Neighbourhood relationships moderate the positive association between family caregiver burden and psychological distress in Japanese adults: a cross-sectional study.

OBJECTIVES: Family caregiver burden is associated with higher psychological distress. However, little is known about the impact of neighbourhood relationships on caregivers' psychological distress. We examined whether neighbourhood relationships of caregivers moderate the association between family caregiver burden and psychological distress. STUDY DESIGN: This was a cross-sectional study. METHODS: We recruited 5321 Japanese adults who participated in the Japan Multi-Institutional Collaborative Cohort Study in the Okazaki area between 2013 and 2017. Participants completed self-reported questionnaires to measure psychological distress (Kessler 6: K6), subjective caregiver burden, and neighbourhood relationships. We performed a multivariable linear regression analysis in which caregiver burden was designated as an independent variable and the K6 score as a dependent variable, adjusting for demographics. The interaction term between caregiver burden and neighbourhood relationships was also included in the analysis. RESULTS: Data from a total of 5069 participants were included (mean age [standard deviation]: 63.1 years [10.3 years]; 2226 [43.9%] female). Caregiver burden was significantly and positively associated with psychological distress (compared with no burden, mild burden: ß = 0.24, P = 0.197; severe burden: ß = 0.60, P < 0.01; P for trend < 0.01). There was a significant negative interaction effect of caregiver burden × neighbourhood relationship on psychological distress (severe burden × good neighbourhood relationship: ß = -3.29, P < 0.01). CONCLUSIONS: A higher caregiver burden was associated with higher psychological distress, and neighbourhood relationships moderated this association. Our findings suggest that good neighbourhood relationships can buffer caregiving-associated psychological distress.

A case of pubic abscess after prostate cancer surgery and radiotherapy treated with rectus femoris muscle flap.

We report the case of a 95-year-old man with soft tissue deficiency associated with a pubic abscess that occurred 30 years after prostate cancer surgery and radiation therapy. A fistula with purulent discharge without any obvious cause appeared in the midline of the lower abdomen and progressed to a soft tissue defect in which several calcium phosphate stones of 5-8 mm in diameter were found. Computed tomography showed calcium deposits on the surface of the pubis and irregular zonal calcifications extending from the pubis to the medial region of both thighs. Conservative treatment did not improve the patient's condition; thus, surgical treatment was performed. The pedicled rectus femoris muscle flap was elevated from the left thigh and transferred to fill the tissue defect, then a split thickness skin graft was applied on it. The tissue defect was successfully repaired, and the patient was able to regain ambulation ability. In the present case, it was presumed that urine exudation around the bladder due to radiation cystitis was involved in the formation of ectopic calculi and subsequent infection. In reconstructing a complex defect associated with infection, using muscle flaps to fill the dead space with well vascularized tissue is considered to be appropriate. In our case, we chose a rectus femoris muscle flap, which has advantages in volume and versatility of transposition owing to long vascular pedicle and requires no microsurgical vascular anastomosis. As a result, the preoperative activity was maintained, the infection was treated, and a good course was obtained.

Erythropoietin and Friend virus gp55 activate different JAK/STAT pathways through the erythropoietin receptor in erythroid cells.

Abnormal erythropoietin (EPO)-independent cell growth is induced after infection of erythroid progenitor cells with a polycythemic strain of Friend virus (FVp). Binding of its Env-related glycoprotein (gp55) to the EPO receptor (EPOR) mimics the activation of the EPOR with EPO. We investigated the gp55-EPOR signaling in erythroblastoid cells from mice infected with FVp and in cells of FVp-induced or gp55-transgenic-mouse-derived erythroleukemia cell lines, comparing it with the EPO-EPOR signaling in EPO-responsive erythroblastoid cells. While the Janus protein tyrosine kinase JAK2 and the transcription factor STAT5 became tyrosine phosphorylated with the EPO stimulation in EPO-responsive erythroblastoid cells from anemic mice, JAK1 and STAT5 were constitutively tyrosine phosphorylated in all of these FVp gp55-induced erythroblastoid or erythroleukemic cells. Moreover, this constitutively tyrosine-phosphorylated STAT5 was unable to bind to its specific DNA sequences and did not translocate to the nucleus. Nuclear translocation and DNA binding of this STAT5 species required EPO stimulation. These findings clearly indicate that the FVp gp55-EPOR signaling is distinct from the EPO-EPOR signaling and suggest that STAT5 may not play an essential role in the transmission of the cell growth signals in FVp gp55-induced erythroleukemia cells.

