Anticipatory postural adjustments associated with a loading perturbation in children with hemiplegic and diplegic cerebral palsy.

Anticipatory postural adjustments (APAs) in preparation for predictable externally induced loading perturbation were studied in children with typically development (TD), hemiplegic (HEMI), and diplegic (DIPL) cerebral palsy. Twenty-seven children (n = 9 in each group) were asked to stand and catch a load dropped from a pre-specified height. Electrical activity of the leg and trunk muscles and center of pressure (COP) displacements were recorded to quantify the APAs. All groups were able to generate APAs prior to the perturbation, but the magnitude was smaller and the onset was delayed in the dorsal (agonist) postural muscles in both HEMI and DIPL as compared to TD. HEMI and DIPL also generated APAs in the antagonist postural muscles. Anticipatory backward COP displacement was significantly different from the baseline value only in the TD and HEMI. HEMI and DIPL displayed a different postural control strategy; HEMI showed no difference in background postural activity from TD, but with diminished APAs in the agonist postural muscles compared to TD, while DIPL showed a higher background postural activity and diminished APAs in the agonist postural muscles compared to TD. These differences are important to consider when designing rehabilitation programs to improve posture and movement control in children with hemiplegic and diplegic cerebral palsy.

Resistance of Fc receptor- deficient mice to fatal glomerulonephritis.

Immune complex-mediated inflammation is a common mechanism of various autoimmune diseases. Glomerulonephritis (GN) is one of these diseases, and the main mechanism of the induction of GN has been unclear. We examined the contribution of Fc receptors in the induction of nephrotoxic GN by establishing and analyzing mice deficient in the Fc receptor gamma chain (FcRgamma). Whereas all wild-type mice died from severe glomerulonephritis with hypernitremia by administration of anti-glomerular basement membrane (GBM) antibodies, all FcRgamma-deficient mice survived. Histologically, wild-type mice showed glomerular hypercellularity and thrombotic changes, whereas the renal tissue in FcRgamma-deficient mice was almost intact. Deposition of anti-GBM antibody as well as complement components in the GBM were equally observed in both wild-type and knockout mice. These results demonstrate that the triggering of this type of glomerulonephritis is completely dependent on FcR+ cells.

Conversion of a poorly differentiated human adenocarcinoma to ascites form with invasion and metastasis in nude mice.

Cells (1 X 10(7)/0.5 ml) from a Borrmann type III poorly differentiated adenocarcinoma of the human stomach were injected ip into nude mice. The injection resulted in ascites carcinoma with invasion (carcinomatous peritonitis) and liver metastasis. The inoculum was obtained from subcutaneous tumors at passage 9 in nude mice that had received serial transplants from the patient with Borrmann type III poorly differentiated adenocarcinoma of the stomach. Serial transfers of 1.5 X 10(6) dispersed cancer cells/0.5 ml into the peritoneal cavity of nude mice converted this adenocarcinoma to an ascites form. Hemorrhagic ascites accumulated within 3 weeks at the first passage and 4-6 weeks in serial passages. Carcinomas peritonitis occurred consistently and was observed in the diaphragm, mesenteries, omentum, and pancreas; metastases were seen in the liver and spleen. Subsequently, iv injection of ascites at passage 3 (6 X 10(5) cells/0.2 ml) into nude mice produced metastatic lesions in the lung and the heart. The histology of the invasive and metastatic lesions in the nude mice was similar to that of the original tumor in the patient with stomach carcinoma.

Nucleotide sequence of the Thiobacillus ferrooxidans chromosomal gene encoding mercuric reductase.

The nucleotide sequence of the Thiobacillus ferrooxidans chromosomal mercuric-reductase-encoding gene (merA) has been determined. The merA gene contains 1635 bp, and shares 78.2% and 76.6% sequence homology with the transposon, Tn501, and plasmid R100 merA genes, respectively. From the sequence, a 545-amino acid (aa) polypeptide was deduced, and comparison with those of Tn501 and R100 revealed 80.6% and 80.0% homology, respectively, at the aa sequence level. Divergence among the three merA aa sequences was clustered within a specific region (aa positions 41-87). By analysis of codon usage frequency, it is speculated that the T. ferrooxidans merA gene originated from Tn501, R100, or a common ancestral gene, but not from T. ferrooxidans itself.

Pylorus-preserving gastrectomy for gastric ulcer--one- to nine-year follow-up study.

