Impact of a stent-less percutaneous coronary intervention strategy using directional coronary atherectomy and a drug coated balloon for left main and ostial lesions

Background

With the advent of drug eluting stents (DESs), the restenosis rate has markedly decreased. However, even with DESs, problems remain unsolved for bifurcated lesions including left main trunk (LMT) and right coronary artery (RCA) ostial lesions. In the era of directional coronary atherectomy (DCA) alone, an optimal DCA provides a significantly lower residual stenosis and lower angiographic restenosis than conventional balloon angioplasty, despite failing to reach a statistical significance for reducing late clinical events as compared to balloon angioplasty (Circulation 1998; 97:322–31.).

Purpose

This study aimed to examine the safety and effectiveness of stent-less percutaneous coronary intervention (PCI) using DCA and drug coated balloons (DCBs).

Methods

From November 2017 to June 2019, a stent-less PCI for LMT and ostial lesions was performed in 32 consecutive cases (male 24/female 8; mean age 70.9±9.8). A stent-less PCI was performed using SeQuent Please™ DCB after an ATHEROCUT™ DCA, and procedural success was obtained in all cases (6 cases with LMT, 18 with left anterior descending ostial, 6 with left circumflex ostial, and 2 with RCA ostial lesions).

Results

The percent plaque area (%PA) decreased from 70.0±7.7% at baseline to 51.6±8.1% after the DCA and to 46.1±9.0% after the DCBs. All patients completed a follow up coronary angiography after 6 months and no restenosis was observed. No major adverse cardiac events occurred in any cases including target lesion revascularizations. In 29 cases that the lumen was confirmed with IVUS at 6 months of follow-up, the lumen area (LA) had expanded significantly from 8.0±2.3 mm2 at baseline (post DCBs) to 8.9±2.7 mm2 at 6 months (P=0.023, Figure 1A). Local paclitaxel may induce late lumen enlargement (LLE) after a DCA/DCB. The group in which the LA increased during the chronic phase was defined as the Increased group and the group in which the LA decreased during the chronic phase was defined as the Decreased group. When comparing the LDL-Cho level pre DCA between the two groups, the LDL-Cho level in the Increased group was significantly low (74.0±25.8 mg/dl vs. 101.0±33.6 mg/dl, P=0.050, Figure 1B).

Conclusions

Stent-less PCI using DCA and DCBs for bifurcated lesions including LMT and RCA ostial lesions was effective, safe, and useful. Furthermore, a chronic LLE effect by DCBs is expected. In addition, intensive lipid-lowering therapy may also contribute to the chronic outcome after DCA/DCBs.

Funding Acknowledgement

Type of funding source: None

Effect of temperature on VFA's and biogas production in anaerobic solubilization of food waste

The effectiveness of methane fermentation treatment used in food waste processing is currently limited by solubilization and acidogenesis. In efforts to improve the treatment process, this study examined the effects of temperature on solubilization and acidogenesis. The solubilization rate of food waste, which was based on suspended solid removal, was 47.5%, 62.2%, 70.0%, 72.7%, 56.1% and 45.9% at 15 degrees C, 25 degrees C, 35 degrees C, 45 degrees C, 55 degrees C and 65 degrees C, respectively. Solubilization rate was accelerated from the middle to late experimental periods under mesophilic (35 degrees C and 45 degrees C) conditions. In contrast, overall solubilization rate was significantly lower under thermophilic (55 degrees C and 65 degrees C) conditions than under mesophilic conditions, although solubilization occurred rapidly in the early experimental period. The production of biogas was high under mesophilic conditions of 35 degrees C and 45 degrees C, at 64.7 and 62.7mL/g-VS, respectively, while it was scarce under thermophilic conditions. Solubilization of food waste was accelerated under both mesophilic and thermophilic conditions; however, solubilization rate was observed to be particularly high under mesophilic conditions, and a shortening of the hydraulic retention time is expected under thermophilic conditions.

Verrucotoxin, a stonefish venom, modulates calcium channel activity in guinea-pig ventricular myocytes

BACKGROUND AND PURPOSE

Stonefish (Synanceia genus) are commonly found in shallow waters of the Pacific and Indian Oceans. The venom of stonefish is stored in the dorsal fine spines and contains a proteinaceous toxin, verrucotoxin (VTX). The stings produced by the spines induce intense pain, respiratory weakness, damage to the cardiovascular system, convulsions and paralysis, sometimes leading to death. Although there are many studies on VTX, the mechanism(s) underlying the VTX-mediated cardiotoxicity is not yet fully understood. The aim of this study was to investigate the modulation of ion channels in cardiac tissue by VTX.