Activation of the JAK1-STAT5 pathway by binding of the Friend virus gp55 glycoprotein to the erythropoietin receptor.

Friend spleen focus forming-virus (F-SFFV) induces acute erythroleukemia in susceptible mice. Initiation of the erythroleukemia is due to binding of the env-related glycoprotein gp55 encoded by F-SFFV to the erythropoietin receptor (EPOR). The gp55/EPOR interaction induces prolonged and growth factor independent proliferation in a factor-dependent cell line. In erythropoietin (EPO) signaling, the JAK2/STAT5 pathway was shown to be activated downstream of the EPOR to transmit the signal to the cells. To determine members of the JAK family and the STAT transcription factor family involved in the gp55/EPOR signaling, we examined tyrosine phosphorylation of JAKs and STATs in F-SFFV-infected erythroid or erythroleukemic cells. JAK1 and STAT5 were constitutively tyrosine-phosphorylated but the DNA binding activity of STAT5 was not induced without EPO stimulation in erythroblastoid cells from spleens of F-SFFV-infected mice and erythroleukemia cell lines derived from gp55-transgenic mice. These results indicate that JAK1 is involved in the gp55/EPOR signaling but STAT5 is not playing an essential role in the growth of those erythroid cells.

Requirement of ceramide for adhesion of Helicobacter pylori to glycosphingolipids.

Direct adhesion of Helicobacter pylori to immobilized glycosphingolipids (GSLs) was compared to that of their corresponding oligosaccharide-conjugated neoglycoconjugates in order to clarify the roles of the carbohydrate and lipid portions of GSLs in H. pylori adhesion. These bacteria were found to adhere to sulfatide, GM3, GalCer and LacCer, but not to ceramide, sphingomyelin, or polyacrylamides conjugated with beta-galactose, lactose, 3'-sialyllactose or 3'-sulfo-beta-galactose. Furthermore, neoglycolipids or bovine serum albumin derivatives with corresponding oligosaccharides were unable to serve as the ligands. H. pylori adhesion to GalCer with alpha-hydroxyl fatty acid was much stronger than GalCer with the non-hydroxyl fatty acid. These results suggest that H. pylori recognize the conformation of GSL with alpha-hydroxyl fatty acid on solid phase.

Experimental studies on the pharmacokinetics and therapeutic effect of cefbuperazone in biliary infection.

A study was carried out using an experimental biliary infection model to investigate the pharmacokinetic characteristics and therapeutic effect of cefbuperazone in the rabbit. Thirty rabbits were divided into three equal groups; a control group of normal animals, a group of infected animals receiving no cefbuperazone, and a group of infected animals receiving 50 mg cefbuperazone/kg intramuscularly. The experimental infection was made by direct inoculation of a suspension of E. coli into the common bile duct after ligation. The results showed that extremely high levels of cefbuperazone were achieved in bile and tissues of the biliary tract and were higher than those in the blood. Moreover, the levels were maintained at effective concentrations even after 6 hours. Viable bacterial cells from bile and the gall-bladder were barely detectable 24 and 48 hours after infection in the cefbuperazone-treated group, whilst counts remained high in the other infected group. White blood cell counts were increased at 24 hours after infection but were significantly lower in the cefbuperazone-treated group. Histological examination revealed marked inflammatory changes in the gall-bladder and bile duct of infected, untreated animals but few, mild changes only were seen in cefbuperazone-treated animals. Similarly, total bilirubin and liver enzymes were markedly increased in infected animals, but transaminases and alkaline phosphatase were significantly lower in the treated compared to the untreated group. The findings indicate, therefore, that cefbuperazone can be a useful antibiotic in biliary infection.