Of 100 patients subjected to pylorus-preserving gastrectomy for surgical treatment of gastric ulcer, 60 were available for follow-up for periods of from one to 9 years. Questionnaires and personal interviews of these 60 and additional laboratory examinations of 40 of them showed results tending to favor the procedure as a highly recommendable technique of gastrectomy. Questions about body weight gain, return to preoperative occupation, and satisfaction with the operation all were answered favorably. In the follow-up laboratory examinations, reduction rates of 57.2 percent for maximal acid concentration, 81.6 percent for maximal acid output, and 70.8 percent for peak acid output. Sphincteric function was generally well preserved on the pyloric ring. Gastric emptying times, ranging from 30 to 180 minutes in 79 percent of the cases, were nearly compatible with the control figures. The results of fat and protein absorption tests performed on some of these patients showed their rates to be within normal ranges. No instances of dumping syndrome, recurrence of ulcer, or other significant postgastrectomy sequelae were recognized. The results indicate pylorus-preserving gastrectomy to be preferable for the surgical treatment of gastric ulcer and other benign lesions of the stomach.

The roles of proximal and distal muscles in anticipatory postural adjustments under asymmetrical perturbations and during standing on rollerskates.

OBJECTIVES: The study addresses two controversial issues surrounding the nature of anticipatory postural adjustments (APAs). The first deals with the reproducible APA patterns in proximal postural muscles and variable APA patterns reported for the muscles controlling the ankle joint (TA-SOL). We hypothesized that the TA-SOL muscles participate mainly in the compensation of lateral and rotational perturbations, in particular those associated with asymmetrical movements. The second issue deals with decreased APAs reported during both very stable and unstable standing. We hypothesized that APA changes during unstable standing might depend on the actual mechanical nature of instability. METHODS: Eight healthy subjects were recruited who had had no prior experience with rollerskates. They performed series of bilateral and unilateral, flexion and extension movements during regular standing and bilateral movements during standing on rollerskates. EMG changes and shifts of the center of pressure were analyzed within a time window typical of APAs. RESULTS: We found that APAs in proximal muscles were decreased during unilateral shoulder movements as compared to APAs during bilateral movements but did not show right-left differences. In contrast, the distal muscles (TA-SOL) showed little involvement during bilateral movements, while a clear right-left asymmetry was seen during unilateral movements. Bilateral movements performed while standing on rollerskates were accompanied by unchanged APAs in the proximal muscle pairs and increased APAs in the TA-SOL pair. CONCLUSIONS: We conclude that the proximal muscles provide a general pattern counteracting expected perturbations in the anterior-posterior direction while the distal muscles deal with asymmetrical perturbations and the modulation of APAs in unusual conditions such as standing on rollerskates. There seems to be no unambiguous relation between the magnitude of APAs and the stability of standing: Depending on the exact mechanical nature of postural instability, it could be associated with qualitatively different changes in the APAs.

Anticipatory postural adjustments during load catching by standing subjects.

OBJECTIVES: (1) To study differences in the generation of anticipatory postural adjustments (APAs) in arm and trunk/leg muscles prior to catching a load released either by the subject him-/herself or by the experimenter. (2) To study the importance of different mechanical characteristics of the load at impact for the generation of APAs prior to load catching. METHODS: Standing subjects were asked to catch loads dropped onto the left hand from different heights either by the experimenter or by the subject's right hand. The load mass and release height were manipulated to keep either the mass or the momentum of the load at impact constant. APAs were quantified with integral electromyographic indices. RESULTS: APAs were observed in leg, trunk and arm muscles prior to load impact for both self- and experimenter-release trials. Kinetic energy showed higher correlations with the magnitude of APA than momentum, but only in experimenter-release trials. CONCLUSIONS: Subjects can generate APAs in both arm and trunk/leg muscles in the absence of an explicit voluntary action. The relative importance of kinetic energy and momentum for defining the magnitude of APAs can reflect the difference in the sources of information used to prepare for the forthcoming perturbation during self- and experimenter-released load catch.

[Out line of measurement of gastric emptying using by radioisotope and its problems awaiting solution].