EXPERIMENTAL APPROACH

The effects of VTX on changes in the voltage or current in guinea-pig ventricular myocytes were investigated using a patch clamp method.

KEY RESULTS

VTX (10 microg ml(-1)) prolonged the action potential duration by 2.5-fold. VTX increased L-type Ca(2+) currents (I (Ca(L))) in a concentration-dependent manner with a EC(50) value of 7 microg ml(-1) and a maximum increase of 3.1-fold. The non-selective beta-adrenoceptor antagonist, propranolol (1 microM) and the selective beta(1)-adrenoceptor antagonist, CGP20712A (10 microM) each abolished the effect of VTX (100 microg ml(-1)) on I (Ca(L)). Furthermore, the protein kinase A (PKA) antagonists H-89 (10 microM) and Rp-8-Br-cAMPS (30 microM) inhibited the effect of VTX on I (Ca(L)).

CONCLUSIONS AND IMPLICATIONS

VTX modulates Ca(2+) channel activity through the beta-adrenoceptor-cAMP-PKA pathway.

Salmonella prevalence and total microbial and spore populations in spices imported to Japan

A total of 259 samples of 40 types of spices were tested for Salmonella prevalence and total microbial and spore populations. Salmonella enterica serotypes Weltevreden and Senftenberg were isolated from a black- and red-pepper sample, respectively. Because Salmonella was not detected by the most-probable-number method, it indicated that at least one cell of the microorganism was present in 25 g of sample. The mean aerobic bacterial count was greater than 5.39 log CFU/g in turmeric, garam masala, curry powder, and paprika. The mean bacterial spore counts were greater than 4.33 log CFU/g in turmeric and curry powder. The mean aerobic bacterial count in the two Salmonella-isolated samples was 6.93 log CFU/g. These results indicate that spices can be a source of contamination in the products where they are used as ingredients, and methods to reduce the microbial load in spices should be used.

Increased lymphoid MxA expression in acute asthma exacerbation in children

BACKGROUND

Although the association between acute asthma exacerbation and viral infection has been well documented, virus identification rates vary. It has recently been reported that the expression of MxA protein in lymphocytes, inducible by type I interferons, can serve as a sensitive marker for viral infection in the host. The objective was to determine the contribution of viral infection to precipitation of asthma attacks in children.

METHODS

We studied 186 asthmatic children, aged 0-12 years, over a 1-year period to evaluate MxA protein levels in peripheral blood lymphocytes by using a flow cytometric analysis in whole blood.

RESULTS

Of all the subjects, 80 (47%) exhibited significantly elevated levels of MxA expression in lymphocytes, presumably indicating the states of viral infection. The association of viral infections with acute asthma exacerbation seemed to be marked in younger children: enhanced MxA expression was seen in 73.3% of infants (aged 0-1 year), 49.5% of toddlers (aged 2-5 years), and 26% of schoolchildren (aged 6-12 years). Seasonal changes in the frequency of viral infection associated with deterioration were also observed.

CONCLUSIONS

Flow cytometric assay of MxA protein expression in whole blood appears to be an easy and useful method to evaluate viral infections in acute asthma exacerbation.

CD30 expression on circulating memory CD4+ T cells as a Th2-dominated situation in patients with atopic dermatitis

Th2 clones have been reported to express CD30 preferentially, but whether T cells producing Th2-type cytokines may favor CD30 expression in the in vivo state remains unknown. We investigated the expression of CD30 on circulating T cells in atopic dermatitis (AD) as a Th2-dominated disorder. Peripheral blood mononuclear cells were prepared from 51 AD patients and 14 nonatopic controls, and their phenotypes were analyzed with flow cytometry. Cytokine production by stimulated CD4+ T cells was also assessed by the single-cell-staining method. Flow cytometric analysis clearly revealed that CD30+ T cells were identifiable in the blood of AD patients with greater frequency compared to controls. The important finding was that CD30 expression was restricted to a small but substantial population of memory (CD45RO+) CD4+ T cells, but not CD8+ ones. In AD patients, it was demonstrated that the percentages of CD30+ cells within CD45RO+ CD4+ T cells correlated well with the disease severity, serum IgE levels, peripheral eosinophil counts, and tendency toward Th2-dominant cytokine pattern as determined by the ratio of interleukin-4 to interferon-gamma production. This study suggests that CD30 expression in circulating T cells might serve as an in vivo marker for the Th2-dominated condition.