In vivo activity of cefbuperazone (T-1982) against various experimental infections in mice.

The protective activity of cefbuperazone (T-1982) was compared with those of latamoxef, cefotaxime, and cefmetazole against intraperitoneal and urinary tract infections in mice. In both tests, cefbuperazone manifested a higher activity than the other cephems against infections with Escherichia coli and Klebsiella pneumoniae. Cefbuperazone also showed a comparatively high degree of prophylactic effect; this activity was observed even when given 4 hours before bacterial challenge. The good in vivo activity of cefbuperazone could not be explained by the differences between the antibiotics on the basis of the serum levels and vitro activity. Mice, treated with cefbuperazone, showed a statistically significant prolongation of survival time against intraperitoneal challenge with Candida albicans, but not when treated with the other cephems. This finding suggests that the host defense mechanisms stimulated by cefbuperazone may contribute to the good in vivo activity of this antibiotic.

Novel human topoisomerase I inhibitors, topopyrones A, B, C and D. II. Structure elucidation.

The structures of novel topoisomerase I inhibitors, topopyrones A, B, C and D were elucidated by spectral analysis of the chemical derivatives. These compounds are an anthraquinone type containing a fused 1,4-pyrone moiety. Topopyrones A and B contain a chlorine atom, however C and D do not. It was suggested that topopyrones B and D are converted from topopyrones A and C, respectively by Wessely-Moser type rearrangement.

Novel human topoisomerase I inhibitors, topopyrones A, B, C and D. I. Producing strain, fermentation, isolation, physico-chemical properties and biological activity.

In the course of a screening program for specific inhibitors of human topoisomerase I using a recombinant yeast, we have discovered four new active compounds. All four compounds were isolated from the culture broth of a fungus, Phoma sp. BAUA2861, and two of them were isolated from the culture broth of a fungus, Penicillium sp. BAUA4206. We designated these compounds as topopyrones A, B, C and D. Topopyrones A, B, C and D selectively inhibited recombinant yeast growth dependent on expression of human topoisomerase I with IC50 values of 1.22, 0.15, 4.88 and 19.63 ng/ml, respectively. The activity and selectivity of topopyrone B were comparable to those of camptothecin. The relaxation of supercoiled pBR322 DNA by human DNA topoisomerase I was inhibited by these compounds, however they did not inhibit human DNA topoisomerase II. Topopyrones A, B, C and D were cytotoxic to all tumor cell lines when tested in vitro. Topopyrone B has potent inhibitory activity against herpesvirus, especially varicella zoster virus (VZV). It inhibited VZV growth with EC50 value of 0.038 microg/ml, which is 24-fold stronger than that of acyclovir (0.9 microg/ml). Topopyrones A, B, and C were inhibitory to Gram-positive bacteria.

Glomosporin, a novel antifungal cyclic depsipeptide from Glomospora sp. II. Structure elucidation.

The structure of glomosporin, an antifungal antibiotic, was elucidated by NMR and MS spectroscopic studies. Glomosporin is a novel cyclic depsipeptide with an amino acid sequence Ser-Ala-Asp-Asn-Asn-Ser-Thr, and a 3,4-dihydroxy-4-methylhexadecanoic acid side chain.

Glomosporin, a novel antifungal cyclic depsipeptide from Glomospora sp. I. Production, isolation, physico-chemical properties and biological activities.

A novel antifungal cyclic depsipeptide termed glomosporin, which has a fatty acyl side chain, was isolated from a barley solid culture of Glomospora sp. The strain was isolated from fallen pine leaves collected in Fukusima Prefecture, Japan and identified as Glomospora sp. BAUA 2825. Glomosporin was purified by butanol extraction followed by preparative HPLC. Glomosporin showed antimicrobial activity against fungi including clinically important Aspergillus fumigatus.

