Antimicrobial activity of Harpullia ramiflora

The methanol extracts of Harpullia ramiflora, leaves, flowers, stem and root barks were partitioned (petrol, dichloromethane, ethyl acetate). In respect to crude extracts, all fractions demonstrated broader spectrum and higher levels of antibacterial activity. The ethyl acetate fraction of the flowers exhibited the highest activity. No activity was shown against the tested moulds.

Antimicrobial activity of Castanopsis acuminatissima

The methanol extracts of Castanopsis acuminatissima leaves, stem and root barks were partitioned (petrol, dichloromethane, ethyl acetate). Though all of the crude methanolic extracts and obtained fractions from them, showed a broad spectrum of antibacterial activity, in most cases the activity was decreased on fractionation. None was active against tested moulds.

Autonomic consequences of brainstem infarction

OBJECTIVE

It is well known that patients with brainstem infarctions sometimes experience dizziness, vertigo and falls, although the exact mechanism is not clear. Therefore, we designed a study to quantify autonomic function in patients with brainstem infarction.

PATIENTS AND METHODS

We examined autonomic function in 15 patients with brainstem infarctions, who had a history of vertigo, nausea, floating sensation and/or general fatigue during standing, and 31 age-matched controls using the composite autonomic scoring scale (CASS), which was used to grade autonomic function. The patients underwent initial autonomic assessment and then were subjected to aniracetam therapy. The drug was given orally (dose of 600 mg/day) for a duration of 56 days. Upon completion of aniracetam administration, the CASS was again tested.

RESULTS

Upon initial assessment, the patients had mild reductions in mean blood pressure (MBP) and lack of an increasing heart rate (HR) within 5 min of head up-tilt, an impairment in BP correction during late phase II and reduced phase IV beat-to-beat BP response to the Valsalva maneuver, and reduced heart rate response to deep breathing (HRdb). CASS indicated mild autonomic dysfunction. After 8 weeks of treatment with aniracetam, the patients' symptoms improved and the autonomic tests showed improvement in autonomic function.

CONCLUSION

Part of the pathogenesis of recurrent vertigo or dizziness with brainstem infarction might be due to mild autonomic dysfunction. Aniracetam, which activates the cholinergic system in brain, might correct the cardiovagal system in these patients. The CASS may be a sensitive tool for assessing mild autonomic dysfunction in patients with brainstem infarction.

A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation

A prospective study on medial patellofemoral ligament reconstruction for recurrent patellar dislocation was performed. At an average follow-up of 5.9 years, 27 MPFL reconstructions using a mesh-type artificial ligament and medial retinaculum slip coverage were reviewed using the Crosby and Insall grading system. Fifteen knees (55%) were classified as excellent, 11 knees (41%) as good, 1 knee (4%) as fair/poor and none as worse. At a mid-term follow-up, medial patellofemoral ligament reconstruction should be considered as a safe and effective operation.

Large and asymptomatic pancreatic islet cell tumor in a patient with multiple endocrine neoplasia type 1

The major phenotypes of multiple endocrine neoplasia type 1 (MEN 1) consist of three lesions characterized by hyperparathyroidism, pituitary tumors, and endocrine pancreatic tumors. The endocrine pancreatic tumors are a significant cause of disease-related mortality in MEN 1. Although symptomatic pancreatic tumors such as insulinoma and gastrinoma should be resected, the management of asymptomatic pancreatic tumors is not established. In asymptomatic pancreatic tumors, the most important factor is the propensity for malignant transformation of the tumors. Although there are no means to foresee it, the size of the pancreatic tumors might be predictive of malignant development in MEN 1. We report here a patient with MEN 1 who had a large asymptomatic pancreatic tumor. The patient (72-yr-old man) was diagnosed with primary hyperparathyroidism and underwent a total parathyroidectomy. Genetic examination showed a germline mutation of the MEN1 gene (E45G). Abdominal magnetic resonance imaging revealed a large (>6 cm) tumor with a heterogeneous pattern in the tail of the pancreas. No metastases of the tumor were evident. Serum levels of insulin, gastrin, and glucagon were normal, and the patient had no symptoms. Operative resection was performed, and microscopic examination revealed that the tumor was an islet cell tumor stained with multiple hormones. This is a case indicating that asymptomatic pancreatic tumors associated with MEN 1 might be indolent independent of their size.

