity was not detected in extracts of other bacteria examined, in C. pasteurianum C1 grown with sulfate or sulfite as the sulfur source, or in a Klebsiella isolate assimilating taurine-sulfur by aerobic respiration. More common aminotransferase activities (e.g., with aspartate or glutamate as the amino donor and pyruvate, oxalacetate, or (alpha)-ketoglutarate as the amino acceptor) were present, no matter what sulfur source was used for growth. Partial characterization of the taurine-pyruvate aminotransferase revealed an optimal temperature of 37(deg)C and a broad optimal pH range of 7.5 to 9.5.

Automated analysis of protein NMR assignments using methods from artificial intelligence

An expert system for determining resonance assignments from NMR spectra of proteins is described. Given the amino acid sequence, a two-dimensional 15N-1H heteronuclear correlation spectrum and seven to eight three-dimensional triple-resonance NMR spectra for seven proteins, AUTOASSIGN obtained an average of 98% of sequence-specific spin-system assignments with an error rate of less than 0.5%. Execution times on a Sparc 10 workstation varied from 16 seconds for smaller proteins with simple spectra to one to nine minutes for medium size proteins exhibiting numerous extra spin systems attributed to conformational isomerization. AUTOASSIGN combines symbolic constraint satisfaction methods with a domain-specific knowledge base to exploit the logical structure of the sequential assignment problem, the specific features of the various NMR experiments, and the expected chemical shift frequencies of different amino acids. The current implementation specializes in the analysis of data derived from the most sensitive of the currently available triple-resonance experiments. Potential extensions of the system for analysis of additional types of protein NMR data are also discussed.

Separation of multiple forms of acidic glutathione S-transferase isozymes in a susceptible and a resistant strain of house fly, Musca domestica (L.)

The acidic glutathione S-transferases from a CSMA (susceptible) strain and a Cornell-R (resistant) strain of houseflies were purified and separated utilizing affinity chromatography followed by chromatofocusing. Nine fractions were isolated from each house fly strain. Fraction 1 had the highest 1-chloro-2,4-dinitrobenzene vs. 1,2-dichloro-4-nitrobenzene ratio (CDNB/DCNB ratio) in both strains and the ratio of all the other fractions tended to decrease as the isoelectrical points decreased except for fractions 4 and 9. Most fractions from the CSMA strain had higher CDNB conjugation activities than the fractions from the Cornell-R strain, but all the fractions from the CSMA strain had lower DCNB conjugation activities than fractions from the Cornell-R strain. Steady-state kinetics of all the fractions were examined. The Km values obtained from both strains ranged from 0.36 to 1.12 mM, while the Vmax value ranged from 3.0 to 32.6 mumol/min/mg. In the 100,000 g supernatant, the CDNB specific activities in the CSMA strain was about 1/3 of the activity in the Cornell-R strain but it was about 1.5-fold following affinity chromatography. The specific activity for DCNB measured in the CSMA strain was only 1/5 of the activities of the Cornell-R strain in the 100,000 g supernatant, but was about the same after affinity chromatography. The difference was due to the selectivity of the affinity column used in the current study.

Immunological comparison of cytosolic glutathione S-transferases between rat and two strains of houseflies

Five different antisera, which include three antisera raised against rat liver glutathione S-transferases (GST), one antiserum raised against human pi GST, and one antiserum raised against housefly GST1, were used to examine their cross-reactivity with different classes of GST subunits isolated from rat liver and the housefly. Two classes of rat liver GSTs, alpha and mu, were isolated from rat liver and two classes of housefly GSTs, GST1 and GST2, were isolated from both CSMA and Cornell-R strains. Antiserum against GST 3-3 was the most reactive antiserum and reacted not only with the mu class of GSTs but also with the GST1 class from both CSMA and Cornell-R strains. Antiserum against human pi GST and antiserum against housefly GST1 had weak immunological reactivity toward the GST1 class from both strains of housefly. Antiserum against GST 4-4 and antiserum against GST 1-1 had no immunological reactivity toward any class of GSTs from housefly. None of the five antisera had any immunological cross-reactivity toward subunit 2 of the alpha class of rat GST and the GST2 class of housefly GSTs from both strains.

Assessment of postoperative hearing in 528 middle ear and mastoid surgery cases in Tokai University Hospital

The postoperative hearing results in cases of tympanoplasty, radical mastoidectomy, modified radical mastoidectomy and tympanoplasty combined with modified radical mastoidectomy on 528 ears, performed in the Tokai University Hospital between 1975 and 1980 were assessed. The assessment was based on pure-tone audiograms taken 3 months to 5 years after the operation. Out of 528 cases 70.5% gained better postoperative hearing, 6% showed no change of hearing and 23.5% showed deterioration of hearing. Auditory success of those who attained social hearing, air-bone gap closure to within 20dB or gained hearing of 20 dB or more was 53.4%. The results in cholesteatoma cases were poorer than those of non-cholesteatoma cases. In 44% of the cases, ossiculoplasty was performed, and the most successful ossiculoplasty results were obtained when the malleus was repositioned to the head of the stapes. Fairly good results were achieved when an artificial prosthesis, such as a Teflon-piston, Gelfoam-wire or platinum-piston, was used. The least successful results were found when the incus was transpositioned. In the non-ossiculoplasty group, type I tympanoplasty produced 59.5% auditory success whereas 37.3% auditory success was achieved in radical mastoidectomy. Better auditory success rates were obtained when the bony bridge was preserved than when it was removed. The results were identical in cases where the mastoid cavity was obliterated or when it was kept open. A new technique, "scutumplasty", was used for reconstructing the scutum. Revision surgery was required in only 3.4% of the cases.

