Job stress, psychosocial strain, and physical health problems in women employed full-time outside the home and homemakers. A pair of studies was conducted to investigate for both women employed full-time outside the home and homemakers: (a) relations between job-related stress and various indices of psychosocial strain and reported physical health problems; and (b) social support and number of children in the home in regard to direct relations with indices of psychosocial strain and physical health problems as well as moderating effects on relations between job stress and these indices. Self-report data were collected from 91 women employed outside the home and 95 homemakers. For both groups of women, more quantitative overload was associated with more tension and health problems. Greater quantitative overload was associated with more marital dissatisfaction for homemakers but not for women employed outside the home. Greater underutilization of skills for both groups of women was associated with more self-reported tension and poorer quality of marital relations but was not associated with health problems. Less reported tension was associated with greater overall social support for homemakers and greater social support from supervisors for women employed outside the home. Better quality of marital relationships was associated with greater overall social support for homemakers and greater social support from husbands and relatives/friends for women employed outside the home. For women employed outside the home, social support from supervisors and coworkers were found to moderate some of the relations between job stress and measures of psychosocial strain. Social support for homemakers, however, evidenced no moderating effects for relations involving job stress. Possibly because of low mean number and small variability in number of children in these samples, no direct relations or moderating effects were found for number of children for either group of women.


A prospective study of women's health: the effects of stress, hardiness, locus of control, Type A behavior, and physiological reactivity. This study was a five-year follow-up of women who had participated in a previous experiment. At time one, we obtained measures of hardiness, Type A behavior, locus of control, stress, illness, and physiological reactivity. At time two, we obtained measures of illness for the past twelve months. Multiple regression analyses support the hypotheses that both hardiness and locus of control buffer the effects of stress on illness. Furthermore, Type A classification was associated with greater illness frequency and resting systolic blood pressure predicted future health status. An examination of all variables simultaneously revealed that future illness frequency is best predicted by locus of control x stress, high resting systolic blood pressure and low systolic reactivity. Future illness severity was best predicted by locus of control and resting systolic blood pressure. These results support the hypotheses that hardiness and locus of control buffer the effects of stress on health in women employed as clerical workers; however, the predictive power of hardiness in these women is largely accounted for by the contribution of locus of control.


Restructuring federalism: the effects of decentralized federal policy on states' responsiveness to family planning needs. The Reagan Administration sought to decentralize many federal programs by (1) consolidating categorical grants into black grants; (2) reducing their funding; and (3) relying more upon state fiscal support. This study examines the effects of this decentralist policy upon the federal family planning program. Two periods are analyzed: (1) FY 1976-1981, the period immediately prior to the Reagan Administration and (2) FY 1982-1987, the period during the Reagan Administration. Findings show that a more decentralized program produced less responsiveness to individual state needs for family planning, and that these effects could have been predicted from the previous period.


Health and perimenstrual symptoms: health outcomes for employed women who experience perimenstrual symptoms. This cross-sectional study describes physical health, psychological well-being, role satisfaction, and social support as reported by employed women who experience perimenstrual symptoms in comparison with employed women who do not experience perimenstrual symptoms. Both groups were similar in their employment and educational status. Yet, in addition to more physical health problems and a lower sense of psychological well-being, the symptomatic women were less satisfied with various aspects of their social lives and reported less social support. Results of this study provide empirical data from which to begin developing interventions directed toward the symptomatic woman's lifestyle and not just the specific perimenstrual symptom she experiences.


Women's perceptions about the way social roles promote or constrain personal nutrition care. Research suggests that roles may affect women's health promoting behavior. This study was designed to discover, understand and develop hypotheses about the ways in which women's social roles influence their attitudes and beliefs about personal nutrition care. In-depth interviews were conducted with 36 married mothers, both employed and homemakers, at three different life stages. Interviews were analyzed using the constant comparative method of qualitative analysis. These data suggest that social roles influence women's attitudes about personal nutrition care in both positive and negative ways; this influence is modified by women's changing interpretations of their family roles at different life stages. The results have important implications for the prevention of chronic disease among women.


Health beliefs and behaviors of Saudi women. This paper describes perceptions of familiarity with symptoms and beliefs about illnesses based on interviews with 50 Saudi women. The sample was young, with 82% under the age of 40, and not well educated by Western standards, with one-third being illiterate and 80% having no more than a primary school education. More than half lived in households of six or more. Although there was greater awareness of germs as causative factors in illness than previous studies in Saudi Arabia had demonstrated, beliefs in multiple causes, including religious beliefs about disease causation, persisted. There was an apparent lack of understanding of specific causes of various illnesses or of the rationale for preventive measures. This lack of understanding may be related to the low education levels and/or deeply ingrained cultural beliefs.


Atypical clinical manifestations of hepatitis A. Viral A hepatitis is a self-limited infection occurring predominantly among children usually as an anicteric often subclinical illness. Adults afflicted with this virus are more likely to develop icteric hepatitis. This is exemplified in developed countries when a common source outbreak occurs among non-immune adults. Fulminant hepatitis is uncommon in the USA and hepatitis A has never been documented to evolve into chronic hepatitis. However, prolonged cholestasis and relapsing hepatitis are well described. The usual features of cholestatic viral hepatitis A are pruritus, fever, diarrhoea, and weight loss. Serum bilirubin levels are > 10 mg/dl and the clinical course lasts at least 12 weeks. Cholestasis will spontaneously resolve, although corticosteroids will hasten the resolution but may predispose the patient to develop a relapse of the hepatitis. A biphasic or relapsing form of viral hepatitis A occurs in 6 to 10% of cases. The initial episode lasts 3 to 5 weeks and is followed by a period of remission characterized by normal liver chemistries lasting 4 to 5 weeks. Relapse may mimic the initial episode of the acute hepatitis. The full duration of the illness ranges from 16 to 40 weeks from the onset and immunoglobulin M antibody to hepatitis A virus persists throughout the clinical course. Hepatitis A virus has been recovered from stools during the relapse. Extrahepatic manifestations of hepatitis A include evanescent skin rash and transient arthralgias. Documented cases of arthritis and cutaneous vasculitis have been associated with cryoglobulinaemia and are rare.


Management of acute and fulminant hepatitis A. Symptomatic viral hepatitis A usually only requires supportive therapy and the majority of cases are managed in the community. The prodromal symptoms of nausea, anorexia and lethargy tend to improve with the onset of clinical jaundice. Fulminant hepatic failure is said to be an uncommon complication, occurring in only 0.14-0.35% of hospitalized cases. However, an increasing incidence has been documented in some northern European countries where up to 20% of cases of fulminant viral hepatitis is due to hepatitis A. This trend parallels the increasingly delayed exposure to hepatitis A and the increased severity of the illness when contracted in later life. The risk of developing fulminant hepatic failure is best monitored using coagulation factor assays, with the prothrombin time and factor V levels being the most favoured. The diagnosis is established with the onset of encephalopathy. Patients progressing to grade 4 encephalopathy have a reasonably good prognosis compared to other aetiologies and survival rates of up to 67% have been obtained with medical management, despite the co-existence of such complications as cerebral oedema, renal and respiratory failure and the metabolic sequelae of acute liver failure. Nevertheless, some patients require emergency liver transplantation and 10 such patients have been reported to date. Transplantation is especially required in older patients (> 40 years) and those who are jaundiced for > 7 days before the onset of encephalopathy. The serum bilirubin and the prothrombin time complement these parameters in the decision making process.


Epidemiology of hepatitis A: seroepidemiology and risk groups in the USA. Surveillance and seroepidemiological data are important in determining optimal hepatitis A vaccine strategies. In the USA, after a decade of declining rates, reported hepatitis A rates gradually increased from 9.2 cases per 100,000 population in 1983 to a peak of 14.4 per 100,000 in 1989. In 1991, 23,144 cases were reported, for a rate of 9.1 per 100,000. Since 1983, rates in males have been consistently 20% higher than in females. Rates in children, adolescents and adults up to 39 years old have been roughly equivalent and approximately threefold higher than for persons > or = 40 years old. Among reported cases in 1989, the most commonly reported risk factor was personal contact with a hepatitis A case (26%), followed by employment or attendance at a day-care centre (14%), a history of injecting drug use (11%), a history of recent international travel (4%), and association with a suspected food or waterborne outbreak (3%). Of cases, 42% had no known risk factor for infection. The prevalence of antibody to hepatitis A virus in the general US population was 38.2%, based upon testing of 9516 participants from the second National Health and Nutrition Examination Survey conducted from 1976 to 1980. Prevalence increased steadily with age, ranging from 11% in persons < 5 years of age to 74% in persons > or = 50 years old. Because some groups may be difficult to vaccinate prior to disease exposure (contacts of cases) or are difficult to reach (drug users or persons with unidentified risk), a selected risk group vaccination strategy may not be successful in reducing the disease burden in the USA.(ABSTRACT TRUNCATED AT 250 WORDS)


Hepatitis A in Swedish travellers.

Hepatitis A in Swedish travellers. The incidence of hepatitis A is very low in Sweden. It has been shown that the prevalence of antibodies to hepatitis A virus is 6.6% in individuals < 40 years of age and 1% in those < 20 years old. The number of reported cases of hepatitis A infection has declined from 628 in 1985 to approximately 250 during the last four years. The attack rate per 100,000 inhabitants has thus declined from 7.3 to approximately 3 during this period. The number of cases in travellers has been stable at approximately 140 cases per year during the period 1985-1990. About one-third of the cases are associated with travel to either Europe or Asia. Immune globulin has been widely used as prophylaxis but use has declined. Based on travel statistics and estimation of the use of immune globulin, a risk ratio was calculated for the relation between the number of travellers not receiving immune globulin and cases of registered hepatitis A infection. This risk ratio was > 50,000 for travel to the Mediterranean part of Europe, approximately 100 for travel to Africa and approximately 300 for travel to Asia.


Hepatitis A in Norwegian troops.

Hepatitis A in Norwegian troops. More than 40,000 Norwegian troops have served in various UN peacekeeping operations since 1947. Coming from an area with low natural protection against hepatitis A, this disease has been a major concern to military authorities planning peacekeeping operations. More than 50 individuals have been repatriated due to hepatitis A, causing additional cost to the operations. After introduction of standard passive immunization with 2 ml immune globulins, reasonable protection was obtained for a limited time despite increasing risk of infection.


