Observation of the spatial distribution of gravitationally bound quantum states of ultracold neutrons and its derivation using the Wigner function.

Ultracold neutrons (UCNs) can be bound by the potential of terrestrial gravity and a reflecting mirror. The wave function of the bound state has characteristic modulations. We carried out an experiment to observe the vertical distribution of the UCNs above such a mirror at the Institut Laue-Langevin in 2011. The observed modulation is in good agreement with that prediction by quantum mechanics using the Wigner function. The spatial resolution of the detector system is estimated to be 0.7 µm. This is the first observation of gravitationally bound states of UCNs with submicron spatial resolution.

Hg concentrations in fish from coastal waters of California and Western North America.

The State of California conducted an extensive and systematic survey of mercury (Hg) in fish from the California coast in 2009 and 2010. The California survey sampled 3483 fish representing 46 species at 68 locations, and demonstrated that methylHg in fish presents a widespread exposure risk to fish consumers. Most of the locations sampled (37 of 68) had a species with an average concentration above 0.3µg/gwet weight (ww), and 10 locations an average above 1.0µg/gww. The recent and robust dataset from California provided a basis for a broader examination of spatial and temporal patterns in fish Hg in coastal waters of Western North America. There is a striking lack of data in publicly accessible databases on Hg and other contaminants in coastal fish. An assessment of the raw data from these databases suggested the presence of relatively high concentrations along the California coast and in Puget Sound, and relatively low concentrations along the coasts of Alaska and Oregon, and the outer coast of Washington. The dataset suggests that Hg concentrations of public health concern can be observed at any location on the coast of Western North America where long-lived predator species are sampled. Output from a linear mixed-effects model resembled the spatial pattern observed for the raw data and suggested, based on the limited dataset, a lack of trend in fish Hg over the nearly 30-year period covered by the dataset. Expanded and continued monitoring, accompanied by rigorous data management procedures, would be of great value in characterizing methylHg exposure, and tracking changes in contamination of coastal fish in response to possible increases in atmospheric Hg emissions in Asia, climate change, and terrestrial Hg control efforts in coastal watersheds.

Treatment with mild brain hypothermia for cardiopulmonary resuscitation after myoclonic seizures in infant with robertsonian type of trisomy 13.

Congenital chromosomal abnormality with trisomy 13 is known to be associated with poor life prognosis and lethal. Therefore, physician advice the patients be kept in intensive treatment with resuscitation and state of the art intensive care when sudden change in the general condition with this trisomy is observed. We report herein, the treatment with mild brain hypothermia therapy for cardiopulmonary resuscitation after myoclonic seizures in infant with Robertsonian type of trisomy 13 in intensive care unit. Our study indicated that brain hypothermia therapy and steroid pulse therapy on an infant who was believed to have post-resuscitation hypoxic encephalopathy was highly effective as the patient's general condition recovered to the original state after four months.

Studies of anaerobic bacteria in chronic otitis media.

In the 760 cases of chronic otitis media studied from 1970 to 1976, the detection ratio of anaerobic bacteria and the relation between the nature of anaerobic bacteria and the conditions of focus were investigated. In 8.2% of 760 cases 9 kinds and 81 strains of anaerobic bacteria was detected. Most of the anaerobic bacteria were Peptococcus sp. or Bacteroides sp. and in general non-sporogenic anaerobic bacteria accounted for 97.5%. Anaerobes were frequently detected in cases where the middle ear cavity was filled with cholesteatoma or granulation and in cases of infection recurring after operation.

A clinical study on the magnetic stimulation of the facial nerve.