Characterization of the yeast Cdc7p/Dbf4p complex purified from insect cells. Its protein kinase activity is regulated by Rad53p

The yeast Saccharomyces cerevisiae Cdc7p/Dbf4p protein kinase complex was purified to near homogeneity from insect cells. The complex efficiently phosphorylated yeast Mcm2p and less efficiently the remaining Mcm proteins or other replication proteins. Significantly, when pretreated with alkaline phosphatase, Mcm2p became completely inactive as a substrate, suggesting that it must be phosphorylated by other protein kinase(s) to be a substrate for the Cdc7p/Dbf4p complex. Mutant Cdc7p/Dbf4p complexes containing either Cdc7-1p or Dbf4-1 approximately 5p were also partially purified from insect cells and characterized in vitro. Furthermore, the autonomously replicating sequence binding activity of various dbf4 mutants was also analyzed. These studies suggest that the autonomously replicating sequence-binding and Cdc7p protein kinase activation domains of Dbf4p collaborate to form an active Cdc7p/Dbf4p complex and function during S phase in S. cerevisiae. It is shown that Rad53p phosphorylates the Cdc7p/Dbf4p complex in vitro and that this phosphorylation greatly inhibits the kinase activity of Cdc7p/Dbf4p. This result suggests that Rad53p controls the initiation of chromosomal DNA replication by regulating the protein kinase activity associated with the Cdc7p/Dbf4p complex.

Phytochemical flavones isolated from Scutellaria barbata and antibacterial activity against methicillin-resistant Staphylococcus aureus

A crude extract prepared from Scutellaria barbata D. Don (Lamiaceae) was analyzed in the effort to discover antibacterial compounds against high-level strains of methicillin-resistant Staphylococcus aureus (MRSA). Apigenin and luteolin were isolated from the plant as active constituents against the bacteria. These flavonoid congeners were selectively toxic to S. aureus, including the MRSA and methicillin-sensitive S. aureus strains.

Population-based mapping of pulmonary adenoma susceptibility 1 locus

Pulmonary adenoma susceptibility 1 (Pas1), the major locus affecting inherited predisposition to lung tumor development in mice, maps near the Kras2 gene. We previously reported a significant association between a KRAS2/RsaI polymorphism and the risk and prognosis of lung adenocarcinoma (ADCA) in the Italian population. In the present case-control study, we examined 269 lung ADCA patients, 121 squamous cell lung carcinoma patients, and 632 healthy individuals (general population controls) in the Japanese population with genetic markers spanning approximately 1200 kb in the KRAS2 region. Allele-specific oligonucleotide hybridization revealed the same KRAS2/RsaI polymorphism associated with risk and prognosis as in Italian lung ADCA patients; the polymorphism was significantly associated with clinical stage (P < 0.001) and survival rate (log rank = 0.0014), confirming the mapping of PAS1 and pointing to the role of this locus in human lung cancer.

Recovery of parathyroid function after total thyroidectomy

To prevent postoperative hypoparathyroidism following total thyroidectomy, the parathyroid glands are preserved in situ and/or resected or devascularized parathyroid glands are autotransplanted. We conducted a retrospective investigation utilizing biochemical and specific endocrine assessments to evaluate the difference in recovery of parathyroid function between the two operative methods. A total of 92 patients underwent total thyroidectomy at our hospital during the period between 1990 and 1997. These patients were divided into a preservation group (n = 83), with one or more preserved glands in situ, and an autotransplantation group (n = 9), with only transplanted glands. The level of intact parathyroid hormone (PTH) was completely restored by 1 year postoperatively in 83% (69/83) of the preservation group patients. In the remaining 14 patients (17%), the intact PTH had fallen below detectable levels on postoperative day (POD) 1, then subsequently recovered to 70% of the preoperative levels. Comparatively, in the autotransplantation group, the mean level of intact PTH recovered to only 43% of the preoperative levels. The results of this study suggest that parathyroid glands should be preserved in situ whenever possible, and that when intact PTH levels fall below detectable limits on POD 1, they may never recover to the preoperative levels in those patients.