A study of the ecology of the house dust mite in dwelling houses

The habitat of dust mites in dwelling houses in Japan was studied to determine the relation between mites in dust and mite allergy. Dust mites increased in the summer and decreased in the winter. Mite propagation was influenced by the temperature and relative humidity. Mites were found in higher concentrations in dust from concrete houses than that from wooden houses. Carpet dust contained numerous mites and tatami, sofas and bed mattresses were also habitats of mites. Mites existed universally in all samples of dust examined. Sensitization to mite allergen depends mainly on the atopic diathesis of patients and not on the mite count.

Nasal allergy in spinning mill workers and the possibility of allergenicity of chemical fibers and cotton linters

During a three-year period from 1976, we examined fifty eight patients with nasal allergy who worked in spinning mills or handled sewing machines. Skin tests and procative nasal tests were performed on these patients with crude and fractionated extracts from cotton linters, cotton cloth and chemical fibers. The crude aqueous antigens were extracted in dextro-phenol solution and fractionated by Saphadex G-100. It was possible that the cotton and chemical fibers included components which were the cause of hypersensitivity, but there is still doubts concerning their reaction as irritant substances. Serum specific IgE antibody was found in extracts from chemical fiber. Therefore, spinning mill dust acts as an irritant of the nose add the possibility of antigenicity of the dust for immediate type nasal allergies can not be denied from the present study.

Macro-monitoring: a step toward rational psychopharmacotherapy

A 15-item checklist was used to monitor the drug therapy of 516 patients in five clinical settings. The primary purpose of this study was to determine the extent of irrational drug use in these several settings. After gathering baseline data, two similar clinical units were selected for a six-month follow-up to determine the impact of drug consultation by an expert clinical psychopharmacologist. In the unit where drug consultation was provided, there was a significnat reduction in extended antiparkinsonian agent use (p less than 0.001), multiple daily dosage (p less than 0.001), inappropriate anxiolytic use (p less than 0.01), polypharmacy (p less than 0.001) and too rapid change in medication (p less than 0.01). The unit that did not have drug consultation continued to have a high percentage of patients receiving drugs in an inappropriate manner. Although the consultant had a significant impact on drug use, it was recognized that such consultation is not feasible for most psychiatric facilities. The checklist itself is a systematic tool that can be used to identify prescribing practices of questionable appropriateness. If used properly by the pharmacist, the checklist can serve as a supportive system to assist the physician in providing better patient care.

Study of EEG sleep characteristics in patients with anorexia nervosa before and after restoration of matched population mean weight consequent on ingestion of a "normal" diet

This experimental study confirms that insomnia and especially early morning waking is associated with low body weight in anorexia nervosa. It extends the view that there is a relationship between reduced nutritional intake and consequent change in weight and sleep disturbance. This relationship was studied by comparison of certain sleep EEG parameters in a group of hospitalized anorexia nervosa patients before and after a regime of re-feeding to matched population mean weight on a ‘normal’ diet. At low body weights, the patients had less sleep and more restlessness, especially in the last 4 hr of the night. After weight gain, there was a significant increase in length of sleep and REM sleep. The implications of these results are discussed with particular reference to an association between various anabolic profiles and differing need for REM sleep.

Bone morphogenesis in implants of insoluble bone gelatin

Insoluble bone gelatin with inclusions of insoluble noncollagenous protein produces new bone when implanted in muscle in allogeneic rats. The implanted residue provides the milieu for expression of bone morphogenetic potential of migratory mesenchymal cells. Neutral buffer solutions activate endogenous enzymes that degrade components essential for cell interactions and differentiation of bone. Chloroform-methanol either denatures or extracts constituents responsible for degradation. Insoluble bone gelatin produces new bone after extraction at 2 degrees with neutral salts, 0.5 M EDTA, 0.1 M Tris.HCl, 4 M urea, 0.5 M hydroxylamine, and 10 M KCNS, as well as after limited digestion with pepsin or collagenase, but not after extraction with 5 M guanidine, 7 M urea, water saturated with phenol, or after alkali hydrolysis with 0.1 N NaOH. The specific activity of cell populations interacting with insoluble bone gelatin suggests that a chemical bond between collagen and a noncollagenous protein or part of a protein, cleaved by a neutral proteinase, controls the bone morphogenetic reaction.