The radioisotopic technique has been recognized as the best method of measuring gastric emptying all over the world, but several problems which must be solved have remained in it. The first is the confusion in the choice of a standard meal of ordinary food labeled with radioisotope. A meal for use in this studies must be reproducible in quality, and radioisotope must be homogenously distributed in it. It is necessary to consider the efficiency of examination, and to release a examinee's agony, therefore a meal must leave the stomach within the tolerable limits of a patient who keeps himself unshaken during measurement. If a liquid meal is used, we can easily make use of foods on the market. But, if a solid meal, a practical difficulty stands in front of us; Who prepares to cook it? Unless this problem has been solved, the radioisotopic method is never found general acceptance as a clinical examination. The second is the confusion in the choice of a posture during measurement. We must select such posture that never alter a patient's characteristics of his gastric emptying. For example, it is difficult to prove rapid evacuation in a patient with dumping syndrome, if we examine him in supine position. A final problem is to re-examine what kinds of index are necessary to investigate the gastric emptying curve with many variations except of half-emptying time which has been used popularly as the index of the rate of it. We gave an out-line of the methods of measuring gastric emptying using radioisotope and a suggestion of its some problems awaiting solution.

[Experience of surgical therapy of pyothorax in the pleural fistula of the bronchi and esophagus due to esophageal cancer].

The esophagectomy and total left pneumonectomy were carried out in a 53-year-old male who had developed pyothorax in the pleural fistula of the bronchi and esophagus due to esophageal cancer, and then reconstruction of the esophagus by route of the anterior thoracic wall was performed using stomach tube biphasically. The postoperative course was favorable, and oral intake was possible, and his physical condition recovered as the patient could repeat stopping out from hospital while he died by pneumonia after 7 months. The remote metastasis or metastasis to the mediastinal lymph-node were not noted by autopsy. It is considered that there are cases having indication for active resection among A3-esophageal cancers.

[A study of the antineoplastic activity of K18].

K18 is a new drug produced by a combination of Melphalan and human immunoglobulin. K18 produced an inhibitory effect on the proliferation of human gastric and colon cancer transplanted in to nude mice. Also, combination effects of K18 with MMC and 5-FU were recognized in the same system. In a study of distribution after K18 administration, the accumulation and retention of this drug in the tumor region were observed. In the case of Melphalan administration, these phenomena were not observed. The antitumor activity of tumor homogenate was evaluated using a colony-forming assay with KB cells. As to the Melphalan-treated group, a four-hour homogenate reduced the number of colonies but a 48-h one did not. In the K18-treated group, the four-hour homogenate decreased the number slightly and the decrease became obvious with 48-h homogenate. In cell cycle analysis using K18 or Melphalan administration, gathering of S-phase cells was observed, but these changes appeared later with K18 than with Melphalan. This result showed that the effect of K18 was produced by the alkylating activity of Melphalan which was combined with immunoglobulin. For clinical application, K18 was administered to cancer patients at a dose of 60-90 mg every day. Two cases of good response were achieved. No side effect was observed. This remarkable efficacy and low degree of side effects in clinical application is probably due to the higher affinity and accumulation of K18 in the tumor region. K18 is a useful new drug for clinical application alone, or in combination with other chemotherapeutic drugs.

[A cooperative study of alternating immunochemotherapy with futraful and PSK (second report)--3-year survival rate].

Patients who had undergone gastrectomy for stomach cancer were placed on adjuvant chemotherapy two weeks after surgery. They were divided into three groups according to the following regimen in order to compare the 3-year survival rate : in the first group, administration of futraful was carried out for 3 consecutive months and followed by administration of PSK for 2 consecutive months. This course was repeated for more than 2 courses. Administration of futraful in the second group was repeated for 3 consecutive months with 2 months of withdrawal and repeated for more than 2 courses. The third group received surgery alone. When all the patients of each group were compared, there was no difference in 3-year survival rate, but the group receiving alternating therapy with futraful and PSK showed a significantly high survival rate for the first year only. Further, among patients having stage III carcinoma, those with n2 + n3 or poorly differentiated adenocarcinoma had a remarkably high survival rate.

[Immunosuppressive treatment of ulcerative colitis].

5-aminosalicylic compounds and corticosteroids are standard drugs, which have been used for treatment of ulcerative colitis (UC). Although unusually we experience severe active UC, such as refractory cases to these drugs. Immunosuppressive agents are introduced and effective for these cases. In the treatment for UC, 6-mercaptopurine and azathioprine are effective, but it takes a few months until their optimum effect. So these drugs are not suitable for severe active UC which needs rapid treatment. On the other hand, newer immunosuppressive agents such as cyclosporin, tacrolimus have a rapid onset of action. These drugs are very effective, but have side effects. We will review immunosuppressive treatment strategy of UC.