Expression of influenza neuraminidase in baculovirus-infected cells. Recombinant influenza neuraminidase (NA, subtype 2, A/NT/60/68) was produced by recombinant baculovirus-infected insect cells. The recombinant NA retained enzyme activity and was located on the cell surface. Enzyme activity was both cell-associated and in the cell free supernatant; maximal NA activity was found in the supernatant. Recombinant NA was recognised by polyclonal antisera and by three monoclonal antibodies specific for NA (subtype 2). Enzyme activity was also neutralised by polyclonal antisera. Recombinant NA thus retains most of the immunological and activity properties of authentic influenza NA. Immunoprecipitation of [35S]Methionine-labelled cells and supernatant and partial purification of NA indicated that a approximately 50-kDa form of NA was present in the supernatant, whilst the expected size (approximately 67-kDa) was cell-associated. Purified recombinant extracellular virus was also enzymatically active, and contained the 67-kDa NA which was located on the membrane capsule of the virus. This suggests that the virus had acquired the cell-associated form of recombinant NA during the budding process from the cell.


Characterization of baculovirus-expressed hemagglutinin and fusion glycoproteins of the attenuated measles virus strain AIK-C. With measles virus cDNA of the avirulent vaccine strain AIK-C, two cDNAs of H or F genes were amplified by the polymerase chain reaction. The amplified cDNAs were inserted respectively to the baculovirus transfer vector pAcYM1 derived from the nuclear polyhedrosis virus of Autographa californica (AcNPV). After co-transfection of the transfer vectors with AcNPV DNA to Spodoptera frugiperda cells, recombinant baculoviruses were screened by plaque assay, and the viruses containing H-cDNA or F-cDNA were named H-AIK or F-AIK, respectively. By Western blot analyses, the band around 80 kDa and some smaller bands were appeared in the H-AIK infected S. frugiperda cells, and the band around 40 kDa was detected in the F-AIK infected cells. Immunofluorescence studies on unfixed S. frugiperda cells infected with H- or F-AIK recombinants showed that both antigens were transported to the cell surface. When green monkey red blood cells were added to the recombinant infected cells, H-AIK infected cells showed haemadsorption, and cells infected with F-AIK lysed the red blood cells. The recombinant proteins elicited the neutralizing antibodies against measles virus.


[Polymyalgia rheumatica and giant cell arteritis; diagnosis and side effects of low-dose long-term glucocorticoid therapy]. Due to good therapeutic results and few side-effects so-called "low-dose glucocorticoid therapy" (ldgc) with daily glucosteroid dosage below 10 mg prednisolone-equivalent has recently been recommended in managing polymyalgia rheumatica and giant cell arteritis. This fact is of important interest, since mean therapy time is often over a period of five years. An open-prospective study with 75 patients in a rheumatological unit was done in which different clinical histories were examined and glucosteroid side effects of 47 patients who had received therapy over six months were analyzed. Main side-effect shown was osteoporosis (n = 7), other known steroid-side effects were quite seldom (less than 5%). Dosage regimens and therapy monitoring criteria are proposed.


[Recording muscle spasm in the musculus erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies]. Using 31P nuclear magnetic resonance, the following parameters were determined in the resting musculus erector spinae of five patients suffering from chronic low back pain, five patients with fibromyalgia, and five healthy controls: Inorganic phosphate (Pi), phosphocreatine (PCr), ATP gamma, ATP alpha, ATP beta. The intracellular pH was derived from the chemical shift of Pi referenced to the PCr resonance. In addition, the Pi-Index was calculated according to the formula: Pi/(Pi + PCr). We discovered a tendency towards a shift of the Pi resonance in the alcalic direction, which was the larger, the stronger muscle spasm was found on palpation. The pH showed the most reliable relationship to the clinical status of muscle spasm. The surprising finding that there is no acidification within the spasmed muscle indicates that generalized hypoxia does not exist in this tissue. This has already been shown with PO2 measurements. An intracellular acidification is only recorded during maximal isometric contraction. Thus, ischemia cannot be responsible for pain experienced during muscle spasm.


[Regulation of dimethylbenzanthracene-induced P1-450 gene expression in human lung tumor cells in culture]. Dimethylbenzanthracene (DMBA) stimulates expression of P1-450 gene in human lung tumor cells (ChaGo). A concentration and time-dependent increase in the level of P1-450 specific mRNA sequences has been observed in ChaGo cells treated with sublethal concentrations of DMBA. The methylation pattern of "-CCGG-" sequence of most of the coding region and of the 3' end of P1-450 gene is not affected by such DMBA treatment; DMBA-treatment of the cell induces hypomethylation of only the 5' end "-CCGG-" sequences of the gene. These results demonstrate that DMBA-treatment of ChaGo cells induced increased expression of gene can be correlated to the increased degree of site specific hypomethylation of the internal "-C-" residues of the "-CCGG-" sequences located at the 5' end of the P1-450 gene. However, it is also possible to have other molecular mechanism of regulation.


[Determination of regional rate of glucose metabolism in lumbar muscles in patients with generalized tendomyopathy using dynamic 18F-FDG PET]. Generalized tendomyopathy (GTM), or fibromyalgia (FM), is a disease characterized by wide-spread pain in the musculoskeletal system which usually begins at a single site, e.g., as low-back pain or cervical syndrome, and develops into generalized pain over months or years. The disorder affects primarily women, beginning around the age of 35 and reaching its peak during or after the menopause. Its etiology is still unknown. Secondary forms are observed particularly in rheumatoid arthritis. In order to get more information on FM we determined the local metabolic rate of glucose in vivo in the skeletal muscle (lumbar region) with dynamic 18F-FDG positron emission tomography (PET). 2 healthy volunteers and 6 female patients with FM reaching in age from 31 to 53 years were scanned. As 18F-FDG PET scanning is a metabolic tool, it is crucial to observe standardized conditions of metabolic steady-state. We used, therefore, the hyperinsulinemic euglycemic insulin clamp technique to stimulate the myogenic glucose uptake under stable plasma-glucose levels. The local metabolic rates of glucose utilization were estimated with a non-linear least squares fit on the 3 compartment 18F-FDG-model. A lumped constant of 0.67 was assumed. Under glucose clamp conditions patients with FM showed a significantly (p < 0.001) lower metabolic rate of glucose (4.3 +/- 1.1) mumol/100 g tissue/min compared with normal volunteers (8.5 +/- 2.3 mumol/100 g/min). Due to a significantly (p < 0.005) increased glucose backflow from tissue into the vascular space (k2 in the kinetic model) the rate of phosphorylation was markedly reduced in patients with FM.(ABSTRACT TRUNCATED AT 250 WORDS)


Immunohistochemical studies of age-associated amyloid deposition in the joint of senescence-accelerated mouse (SAM). The senescence-accelerated mouse (SAM) is a murine model of accelerated senescence and consists of the senescence-accelerated prone mouse (SAM-P) and senescence-accelerated resistant mouse (SAM-R), the latter of which shows normal aging characteristics. SAM shows a high incidence of age-associated microscopic amyloid deposition in synovial joints and intervertebral discs and the lesion is histologically quite similar to that of humans. The amyloid fibril protein of these mice is well characterized as a murine systemic senile amyloid (ASSAM). Twenty SAM-P and three SAM-R mice were used for this immunohistological study. Synovial joints and intervertebral discs were stained by immunoperoxidase method (PAP) using anti-ASSAM and anti-mouse AA antibodies and compared with birefringence in a Congo-red-stained section. Positive staining was observed in annulus fibrosus of the intervertebral discs, blood vessels, synovia, and on the surfaces of the meniscus and articular cartilage, exactly at the same site where green birefringence in Congo-red staining was observed. Both ASSAM and AA existed in the articular structures of SAM and the incidence of AA was significantly correlated with systemic signs of inflammation at autopsy. Among blood vessels, synovium and articular cartilage, there was no one tissue where amyloid deposited earlier than others. It was postulated that amyloid is transported via synovial fluid as its fibrillar form or as a precursor and that it deposits on the surface of articular cartilage.


[A dynamic observation on the fate of samarium in mouse liver]. It is generally considered that the rare earth compounds are plasma membrane-impermeable, thus affecting the cells only on their surface. Recently, we found that after repeated injections to mice of large dose of samarium trichloride, a soluble compound of rare earth, samarium aggregates appeared in Kupffer cells and hepatocytes of liver. In this study, we aimed at observing the route by which samarium enters the liver cells and the process of the formation of samarium aggregates. Samarium trichloride was given to Swiss mice at one dose of 70 mg/kg intravenously. Thereafter, at different intervals from 15 min to 48 h after the injection, the samarium in liver was traced dynamically by electron microscopy and X ray microanalysis. From 15 min to 2 h both Kupffer cells and hepatocytes endocytosed samarium-containing particles and formed phagosomes, in which the ingested particles were progressively concentrated. Besides, the small phagosomes fused with each other. Phagocytosis was especially active in Kupffer cells. During the 4 h to 24 h many Kupffer cells were degenerated and broken. In hepatocytes the phagosomes gathered mostly around the bile canaliculi. Groups of highly electron-dense particles were found in the lumen of bile canaliculi, implying the excretion of samarium by bile. At the 48 h, the samarium-containing phagosomies were found still in both kinds of cells in the liver.


[The establishment of human anti-tetanus toxoid hybridomas with in vitro immunized human tonsil cells]. Human tonsil cells in vitro immunized with tetanus toxoid were fused with human-mouse heteromyeloma line RF to generate human-mouse hybridomas. Hybridoma 891112-50 was cloned and 2 subclones (891112-50-3 and -4) were obtained. The secreted antibodies from the subclones were antigen specific, since they did not cross react with three irrelevant antigens (OVA, TCS and F gamma G). The hybridomas were quite stable. After 13 passages in tissue culture flasks, they still retained their antibody secreting ability. From flow cytometry analysis the subclone 50-3 was more stable than the subclone 50-4. The human immunoglobulin contained in supernatant collected during regular passages was equivalent to 69.6 micrograms/ml.


The coexistence of mutilating rheumatoid arthritis, progressive systemic sclerosis and polycythemia vera--a case report. A 41-year-old patient with mutilating rheumatoid arthritis and progressive systemic sclerosis, who developed a chronic myeloproliferative disorder polycythemia vera was observed. Some of the pathogenetic aspects of this case with special respect to the function abnormalities of peripheral blood polymorphonuclear cells are analyzed.


