Application of beam emission spectroscopy to NBI plasmas of Heliotron J.

This paper describes the application of the beam emission spectroscopy (BES) to Heliotron J, having the nonsymmetrical helical-magnetic-axis configuration. The spectral and spatial profile of the beam emission has been estimated by the numerical calculation taking the collisional excitation processes between plasmas (electrons/ions) and beam atoms. Two sets of the sightlines with good spatial resolution are presented. One is the optimized viewing chords which have 20 sightlines and observe the whole plasma region with the spatial resolution Δρ less than ±0.055 using the newly designed viewing port. The other is 15 sightlines from the present viewing port of Heliotron J for the preliminary measurement to discuss the feasibility of the density fluctuation measurement by BES. The beam emission has been measured by a monochromator with a CCD camera. A good consistency has been obtained between the spectral profiles of the beam emission measured by the monochromator and the beam emission spectrum deduced by the model calculation. An avalanche photodiode with an interference filter system was also used to evaluate the signal-to-noise (S/N) ratio of the beam emission in the present experimental setup. The modification of the optical system is being planned to improve the S/N ratio, which will enable us to estimate the density fluctuation in Heliotron J.

Multichannel Langmuir probe for turbulence study in Heliotron J.

New multichannel Langmuir probe system was developed and installed to Heliotron J. The objective of the new probe is to characterize basic turbulence property and the resulting transport in advanced helical configuration. The probe developed here consists of four sets of triple probe and one pin for floating potential measurement. Initial experiments in neutral beam heating plasma were conducted and fluctuation profile of radial and poloidal electric fields and Reynolds stress were estimated. For precise evaluation of the electric fields and Reynolds stress, a technique to compensate radial change of tilt angle between probe array and magnetic surface was proposed and applied to the initial results obtained in edge region of Heliotron J where the complicated magnetic structure exists.

Efficacy of maternal serum screening in the prenatal detection of fetal chromosome abnormalities in Japanese women.

OBJECTIVE: This prospective study assesses the efficacy of maternal serum screening for use in prenatal diagnosis of fetal anomaly and chromosome imbalance in Japanese women. METHODS: Maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol were measured in 1,055 singleton pregnant women between 14 and 20 weeks of gestation. A calculated risk for trisomy 21 of >/=1/299 or alpha-fetoprotein >/=2.5 multiples of the median was adopted as positive. RESULTS: Three hundred and seventy-eight of the 1, 055 women screened (35.8%) were identified as positive. Sensitivity, false-positive rate, and positive predictive value in women aged <35 years were 60.0, 10.6, and 6.8%, respectively, and these values were 87.5, 49.3, and 4.2%, respectively, in women aged >/=35 years. The false-positive rate in women aged <35 years was significantly lower than that for women aged >/=35 years (p < 0.001). Chromosomal abnormalities were identified in 21 cases, including 10 with trisomy 21, 5 with trisomy 18, 2 with trisomy 13, and 4 with other chromosomal disorders. Seventeen of the 21 cases (81.0%) showed screen-positive results, and among these all 10 cases with trisomy 21 were detectable. Two cases with trisomy 18, 1 with trisomy 13 and 1 with isochromosome X showed extremely low human chorionic gonadotropin levels (0.4 +/- 0.1 multiples of the median, mean +/- SE), although they were screen negative. Of the 264 women who did not undergo amniocentesis, none had any clinical findings consistent with aneuploidy after birth. CONCLUSIONS: Our results suggest that the evaluation of each serum marker, as well as of the calculated risk, was significantly important in the prenatal detection of fetal aneuploidy.

[Successful treatment of a patient with recurrent ovarian clear cell adenocarcinoma under combination chemotherapy of 5-FU (civ) and low-dose CDDP (i.v.)].

Resistance to conventional chemotherapy including CDDP is the most important therapeutic problem in ovarian cancer. The combination chemotherapy of 5-FU (civ) and low-dose CDDP (i.v.) was applied to a patient with recurrent ovarian clear cell adenocarcinoma (stage IIa), which is often more resistant to systemic chemotherapy than other ovarian adenocarcinomas and is a poor prognostic factor. The patient underwent cytoreductive surgery. Then, 5-FU 375 mg/m2/day civ (days 1-5, 8-12, 15-19, 22-26) and CDDP 3.75 mg/m2/day i.v. (days 1-5, 8-12, 15-19, 22-26) were administered. After four courses of this treatment, there is no sign of recurrence. This result indicates that the combination of 5-FU and CDDP is useful in the treatment of recurrent ovarian cancers.