OBJECTIVES: A clinical study on the usefulness of magnetic stimulation of the facial nerve, with special attention paid to the selection of the coil shape and stimulation procedures. STUDY DESIGN: The subjects consisted of 55 patients with Bell's palsy, 1 patient with a cerebellopontine angle (CPA) tumor, 1 patient with multiple sclerosis (MS), and 30 normal subjects. Three types of coils were used in this study; a 90-mm large single coil, a 40-mm small single coil, and a 20-mm small double coil. METHODS: The compound muscle action potentials (CMAPs) and long latency response were evoked by transcranial magnetic stimulation (TMS) with a 90-mm large single coil. The 40-mm small single coil was used to test blink reflex by aiming it at the supraorbital nerve as the target site. The subcutaneous activation of the infra-auricular facial nerve was performed with the 20-mm double coil. RESULTS: The reproducible CMAP and long latency responses were obtained from normal subjects with TMS. However, responses were observed only in patients with relatively mild Bell's palsy. The magnetic stimulation-evoked responses reflected the brainstem function in the patients with a CPA tumor and MS. CONCLUSION: Although magnetic stimulation remains inferior to conventional electric stimulation in some sense and requires further study, this method is potentially useful because it can stimulate the facial nerve continuously from the cortex to the periphery and can effectively evoke responses reflecting the brainstem function.

Microorganisms isolated from infected aural fistulas.

Aural fistula is a congenital deformity of the external ear relatively common in Orientals and rare in Caucasians. Suppuration tends to occur, and chemotherapy rather than surgical drainage should be attempted. However, the lack of information concerning infected aural fistulas has made appropriate chemotherapy difficult. Microorganisms isolated from 13 cases of infected aural fistulas were studied from January 1981 to December 1982. Six species and 22 strains were isolated; nonsporeforming faculative anaerobes were detected in 12 cases. The isolated pathogens included Peptococcus sp (10 cases), Peptostreptococcus sp (3), Bacteroides sp (3), and Fusobacterium sp (2). One case exhibited only Staphylococcus aureus. Our data also stresses the etiologic importance of anaerobic gram-positive cocci in infected aural fistulas.

Treatment of laryngotracheoesophageal cleft.

Four patients with laryngotracheoesophageal cleft were treated in our institution. Two of the patients survived and two died. Cleft levels ranged from partial 15 mm laryngotracheoesophageal to total with extended right bronchoesophageal cleft.

Bacteriology of acute otitis media in Japan and chemotherapy, with special reference to Haemophilus influenzae.

Middle ear effusions from 574 patients with acute otitis media (AOM) were sampled and cultured in metropolitan Tokyo. Sampling was done by myringectomy and from otorrhea after the occurrence of spontaneous perforation. Streptococcus pneumoniae and Haemophilus influenzae were isolated more widely in 'fresh' (myringotomized) cases than in 'old' cases. The freshness of cases, and the sampling and culture techniques appear to account for the difference in reports concerning causative pathogens of AOM from Japan on one hand and the U.S.A. and Scandanavia on the other. The relatively high detection rate of H. influenzae indicates its importance in all age groups. H. influenzae was isolated from a second group of 50 patients, and MIC values were determined. ABPC proved to be the most effective chemotherapy, except in cases (10%) of beta-lactamase producing H. influenzae. The correlation between the main causative pathogens of AOM and penicillin concentrations found in middle ear effusions was also investigated. The oral administration of 10-12 mg/kg of ABPC surpassed the 85% MIC level against H. influenzae.

Effects of folinic acid on 5-fluorouracil induced cell lethality with or without cisplatin against head and neck laryngeal squamous carcinoma multicellular tumor spheroids.

We evaluated the efficacy of folinic acid (Leucovorin, LV) on cell lethality induced by 5-fluorouracil (FU) alone or in combination with cisplatin (DDP) by using the HEp-2 laryngeal squamous carcinoma multicellular tumor spheroids (MTS) system. For LV, non-toxic concentration of 10(-5) M was used. For cells in the monolayer, 6 and 24 h exposure to LV increased FU-induced cell lethality approximately 7- and 2-fold, respectively, whereas LV did not influence the effect of FU for MTS. LV's lack of effect on cells in MTS may be interpreted to mean that LV cannot penetrate the MTS. For the monolayer, simultaneous exposure to 3 drugs, DDP, FU and LV, produced synergistic interaction. However, sequential exposures were marginally synergistic or antagonistic, irrespective of sequence of DDP first or last. In contrast, DDP followed by FU plus LV was most synergistic for MTS. Simultaneous exposure was also synergistic, however, FU plus LV followed by DDP was antagonistic. These results suggest that LV is unable to penetrate into the MTS core to potentiate FU activity. DDP appears to have enhanced LV penetration into the MTS core. The exploration of means to overcome limited penetration of LV appears important for successful treatment of head and neck carcinoma.