Toxicological studies on pipemidic acid. V. Effect on diarthrodial joints of experimental animals.

Pipemidic acid (PPA) orally given in a dose of 100 mg/kg/day or more was found to cause lame gait in immature beagle dogs of about 3 months old. Their diarthrodial joints were abnormal with increased synovial fluid and blister formation under the outer layer of the articular cartilage. However, such an abnormality was not found in dogs younger than 2 weeks or older than 12 months. The blisters were formed at the joint areas bearing the body weight at a time when PPA was considered to be present there. Nalidixic and piromidic acids, structural analogues of PPA, also caused abnormality similar to PPA. The severity of the arthropathy was slight with piromidic acid as compared with PPA and nalidixic acid. The gait abnormality was almost disappeared spontaneously even if medication was continued. The incidence of the arthropathy was not or rarely observed in any young rats, rabbits and monkeys.

Instrumentation surgery for funnel chest.

Thirty four patients with funnel chest were operated on using the Zimmer plate and/or U shaped rod. There were no recurrences of the chest deformity and 78.6% were satisfied with the result. The low % VC significantly improved after the operation. Five cases had one of the following complications, massive bleeding from the internal thoracic artery, partial skin necrosis, rotational dislodgement of the rod, temporal subcutaneous infection or partial rupture of the pectoral muscle incision. The blood loss ensuing in one operation during the last 8 years has been less than 300 ml and the postoperative bed rest was less than 7 days. All the patients could get back to the preoperative daily activities within three weeks without wearing brace or chest protector. Therefore, our method is considered to be less invasive and very useful for correction of the funnel chest deformity.

A comparative vibrational and NMR study of cis-cinnamic acid polymorphs and trans-cinnamic acid.

The IR and Raman spectra of the two polymorphic forms (58 degree- and 68 degree-forms) of cis-cinnamic acid were measured, and the spectral differences discussed on the basis of the crystal structures of the two forms. The IR bands related to the COOH group differ in the frequencies and band shape, reflecting differences in the hydrogen bonding between the two modifications. These spectra were compared with those of trans-cinnamic acid. The IR, Raman, and NMR spectra of the isotopic compounds, including the deuterated and 13C analogs of the cis and trans acids, were also recorded in the solid state and in solution to confirm the spectral assignments.

Molecular structure and vibrational spectra of phenolphthalein and its dianion.

Infrared (IR) and Raman spectra of phenolphthalein (PP) and its dianion form (sodium and potassium salts) were studied both in the solid state and in aqueous solution. Band assignments were carried out on the basis of the isotope shifts of the ring deuterated and 13C-substituted derivatives. Spectral analyses reveal that the PP dianion exists as mixtures of the benzenoid form (colorless) and the quinonoid form (colored) in the solid state and in aqueous solution, while the neutral PP solely takes the gamma-lactone form. This work provides the first vibrational spectroscopic evidence for the coexistence of the two species in the PP dianions.

[Spontaneous regression of lumbar hernia of the nucleus pulposus. Follow-up study of 4 cases by repeated magnetic resonance imaging]. / Régression spontanée des hernies du nucleus pulposus au niveau lombaire. 4 cas suivis par des IRM répétées.

INTRODUCTION: As yet there have been no consistent magnetic resonance (MR) imaging studies on spontaneous regression of herniated lumbar nucleus pulposus (HNP). We present four patients in whom follow-up MRI images demonstrated spontaneous regression or complete disappearance of a herniated lumbar nucleus pulposus. One patient presented with a large extruded type, and the rest had the sequestrated type. All patients made evolved favorably with conservative therapy. RESULTS: Follow-up MRI images revealed a remarkable regression of the HNP in the extrusion case and complete disappearance in the sequestration cases. In the extrusion case, follow-up MRI images showed rapid shrinkage of the portion extruded into the epidural space. In the sequestration cases, MR images with Gadolinium DTPA (enhanced MR images) showed that the enhanced lesion around the HNP had reduced its size as the HNP diminished. Final MR images could not detect the HNP in any view of the spinal canal. CONCLUSION: We therefore concluded that the regression of HNP in MR images might have been due more to resorption than to dehydration.