Recent trends in the prevalence of Down syndrome in Japan, 1980-1997.

The aims of the present study were to determine recent trends in the prevalence of Down syndrome (DS) in Japan, and to determine whether recent changes in demographic and social habits and access to prenatal diagnosis have influenced the livebirth rates of DS. Livebirth statistics indicate that the birth rate in Japan has decreased for women in their 20s and has increased for those in their 30s and 40s. During an 18-year period between 1980 and 1997, 1,299 consecutive DS infants were born among a total of 2,232,694 births, a rate corresponding to approximately 10% of all births in Japan over the same period. The increasing risk of DS with advancing maternal age was confirmed. The overall prevalence was 5.82 DS births per 10,000 livebirths (8.3-9.7 per 10,000 after correction according to the estimated ascertainment ratio: 60-70%). The prevalence rate by year of child birth represents a statistically significant increase (P = 0.001). In conclusion, recent trends in the prevalence of DS in Japan from 1980 to 1997 failed to show a consistent tendency to decrease, probably because of the concomitant increase in pregnancy in advanced maternal age.

Chromosomal analysis in 894 induced abortuses from women of advanced maternal age in relation to gestational weeks and fetal sex ratio.

OBJECTIVE: To clarify the prenatal sex ratio, and types and frequencies of chromosome anomalies in relation to gestational weeks in women of advanced maternal age. METHODS: Chromosomal analysis was performed in 894 induced abortuses derived from elderly pregnant women 35 or more years of age. RESULTS: The embryonic sex ratio in the chromosomally normal (abnormal) gave a preponderance of females over males in lower gestational weeks [366/458 (63/73); 79.9 to 100 (86.3 to 100) in 4-10 weeks]; the reversal of dominancy in those from females to males occurred in the 11th gestational week [41/29(5/4); 141.4 to 100 (125.0 to 100) in 11-20 weeks]. The frequency of trisomy in females at 10 weeks of gestation was significantly high (7/28; 25%). CONCLUSIONS: This study showed that the existence of a difference of and a reversal of the sex ratio in gestational weeks. It was considered that there might be a lower viability of genetically handicapped males as compared to such females. However, the reversal of the sex ratio, such as that observed between 9th and 10th gestational weeks, might reflect events occurring after implantation.

Necrotizing funisitis: clinical significance and association with chronic lung disease in premature infants.

OBJECTIVES: Our purpose was to analyze the clinical significance of necrotizing funisitis, an unusual type of chronic inflammation of the umbilical cord, and to determine whether necrotizing funisitis is associated with chronic lung disease in premature infants. STUDY DESIGN: A total of 52 perinatal factors were prospectively assessed in 18 pregnant women and their fetuses in cases of chorioamnionitis at delivery occurring at 22 to 30 gestational weeks; a statistical comparison between the necrotizing funisitis group (n = 5) and the group without necrotizing funisitis (n = 18) was carried out. RESULTS: Significant correlations were found between necrotizing funisitis and the following factors: maternal serum C-reactive protein level on admission (p = 0.014), fetal distress (p = 0.044), umbilical artery blood pH value (p = 0.037) and polynuclear neutrophilic leukocyte count at birth (p = 0.014), chronic lung disease (p = 0.035), need for dexamethasone therapy for chronic lung disease (p = 0.029), duration of oxygen supplementation (p = 0.026), and length of hospital stay (p = 0.026). CONCLUSIONS: There was a significant association between necrotizing funisitis and development of chronic lung disease, suggesting that necrotizing funisitis is an important risk factor for the development of chronic lung disease.

[The relation between delivery method and prognosis for very low birth weight infants].

To further understand the relationship between perinatal factors and prognosis (neonatal and infantile death and major handicaps), we retrospectively studied 128 singletons weighing less than 1,500g (very low birth weight; VLBW) infants, without maternal complications, IUGR or major congenital anomalies. The gestational age (mean +/- SD) at delivery and the birth weight (mean +/- SD) of subjects were 27.1 +/- 2.0 weeks and 1,041.1 +/- 264.1g, respectively. The results of the current study were as follows: 1) Malpresentation, low Apgar score (APS) and Respiratory distress syndrome (RDS) were observed more frequently in non-intact survivors than in intact survivors with statistical significance. Although the occurrence of fetal distress was correlated with low pH in the umbilical artery, no significant correlation was evident between the prognosis and either of the two above mentioned factors. The intact survivors had a significantly high frequency of PROM despite no correlation with signs of infection (WBC, CRP). 2) As to delivery methods in terms of prognosis, a cephalic-vaginal group had the best prognosis and a breech-vaginal group had the worst, with statistical significance. A higher frequency of poor prognosis for infants was found in a malpresentation group with cesarean delivery and cervical dilation of more than 4cm. Thus, vaginal delivery is a possible option in case of cephalic VLBW infants.