Synergistic interaction of natural human tumor necrosis factor-alpha/natural human interferon-alpha mixture alone and in combination with cisplatin against head and neck laryngeal squamous carcinoma multicellular tumor spheroids.

We evaluated the effects of each component, natural human tumor necrosis factor-alpha (nHuTNF-alpha) and natural human interferon-alpha (nHu-IFN-alpha), and the combined nHuTNF-alpha/nHuIFN-alpha preparation with or without cisplatin (DDP) at tumor mass level. Multicellular tumor spheroids (MTS) of approximately 500 microns in diameter were produced from HEp-2 laryngeal squamous carcinoma cell line by liquid overlay culture technique. Cell kill effects of 72 hr exposure to nHuTNF-alpha, nHuIFN-alpha, or nHuTNF-alpha/nHuIFN-alpha against cells in MTS were 2-3-fold less than those in monolayer. In MTS, does response curves become progressively flat at high drug concentrations, indicative of poor drug penetration into the MTS core. Combination nHuTNF-alpha/nHuIFN-alpha produced synergistic cell kill for both MTS and monolayers. For monolayer cells exposure to nHuTNF-alpha/nHuIFN-alpha first (72 hr) followed by DDP (1 hr) after 1 hr rest period was synergistic with combination index (CI) of approximately 0.8 at LD50. Simultaneous (72 hr in nHuTNF-alpha/nHuIFN-alpha with DDP in last 1 hr) or reverse order of exposure were antagonistic. In contrast, for MTS, DDP followed by nHuTNF-alpha/nHuIFN-alpha was most synergistic with CI of approximately 0.2. Simultaneous exposure or nHuTNF-alpha/nHuIFN-alpha followed by DDP showed synergism with CI of approximately 0.5 and 0.8, respectively. The improved efficacy of DDP followed by nHuTNF-alpha/nHuIFN-alpha sequence for MTS cells appears to be due to increased nHuTNF-alpha/nHuIFN-alpha penetration into the MTS core aided by DDP.

Equivalent dipoles for middle latency auditory evoked potentials using the dipole tracing method.

During the last decade, new dipole localization techniques have prompted the search for the neuronal generators of evoked potentials. In this study we have reported the equivalent dipoles for the middle latency auditory evoked potentials (MAEPs) by the mean of these localization using the dipole tracing method. MAEPs that were recorded from 19 normal human subjects attending to random binaural clicks were analyzed using the dipole tracing method. Equivalent dipoles (EDs) were found, using both the single-dipole model and the two-dipole model, for components occurring from 0 to 60 ms after stimulus onset. The dipole analysis accounted for the real head geometry based on three-dimensional digitization of measured head shape, and the results were experimentally correlated to those of magnetic resonance imaging to increase the accuracy of ED localization. For components in the first 15 ms latency (P0 and Na), neither model provided EDs with reproducible high dipolality. Na was particularly difficult to analyze, as this component was often contaminated by myogenic potentials. The results provided by the two-dipole model for the Pa component (20-30 ms) showed three variations: in three subjects, one ED was located in each supratemporal cortex; in another three, one ED was located in the right temporal cortex and the other in the midbrain; and in the remaining thirteen subjects, both EDs were in the midbrain. The single-dipole model and the two-dipole model both found EDs in the midbrain for Nb. Further study is necessary to determine the cause or causes of the variety in our results. And it is also necessary to try the study using unilateral ear stimulation with/without contralateral masking noise for understanding the mechanism of the binaural interaction.

Induction chemotherapy with cisplatin, etoposide, and mitomycin-C (PEM) regimen in advanced cases with cancer of pharynx and oral cavity.