Association of rheumatoid arthritis with Kartagener's syndrome in a patient with HLA-DR1-DR4-B27 haplotype. A case of severe seropositive rheumatoid arthritis associated with Kartagener's syndrome in a patient positive for B27, DR4, and DR1 has been presented. A number of immunological disturbances were observed, especially defective granulocyte function and depressed delayed hypersensitivity.


[Quantitative evaluation of the stability of antibody production by human-mouse hybridoma clones with flow cytometry analysis]. The paper described a method of quantitative stability analysis of antibody production by hybridoma clones with flow cytometry (FACS). Through FACS analysis the frequency of antibody-negative variants was measured. The rate of generation of antibody-negative variants/cell/generation (mu) could be calculated through Luria-Delbrück fluctuation analysis. The results showed that the value of mu was correlated to the antibody production of hybridoma clones: the larger was the mu value, the more unstable was the antibody production by the hybridoma clones. The experimental results suggested that the clone was stable if its mu value was on the magnitude of 10(-3), while the clone was not stable if its mu value was on the magnitude of 10(-2). According to requirements of single cell for FACS analysis and presence of a variety of methods for dispersing cell aggregates to single cells, the authors regard that this method is fully suitable for analysis of cells in suspension or even in the form of aggregate.


[Synthesis cloning and expressions in E coli of human insulin A and B chain genes]. Human insulin A and B chain genes were designed and synthesized by using a rapid and simple method. The synthesized A and B chain genes were cloned separately. The expression (plasmids) pWR 590-HIA and pWR 590-HIB were constructed, and the two plasmids can direct the synthesis of the approximately 590 amino acid-long truncated beta-galactosidases fused to human insulin A or B chains. The fused A or B chain proteins were isolated from the fermented cells and cleaved with BrCN. The resulting mixtures were sulfonated and the sulfonated A and B chains were purified. Human insulin was obtained by using an A and B chain combination method.


[Studies on the function of Ser579 and Arg580 in beta-subunit of penicillin G acylase with the method of site-specific mutagenesis]. According to the comparison of amino acid sequence between PGA (Penicillin G Acylase) and PBPs (Penicillin Binding Protein), We suggest that No. 565-595 peptide fragment in beta-subunit of PGA may be a substrate-binding site of enzyme. Plasmid pTZGA was constructed by cloning the 2.6 kb PGA gene of pWGA into phagemid pTZ18U The technique of site-specific mutagenesis was used to study the role of residue No. 579 (Ser) and No. 580 (Arg) of PGA. Four kinds of mutants were obtained (Ser579-->Gly579, Arg580-->Gly580, Arg580-->Glu580, Arg580-->Lys580), both Glu580 and Gly580 mutants showed no activity of enzyme and Lys580 mutant remained 30% and Gly579 mutant kept 70% activity of wilde type. The same protein expression of four mutants according to the results of ELISA indicate that mutation does not affect the expression of PGA, but Arg580 residue may be essential for substrate-binding or catalysis of PGA.


A probable involvement of rice allergy in severe type of atopic dermatitis in Japan. 1006 patients with typical and atypical lesions of atopic dermatitis (AD) were analysed statistically. The clinical severity was closely correlated to serum IgE values and RAST (radio-allergosorbent test) positivity. The frequency of RAST-positive antigens was significantly correlated with serum IgE values (gamma = 0.712; p < 0.01). The analysis of multiple correlation between the clinical severity and each RAST score for mite, egg white and rice antigens suggested a strong contribution of rice allergy to the development of severe AD. 25 patients with severe AD and positive rice-RAST were treated by rice exclusion diet. The results were as follows: 9 cases remarkably responsive, 10 cases moderately responsive and 6 cases unresponsive. The rice-RAST titre decreased most remarkably in the 1st group. The wheat-RAST titre also decreased in the 1st, in spite of taking wheat foods every day, but increased in the 3rd. A probable role of rice allergy in severe AD in Japan is discussed.


Mass trial of hypoallergenic rice (HRS-1) produced by enzymatic digestion in atopic dermatitis with suspected rice allergy. HRS-1 Research Group. The clinical usefulness of a hypoallergenic rice (HRS-1) which was produced by enzymatic decomposition of the constituent proteins of original rice was evaluated in a multicentre study in 44 subjects with recalcitrant atopic dermatitis (AD), who were suspected of having rice allergy. The subjects were fed for at least 4 weeks with HRS-1 instead of eliminating both regular rice and wheat from their daily diet. The extent of overall skin lesions was expressed by using the AD affected area and severity index (ADASI). A statistically significant decrease in ADASI was observed at the 2nd and the 4th week readings and at the end of the study. A provocation test with regular rice was carried out in 5 of 44 subjects following the HRS-1 therapy. An obvious increase in ADASI was found in all of these 5 cases just after this procedure. On final evaluation, 77% of the patients tested showed 'moderate' to 'remarkable' improvement, and 59% of the patients a 'moderate' to 'remarkable' reduction in use of the steroid ointment concomitantly used for the treatment. Finally, HRS-1 was evaluated as 'useful' or 'very useful' in 69% of the subjects.


Extreme dietary measures in the management of atopic dermatitis in childhood. Of 63 children with severe atopic dermatitis who were treated with a diet eliminating all but 6 foods for a 6-week period, 9 (14%) abandoned the diet, 21 (33%) completed the diet but did not benefit, and in 33 (52%) there was significant benefit. However, the outcome at 12 months was the same regardless of the response to the diet because of the tendency for dermatitis to markedly improve in all three groups. Of 37 children with exceptionally severe atopic dermatitis treated with an antigen avoidance regimen comprising hospitalization, exclusive feeding with an elemental formula for a median duration of 30 days, and measures to reduce exposure to pet animal and dust mite antigens at home, 10 (27%) either failed to respond to the regimen or relapsed within 12 months, and sustained improvement was seen in 27 (73%) patients. A few-food diet or a strict anti avoidance regimen may be associated with improvement of atopic eczema where conventional treatments have failed.


High-dose-UVA1 phototherapy: a novel and highly effective approach for the treatment of acute exacerbation of atopic dermatitis. High-Dose-UVA1 irradiation has recently been found to be a new, prompt-acting and highly effective phototherapeutic approach to the treatment of patients with acute exacerbation of atopic dermatitis. This therapeutic efficacy was demonstrated by a marked improvement of clinical symptoms as well as of laboratory parameters, which were found to reflect disease activity in atopic dermatitis. Investigation of the photoimmunological mechanisms responsible for the therapeutic effectiveness of this modality indicates that eosinophils and epidermal Langerhans cells may be targets for High-Dose-UVA1.


The treatment of difficult atopic dermatitis in childhood with oral beclomethasone dipropionate. Beclomethasone dipropionate (BDP) is a synthetic glucocorticoid with great topical potency. It has previously been demonstrated to be an effective treatment for childhood atopic dermatitis (AD) when given orally. We have monitored linear growth and adrenal function in a group of children treated with oral BDP for severe AD. Stable control of disease was achieved in 10/14 patients (mean dose: 1000 micrograms/day, range 800-1800). At this maintenance dose, there was evidence of deceleration of linear growth in 7/10 patients. There was no significant difference between pre-treatment 8 a.m. plasma cortisol levels and those on the maintenance dose. However, there was a reduction in 24-hour urinary cortisol excretion during maintenance treatment, although this did not reach statistical significance. We regard oral BDP as a useful treatment in widespread childhood atopic AD that has not responded adequately to topical therapy. However, it is mandatory that growth be monitored carefully during its use.


Successful treatment of therapy-resistant atopic dermatitis with clobetasol propionate and a hydrocolloid occlusive dressing. During recent years, 48 patients with therapy-resistant chronic skin lesions of atopic dermatitis have been treated once a week with clobetasol propionate lotion left under Duoderm occlusive patches. They had previously failed to respond, or responded only sparsely, to topical corticosteroids. The lesions resolved completely in 44 patients, while partial remission was observed in the remaining 4. The mean time needed to obtain complete remission was, for lichenifications, 2 weeks; pruriginous lichenoid papules, 12 days; chronic hand eczema, 2.5 weeks; nummular eczema, 8 days; perioral eczema, 11 days, and breast eczema, 10 days. Adverse experiences were mild and infrequent. The amount of topical corticosteroid required was reduced to at most one-twentieth and to as little as one-hundredth of the amount of common topical steroid treatment needed. We conclude that clobetasol propionate and Duoderm once a week is the best treatment for resistant lesions of atopic dermatitis.


Allergen-antibody complexes in the treatment of atopic dermatitis: preliminary results of a double-blind placebo-controlled study. Twenty-three adult patients suffering from chronic atopic dermatitis (AD) have been treated by regular injections of complexes made of D. pteronyssinus allergens and specific autologous antibodies. A double-blind placebo-controlled protocol was followed for 4 months, then the patients were treated openly to complete a full year on active therapy. Preliminary results are presented for the first 8 months. Seventy-three percent of patients improved when treated with complexes, showing a mean improvement of more than 70% after 4 months. This study suggests that injections of allergen-antibody complexes is an effective treatment of at least some forms of AD and confirms that airborne allergens are significant exacerbating factors of AD.


Recent epidemiological and genetic studies in atopic dermatitis. In a prospective computerized study, basic and minor features of atopic dermatitis were studied systematically in established cases of atopic dermatitis (AD; n = 428) and compared with subjects randomly collected from the caucasian normal population of young adults (NP; n = 659). Complete genetic data (history of AD, allergic rhinitis, allergic asthma) were obtained from the first-degree relatives of all subjects (about 9,000 family members). In young adults, atopy was found in 22.5% (AD 4.7%, allergic rhinitis 17.9%, allergic asthma 4.8%). Of 428 AD patients, 54% had 'pure' AD and 46% suffered from a 'mixed' type with concomitant respiratory allergies (RA). The general risk of developing AD and atopy increases with each first-degree family member already suffering from atopy. Our study further supports the evidence of a genetic influence on symptom specificity. Risk figures for genetic counselling are given. The complex interplay of atopic symptoms and signs in the diagnosis of AD has been analysed by a CART analysis. Compared with non-eczematous controls, the odds ratios (OR) of frequent features in AD are as follows: xerosis (OR 27.9, 95%-CI 23.2-33.8), itch when sweating (OR 25.4, 95%-CI 21. 1-30.1), white dermographism (OR 19.3, 95%-CI 16.2-23.2), wool intolerance (OR 15.8, 95%-CI 13.40-18.5), whereas the OR of elevated IgE (> 150 U/ml) was only 5.0 (95%-CI 4.3-5.8). But when comparing the AD patients with concomitant RA separately, the odds ratio is increased to 16.2.