Molecular weight-dependent lymphatic transfer of fluorescein isothiocyanate-labeled dextrans after intrapulmonary administration and effects of various absorption enhancers on the lymphatic transfer of drugs in rats.

We have developed a new method to evaluate the transfer of macromolecular drugs to intrapulmonary lymph nodes in rats after intrapulmonary administration. By using this method, we observed that the transfer of fluorescein isothiocyanate dextrans (FDs) to the intrapulmonary lymph nodes was markedly higher than that to iliac lymph node, a non-intrapulmonary lymph node. The transfer of FDs to the intrapulmonary lymph nodes increased with increasing their molecular weights and the threshold for a high lymph node-to-plasma level ratio (CLN/CP) was between 10 and 20 kDa. The effects of absorption enhancers on the transfer of FDs to intrapulmonary lymph nodes were also examined in rats. Absorption enhancers used in this study were EDTA, sodium glycocholate (Na-GC), mixed micelles (MM), N-lauryl-beta-D-maltopyranoside (LM), sodium caprate (Na-Cap). The transfer of FD-20, FD-40 and FD-70 to intrapulmonary lymph nodes after intrapulmonary administration increased in the presence of LM. In particular, the lymphatic transfer of FD-40 was remarkably increased in the presence of LM. Similarly, Na-GC and MM improved the transfer of FD-40 to intrapulmonary lymph nodes. These results suggest that absorption enhancers such as LM, Na-GC and MM are effective for improving the transfer of macromolecular drugs to intrapulmonary lymph nodes.

[Placental transfer and pharmacokinetic parameters of flomoxef during the perinatal period].

Flomoxef (FMOX), a new oxacephem with low MIC values against not only Gram-negative bacilli (GNB) but also against Gram-positive cocci (GPC), was evaluated for its transfer into fetus, amniotic fluid, maternal milk, spinal fluid and urine during the perinatal period following a single intravenous drip infusion at a dose of 1 g for 30 minutes. The results obtained are summarized below. 1. High concentrations of FMOX were demonstrated in maternal serum, umbilical arterial serum and amniotic fluid with Cmax values of 48.0, 10.99 and 10.20 micrograms/ml, respectively. 2. Maternal urinary excretion rate was 65.4% in the first 6 hours after administration. 3. In contrast, maternal milk and spinal fluid levels were lower than 3 and 0.20 micrograms/ml, respectively. These results showed a good placental transfer of FMOX, which is very useful for various perinatal infections. No adverse effects were observed in mothers and neonates during the course of this study.

[Clinical studies on flomoxef in pregnant women with infections during the perinatal period].

Clinical efficacies of flomoxef (FMOX), which is a newly developed oxacephem antibiotic, were evaluated in 14 cases of obstetric and gynecologic infections during the perinatal period. The results were excellent in 6 cases (42.9%) and good in 8 cases (57.1%). No side effects nor abnormal clinical laboratory test results were observed in mothers or neonates. Thus, FMOX appears to be a useful antibiotic for perinatal infections.

[Changes in serum levels of gynecological tumor markers throughout the period from early gestation to puerperium].

The aim of this study is to elucidate the change in serum levels of gynecological tumor markers throughout the period from the early gestational stage to puerperium. We measured eight tumor markers of--CA 125, TPA, SCC, AFP, haptoglobin, ferritin, CA19-9 and CEA--in 17 healthy women with a normal course of pregnancy, delivery and puerperium, and obtained the following results: 1) Profiles of change in serum levels of CA125, SCC, haptoglobin and ferritin were similar during pregnancy, with those levels being the highest at 4-15 weeks of gestation and declining gradually from 16 to 27 weeks. Serum levels of these four markers decreased significantly (p less than 0.01) at 16-27 and 28-40 weeks of gestation, respectively. 2) A significant (p less than 0.01) increase in CA125 and SCC was observed 2 hours after delivery compared with the levels in the first stage of delivery. However, these two markers decreased to the normal range after the fifth day postpartum. 3) Serum TPA decreased significantly (p less than 0.05) in 16-27 weeks of gestation, comparing with those of 4-15 weeks. Serum CA19-9 and CEA remained almost unchanged within the normal range throughout the period from pregnancy to puerperium. 4) Tumor markers of CA125, TPA, SCC, haptoglobin, ferritin and CEA of which serum levels decreased during the course of pregnancy and puerperium might be a clue to judge whether gynecological tumors in pregnant women are malignant or benign.