Differential expression of the chemokine receptors by the Th1- and Th2-type effector populations within circulating CD4+ T cells

The in vitro studies have proposed that human Th1 cells favor expression of CXCR3 or CCR5, whereas Th2 cells favor CCR3 and CCR4. In this study, the in vivo relevance of expression of these chemokine receptors on Th cells was investigated in patients with atopic dermatitis (AD) as the Th2-dominated disorder and nonatopic normal individuals. Flow-cytometric analysis using monoclonal antibodies against CXCR3, CCR5, CCR3, and CCR4 disclosed that a substantial proportion of memory (CD45RO+) CD4+ T cells in the blood of AD and normal patients expressed CXCR3, CCR5, or CCR4, but expression of CCR3 on these cells was negligible. Stimulation studies combined with intracellular cytokine staining revealed that the cells capable of producing Th2 cytokines, such as interleukin-4 (IL-4), IL-5, and IL-13, were restricted to the CCR4-expressing population within memory CD4+ T cells. Concerning Th1 cytokine production, interferon-gamma (IFN-gamma)-producing cells resided exclusively in CXCR3-expressing memory CD4+ T cells, although IFN-gamma production was found in both memory CD4+ T cells with and without CCR5 expression. We observed that CCR4-expressing memory CD4+ T cells in the blood were more increased in AD patients as compared with normal patients, whereas CXCR3-expressing memory CD4+ T cells were present in a lower frequency in AD than seen in normal patients. These results suggest that CXCR3 and CCR4, but not CCR5 or CCR3, appear to serve as the useful markers for identification of circulating Th1 and Th2 effector populations.

Collaborative evaluation of detection methods for Escherichia coli O157:H7 from radish sprouts and ground beef

For the evaluation of plating and immunological methods applicable to the detection of Escherichia coli O157:H7 from ground beef and radish sprouts, a collaborative study was conducted. It focused on a comparison of the efficiency of the plating and immunological methods using various plating agars and immuno-kits in combination with enrichment in modified E. coli broth supplemented with novobiocin (mEC + n), and using immunomagnetic separation. The plating media tested were sorbitol MacConkey agar (SMAC), SMAC supplemented with cefixime (0.05 mg/l) and potassium tellurite (2.5 mg/l) (CT-SMAC), and agars containing beta-glucuronidase substrates such as BCM O157 and CHROMagar O157. The immuno-kits used were Now E. coli, Path-Stick O157, VIP, EHEC-Tek ELISA System and Rapiblot E. coli O157. The 20 participating laboratories attempted to detect E. coli O157:H7 in 25 g chilled and frozen samples of ground beef uninoculated and inoculated with E. coli O157:H7 at levels of 138.9 and 23.9 cfu/25 g, and in 25 g chilled and frozen samples of radish sprouts uninoculated and inoculated at levels of 20.4 and 1.7 cfu/25 g. E. coli O157:H7 was recovered well from ground beef by all of the methods except direct plating with SMAC. For radish sprouts, the IMS-plating methods with CT-SMAC, BCM O157 and CHROMagar O157 were most efficient at detecting E. coli O157:H7 in more than 90% of the chilled samples inoculated at the level of 20.4 cfu/25 g. All the methods were less sensitive when applied to similar levels of E. coli O157:H7 in radish sprouts (20.4 cfu/25 g) compared with ground beef (23.9 cfu/25 g) especially if the sprouts were frozen. The sensitivity of the immuno-kits appeared to be similar to the IMS-plating methods, but the specificity was lower. Based on the results, we recommend the IMS-plating method using CT-SMAC and agars containing beta-glucuronidase substrate in combination with static enrichment incubation in mEC + n at 42 degrees C.

Three cases of primary lung cancer undetected by an annual checkup

An annual check by chest roentgenogram is very important for the early detection of lung cancer. We present three cases of primary lung cancer which were not detected by the double check system or previous examination. The three patients visited our hospital for evaluation of an ill-defined opacity in the upper lobe of the lung. In the three cases, no abnormality had been reported in the previous year's annual chest X-ray, and we concurred in the decisions. The correct diagnoses of the three cases were well or poorly differentiated adenocarcinoma, and were still amenable for surgical therapy. A poorly defined tumor in this region is very difficult to detect because of superimposed opacities of other anatomical structures. When a questionable shadow in this region is found but without the typical radiological features of lung cancer, it is important to search for indirect indications of adenocarcinoma. These may include fibrotic changes and absence of inflammation. In our cases, the increased number of normal-size bronchi penetrating the ill-defined tumor, seem to have diagnostic significance.