Comparative effects of two topical antiseptics (chlorhexidine vs KMn04) on bacterial skin flora in atopic dermatitis. In order to determine the efficacy and tolerance of two topical antiseptics, chlorhexidine vs KMn04 (diluted at 1:20,000), we compared their bacteriological and clinical effects in a randomized trial on 20 children with Atopic Dermatitis (AD) treated with topical steroids (desonide). After treatment, a clinical improvement was noted in the two groups, though without statistical differences. In vivo: Before treatment, Staphylococcus aureus (S.A.) density was high and predominant in both groups. After treatment, the decrease in S.A. was greater in the chlorhexidine group than in the KMn04 group, without significant difference. In vitro: At the clinical dilution used, there was a statistical difference (p < 0.05) between the number of killed bacteria in the chlorhexidine group (-3 log) and the number in the KMn04 group (-1 log). This study confirms the role and importance of the choice of a topical antiseptic in the treatment of AD.


Re-evaluation of skin lesion distribution in atopic dermatitis. Analysis of cases 0 to 9 years of age. Distribution of skin lesions was studied in 1,012 patients under 10 years of age, with atopic dermatitis. Of these, 812 (80.2%) had an atopic history; 200 did not. Both categories were divided by age into five subgroups (3-5 months, 6-11 months, 1 year, 2-4 years and 5-9 years) and the incidence of lesions in each of 52 skin regions was compared between the positive and negative history groups and between different age groups. The results were as follows. 1. There was a change in predilection site, from the head (the scalp, face and peri-auricular area) to the neck and flexures (cubital and popliteal fossae) between 1 and 2 years of age. 2. The trunk (shoulders, chest, abdomen and back) was the most common predilection site in both infants and children. 3. Only the upper arm was affected more frequently on the external side than the internal side in all age groups. 4. The nose, mamillae, palms and feet were the least affected areas in all age groups. 5. Incidences in the positive history group were no higher than in the negative group.


Factors influencing the localization of atopic dermatitis. Atopic dermatitis is clinically characterized by the involvement of preferential sites. Some of these localizations, such as the face in the first year of life and later on the flexural aspect of the limbs, are constant and thus characteristic of atopic dermatitis. They are probably determined by factors that are identical for all subjects, whereas the less constant localizations are probably influenced by individual factors. The author discusses from a clinical point of view the factors that can influence localization and the lack of involvement of certain sites in atopic dermatitis. An unusual localization of atopic dermatitis, such as around congenital nevi, is also discussed.


The barrier function in atopic dry skin. Disturbance of membrane-coating granule exocytosis and formation of epidermal lipids? Non-eczematous atopic dry skin (DS) shows an enhanced transepidermal water loss denoting an impaired water permeability barrier (WPB) function. The WPB is formed by intercellular lipid lamellae located between the horny cells of stratum corneum (SC). The lipids are provided via the exocytosis of membrane-coating granules (MCG). By differentiating two dynamic states of MCG, the ultrastructural morphometric comparison of atopic DS and healthy skin of controls revealed a retarded and incomplete extruding mechanism of these organelles. Additionally the structure and spacial organization of the epidermal lipids in DS and healthy skin were visualized and analysed by applying a special primary fixation (acrolein vapour) and post-fixation with ruthenium tetroxide. The present findings suggest that some pathologic extruding mechanism of MCG in DS may be responsible, at least partly, for the recently detected biochemical alterations of epidermal lipids and for the deficient WPB.


ADASI score: atopic dermatitis area and severity index. The scoring system for atopic dermatitis presented is based on determination by point counting of involved body areas. On body diagrams, involved areas are colour-coded according to the severity of the skin changes and evaluated by applying a transparent grid. To obtain the ADASI score, the area fractions are weighted and multiplied by the intensity of the itching. The scoring values obtained are analysed by trend-and-time series analyses. These methods allow a clear statistical evaluation in each individual case. In a study on the effect of borage oil on atopic dermatitis, the value of this scoring system and of the statistical single-case analytic methods could be demonstrated.


The immunopathogenic role of food hypersensitivity in atopic dermatitis. Food hypersensitivity is reported to play an immunopathogenic role in atopic dermatitis in approximately one-third of children. In 320 selected children with moderate to severe atopic dermatitis, 63% of children were found to have food hypersensitivity by double-blind placebo-controlled food challenges. Both IgE-mediated mast cell and mononuclear cell activation appear responsible for the eczematous lesions resulting from ingestion of food allergens.


Type I allergy to foods in atopic dermatitis. Comparison between RAST-positive and RAST-negative cases. Radioallergosorbent tests (RASTs) with five common foods were performed in 183 patients with atopic dermatitis. The results showed that about half of the patients had type I allergy to at least one of the five foodstuffs. The RAST results correlated roughly to the severity of dermatitis. In each group of patients with mild, moderate and severe atopic dermatitis, positive RAST reactions to common foods occurred predominantly in patients who had a personal or a family history of respiratory atopy. Positive RASTs were rare in patients with pure atopic dermatitis who had neither personal nor family history of respiratory atopy. It seems likely that type I food allergy occurs predominantly in those patients with atopic dermatitis who have a predisposition to respiratory atopy.


Food immediate-contact hypersensitivity (FICH) and elimination diet in young children with atopic dermatitis. Preliminary results in 107 children. In atopic dermatitis [AD], not only food consumption, but direct skin-contact too can provoke hypersensitivity reactions. We imitated food immediate-contact hypersensitivity [FICH] to cow's milk, egg, peanut or soy by a skin provocation test. This skin application food test [SAFT] was applied in 91 patients aged up to 5 years and suffering from AD, and in 16 healthy controls (all SAFT-negative). In the SAFT-positive patients (n = 61), FICH to egg was observed in 72%, to cow's milk in 47%, to peanut in 34% and soy in only 1 patient. SAFT and RAST scores correlated weakly. Nevertheless, many discrepancies between SAFT and RAST results were found. In 20 of the 61 (33%) patients with FICH, a flare-up in AD was noted at SAFT testing. Upon introducing dietary restrictions, AD improved impressively in 9 of 23 patients who could be followed up. FICH is an important symptom in children with AD and food allergy.


Study of immune-responsiveness to wheat antigen by IgG, IgA, and IgE immunoblotting with sera from patients with atopic dermatitis. To investigate the immune mechanism underlying the IgE-mediated hypersensitivity to food antigens, wheat-flour proteins were extracted in mild condition, and IgG antibodies were detected by the ELISA method. Atopic dermatitis patients who had high scores for IgE-RAST were shown to have increased levels of IgG antibodies to wheat proteins. To define the allergenic polypeptides or epitopes in wheat proteins, each patient's serum was subjected to determination of IgG, IgA, and IgE antibodies to each protein component, using a highly sensitive immunoblotting method. Low molecular weight polypeptides bind specifically IgG, IgA, and IgE antibodies in serum from atopic dermatitis patients. Thus, there are specific components or epitopes in wheat proteins which are closely related to the disease states.


Lymphocyte transformation test for house dust mite in atopic dermatitis: relationship between mite antigens for type I and type IV allergy. Using a crude extract obtained from Dermatophagoides farinae, and its four fractions (I, II, III and IV) partially purified by high-speed gel filtration chromatography, scratch tests and lymphocyte transformation tests (LTTs) were performed on 37 patients with atopic dermatitis. Crude mite antigen provoked positive scratch test reactions in 25 (68%), and positive LTT reactions in 19 (51%) of the 37 patients examined. Mite antigen fractions I, II, III and IV induced a positive LTT reaction in 19, 22, 17 and 7 patients, respectively. Of the 65 positive LTT reactions, 25 accompanied a positive scratch test to the antigen fraction which provoked the positive LTT reaction, but 40 accompanied a negative scratch test. These findings suggest that house dust mite antigen fractions for type IV allergy are different from those for type I allergy in a considerable proportion of patients with atopic dermatitis.


IgE-binding molecules on human Langerhans cells. We have recently demonstrated that normal human Langerhans cells are able to bind IgE. The study of IgE-binding molecules on normal LC led to the characterization of three distinct structures able to bind IgE, viz. the low affinity receptor for IgE, Fc epsilon R2/CD23, the so-called IgE-binding protein epsilon BP which is the human homologous of the murine Mac-2 antigen, and finally the high affinity receptor for IgE, Fc epsilon RI. In this review, we summarize the most recent data on these structures and their putative physiological relevance is discussed with regard to the atopic disease.


Positive antinuclear antibody in atopic dermatitis. Serum samples from atopic dermatitis (AD) patients were examined with two antinuclear antibody-detecting methods, using HEp-2 cells as substrate. 34.0% of 47 AD patients tested with FITC-conjugated polyvalent immunoglobulins (method 1) had positive antinuclear antibody (ANA). 26.3% of 57 AD patients examined with FITC-conjugated anti-IgG (method 2) had positive ANA. We found that AD patients who had facial lesions tended to have positive ANA, whereas severe AD patients tended to have high titres of ANA.


Study of circulating immune complexes in atopic dermatitis. The authors examined sera from 92 patients (78 adults, 14 children) with atopic dermatitis (AD), for the presence of circulating immune complexes (CIC). Using the PEG precipitation technique they found an increase in CIC total protein. In the quantity of precipitated proteins, elevated IgA and IgG levels and decreased C3 in CIC were measured. Neither the acute nor the subacute stage of the disease, nor skin involvement, correlated with CIC. In increased content of CIC was found in patients who had AD with associated disease recurrent infections, recurrent conjunctivitis, asthma, allergic rhinitis) and especially with pustulosis varicelliformis Kaposi, i.e. eczema herpeticatum. The T lymphocytes, together with other surface complement receptor-positive cells, are able to induce CIC production and keep them in solution.