With the aim of improving survival rate in advanced head and neck cancer, we scheduled 26 patients to receive PEM regimen. This regimen consisted of cisplatin (CDDP)(P), etoposide (VP-16)(E), and mitomycin-C (MMC)(M) (CDDP 60 mg/ m2/2 hr infusion on day 1; VP-16 40 mg/m2/1 hr infusion on days 1-3; MMC 7 mg/m2 iv bolus on day 1). Of 25 patients evaluable for response, 8 complete response (CR), 14 partial response (PR) were achieved, with an overall response rate (RR) of 88%. Myelosuppression was major side effect and thrombocytopenia (23% greater than WHO grade) was dose limiting toxicity. Other adverse reactions including mucositis were all mild and transient. Since limited mucosal toxicity, full course of following treatment including radiotherapy and/or surgery could be done satisfactorily. We concluded that this regimen produced beneficial effect as the adjuvant setting in patients with cancer in pharynx and oral cavity because of limited mucosal toxicity.

[A case of convergence spasm in hysteria improved with a brief psychiatric assessment].

We report a 16-year-old female who developed double vision. The diplopia was in the horizontal plane and persisted for 3 weeks. She also complained of headache and nausea. She kept her eyes closed unless she was told to open. When eyelids were passively open, both eyes deviated inward in an adducted position. The pupil size and the reaction to light were normal. No weakness was noted in the extraocular muscles when each eye was examined individually. The rest of the neurologic examinations were normal. We thought that she had a convergence spasm. Brain CT and MRI were normal. The CSF and blood chemistries were also normal. We treated her with supportive psychotherapy and her convergence spasm disappeared. We concluded that her convergence spasm was a manifestation of conversion hysteria.

[Combination chemotherapy of solid tumor--effects of hyaluronidase on doxorubicin (DXR) penetration into multicellular tumor spheroids (MTS)].

We have studied the effects of hyaluronidase (HYD) on the penetration and cell kill effect of doxorubicin (DXR) using multicellular tumor spheroids (MTS). MTS of approximately 500 microns in diameter were prepared by liquid over lay culture technique from PC-10 lung and HEp-2 laryngeal squamous carcinoma cell lines. Cells in MTS and monolayer were exposed for various durations to HYD, followed by 1 hr, rest interval, and by 1 hr. exposure to DXR. MTS and monolayer cells were then trypsinized to a single cell suspension and subjected to clonogenic assay. For PC-10 MTS, pretreatment with HYD for 24 hr. resulted in approximately 10-fold increases in DXR cell kill effects as compared to DXR alone. HEp-2 MTS were more sensitive to HYD pretreatment. Thus, 1 hr. exposure to HYD produced approximately 4-fold increases in DXR-induced cell lethality. Fluorescent microscopic study revealed that 1hr. exposure of MTS to DXR produced DXR fluorescence only 1-2 outer layer of MTS. When MTS were pretreated with HYD, there was an enhanced penetration of DXR fluorescence into the MTS core. HYD-induced enhancement of DXR penetration and its cell kill effect was dependent on the exposure time and tumor cell origin.

A case with quadruple primary cancers of head and neck.

Despite progress in techniques for early detection and treatment of cancers, cases of multiple primary cancers are apparently increasing. This paper reported quadruple primary cancers of stomach, lung, hypopharynx and maxillary sinus in a 63-year-old male. He finally died of brain metastasis and pneumonia by MRSA (Me Resistant S. aureus).

Salvage chemotherapy with PEM and long-CF regimen in CDDP refractory advanced head and neck cancer.

With the aim of increasing complete response rates and improving survival in cisplatin (CDDP)-based combinations (CDDP + 5-fluorouracil (5FU) and/or CDDP+methotrexate (MTX)+bleomycin (BLM) of refractory advanced head and neck cancer, we scheduled 21 patients to receive PEM and Long CF, PEM regimens consisting of CDDP (P) Etoposide (Etop) (E) and mitomycin-C (MMC) (M) (CDDP 60 mg/m2/2 hr. infusion on day 1; Etop 40 mg/m2/1 hr. infusion on day 1, 2, 3; MMC 7 mg/m2 iv bolus on day 1). Of 12 patients evaluable for response, 2 CR, 3 PR were realized, with an overall response rate of 42%. Myelosuppression was the major side effect, and thrombocytopenia (8% greater than WHO grade III) was the dose-limiting toxicity. Long CF consisted of CDDP (C) and 5FU (F) (CDDP 8 mg/m2/2 hr. infusion on day 1-5, 8-12, 15-19, 22-26; 5FU 300 mg/m2/24 hr. infusion or tegaful.uracil (UFT-E) 400 mg/m2 P.O. on day 1-28. Of 8 patients evaluable for response, 3 PR were realized, with an overall response rate of 38%. N&V and leukopenia were the major side effects. These adverse reactions were all transient. We concluded that these two regimens produced beneficial effects in patients with advanced recurrent head and neck cancer which had already been treated with CDDP-based combinations.