Occurrence of a methyl derivative of saxitoxin in Bangladeshi freshwater puffers

A new component of paralytic shellfish poison was isolated from a Bangladeshi freshwater puffer Tetraodon cutcutia. Its structure was deduced to be carbamoyl-N-methylsaxitoxin based on electrospray ionization mass spectrometry, [1H] NMR, and conversion experiments.

Occurrence of paralytic shellfish poisons in Thai freshwater puffers

Screening tests were carried out on the toxicity of freshwater puffers Tetraodon leiurus complex and Tetraodon suvatii collected from Udonthani province, north-eastern Thailand. Toxicity was highest in the liver and varied according to the location and season of fish catch. Fish which were reared in tap water for 3 months reduced the toxicity substantially. Partial purification was achieved by an ultrafiltration technique. Toxin components were consequently identified by high-performance liquid chromatography. It was found that toxins separated from the eggs, liver, skin and muscle of these puffers were composed of saxitoxin, neosaxitoxin and decarbamoylsaxitoxin.

Amino acid requirements for the growth and enterotoxin production by Staphylococcus aureus in chemically defined media

The production of enterotoxins A, B, and C by five strains of Staphylococcus aureus was studied in a series of defined media, each differing from the complete defined medium in the lack of one amino acid. Valine was required for growth; arginine and cystine for growth and enterotoxin production. Omission of individual amino acid affected in different ways the yields of the toxins produced.

Occurrence of paralytic shellfish poison in Bangladeshi freshwater puffers

Two species of freshwater puffer fish, Tetraodon cutcutia and Chelonodon patoca, collected from several locations in Bangladesh, showed lethal potency in mice ranging from 2.0 to 40.0 MU/g tissue as paralytic shellfish poison. In both species, toxicity of the skin was generally higher than the other tissues examined (muscle, liver and ovary). Water-soluble toxins from T. cutcutia were partially purified by activated charcoal treatment followed by column chromatographies using Bio-Gel P-2 and Bio-Rex 70. Analyses by cellulose acetate membrane electrophoresis and high-performance liquid chromatography with fluorometric detection demonstrated that the toxins were composed of saxitoxin, decarbamoylsaxitoxin, gonyautoxins 2 and 3, decarbamoylgonyautoxins 2 and 3, and three unidentified components which are possibly related to paralytic shellfish poison.

Two new isomers of domoic acid from a red alga, Chondria armata

Isodomoic acids G and H, two new isomers of the neurotoxin domoic acid, along with isodomoic acids A, B, E and F, were isolated from a red alga, Chondria armata, collected at the southern tip of Kyushu Island. The structures of two of these were deduced to be (E, E) and (Z, E) isomers of 2-carboxy-4-(5-carboxy-l-methyl-2-hexenylidene)-3-pyrro- lidineacetic acid, based on electrospray ionization mass and [1H]nuclear magnetic resonance spectral analyses including [1H-1H]correlation spectroscopy and nuclear Overhauser effect correlation spectroscopy.

[Study of cockroach allergy in asthmatic children. The positive rates and antigenicity of cockroach allergen]

The specific IgE antibodies to 4 species of cockroach were measured in sera from 51 asthmatic children 6 to 16 years old by RAST and CAP system. Positive rates of RAST to Periplaneta fuliginosa, Blattela germanica, Periplaneta americana and Periplaneta japonica were 17.6%, 29.4%, 19.6% and 15.7%, respectively and those of CAP system to Periplaneta fuliginosa and Blattela germanica were 15.7%, respectively. Among those with positive RAST to 4 species of cockroach there were significant correlations. Significant correlations were observed also between the RAST titer for the whole bodies and feces of Periplaneta fuliginosa and Blattela germanica and immunoblotting analysis of sera obtained from two cockroach-positive patients revealed common sensitive fraction between whole body and feces. Immediate bronchial response was detected by bronchial provocation test. RAST inhibition study indicated no cross-reacting allergenicity between cockroach and mite. Collectively, cockroach is one of important inhalent allergens in asthmatic children.