Secular change in the occurrence of atopic dermatitis. Atopic dermatitis is a common disease, and population-based studies indicate that the frequency of atopic dermatitis has increased substantially during recent decades. It has been generally accepted that disease onset occurs before 7 years of age in 80-90% of the cases, and consequently the epidemiology of atopic dermatitis has been studied mostly in children on admission of first grade school. Before 1960 about 2-3% of children suffered from atopic dermatitis. In the 1960s, some 4-8% was recorded in several studies, and for those born after 1970 most researchers found that 9-12% developed atopic dermatitis during childhood. The diagnostic criteria of Hanifin and Rajka are cumbersome for population studies not designed specifically for children. In order to compare epidemiologic data from varying times and locations, a framework for questionnaire studies in atopic dermatitis is proposed.


The relationship between allergy, clinical symptoms and bronchial responsiveness in atopic dermatitis. Atopic Dermatitis (AD) and asthma are closely associated with respect to epidemiology, hereditary factors and occurrence in the same individuals. Bronchial Hyperresponsiveness (BH), the hallmark of asthma, can also be a physiopathological feature of AD, even in the absence of clinical asthma. We studied 78 subjects with AD. A follow-up study was performed in 27 of these. Data on respiratory and dermatologic symptoms were collected by means of a standardized questionnaire. Skin reactivity was evaluated by prick testing, and in 57 subjects BH was assessed with a methacholine test (Mch). Twenty-one subjects had asthma and 36 showed a positive skin reaction. A PC20 FEV1 was measurable in 38 subjects. Males were found more likely to be Mch responders than females (p < 0.05). Mch responders also showed an earlier age at onset of AD than nonresponders (2.1 yrs vs. 6.2, p = 0.03). Determinants of the degree of BH were evaluated by a stepwise multiple regression analysis, taking the log of the slope of the concentration response curve as dependent variable. In the final model we found that the degree of BH was directly related to wheezing (p = 0.0017) and coughing (p = 0.04) and inversely related to lung function (p = 0.0082) and age (p = 0.0008). Neither skin reactivity nor grading of AD were statistically significant. The longitudinal study demonstrated that the courses of AD and BH seem to run parallel only in skin-negative subjects, whereas an increase in BH was observed in skin-positive subjects.


Mast cell invasion of peripheral nerve in skin lesions of atopic dermatitis. To ascertain whether or not a spatial relationship between mast cells and peripheral nerves is present in skin lesions of atopic dermatitis, 10 biopsy specimens of the skin lesions were examined with both semi-thin and ultrathin serial sections. Mast cell invasion of peripheral nerves was observed in 9 out of the 10 biopsy specimens (4 subacute lesions, 3 lichenified lesions, and 3 prurigo lesions). The mast cells within peripheral nerves often showed degranulation, and the nerve fiber bundle showed conspicuous edema. The degranulation of mast cells within peripheral nerve bundles and edema of the nerve bundle may pay a role in provoking or aggravating itchiness of atopic dermatitis.


Are disturbances of omega-6-fatty acid metabolism involved in the pathogenesis of atopic dermatitis? Recent evidence indicates that the primary defect in atopic dermatitis (AD) might concern the maturation and differentiation of T cells which infiltrate the skin or are unable to control T cell infiltration of the skin. Unfortunately, there is no information on thymus hormones, T cell differentiation factors or cytokines during early T cell maturation in atopic infants. One of these factors at fault might involve a deficiency of essential long-chain omega-6-fatty acids and E-type prostaglandins which are important for thymic T cell maturation and thymus hormone action. Deficiencies of 6-desaturated omega-6-fatty acids have been observed in plasma phospholipids, epidermal and red cell phospholipids of patients with AD, in umbilical cord plasma lecithin of newborn infants with increased cord blood IgE levels, in cord blood T-cells of 'atopy-at-risk' newborn infants, in atopic monocytes, in adipose tissue lipids of patients with AD, in breast milk lipids of mothers with a history of AD, and in breast milk lipids of mothers of infants with AD. Reduced release of arachidonic acid has been measured in atopic monocytes and platelets. Diminished formation of prostaglandin E2 (PGE2) has been observed in atopic monocytes under stimulated and unstimulated conditions and in inflamed and non-inflamed atopic epidermis. PGE2 is able to suppress interleukin 4-induced IgE synthesis of human non-atopic mononuclear cells in vitro. We have demonstrated a suppressive effect of PGE1 and PGE2 on in vitro IgE synthesis of mononuclear blood cells of patients with AD and respiratory allergies.(ABSTRACT TRUNCATED AT 250 WORDS)


Abnormalities of cutaneous microcirculation in atopic eczematics. There are signs of abnormal microcirculation in atopics, yet reliable methods for its non-invasive measurement are scarce so far. Since the phenomenon of dermographism (D) elicited by blunt stroking of the skin reflects the functional response of cutaneous vessels to pressure, we studied the haemodynamics of D using laser-Doppler microfluxometry (LDF) and infrared thermography (IR-TH) in patients with atopic eczema (n = 23) and in healthy controls (n = 21) under standardized investigative conditions. Only in-patients not treated with corticoids were selected. LDF values showed a marked reduction in the intensity of hyperaemia in the patients as compared with the controls, according to the visual degree of the dermographic blanching effect (white, delayed white, indifferent; pink). A reduction of the radiating skin temperature vis-à-vis the controls was measured by IR-TH. These results yield evidence that dermographic pallor of atopic skin depends on the strength of local vasoconstriction, possibly including altered blood flow in cutaneous shunt vessels.


Allergic contact dermatitis in atopic dermatitis. Of 73 adult patients attending a clinic specially provided to treat patients with atopic dermatitis, 31 (42%) showed one or more positive patch reaction on contact testing. There was a striking female preponderance in the patch test positive group (26F:5M) in contrast to those with negative test results (9F:17M). The commonest allergens identified were fragrances in 13 patients, nickel (7), rubber (5), lanolin (4) and formaldehyde (3). In 21 patients, topical preparations, cosmetic or medically prescribed, could be implicated. Contact sensitivity seems to be relatively common in adult patients who have a continuing problem with their atopic dermatitis. Recognizing this sensitization may be important in their management.


Effect of short-term egg exclusion diet on infantile atopic dermatitis and its relation to egg allergy: a single-blind test. A unique, single-blind, controlled trial of egg exclusion was performed in infants under 3 years of age, with atopic dermatitis, and/or their breast-feeding mothers. All subjects were put on an exclusion diet, but assessment of the effect of egg exclusion was made without knowing the results of allergy the tests. Results showed that there was a statistically significant correlation between the effect of egg exclusion and egg allergy, but only in infants 3-6 months old. Combination with other allergies did not seem to affect the results at this age. These findings indicate that egg exclusion is effective in ameliorating skin symptoms of atopic dermatitis only in early infancy and in the presence of egg allergy, irrespective of combination with other food allergies. This may be correlated to high RAST scores to egg at this age.


Review of chemosystematics: multivariate approaches to oral bacteria and yeasts. There are several problems related to the classification and identification of bacterial and yeast species assigned to the genera Actinobacillus, Haemophilus, Pasteurella, Bacteroides, Prevotella, Porphyromonas, Campylobacter, Wolinella, Treponema, Candida, Torulopsis, and Saccharomyces, most of which belong to the resident oral microflora. The present review was written to demonstrate how multivariate analyses of data on cellular fatty acids, sugars, enzyme activities, and lysis kinetics during ethylenediaminetetraacetic acid (EDTA) and EDTA plus lysozyme treatment can be used to distinguish closely related species of these bacterial and yeast genera. With the exception of the Actinobacillus-Haemophilus-Pasteurella group, fatty acids were more discriminating than sugars. Enzymes from whole cells and outer membrane vesicles also contributed to taxonomic distinction. Apparently, chemosystematics, involving multivariate analyses, is a useful adjunct in oral microbial taxonomy.


The effect of ovariectomy on dentin formation and caries in adult rats. Since acute osteoporosis is known to enhance bone remodeling and osteoid formation, it may also affect dentin apposition. We induced osteoporosis in 15-week-old Wistar rats by ovariectomy and dental caries by Streptococcus sobrinus infection in the presence of either a high sucrose (cariogenic) diet or a non-cariogenic diet. Intact animals with the same diets served as controls. After 99 days of cariogenic challenge the rats were killed, and the success of ovariectomy was confirmed by failure to detect ovarian tissue and observation of marked atrophy of the uterine horns. Areas of dentinal apposition during the experiment and carious lesions were quantified with a tetracycline method. Ovariectomy activated dentin formation significantly in rats fed either a high-sucrose or a non-cariogenic diet, indicating enhanced odontoblast function. The rate of dentinal apposition in adult rats was smaller than reported in young animals. The effect of ovariectomy on caries remained negligible.


The effect of phenytoin medication on dentin apposition, root length, and caries progression in rat molars. To determine the effect of phenytoin (PHT) on dentin apposition and the rate of caries progression in dentin, 40 Wistar rats were treated daily for 35 days with intraperitoneal injections of 5,5-diphenylhydantoin. Twenty-eight controls received saline with pH adjusted to that of PHT. One PHT and one control group were fed a 43% sucrose diet, and the others a non-cariogenic pellet diet. Streptococcus sobrinus was inoculated to induce caries. Schiff staining was used to determine caries. The areas of dentin apposition and dentinal caries lesions were quantified after tetracycline staining. The root lengths were measured. PHT reduced slightly the dentin apposition and activated significantly the progression of the dentinal carious lesions. No difference in caries initiation was found. The high-sucrose diet reduced dentin apposition and increased the rate of progression of existing caries greatly. Our study suggests that both the high-sucrose diet and PHT have an effect on secreting odontoblasts, which can be seen as an alteration in dentin apposition and caries progression rates in dentin.


Adaptation of resin facings to cast gold alloy restorations in the mouth. The occurrence of marginal spaces between the resin facing and gold alloy framework in 176 crowns and bridge retainers was studied. The restorations were made for canine teeth. The assessment of spaces at the cervical alloy-resin junction was carried out by examining slides of the buccal surfaces taken after application of disclosing agent. Spaces at the incisal alloy-resin junction were assessed by examining resin models under the stereomicroscope. Randomly selected restorations were grouped and examined with reference to length of clinical service (1, 3, 6, and 9 years). The methods were tested for reliability and consistency. The results showed that the frequency of cervical spaces tended to increase with length of clinical service, whereas the frequency of the incisal spaces seemed to remain unchanged. The most severely worn facings had the highest frequency of cervical spaces. In contrast, the least worn facings seemed to have the highest frequency of incisal spaces. For both the cervical and the incisal spaces the highest frequencies were found for relatively long resin facings.