Chromosomal studies on 934 induced abortuses of middle-aged pregnant women.

A total of 934 induced abortuses of middle-aged pregnant women (35-48 years old) were chromosomally surveyed. The mean gestational age was 7.6 +/- 2.0 (S.D.) weeks after the first day of the last menstrual period, and the mean maternal age was 39.6 +/- 2.7 (S.D.) years. There was a high incidence of chromosomally abnormal fetuses in induced abortions, which markedly increased with the advancing age of the women: 9.6% (40/418) for the 35-39-year-old age group, 20.7% (100/484) for the 40-44-year-old age group, and 43.8% (14/32) for the 45-48-year-old age group, averaging 16.5%.

[Basic and clinical studies on aztreonam in obstetric and gynecologic infections during the perinatal period].

The basic and clinical efficacies of aztreonam (AZT) were evaluated in obstetric and gynecologic infections during the perinatal period. The results obtained are summarized below. 1. Concentrations of AZT in umbilical venous blood and amniotic fluid showed a good placental transfer of AZT. The rate of placental transfer of AZT was very similar to rates for cephalosporins. 2. Since the clinical efficacy rate of AZT in the treatment of Gram-negative bacterial infections was 80.0%, AZT appears to be a useful drug against Gram-negative bacterial infections.

[Pharmacokinetics and materno-fetal influence of ritodrine hydrochloride during the continuous treatment of threatened premature labor].

The cardiovascular and metabolic effects of ritodrine hydrochloride on the mother and fetus were investigated during the 28-day and/or longer continuous treatment of threatened premature labor. Concentrations of ritodrine in maternal venous blood during the treatment, and placental transfer of the drug into the fetal circulation and amniotic fluid were also determined to ascertain the effectiveness and safety of the drug. Seventeen volunteer patients at 27-34 weeks of gestation were given a total dose of 2,850-7,350mg of ritodrine intravenously at a mean infusion rate of 72.9 micrograms/min for 28-66 days, when the maternal serum concentration of ritodrine was maintained at approximately 200ng/ml throughout the treatment period. A significant but slight increase in the maternal heart rate and serum glucose, and a slight fall in maternal blood pressure were observed during ritodrine infusion. The fetal heart rate did not change significantly. Although ritodrine also produced decreases in the red blood cell count, hemoglobin and hematocrit, these changes were transient and recovered to the control level thereafter. The ratios of umbilical venous blood and the amniotic fluid concentration of ritodrine to maternal venous concentrations determined at cesarean section were 0.68 and 1.64, respectively, suggesting that a gradual accumulation of placentally transferred ritodrine may occur when long-term continuous infusion is carried out. There were no noticeable drug-related findings in mothers and newborns during and after labor. These results indicate that threatened premature labor may be well effectively controlled by ritodrine without severe side-effects on the mother or fetus in treatment for along period.

[Studies of aztreonam transfer into the fetus and amniotic fluid in early pregnancy].

The materno-fetal transfer of aztreonam by a single intravenous dose of 1 g was examined in 7 volunteer women undergoing induced abortion in early pregnancy and the following results were obtained. After administration of the drug, maternal blood levels at 15, 30, 60 and 120 minutes were 77.24 +/- 6.09 micrograms/ml (Mean +/- S.E.), 37.84 +/- 5.85 micrograms/ml, 25.62 +/- 3.15 micrograms/ml and 18.10 +/- 2.22 micrograms/ml, respectively. Amniotic fluid level of the drug was low in 3 cases, of which amniotic fluid levels were determined; 0.74 microgram/ml after 229 minutes, 0.83 microgram/ml after 280 minutes and 0.74 microgram/ml after 328 minutes. Fetal tissue concentration of the drug was below our detection limit at 120 minutes. Tissue levels of villus and decidua in 6 cases were also too low to be detectable between 89 and 328 minutes after injection.