[Airborne Japanese cedar allergens studied by immunoblotting technique using anti-Cry j I monoclonal antibody--comparison with actual pollen counts and effect of wind speed and directions]

We collected airborne particles of Japanese cedar pollen with Burkard's sampling tape in Toyama from February to April 1992. The tape was cut into two pieces in parallel to time axis. The one of piece of the tapes was stained with glycerin-jerry and stained pollens were counted with a microscope. The other piece was treated according to the immunoblotting technique. The airborne pollen allergens, reacting with anti-Cry j I monoclonal antibody, were stained as blue spots. The spots were classified by diameter into two groups, large spots (> 50 microns) and small spots (< 50 microns). There were significant correlations found between the airborne Cry j I allergen spots (in large and small) and actual pollen counts obtained with the Burkard's sampler and the Durham's sampler (r = 0.729, 0.586 in large spots and r = 0.676, 0.489 in small spots, p < 0.001). The counts of small spots stayed in high level even in April when actual pollen counts decreased. We concluded that this discrepancy was caused by allergenic crushed cedar pollen particles staying floating longer than actual pollens. Secondly we set a gauge of wind speed and direction at the same point as the samplers. The actual pollen counts and large spots counts were significantly larger in the wind (SE wind in Toyama city) from cedar trees blooming area than other areas. However small spots counts did not differ significantly according to wind directions. Wind speed did not effect on actual pollen counts, large spots counts and small spots count.

[Mass-screenings for osteoporosis using computed X-ray densitometry (CXD): in a mobile unit]

The early diagnosis and treatment of osteoporosis is considered to be important for the prevention of fractures which often cause elderly to become bed-ridden. Computed X-ray densitometry (CXD), a method to measure bone mineral content in the metacarpus II utilizing a simple X-ray image, has been used for mass-screening of osteoporosis, because of its utility and reliability. However, due to its requiring adequate X-ray equipment, this method is often unsuitable for use in small facilities in a remote mountain areas. The use of CXD for osteoporosis screening, was attempted in a mobile unit for tuberculosis screening, by our public health center. The results showed that it is possible to use CXD in combination with a mobile unit, correcting the obtained values according to the radiographic conditions. With this set-up, CXD was used for mass-screening of osteoporosis in a total of 1150 subjects living in mountainous areas of Yoshino-gun, Nara prefecture, and CXD was found to be convenient and effective for mass-screening. The use of CXD in a mobile chest X-ray unit can be expected to be useful for mass-screening of osteoporosis especially in remote mountainous areas having inadequate X-ray equipment.

Properties of hemagglutinins newly separated from toxic phytoplankton

Unique substances of the hemagglutinating activity were separated from unialgal cultures of the toxic phytoflagellates, Chattonella marina and Gymnodinium sp. Molecular masses of the substances were estimated to be 14,000 in Chattonella and 15,000 in Gymnodinium. These two substances contained phosphorus, hexose (galactose) and glycerol in the following molar ratios; 1.00:1.18:1.24 (Chattonella) and 1.00:1.07:1.10 (Gymnodinium). Hemagglutinating titres using rabbit red blood cells were inferred to be 25,000 in both preparations. In the presence of Chattonella hemagglutinin (0.10-0.50 microM), the growth of C. marina in Provasoli's ES media was little affected during 24 h of incubation, whereas a marked suppression took place in growth in Gymnodinium sp. (50% inhibition, 0.12 microM) or the diatom Nitzschia closterium (0.17 microM). On the other hand, Gymnodinium hemagglutinin inhibited the growth of the three species of phytoplankton. A 50% inhibition occurred at 0.12 microM in C. marina, at 0.22 microM in N. closterium or at 0.50 microM in Gymnodinium sp.

[Bronchial hypersensitivity and development of bronchial asthma in children with atopic dermatitis]

Using histamine inhalation tests, we followed changes in bronchial hypersensitivity in 48 children with atopic dermatitis (AD) who were nonasthmatic on their initial visit. Twenty-three of these subjects became asthmatic during the follow-up period. The respiratory thresholds to histamine RT-Hist) of children with AD were widely distributed, ranging from 156 to more than 5000 micrograms/ml. There was a statistical difference in RT-Hist, as those who became asthmatic showed lower levels (< or = 625 micrograms/ml) at 2-6 yr of age. The percentage of peripheral eosinophil counts and IgE level was significantly elevated in those who became asthmatic. Subjects who developed asthma were more likely to have had positive D.p. RAST when they were less than 2 yr of age. The development of asthma in children with AD showed no significant relationship with family history of bronchial asthma.