Deletion analysis of the flagellar switch protein FliG of Salmonella

The flagellar motor/switch complex, consisting of the three proteins FliG, FliM, and FliN, plays a central role in bacterial motility and chemotaxis. We have analyzed FliG, using 10-amino-acid deletions throughout the protein and testing the deletion clones for their motility and dominance properties and for interaction of the deletion proteins with the MS ring protein FliF. Only the N-terminal 46 amino acids of FliG (segments 1 to 4) were important for binding to FliF; consistent with this, an N-terminal fragment consisting of residues 1 to 108 bound FliF strongly, whereas a C-terminal fragment consisting of residues 109 to 331 did not bind FliF at all. Deletions in the region from residues 37 to 96 (segments 4 to 9), 297 to 306 (segment 30), and 317 to 326 (segment 32) permitted swarming, though not at wild-type levels; all other deletions caused paralyzed or, more commonly, nonflagellate phenotype. Except for those near the N terminus, deletions had a dominant negative effect on wild-type cells.

Prognostic factors in young women with endometrial carcinoma: a report of 20 cases and review of literature

We retrospectively reviewed the pathologic features of patients with endometrial carcinoma (EC) treated in our facility between 1989 and 1998. First, we identified the clincopathologic features of young women with EC and compared them with similar patients from the literature. Second, 148 EC patients were divided into two groups: group A (age</=45 years, n = 20) and B (age>45, n = 128). The mean follow-up periods were 65 months and 50 months in groups A and B, respectively. Group A patients had better disease-free survival (Kaplan-Meier method, P = 0.0283) compared to group B patients. The independent variables related to disease-free survival (Cox regression analysis) were age (P = 0.0001), stage (P = 0.0183), histology (P = 0.0011), and lymph node metastasis (P = 0.0007). The distribution of stage was significantly different between the two groups (Chi-square test, P = 0.0089). More group A patients (18 of 20; 90%) had early stage disease. There were no significant differences (Fisher's exact test) between the two groups in histology, grade, cervical involvement, vascular invasion, tumor size, ovarian malignancy, and lymph node metastasis. However, group A patients had a significant higher incidence of disease confined to the inner half of the myometrium than group B patients (P = 0.0004). We statistically confirmed that young women with EC had better outcome due to a significantly higher proportion of early stage disease and less myometrial invasion than older patients.

Aging differentially modifies sensitivity of nerve blood flow to vasocontractile agents (endothelin-1, noradrenaline and angiotensin II) in sciatic nerve

This study examined the influence of the vaso-constricting agents (noradrenaline, endothelin-1 and angiotensin II) in Sprague-Dawley rats aged 2, 6 and 24 months by evaluating epineurial arteriolar vasoreactivity in response to superfused teat agents. Nerve blood flow (NBF) was measured using microelectrode H2 polarography. In 24-month-old rats, NBF was decreased and vascular resistance (VR) was increased compared with 2- and 6-month-old rats. All of the constricting agents reduced NBF in the 2-, 6- and 24-month groups, however, the effects of the constricting agents reduced significantly with age. These results suggest that during aging, there is a decline of vasoconstrictive responses to noradrenaline, endothelin-1 and angiotensin II in peripheral nerve and that these changes may be due to altered function of receptors.

Antimicrobial activity of Evodia elleryana

The methanol extracts of Evodia elleryana, leaves, stem wood, stem bark, root wood and root bark were partitioned (petrol, dichloromethane, ethyl acetate). All obtained fractions showed a broad spectrum of antibacterial activity, while none were active against tested moulds.