[In vivo antibacterial activity of cefbuperazone. Synergy of cefbuperazone for bactericidal effect with human polymorphonuclear leukocytes].

Studies were done utilizing E. coli No. 59 which are resistant against human and mouse serum, and the following results were obtained. The therapeutic effect of cefbuperazone (CPBZ) against systemic infections of mice was much higher than that of cefmetazole (CMZ), cefotetan (CTT), latamoxef (LMOX) and cefoperazone (CPZ). Synergistic bactericidal effect with human polymorphonuclear leukocytes was more marked for CBPZ than CMZ.

[Combination chemotherapy of human renal cell carcinoma in athymic nude mice with human lymphoblastoid interferon (HLBI) and UFT, 5-Fu].

The effectiveness of interferon alpha (HLBI) for nude mouse transplantable human renal cell carcinoma 72nd general meeting, in combination with UFT and 5-Fu, was examined using, 1 x 10(7) IU/kg, 2 x 10(7) IU/kg HLBI; 25 mg/kg 5-Fu; and 10 mg/kg, 20 mg/kg UFT, administered for 10 consecutive days. The ratio of relative mean tumor weight of treated group to control group was under 42% for the combination of 25 mg/kg (I.P.) 5-Fu, 20 mg/kg UFT, and HLBI and the effect was particularly clear for the combination with 2 x 10(7) IU/kg which indicated a grade IIA histologic classification. In comparison with the control groups only UFT (20 mg/kg) and HLBI (2 x 10(7) IU/kg) showed significant inhibition when administered alone. Although none of the drugs had an inhibitory effect when administered alone, in combined use they showed a strong antitumor effect which was more than synergistic. Orally administered 5-Fu showed a statistically significant difference only in the combination with 2 x 10(7) IU/kg HLBI. Furthermore, the concentration of 5-Fu in the tumor tissue was not affected by the route of administration or drug combination, whereas that in the serum was below the limit of detection in the intraperitoneally administered cases, 0.0096 +/- 0.0079 microgram/ml, lower than the value for orally administered cases. The 5-Fu concentration was 0.026 +/- 0.012 microgram/ml for orally administered UFT which was significantly higher than the value obtained for orally administered 5-Fu. Thus, combination therapy of HLBI and UFT for renal cell carcinoma is expected to be clinically useful.

[Two cases of primary urethral carcinoma in females].

Two cases of primary female urethral carcinoma are presented and discussed. The patients were 70 years old and 65 years old, and the pathological diagnoses were squamous cell carcinoma and adenocarcinoma, respectively. The patient with squamous cell carcinoma had metastasized inguinal lymph nodes at the first consultation, despite the administration of bleomycin, and the tumor had widely metastasized to skin of the lower extremities. She died of cachexia and disseminated intravascular coagulopathy (DIC). The other patient with adenocarcinoma was treated by postoperative cobalt radiation therapy in a total dose of 6,000 rads. After 18 months, she had recurrence of tumor in urethra, and developed Virchow's node metastasis, she died of acute renal failure. Both patients died within two years.

[Two cases of priapism cured by transcatheter embolization of internal pudendal arteries].

We report here two cases of priapism. One of these cases was suspected to be drug induced and high and low flow mixed type. The patient had taken the drugs, alpha-blocker for hypertension and dysuria by BPH for a long time. He was treated by a caveno-glandular shunt. After surgery, detumescence was obtained for some time, but erection appeared again soon. Transcatheter embolization of the internal pudendal arteries was then performed, and detumescence became permanent. The other case was an idiopathic and high flow type. Detumescence was achieved soon by transcatheter embolization of the internal pudendal arteries only, then he experienced morning erection imperfectly on the 9th day after this treatment. The management of priapism as reported to date is also reviewed.