[Bronchial hypersensitivity to histamine in asthmatic children longitudinal study from first visit to remitted state]

In order to examine the changes in bronchial hypersensitivity, histamine inhalation tests were evaluated in 27 asthmatic children who remitted. The respiratory threshold to histamine (RT-Hist) 2-3 yrs after remission was higher than in the initial test, in their worst periods of the asthma and just before remission (p < 0.001, p < 0.001, p < 0.005, respectively). Eleven subjects (40.7%), showed no improvement of bronchial hypersensitivity 2-3 yrs after remission (RT-Hist was 1250 micrograms/ml or lower). In this group, the asthma score per year two and three years before symptom-free state was higher than in the group with improved bronchial hypersensitivity (p < 0.05). There was no significant difference between % fall of FEV1.0 in RT-Hist in the worst periods of the asthma and 2-3 yrs after remission. FEV1.0/VCP, %V50, %V25 and V25/Ht 2-3 yrs after remission were higher than those in the worst periods of the asthma.

[A case of anaphylaxis caused by sunflower seed]

A 14 years old boy experienced an anaphylactic reaction of dyspnea, vomiting, urticaria and hypotension after he ate sunflower seeds. Specific IgE-mediated hypersensitivity to sunflower seen extract was demonstrated by skin tests and radioallergosorbent test (RAST). By immunoblotting test analysis (SDS-PAGE, Western blotting method), the allergenic activity of sunflower seem were shown to be in the MW range of 13.5 Kd.

Occurrence of carbamoyl-N-hydroxy derivatives of saxitoxin and neosaxitoxin in a xanthid crab Zosimus aeneus

Two novel paralytic toxins were isolated from toxic specimens of a xanthid crab Zosimus aeneus inhabiting Ishigaki Island, Okinawa. The structures of two of these were deduced to be carbamoyl-N-hydroxysaxitoxin and carbamoyl-N-hydroxyneosaxitoxin based on electrophoresis, high performance liquid chromatography, electrospray ionization mass spectrometry, 1H NMR, 13C NMR and conversion experiments. They showed specific toxicities of 1700 and 1400 mouse units per mg on i.p. injection into mice.

[Evaluation of the Magic Lite SQ specific IgE kit]

The new IgE specific antibody assay kit (Magic Lite SQ) was evaluated by comparing its results with those obtained by the Phadebas RAST and the skin prick tests. Sera from allergic children were used in the tests. The correlation coefficients between the Magic Lite SQ and the Phadebas RAST were as follows: 0.87 for D.p., 0.89 for D.f., 0.87 for HD1, 0.55 for HD2, 0.76 for orchard grass, 0.93 for cat dander, 0.78 for Alternaria, 0.88 for egg white, 0.75 for egg york, 0.81 for milk, 0.75 for say bean, and 0.60 for shrimp. The concordance rate of the two methods was high, except on the case of HD2. The sensitivity and specificity of Magic Lite SQ to the skin prick test was high, except on the case of HD2 and orchard grass. Dilution tests using samples from D.f. positive patients showed a good linearity and excellent quantitativeness. When mite allergen was added to D.f. positive pool serum, mite specific IgE antibody yielded an excellent inhibition curve of up to a maximum of 96%. Since the Magic Lite SQ requires only a small sample of serum and can completed the test in a short time, it is a useful and specific IgE antibody assay kit.

[Airborne Japanese red cedar allergens studied by the immunoblotting technique--comparison with pollen counts obtained by Durham sampling and effect of weather]

We collected airborne particles with Burkard's sampling tape in Toyama from March to July. According to the immunoblotting technique (Takahashi et al, 1990), the airborne pollen allergens were reacted with anti-Cry j I polyclonal antibody and were stained as blue spots. The areas of these spots were measured with a color image analyzer (CIA) and a densitometer. There were significant correlations between the airborne Cry j I allergen spots (CIA and densitometer) and the pollen counts obtained with a Durham sampler (r = 0.624, 0.555, p < 0.001). The airborne Cry j I allergens however, tended to maintain a higher level than the pollen counts (Durham) in May. We theorized that this discrepancy is caused by cross reactivity with other pollen or crushed cedar pollen particles have allergenicity. There was a negative correlation between the Cry j I spots and rainfall. The pollen counts had a negative correlation with rainfall, and a positive correlation with average wind speed. These results suggest that this method is useful in evaluating fluctuations in airborne Cry j I allergen.