Clinical evaluation of preventive and class-I composite resin restorations. This study was initiated in 1986 in response to increased interest in restorative procedures favoring preservation of tooth substance and in the search for alternatives to dental amalgams. Eighty-seven preventive resin restorations in permanent molars and 35 occlusal composite resin restorations in primary molars (limited size) and 13 in premolars were followed up for 2 years. They were placed by a large number of operators, mainly dental students under supervision, and rated by five calibrated instructors in accordance with an internationally accepted system for the evaluation of the clinical performance of dental materials. One composite resin (Occlusin) was used. A survival model was used to calculate the cumulative theoretical number of successful treatments of children who had dropped out. For none of the 6 clinical variables was the success rate lower than 91%, and only 3 of 26 failures were of a nature requiring remake or correction. The failures occurred, with a few exceptions, during the 1st year of observation. The two types of restoration have thus proved to be efficient treatments fulfilling all reasonable requirements in modern operative dentistry.


Prosthodontic claims in the Swedish Patient Insurance Scheme. The Swedish Patient Insurance Scheme includes a guarantee insurance for prosthetic treatment. Retreatments of failures, up to 2 years after cementation of fixed prosthodontics and 1 year after delivery of removable prosthodontics, are covered by the guarantee insurance scheme. Almost all private practitioners were included in this scheme at the time of the study in 1989. During a specific period all claims were studied at the time of reporting, when annexed radiographs and so forth could be analyzed. One hundred and thirty-six claims were recorded with regard to treatment injury, reasons for remake, latency times from cementation or delivery to diagnosis, and details about the teeth or constructions involved in the claim. The dentist's opinion of the cause of the failure was also recorded. The reports covered treatment injuries, most of them root perforations during preparation for a post. The guarantee claims for single crowns concerned porcelain fractures, loss of retention, and root fractures as the most frequent failures. For fixed partial dentures the failures were recorded as loss of retention, porcelain fractures, tooth or root fractures, and metal framework fractures in that order. The dentist gave information about his/her opinion of the reason for the failure in only 38.5% of the claims. There were, however, no clear findings about the reasons for the failures.


Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study. Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.


Accumulation of cholesteryl ester in atherosclerotic lesions. This article reviews aspects of the molecular pathology of cholesteryl ester accumulation in atherosclerotic lesions. 1. Transcytosis of lipoproteins through a cultured endothelial monolayer. 2. Effects of platelets and PGI2 on intercellular transport of endothelial cells. 3. Transformation of macrophages to foam cells. 4. Cholesteryl ester deposition in the extracellular space of atherosclerotic lesions. The development and use of novel monoclonal antibodies recognizing atherosclerotic lesions and peroxidized lipoproteins prepared from then are also discussed.


Atypical adenoma of the thyroid. A clinicopathologic and flow cytometric DNA study in comparison with other follicular neoplasms. A clinicopathologic and DNA flow cytometric study was performed on seven patients (three males, four females) with atypical adenoma of the thyroid gland, using formalin-fixed paraffin-embedded tissues. The results were compared with those of 30 follicular adenomas and 13 follicular carcinomas. The patients ranged in age from 32 to 74 years (mean; 55.8 years), and the mean follow-up period was 11.0 years. All patients except two who died of other diseases were free of thyroid disease after initial surgery. It showed that there was no evidence of clinical cancer in this follow-up study of patients operated on for atypical adenomas. Four of the atypical adenomas were diploid, two were aneuploid, and one was tetraploid. Twenty-seven of the 30 follicular adenomas were diploid. Three patients with aneuploid follicular adenoma were free of disease. Of the 13 follicular carcinomas with a mean follow-up period of 6.9 years, five were diploid, seven were aneuploid, and one was tetraploid. Two patients with aneuploid follicular carcinoma and one with diploid carcinoma developed lung metastases, and one patient each with diploid and aneuploid follicular carcinoma died of disease. There was no significant correlation between histologic features, ploidy status and prognosis among follicular carcinomas. The results of this study suggest that DNA flow cytometric analysis is not a useful tool for predicting the clinical behavior of follicular neoplasms.


Prognostic value of N-myc oncogene amplification and S-100 protein positivity in children with neuroblastic tumors. Data on 43 neuroblastic tumors (30 neuroblastomas and 13 ganglioneuroblastomas) obtained from 22 untreated and 21 pretreated children, were analyzed to determine the correlation between N-myc oncogene amplification and immunohistochemically identified S-100 protein positivity. Sixteen patients in whom the tumor showed significant amplification of N-myc (more than ten copies) died, irrespective of S-100 protein positivity and other conventional factors. Among 27 patients with low amplification of N-myc (less than ten copies), the estimated progression-free survival for those whose tumors had numerous S-100 protein-positive cells (P group), and few or no positive cells (N group) was 75% and 17%, respectively (p < 0.0001). Thus, in addition to N-myc oncogene amplification as a reliable indicator of outcome, S-100 protein positivity should be useful for prediction of prognosis in children with neuroblastic tumors showing low amplification of N-myc. Correlations among these results and other clinical factors are briefly discussed.


Immunohistochemical study of transforming growth factor beta, fibronectin, and fibronectin receptor in invasive mammary carcinomas. Thirty-one cases of mammary carcinoma were examined immunohistochemically for the expression of transforming growth factor (TGF) beta, fibronectin (FN) and fibronectin receptor (FNR) in order to clarify the reason for the reported relationship between TGF beta expression and a high incidence of lymph node metastasis. It was revealed that TGF beta expression is closely related to the expression of FN, an intercellular matrix protein, and its cellular receptor FNR, one of the integrins. The interaction between FN and FNR in a tumor is considered to form the basis of the invasive nature of carcinoma cells. Thus, it is suggested that TGF beta expression in carcinoma cells induces the interaction between FN and FNR, which may lead to carcinomatous invasion resulting in lymph nodal metastasis.


An autopsy case of Crow-Fukase (POEMS) syndrome with a high level of IL-6 in the ascites. Special reference to glomerular lesions. A 58-year-old man developed polyneuropathy, organomegaly, gynecomastia, skin pigmentation, and multiple myeloma (IgG-lambda type). Although transient clinical improvement was obtained with prednisolone and cyclophosphamide, his general condition deteriorated progressively, and he died 3 years after onset. Lymph nodes showed angiofollicular hyperplasia, and the sural nerve revealed segmental demyelination. At autopsy, the glomeruli were enlarged and showed mild mesangial cell proliferation with segmental mesangiolysis and proliferation of endothelial cells forming abnormal vessels. The massive volume of ascites contained a high level of interleukin-6 (IL-6). IL-6, a multifunctional cytokine, may be the pathogenic factor which induces the various clinical symptoms and pathological features of Crow-Fukase (POEMS) syndrome.


Wegener's granulomatosis. Associated with diffuse pulmonary hemorrhage. The authors report a case of Wegener's granulomatosis with the unusual manifestation of diffuse pulmonary hemorrhage. A 58-year-old man complained of bloody sputum and fever. Chest X-ray films showed multiple nodular shadows in both lung fields. He was diagnosed as having Wegener's granulomatosis by transbronchial lung biopsy, which revealed necrotizing granulomatous inflammation with necrotizing vasculitis. Despite treatment with cyclophosphamide and prednisolone, his condition rapidly deteriorated. An extensive diffuse alveolar shadow appeared in both lung fields in chest X-ray films, anemia became worse, and he died of respiratory failure. Autopsy revealed diffuse alveolar hemorrhage with necrotizing capillaritis in addition to the typical pathological findings in Wegener's granulomatosis. The capillaritis was characterized by neutrophilic infiltration of alveolar septa, and fibrin thrombi in alveolar capillaries. Diffuse pulmonary hemorrhage is uncommon in Wegener's granulomatosis. However, once diffuse pulmonary hemorrhage occurs, the respiratory condition rapidly deteriorates and is life-threatening. Therefore, accurate diagnosis and appropriate treatment are required.


Case report of primary cardiac lymphoma. The applications of PCR to the diagnosis of primary cardiac lymphoma. A 75-year-old man initially complained of pollakiuria and low abdominal pain, and died of massive bleeding from an exacerbated gastric ulcer. The diagnosis of primary cardiac lymphoma was made postmortem. The tumor involved only the epicardium and myocardium, which met the criteria of primary cardiac lymphoma as defined by the Armed Forces Institute of Pathology. The lymphoma consisted of large cells and expressed the B cell marker, CD20. Although chronic inflammation due to chronic renal failure was observed in the pericardium around the lymphoma, polymerase chain reaction (PCR) was conducted to detect monoclonality at the DNA level in lymphoma cells, which were shown to comprise a monoclonal population.


Extramedullary plasmacytoma of the thyroid, associated with follicular colonization and stromal deposition of polytypic immunoglobulins and major histocompatibility antigens. Possible categorization in MALT lymphoma. A 78-year-old woman complaining of a neck mass underwent right hemithyroidectomy. The 7 x 6 cm thyroid tumor consisted predominantly of mildly atypical, epithelial membrane antigen-positive plasma cells and scattered lymphoid follicles. Features of follicular colonization (plasma cell infiltration into germinal centers) were noted. Numerous CD45RO-positive reactive T cells and a smaller number of CD20-positive blast-like B cells were also distributed among the plasma cell infiltrate. IgG, kappa-type monoclonality with J-chain reactivity was identified in the plasma cells, including those in the lymphoid follicles. The association of pre-existing lymphocytic thyroiditis was confirmed histologically in the non-tumorous thyroid tissue. The tumor exhibited deposition of reticulin fiber-rich, amorphous eosinophilic substances, provoking pronounced foreign body reactions. The deposit, polytypically immunoreactive for immunoglobulin gamma-, mu-, kappa- and lambda-chains, beta 2-microglobulin and HLA-DR, was scarcely reactive upon amyloid staining, and consisted ultrastructurally of electron-dense, non-fibrillar material and entrapped collagen fibers. Multiple myeloma was ruled out by laboratory, histologic and clinical examinations. The possible categorization of this extramedullary plasmacytoma of the thyroid within low-grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) is discussed.