[Late phase II clinical study of RP56976 (docetaxel) in patients with advanced/recurrent head and neck cancer].

A late phase II clinical study of RP56976 (docetaxel), a new anticancer agent for advanced/recurrent head and neck cancer, was conducted in 29 institutions all over Japan as a multi-institutional cooperative study. Docetaxel was administered by 1 to 2-hour intravenous infusion at a dose of 60 mg/m2 every 3 to 4 weeks. Of 63 patients eligible in this study, 59 were judged as complete cases. Complete response (CR) was observed in 1 patient, partial response (PR) in 13, no change (NC) in 25, and progressive disease (PD) in 20, for an overall response rate of 22.2% (14/63, 95% CI: 12.7-34.5%) in eligible cases, and 23.7% (14/59, 95% CI: 13.6-36.6%) in complete cases. Previously treated patients showed a 17.9% (10/56) response rate, whereas treatment--naive patients showed a 57.1% (4/7) response rate. Among 46 patients who received prior chemotherapy, one CR and 7 PR were observed with a 17.4% response rate. Major hematological toxicities were leucopenia in 95.1% (> or = grade 3, 59.7%) and neutropenia in 90.3% (> or = grade 3, 79.0%). Other severe toxicities (> or = grade 3) included anorexia in 9.7% (6 cases), diarrhea in 3.2% (2 cases), dyspnea in 3.2% (2 cases), and fatigue in 3.2% (2 cases). One patient had a grade 3 interstitial pneumonia; however, symptoms were resolved by the administration of corticosteroids. During this study, one patient died due to multiple organ failure (MOF) caused by disseminated intravascular coagulation (DIC), and this case was reported as a therapy-related death. Based on these results, docetaxel is an active agent for treatment of head and neck cancer.

[Magnetic stimulation of the facial nerve].

Intracranial activation of the facial nerve and the face-associated motor cortex are now possible with noninvasive magnetic stimulation techniques. Compound muscle action potentials (CMAPs) and the Blink reflex, in response to magnetic stimulation, were investigated. Subjects were 10 normal controls and 2 Bell's palsy patients. CMAPs were elicited in the orbicularis oris muscle by magnetic stimulation at the parieto-occipital skull and stylomastoid foramen. Furthermore, CMAPs were evoked by a magnetic coil oriented over the cortex. CMAP recording was possible with magnetic stimulation and the latencies of CMAPs at the parieto-occipital skull were slightly greater than those at the stylomastoid foramen. In 10 normal subjects, the mean onset latency following transcranial magnetic stimulation of the facial nerve at the parieto-occipital skull was 5.07 msec (SD = 0.40), while transcutaneous latency at the stylomastoid foramen was 2.77msec (SD = 0.539). In the blink reflex, R1 latency was 10.99 msec (SD = 1.27), ipsilateral-R2 latency was 37.46 msec (SD = 2.57), and contralateral-R2 latency was 38.925 msec (SD = 3.20). The blink reflex thus had a configuration similar to that evoked by conventional electrical stimulation. In the patients with Bell's palsy, CMAPs elicited by magnetic stimulation were of low amplitude with normal latency. However, in the blink reflex, only a contralateral R2 response could be recorded, and R1 and ipsilateral-R2 showed no response to stimulation at the affected side. Investigation of patients with Bell's palsy using this technique may therefore prove useful in the evaluation of peripheral facial nerve disorders.