[Efficacy of continuous isoproterenol inhalation therapy for severe asthma attacks in younger children]

The aim of this study was to evaluate the efficacy of continuous isoproterenol inhalation therapy for severe asthma attacks in younger children, compared with its efficacy in older children. We used l-body isoproterenol (Proternol L) in 31 children with 42 episodes of severe attacks. They were divided into two group according to age: 20 cases under 6 years old (Group A), and 22 cases over 7 years old (Group B). All of the patients except for one in Group B, eventually improved with this therapy. Wood's clinical scores for Group A were significantly higher than those for group B (p < 0.01). In 22 cases whose scores were 5-6, their SpO2 values at the onset of this therapy were 90.8 +/- 3.17 in group A and 92.4 +/- 3.82% in group B. The improvement time of group A (13.6 +/- 16.2 hours) was significantly longer than that of group B (2.5 +/- 5.66, p < 0.01). The nebulized isoproternol doses for group A were 0.47 +/- 0.168 and for group B 0.26 +/- 0.096 mg/kg/saline 500 ml. The dose for group A was significantly higher than that for group B (p < 0.01). We concluded that continuous isoproterenol inhalation therapy was effective even in younger children. But the degree of efficacy was slightly lower in younger children, although they inhaled higher doses of isoproterenal than older children.

[Efficacy of early use of continuous isoproterenol inhalation therapy for severe asthma attacks in children]

The aim of this study was to evaluate the efficacy and safety of continuous isoproterenol inhalation therapy for asthma attacks in children. We used l-body isoproterenol (Proternol L) in 22 children with 32 episodes of severe attacks. One of them did not respond to this therapy, and two had complications (atelectasis and pneumothorax). Twenty-nine cases were divided into three subgroups according to their clinical scores; A) scores less than or equal to 4, which meant that they were in the early stage of severe attack (n = 9), B) scores 5-6, which meant impending respiratory failure (n = 17), C) scores greater than or equal to 7, which meant respiratory failure (n = 3). The values of SpO2 at the start of this therapy were 94.8, 91.5, 82.0%, respectively. The more severe their attacks were, the lower their SpO2 levels were. The periods until their scores became zero were 0.78, 6.3, 17.2 hours, respectively. There were significant differences between each period respectively (p less than 0.001, p less than 0.01). Heart rates decreased when their symptoms improved, and other adverse effects were not detected. These results suggest that this therapy is effective and safe for children with severe asthma attacks, especially in the early stage.

[Clinical application of T-Scan System. 2. Evaluation of soft mouth guards]

Soft mouth guards are effective to prevent traumatic injury in the maxillofacial region. In this study, we tried to find out the effect of soft mouth guards on the distribution and the magnitude of occlusal force using the T-Scan system. Ten adult subjects volunteered to exert maximum biting force wearing three different types of soft mouth guards. With the limitation of the T-scan system reported in our previous article, following results were obtained. 1) Occlusal forces were more evenly distributed with soft mouth guards than without them. 2) Softer mouth guards were more effective for occlusal force distribution. 3) Since occlusal relationship between mouth guards and mandibular arch could alter the distribution pattern a great deal, occlusion of mouth guards should be examined more carefully.

[Mouth guard and occlusal force distribution]

Mouth guards are effective to prevent traumatic injury in maxillofacial region during sports activities. This study was conducted to investigate the influence of wearing mouth guards on occlusal force distribution with the T-scan system. With comparison to the value of average occlusal force level per occlusal point (OFL) on natural dentition and wearing conventional full arch bite plane, following results were obtained. 1) Difference of OFL within the same dental arch became smaller when mouth guards were on. 2) Statistically significant difference in OFL was not found between two mouth guards with different hardness. 3) During three seconds clenching, OFL in posterior region changed great deal at the initiation but stayed at about the same level after that.

Mouth guard and occlusal force distribution

Mouth guards are effective to prevent traumatic injury in maxillofacial region during sports activities. This study was designed to find out the influence of wearing mouth guards on occlusal force distribution using an occlusal force transducer system (T-Scan system). Occlusal forces were more evenly distributed when mouth guards were in place comparing with natural dentition and with wearing conventional full arch bite planes.