[Scanning and transmission electron microscopic studies of the ultrastructure of the corneal endothelium in developing human eye]. The ultra-microstructure of the human corneal endothelium was examined by scanning and transmission electron microscopy. The samples were corneas of 26 human eyes taken from fetuses of 5-22 weeks gestation and a newborn 10 months after birth. Corneal endothelium appeared at the seventh or eighth week after gestation. Initially, they formed an irregular structure of two to three layers. From the 17th week of gestation they formed a single layer, and assumed the form of a cuboidal epithelium. Scanning and transmission electron microscopy showed numerous microvilli protruding towards the anterior chamber. Within the microvilli uniform microtubules were observed. By the 20th week, these microvilli disappeared, and subsequently, a single long narrow cilium appeared in the center of each cell. Each cilium had an axial filament complex structure. This cilium involuted as development progressed, and was barely visible by the 10th month after birth. The significance of this cilium is not clear.


[Changes in sulfated proteoglycans in alkali injured rabbit cornea]. Morphological changes of sulfated proteoglycans (S-PGs) in the stroma of alkali injured rabbit corneas were examined electron-histochemically following cuprolinic blue (CB) dye binding. The injured eyes were followed for 2 months by slitlamp microscope and photographs. At 1 hour, 3 days, 1 week, 2 weeks, 1 month, and 2 months after the injury, the eyes were enucleated and studied. After 1 hour, while both collagen fibrils and the filaments of S-PGs had already become disarranged; the number of S-PGs appeared to decrease. From 3 days to 1 week after, the number as well as the electron-density of S-PGs were markedly decreased in all areas. After 2 weeks, CB-positive large filaments appeared in anterior stroma. These became larger, more abnormal in shape, and displayed a higher electron density 1 month later. Normally arranged S-PGs can be seen at 2 months later. It was concluded that S-PGs were diminished in alkali-injured corneas. Once they were replaced by abnormal filaments, they gradually recovered normal morphology. Further more the time course of S-PG change correlated with that of corneal transparency after alkali injury.


[Histological study of a model of keratoepithelioplasty in the rat]. A model for keratoepithelioplasty (KEP) was developed using the Lewis rat, and histological studies were performed using the model. The entire corneal epithelium was removed using a spatula and a 1.5-mm-width of the conjunctiva including the limbus was excised. An oval corneal lamellar graft (3 x 1.5 mm) with an intact epithelium taken from another Lewis rat was transplanted on the denuded limbus. Biomicroscopic observation showed significantly less vascular invasion in the part of the cornea adjacent to the lenticule than in other part of cornea, and clear cornea was maintained in the cornea adjacent to the lenticule. Histologically only few vessels were recognized in the lenticule, and the epithelial cells on the lenticule showed histological characteristics of corneal epithelium. These results indicate that surgical function of KEP can be obtained because the lenticules keep distance between corneal epithelium and conjunctival vessels. And it is also confirmed that this model is useful in research on the pathophysiological mechanism of KEP.


[The localization of aldose reductase mRNA in the rat lens]. The localization of aldose reductase (AR), which is thought to be involved in the pathogenesis of sugar and galactosemic cataracts, has been studied using various methods. The AR exists in the lens and its presence is considered to be important at the site of the cataractogenesis. In this study, the localization of AR messenger RNA (ARmRNA) in the lenses of 3-week old and fetal rats was studied by in situ hybridization using a complementary DNA to the rat AR gene. In the lens of 3-week-old rats, ARmRNA was present in the lens-epithelium and the equatorial superficial cortex. The distribution profile was similar to that of AR-immunoreactivities revealed by an immunocytochemical study. In the fetal lens, however ARmRNA was present in the epithelium and the equatorial region, while AR-immunoreactivity was observed mainly in the center of the lens.


[Effects of pre-instilled mydriatics on the intraocular concentration and anti-inflammatory action of topical 0.1% pranoprofen (3)--study on permeability factor]. The authors studied a mechanism of an increase in intraocular concentration of topical 0.1% pranoprofen (PPF) induced by pre-instilled mydriatics (0.5% tropicamide and 0.5% phenylephrine) in rabbit eyes. Ingredient solutions of mydriatics were instilled 60 minutes prior to instillation of PPF. The PPF concentrations in the cornea, aqueous humor and iris-ciliary body did not increase with pre-instilled benzalkonium chloride, chlorobutanol and tropicamide. The PPF concentrations were increased by pre-instilled phenylephrine (PHE), and the concentrations were 2 to 3 times higher than those without mydriatics. The PHE concentration in the aqueous humor was increased about 3 times in the presence of PPF. The octanol/water partition coefficient of PPF was increased in the presence of PHE. These data indicate that the increase of intraocular PPF concentration by the pre-instilled mydriatics was caused by PHE, and the enhancement of transcorneal permeability to PPF may have resulted from the formation of ion-pair complexes between PPF, an anionic drug, and PHE, a cationic drug.


[Spectral absorption characteristics of ocular tissues]. We studied the ocular spectral characteristics of monkey and rabbit eyes in the range of 300 to 900 nm. Measurements were performed on dissected specimens of the cornea, lens, vitreous, sensory retina and retinal pigment epithelium (RPE) plus choroid. Xanthophyll and monkey blood were also studied. Components of the ocular media showed high absorption over the ultraviolet range. The absorption curve of the sensory retina was similar to that of the ocular media. RPE plus choroid showed high absorption over the whole spectral range, with gradual decrease in absorption above 600 nm. The specific absorption curve of both xanthophyll and blood became manifest only when diluted to more than 1:20,000 in the former and to more than 1:100 in the latter. The spectral absorption of the ocular tissue thus became specific only when the thickness or density of the tissue was within a certain range.


[Dye leakage in indocyanine green fundus angiography of a laser photocoagulated lesion]. Argon green laser photocoagulation was performed on adult pigmented rabbit eyes at various intensities (parameters:500 microns spot size, 0.2 sec. exposure, and 70-, 100-, 150- and 200-mW power levels), and fluorescein and indocyanine green (ICG) angiography was performed within one hour after coagulation. Each coagulum of ICG angiography was hypofluorescent in the early phase and brightly fluorescent in the late phase. The fluorescein and ICG dyes spread from the periphery to the center in the moderate and large coagula. The characteristic finding of ICG angiography was expansion of ICG dye around the coagulum, regardless of the degree of the coagulation. This ICG leakage was intra-choroidal because there was no fluorescein dye leakage around the coagulum. We concluded that the ICG dye leakage shows damage to the choroidal vessels due to laser photocoagulation, and is not related to the barrier function of the retinal pigment epithelium.


[Topical timolol and blood-aqueous barrier permeability to protein in human eyes]. The effect of topical 0.5% timolol on the permeability of the blood-aqueous barrier to plasma protein was studied in ten young normal volunteers. Before and after instillation of timolol in one eye, simultaneous measurements of aqueous flow rate, f(t), by fluorophotometry and protein concentration in the anterior chamber, Ca(t), with a laser flare-cell meter were made in both eyes at hourly intervals. The coefficient of protein entry into the anterior chamber was calculated using an equation formulating protein dynamics in the anterior chamber from the changes in f(t), Ca(t), and plasma protein concentration. The Ca(t) in the treated eye showed a maximum increase of 37 +/- 4% (mean +/- SEM) as compared with that in the fellow eye 5 hours after instillation, while the f(t) in the treated eye showed a maximum reduction of 30 +/- 4% 2 hours after instillation. The intraocular pressure in the treated eye showed a maximum reduction of 3.0 +/- 0.3 mmHg 2 hours after instillation. No significant changes were found in the coefficient of protein entry in the anterior chamber between before and after timolol instillation or between timolol-treated and fellow untreated eyes. These results indicated that topical 0.5% timolol does not affect the permeability of the blood-aqueous barrier to plasma protein significantly.


[Fluorescein fundus angiography of optic nerve head in primary open angle glaucoma and low tension glaucoma]. Fluorescein fundus angiography was performed at angle of 20 degrees in the 58 low tension glaucoma (LTG) eyes (30 cases) and 77 primary open angle glaucoma (POAG) eyes (41 cases) and the relation of the optic nerve head fluorescein changes to visual field disturbances (stage classification of Kosaki) was compared between POAG and LTG groups. The filling defect of fluorescein in the deep area and the decrease in number of superficial capillaries were observed in the optic nerve head. The filling defect area of fluorescein in the optic nerve head corresponding to Bjerrum scotoma was recognized even in the mild visual field disturbance cases of both LTG and POAG. The following findings were noted in both LTG and POAG cases; expansion of the filling defect area and the decrease in number of superficial capillaries in the same area with progression of visual field disturbances. Filling defect area of fluorescein of the optic nerve head accorded with visual field disturbance area in 19 LTG eyes (32.8%) and 61 POAG eyes (79.2%). On the contrary, the filling defect area of the optic nerve head was wider than the visual disturbance area in 37 LTG eyes (63.8%) and 16 POAG eyes (20.8%). These findings suggest that blood circulatory disorders of the optic nerve head occurred earlier in LTG than in POAG and that the development of LTG might be closely associated with the blood circulatory disorders.


[A dissociation of thresholds between Goldmann kinetic perimetry and high-pass resolution perimetry in retinitis pigmentosa]. The authors studied the differences between the automated static perimetry of high-pass resolution perimeter (HRP) and the kinetic perimetry of the Goldmann perimeter in 12 patients with retinitis pigmentosa. In a total of 10 eyes of 6 patients, we found 19 quadrants in which the patients were not able to recognize the largest ring target even when the target was within the isopter of the Goldmann perimetry. Also, there were 10 quadrants in which the largest target was not recognized in a total of 6 eyes of 4 patients even though their visual field showed symmetrical isopter in upper and lower or right and left quadrants in the Goldmann perimetry. As a result, it was suggested that the causes of the dissocation were a greater decrease in sensitivity for the low spatial frequency target than the high spatial frequency target and/or a greater decrease in resolution sensitivity than light sensitivity in retinitis pigmentosa.


[National registry of retinoblastoma in Japan (1975-1982). The Committee for the National Registry of Retinoblastoma]. Clinical, pathological and follow-up data on 1,147 cases of retinoblastoma registered in Japan from 1975 to 1982 were statistically analysed. The cumulative survival rate of the 1,147 cases, calculated by the Kaplan-Meier method, was 93.0% at 5 years and 90.3% at 10 years. The survival rate of the 757 unilateral cases was 93.3% at 5 years and 92.3% at 10 years. For the 390 bilateral cases, however, the survival rate was 92.2% at 5 years and 86.7% at 10 years. A Cox multivariate analysis indicated that, among various clinical and pathological findings in the patients, extraocular invasion of the tumor is the most significant risk factor predictive of tumor death. The survival rate of those with extraocular invasion subsequently treated by local radiation and/or systemic chemotherapy was significantly better than the rate of those with extraocular invasion who did not receive aftercare. The cumulative incidence rate of second cancers in 409 cases of hereditary retinoblastoma was 4.8% at 10 years, 9.8% at 15 years and 15.7% at 20 years. The occurrence of a second cancer was the main cause of death in the hereditary cases after 10 years.