Delays and continuation of hospital visits among HIV-infected persons and AIDS cases in Japan

This study attempts to clarify the distribution patterns of delay between HIV transmission and the first hospital visit among HIV-infected persons and AIDS cases in Japan except those infected through blood products. Such hospital visit patterns were analyzed, and the rates of reporting for HIV/AIDS surveillance among diagnosed HIV-infected persons and AIDS cases in hospitals were shown. From 1991 to 1997, a survey and subsequent follow-up were conducted among HIV-infected persons and AIDS cases diagnosed at 74 hospitals in Tokyo. The numbers of HIV-infected persons and AIDS cases were 590 and 208, respectively. The percentage of patients whose estimated date of HIV transmission was obtained ranged 23-41% among Japanese and non-Japanese HIV-infected persons and AIDS cases. Among these patients, 28% to 86% showed a 3-year delay between HIV transmission and their first hospital visit. The rate of HIV-infected persons who continued to visit hospitals within 1 year after their first visit was 77% for Japanese and 45% for non-Japanese; among those after 1 year or more following their first hospital visit the rate was more than 80% among Japanese and over 70% among non-Japanese. The rate of reporting to HIV/AIDS surveillance among diagnosed HIV-infected persons and AIDS cases was 90% or more after 1994 in Japan. The delay between HIV transmission and the first hospital visit was suggested to be very long. Not a few patients stopped visiting hospitals after only a short time. Most diagnosed HIV-infected persons and AIDS cases were reported to the surveillance system of Japan.

Effects of ethanol on neuronal migration and neural cell adhesion molecules in the embryonic rat cerebral cortex: a tissue culture study

To investigate whether ethanol has direct effects on neuronal migration in the cerebral cortex, we performed a tissue culture study using embryonic rat brain with thymidine autoradiography. After we labeled progenitor cells in the ventricular zone of E16 cerebral cortex explants with [3H]thymidine, the explants were cultured for 48 h, and then distribution of labeled cells was evaluated autoradiographically. Adding 3.0 or 6.0 mg/ml ethanol to the culture medium caused significantly decreased distribution of labeled cells in the outer intermediate [control: 2.0+/-0.6% (mean+/-S.D.); 1.0 mg/ml ethanol: 2.1+/-1.5%; 3.0 mg/ml ethanol: 0. 5+/-1.5% (P<0.05); 6.0 mg/ml ethanol: 0.4+/-0.5% (P<0.05)] and the inner intermediate-A zones [control: 19.5+/-6.2%; 1.0 mg/ml ethanol: 13.1+/-8.6%; 3.0 mg/ml ethanol: 3.0+/-3.4% (P<0.01); 6.0 mg/ml ethanol: 5.2+/-2.9% (P<0.01)] compared to the control group. The mitotic index after 48-h culture was significantly reduced in the 6. 0 mg/ml ethanol group (0.260+/-0.114%; P<0.01) compared to the control group (0.600+/-0.158%). This suggests that ethanol inhibits neuronal migration in the cerebral cortex, although prolongation of the cell cycle by ethanol may contribute to the decreased number of labeled cells in the outer intermediate and inner intermediate-A zones. Furthermore, an abnormally dense and tortuous staining pattern of immunoreactive products of N-CAM was seen on the surface of migrating neurons in the 3.0 and 6.0 mg/ml ethanol groups, while the L1 staining pattern did not differ between the control and ethanol groups. These results suggest that abnormal expression of N-CAM may be involved in the inhibition of neuronal migration by ethanol.

Trends in HIV and AIDS based on HIV/AIDS surveillance data in Japan

BACKGROUND

In recent years a decline in the number of new AIDS cases has been observed in several industrialized countries. It is important to know whether these recent trends observed in North America and Europe are also occurring in Japan.

METHODS

The number of people reported with HIV and AIDS by nationality, route of infection, and sex was calculated based on the HIV/AIDS surveillance data available in Japan through December 1997. The effect of reporting delay, which was defined as those HIV and AIDS cases reported in the calendar year following diagnosis, on the trends was examined. The coverage rate in reporting HIV cases was estimated as the ratio of the reported AIDS cases with prior report as an HIV-positive to the total number of reported AIDS cases.