Separation of tetrodotoxin and paralytic shellfish poisons by high-performance liquid chromatography with a fluorometric detection using o-phthalaldehyde

Tetrodotoxin (TTX) and a variety of paralytic shellfish poisons (PSPs) were extracted from toxic specimens of puffer and scallop, and quantitated by high-performance liquid chromatography with a fluorometric detection using o-phthalaldehyde. Fluorescence spectra for the TTX- and PSP-fluorophors in 0.05 M borate buffer (pH 10) showed maxima at 453 nm with 332-nm excitation. The fluorescence intensity per nM of TTX was found to be 3 and those of PSP to be 4-12. This fluorometric technique may be useful for the simultaneous quantitation of TTX and PSP in small volumes of toxin extracts.

Sulfite oxidase from Merluccius productus

Sulfite oxidase (sulfite:oxygen oxidoreductase, EC 1.8.3.1) was purified 482-fold from liver of the Pacific hake Merluccius productus. The molecular weight of the enzyme was found to be 120 000 by gel exclusion chromatography on Sephadex G-100. Electrophoretic analysis on sodium dodecyl sulfate (SDS)-polyacrylamide gel revealed that the enzyme was composed of two subunits whose molecular weight was estimated to be 60 000. The pH optimum of the enzyme was 8.7; Ks for sulfite, 2.5 x 10(-5) M; and that for cytochrome c, 3.6 x 10(-7) M. The enzyme elicited an EPR signal at g = 1.97 characteristic of pentavalent molybdenum. Colorimetric analysis also disclosed that the enzyme contained 2 mol each of heme and molybdenum per mol of protein. This fish liver homogenate in isotonic sucrose solution was fractionated by differential centrifugation into nuclei, mitochondria, microsomes and supernatant (100 000 X g). The major portion of sulfite oxidase activity was found in mitochondria. The sulfite oxidase activity was markedly high in liver and kidney, as compared with that in heart, spleen, muscle, gill and eye.

Treatment of the femoral shaft fracture with a curved heat-treated COP clover-leaf nail

The commonly used straight intramedullary nail has certain limitations and disadvantages. Following radiographic and metallurgical studies we have developed a curved heat-treated clover-leaf nail using a newly developed precipitation hardening stainless steel (COP). The nail is bent with a slot on the convex side and the radius of curvature is 115 cm which corresponds to the anatomical antero-lateral convexity of the human femur. The nail has been satisfactory in clinical use since 1971 and has provided not only more stable internal fixation but also allowed fixation of fractures beyond the middle third of the shaft.

[Anatomical and biomechanical considerations for medullary nailing (author's transl)]

By using X-ray films of 390 adult femurs and 15 cadaveric femurs of Japanese origin, and by measuring successive cross-sections the authors have made morphological and statistical analyses of the shape of the femoral medullary canal. These studies suggest new dimensions for the diameter of the reamer and the amount of contact area between nail and inner cortex. Furthermore it was found that the physiological antecurvature of the femur on the lateral view does not correspond with the prebending of the OA-nail. The authors made some mechanical experiments on four types of nails which are widely used today. As a consequence of these studies, the authors developed a new elastic nail for trial (Okayama-nail). This new type of nail greatly increases the area of contact with the inner femoral cortex. Obviously this nail satisfies better all of Kuentscher's originally mentioned requirements an intramedullary nail.

Reconstruction of the superior vena cava in a patient with a thymoma

Surgical treatment was attempted in a 71-year-old man who had superior vena caval syndrome caused by incomplete obstruction of the superior vena cava with a thymoma. Using a temporary internal shunt, the superior vena cava was almost entirely resected together with the tumor and reconstructed by autogenous venous grafts. Patency of the reconstructed vein was proved by angiography one year after the operation. He has been asymptomatic for 15 months after surgery.

Use of Plastein Reaction in Recovering Protein from Fish Waste

A high quality proteinaceous product is recoverable in 35% yield from fish waste by a process of peptic hydrolysis followed by a pepsin-catalyzed recombination of soluble peptides to form plastein. Hydrolysis is at pH 2.0 and 37 C for 6 hr. Soluble peptides are then separated from insoluble residue, adjusted to pH 4.5, concentrated at 45 C to 30% protein solids, and incubated for 24 hr at 37 C with additional pepsin. The insoluble plastein formed during incubation is filtered, washed, and dried. In a pilot experiment with fillet waste from Petrale sole (Eopsetta jordani), the yield was 35% of total original protein. Proximate composition of the product was: protein, 96.1%; moisture, 2.9%; ash, 0.5%; and lipid, 0.0%. The plastein contained a higher proportion of essential amino acids than did a hydrolysate of the whole waste, all except tryptophan exceeding FAO reference standards.