[Plasma fibrinopeptide A, fibrinopeptide B beta 15-42 and 4 other coagulation factors levels in patients with diabetic retinopathy]. Fibrinopeptide A (FPA), fibrinopeptide B beta 15-42 (FPB beta 15-42) and other coagulation factors (anti-thrombin III, thrombin-antithrombin complex, alpha 2-macroglobulin, plasmin inhibitor complex) were measured in the plasma of 101 patients with diabetes mellitus (DM). The levels in 80 healthy adults were also measured for comparative purposes. The mean levels of FPA, FPB beta 15-42 and the other 4 coagulation factors in the DM patients were significantly higher than in the controls (p < 0.05). The mean levels of FPA and FPB beta 15-42 in patients with diabetic retinopathy (DR) were higher than in those without DR, that is in those with proliferative diabetic retinopathy (PDR) higher than in those with simple diabetic retinopathy (SDR). In patients after panretinal photocoagulation (PRP), the mean level of FPA was higher and that of FPB beta 15-42 was lower than in patients before PRP. In the SDR group, the level of FPB beta 15-42 was significantly correlated with the progression of diabetic retinopathy. We suggest that there was a close correlation between plasma FPA and FPB beta 15-42 levels and activity or progression of disease, and that the investigation of these levels may be useful for the judging of prognosis or effect of therapies of diabetic retinopathy.


[Fourier analysis of pattern visual evoked potentials and changes of the harmonic component in longstanding optic neuritis]. To determine the clinical usefulness of Fast Fourier Transform (FFT) for the detection of abnormal pattern visual evoked potentials (P-VEPs), the P-VEPs were recorded using a checkerboard pattern (check size: 14.4') which was reversed ranging from 4 to 16 per second. Fourteen eyes of 7 patients with longstanding optic neuritis and 15 eyes of age-matched normal controls were examined. Means and the standard deviation of the square root of the FFT power as a function of spectral frequency (1.953 x fHz, f = 1-17) were calculated and statistically significant levels between the two groups were studied for each reversal rate. When the reversal rate was more than 8/sec, The 1st or 2nd harmonic components decreased significantly in optic neuritis and the significant levels (p) of the 1st harmonic component were lower than that (p) of 2nd or 3rd harmonic component. When the reversal rate was 6/sec, the 1st and 2nd harmonic components decreased significantly and 1st harmonic component had the same level of significance as the 2nd harmonic component. When the reversal rate was 4/sec, the 2nd, 3rd, 5th and 6th harmonic components decreased significantly but 1st harmonic component did not. The level of significance of the 3rd harmonic component was the lowest followed by that of 2nd harmonic component.(ABSTRACT TRUNCATED AT 250 WORDS)


[The relation between saccadic eye movements and electrooculogram during light and dark adaptations]. The relation between the amplitudes of saccadic eye movements and the resting potential changes detected around human eyeballs under light and dark adaptations was clarified by means of simultaneous measurements of electrooculogram (EOG) and eye movements. The authors previously reported that the potential changes are proportional to the horizontal saccadic eye movements within +/- 15 degrees (visual angle) under conditions of the room light of approximately 60 lux. There are few reliable data indicative of the presence of the above relations under light and dark adaptations. The result of the simultaneous measurements of EOG and eye movements during the light and dark adaptation at 2-minute intervals in 9 normal subjects showed that the resting potential changes were in direct proportion of the amplitudes of the saccadic eye movements at any time within +/- 20 degrees. In these experiments, the eye positions were monitored with the eye mark recorder during the eye movements. In case the eye positions excursioned from a target, the exact EOG was calculated by measuring eye positions and correcting the EOG errors.


[Short-term and long-term prognosis of recession-resection surgery for exotropia]. The short- and long-term results of recession-resection surgery on 141 exotropic patients were analyzed. The corrected angle of exodeviation one week after surgery was not affected by age at surgery, state of binocular vision or the type of intermittent exotropia. The corrected exodeviation was larger when the pre-operative exodeviation exceeded 30 prism diopters or when previous surgery had been performed. Since there was no difference between the angle of deviation at 4 and 8 years postoperatively, the period of four years was considered to be appropriate for long-term assessment. Post-operative exophoria of less than 15 prism diopters were obtained in patients whose short-term results were overcorrected or were under 5 prism diopters of exodeviation. The surgical guideline for exotropia should be determined considering the short-term and the long-term prognosis. It was concluded that the optimal time for surgery was between 5 and 10 years of age.


[Classification of congenital superior oblique palsy based on principal component analysis]. An attempt was to classify unilateral congenital superior oblique palsy principal component analysis. Each principal component was calculated by taking a linear combination of an eigenvector of the correlation matrix with a standardized original variable. The variables selected for the analysis were vertical deviation in the nine diagnostic positions of 51 cases measured by a synoptometer. The cumulative contributive percent of principal components showed that 88.5% of the variation were accounted for by the first three principal components. The first principal component accounted for 56.7% of the variation in samples indicating the extent of superior oblique palsy in which vertical deviation increases or decreases proportionately. The second principal component accounted for 20.6% of the variation of samples indicating the extent of the incomitance of vertical deviation with a vertical change of gaze. The third principal component accounted for 11.1% of the variation in the sample indicating the extent of the vertical deviation with a horizontal change of gaze.


[A case of invasion of the hyaloid artery into the lens]. A 6-year-old boy with hyaloid artery invasion into the crystalline lens is reported. Both lenses had localized opacities and some brown membranous tissue attached to the posterior lens capsule. He had bilateral persistent hyaloid arteries, and in the right eye this vessel penetrated the lens capsule and invaded the lens. The lens opacity had not increased for 6 years. In persistent hyperplastic primary vitreous we can often see the invasion of fibrovascular tissue into the lens, and this process usually leads to destruction and absorption of the lens. This is an unusual case because the lens showed no significant changes for long period of time in spite of vascular invasion into the lens.


[A case of primary orbital T-cell lymphoma]. A 46-year-old man presented with eyelid swelling and choroidal folds in the right eye. These symptoms were rapidly exacerbated, but inflammatory findings were not observed. MRI tomography confirmed the presence of an orbital tumor compressing the eyeball. In 67Ga scintigram, a hot spot was recognized only at the right orbital region. This orbital tumor was removed subtotally. It was diagnosed histologically as non-Hodgkin malignant lymphoma (diffuse medium cell-type) and stained on paraffin sections, using monoclonal antibodies immunohistochemically. Anti-LCA, anti-MT-1, anti-UCHL-1 antibodies were positive, and anti-MB-1 antibody was negative. The clinical stage was IE in the Ann-Arbor classification. He was treated by radiation and chemotherapy, but died because of opportunistic infection after 6 months. This is, so far as we know, the first case in Japan diagnosed as primary orbital T-cell type malignant lymphoma immunohistochemically.


Comparison of gentamicin toxicity in normal and diabetic rats. Gentamicin treatment caused an elevation in serum urea and creatinine concentrations and ALT activity, associated with pathological changes in the liver and kidney. The pathological and blood chemistry changes were more severe in diabetic gentamicin-treated than in non-diabetic gentamicin-treated rats. Alloxan-diabetic rats had lowered blood glutathione concentrations which may have been responsible for the enhancement of gentamicin toxicity in these rats.


Disposition kinetics and dosage regimen of sulfapyridine in buffalo (Bubalus bubalis). The disposition kinetics and dosage regimen of sulfapyridine were studied in buffalo calves following a single intravenous dose of 100 mg/kg. Distribution half-life (t1/2 alpha) elimination half-life (t1/2 beta) and Vd (area) was 0.181 +/- 0.008 h, 13.4 +/- 0.52 h and 0.59 +/- 0.03 L kg-1, respectively. Total body clearance, which represents the sum of all clearance processes, and tissue/plasma (T/P) ratio were calculated to be 31.1 +/- 2.28 ml kg-1 h-1 and 2.25 +/- 0.09, respectively. A satisfactory intravenous dosage regimen of sulfapyridine in buffalo would be 104 mg/kg followed by 75 mg/kg at 24 h intervals.


Immunization of day-old chickens against Newcastle disease. The avirulent Newcastle disease virus strain designated NDV-6/10, selected by B. Lomniczi at the Veterinary Medical Research Institute, Hungarian Academy of Sciences, is completely safe for day-old chickens by aerosol vaccination. Aerosol immunization using the Hungarian-made MASTERDROP generator (particle size: maximum 7 microns) caused no vaccination reactions among 206,000 chickens with different maternal antibody levels. Other vaccines given simultaneously did not significantly affect the protection elicited against Newcastle disease (ND). Almost 100% and 90% of the aerosolized chickens survived subcutaneous challenge with 10(6) LD50 NDV at 30 and 50 days old, respectively. A single immunization is sufficient for broilers; however, parent flocks should be revaccinated at 7 so 8 weeks old.


Failure to detect a putative oestrus-indicating pheromone in the urine or vaginal secretions of female sheep. Extensive use of gas chromatographic analysis of the volatile and non-volatile components of sheep urine and sheep vulvovaginal secretions at different stages of the oestrous cycle has not succeeded in identifying the putative oestrus-indicating pheromone produced by the ewe. However the putative pheromone is probably not a low molecular weight alcohol, diol, phenol, amine, amide, aldehyde, ketone, fatty acid or steroid.


Immunoreactive prolactin, progesterone and luteinizing hormone in the seminal plasma of buffalo (Bubalus bubalis). The presence of immunoreactive prolactin, luteinizing hormone (LH) and progesterone in buffalo seminal plasma is reported for the first time. Correlations were obtained between various semen attributes and the levels of the above immunoreactive hormones. Statistically significant (P < 0.01) negative correlations were found between the levels of immunoreactive prolactin in semen and sperm motility and viability. The coefficient of multiple linear correlation (R2) between the levels of immunoreactive progesterone, prolactin and LH in the seminal plasma and the various attributes of semen revealed that immunoreactive progesterone and prolactin showed stronger interactions than did LH. The biological significance of these immunoreactive hormones in semen is discussed.