RESULTS

The cumulative number of reported cases of HIV among Japanese and non-Japanese residents of Japan up to the end of 1997 were 1,300 and 1,190, respectively. The cumulative number of reported cases of AIDS among Japanese and non-Japanese up to the end of 1997 were 758 and 298, respectively. The number of reported cases of HIV among Japanese was found to be still increasing, with the major contribution from male cases. The increasing trend in the number of reported AIDS cases among Japanese began to slow in 1996 and 1997. The number of reported cases of HIV among non-Japanese residents of Japan peaked in 1992, and has decreased since then, and remained constant after 1994. In contrast, the number of reported AIDS cases among these non-Japanese tended to increase gradually. There was a slight reporting delay for people with HIV and AIDS. The estimated coverage rate in reporting HIV cases tended to decrease in 1996 and 1997 (1/7.2, 1/10.2, respectively). We point out several reasons for this recent decline and suggest the possibility of an ostensible decline in the estimates.

CONCLUSIONS

We suggest that the number of people with HIV among Japanese has continued to increase, and that the increase in the number of AIDS cases among Japanese is now slowing.

[PGE1 and dopamine administration in a pediatric patient during hepatectomy]

A 2-year-old male underwent medial inferior hepatectomy for the treatment of metastatic tumors. Due to congenital hepatoblastoma, at 6-months of age, right lobectomy of his liver had been performed. To protect liver functions, PGE1 and dopamine were administered during the surgery. Although half of his circulating blood volume was lost, his perioperative hemodynamics was stable, with no development of postoperative liver dysfunction. PGE1 and dopamine may thus be beneficial in pediatric hepatectomy.

Sensorimotor polyneuropathy associated with chronic lymphocytic leukemia, IgM antigangliosides antibody and human T-cell leukemia virus I infection

A 65-year-old man presented with a sensorimotor polyneuropathy associated with B-cell chronic lymphocytic leukemia (CLL) and immunoglobulin M (IgM) antibody to various gangliosides. Electrophysiological studies denoted significant abnormalities of motor and sensory nerve conduction. Although the pathology of sural nerve biopsy looked minimally affected, immunohistochemical studies showed specific binding of IgM to the human peripheral nerve. Our patient also had high titer of antibody to human T-cell leukemia virus I (HTLV-I) in both serum and cerebrospinal fluid (CSF), which might activate B-cell-mediated immunity and facilitate the production of IgM antibody. The other unique feature is the reactivity of antibody to gangliosides. The patient had IgM antibody reactivities to gangliosides with disialosyl residue such as GT1b, GQ1b and GD3, but not to GD1b. IgM antibody to gangliosides with disialosyl residue has been reported in ataxic symptoms, but our patient failed to demonstrate ataxia. Without reactivity to GD1b, sensory ataxic neuropathy might not develop even in the presence of antibody reactive to other gangliosides with disialosyl residue.

Successful autotransplantation of an adrenal gland using a new method of omental wrapping: report of a case

Bilateral total adrenalectomy results in the need for patients to take lifelong supplements of adrenal steroids, with the risk of possible Addisonian crisis. Few reports of the successful autotransplantation of adrenal tissue in muscular pockets have been documented; however, we describe herein the case of a 22-year-old woman in whom autotransplantation of an adrenal gland was successfully performed employing a new method of omental wrapping. The patient underwent bilateral total adrenalectomy for bilateral pheochromocytoma at which time adrenal tissue was sliced into 1-2-mm thick pieces, half of which were placed in muscular pockets in the abdominal rectus muscles, and the remaining half put onto the omentum and wrapped with it. Laboratory examinations done 6 months after surgery showed recovery of her adrenal function, and 4 months later steroid supplements were able to be discontinued. Scintigraphic studies using [131I]-iodomethyl-norcholesterol ([131]I-Adosterol) demonstrated clear activity in the omentum, weak activity in the rectus muscles, and no activity in the adrenal beds. These findings suggest that the omentum may be more suitable as an implantation site for adrenal tissue than muscular pockets.