Conservative treatment with hyperbaric oxygen therapy for cervical spondylotic amyotrophy.

STUDY DESIGN: Small case series of patients with cervical spondylotic amyotrophy (CSA) managed by conservative treatment with hyperbaric oxygen (HBO) therapy. OBJECTIVE: To study the effects of conservative treatment with HBO therapy of CSA patients. SETTING: Department of Orthopaedic Surgery, Imakiire General Hospital, Kagoshima, Japan. METHODS: This study included 10 patients with CSA who underwent rehabilitation, including cervical traction and muscle exercise, for some period of time but did not respond well to it, and were then managed by additional HBO therapy for rehabilitation. Information was obtained on the duration of symptoms and strength of the most atrophic muscle, intramedullary high-signal-intensity changes on T2-weighted magnetic resonance imaging, presence of 'snake-eyes' appearance and the number of stenotic canal levels. RESULTS: The mean duration of symptoms before HBO treatment was 3.1 months. The axial T2-weighted magnetic resonance images of all 10 patients showed a 'snake-eyes' appearance. The mean number of stenotic canal levels was 0.3. There was marked improvement on manual muscle testing from a mean of 1.9 pretreatment to a mean of 4.4 at the last follow-up after HBO therapy. The outcomes of all 10 patients, whose results were classified as excellent or good, were considered clinically satisfactory. CONCLUSION: To our knowledge, conservative treatment with HBO therapy for CSA patients has not previously been described. It appears that HBO therapy might improve ischemic injury of the anterior horns in CSA patients with short duration of symptoms.

O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) uptake in mouse thymoma cells, and its biodistribution in mice and human volunteers.

PURPOSE: To evaluate O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) uptake in mouse malignant thymoma (EL4), and its biodistribution in mice and humans. MATERIAL AND METHODS: First, 18F-FET uptake in EL4 cells was examined in an in vitro study. Second, the kinetics of 18F-FET uptake and its biodistribution were examined in mice after subcutaneous injection of EL4 cells and complete Freund's adjuvant. Finally, the kinetics of 18F-FET uptake and its biodistribution in healthy human volunteers were examined. RESULTS: In an in vitro study, 18F-FET was extensively incorporated in EL4 cells. In an animal study, 18F-FET accumulation in normal organs peaked within 30 min postinjection. The mean ratios of 18F-FET uptake in tumors and in inflammatory lesions to that in muscle tissue at 60 min postadministration were 2.18 (range 2.00-2.29) and 1.04 (range 0.95-1.14), respectively. In a human study, static images were taken 60 min after 18F-FET administration. Mean standardized uptake values (SUVs) of the liver (1.52, range 1.38-1.71) and kidneys (1.90, range 1.74-2.24) were nearly equal or slightly higher than that of muscle tissue (1.19, range 0.99-1.33). CONCLUSION: This study demonstrates that 18F-FET accumulation in thymoma is significantly higher than in normal organs. 18F-FET could be a useful tracer for tumor imaging.

Effect of Er:YAG laser irradiation on acid resistance to bovine dentin in vitro.

Resin bond strength to Er:YAG laser irradiated dentin has been reported to be lower than that of unlased dentin. The reasons have been much discussed, but not clarified. One hypothetical cause has been discussed that lased dentin is acid resistant, therefore, the etching effect of acid conditions decreases. The purpose of this study was to evaluate the acid resistance of laser-irradiated dentin and compare it with the dissolved mineral of Er:YAG laser irradiated dentin and unlased dentin. This experiment was a pilot study to assess the etching effect of pre-conditioner for resin bonding to lased dentin. Bovine dentin was irradiated by Er:YAG laser and immersed in 0.1 M lactic buffer solution (pH 4.0). The dissolved Ca and P in the solution were then both measured. Dissolved Ca from lased dentin was not significantly different from that coming from unlased dentin (p > 0.05). The molar ratio of Ca/P did not differ significantly between lased and unlased dentin, either (p > 0.05). Under FE-SEM view before immersion, the dentin surface was covered with a smear layer in unlased dentin, but this layer was not clearly observed in lased dentin. These results suggested that the lased dentin had little or no resistance to lactic buffer solution.

Relationship of coffee consumption with serum lipids and lipoproteins in Japanese men.

PURPOSE: To examine the relationship of instant coffee and brewed coffee with serum lipids and lipoproteins in Japanese men. METHODS: Study subjects were 4587 male self-defense officials aged 48-56 years who had a preretirement health examination at one of the three hospitals of the Self-Defense Forces from October 1986 to December 1992. A self-administered questionnaire ascertained lifestyle characteristics including consumption of a limited number of foods and beverages by all of the men. Serum concentrations of total cholesterol (TC), triglycerides (TG), and high density lipoprotein (HDL) cholesterol were measured, and low density lipoprotein (LDL) cholesterol levels were calculated from the values of TC, TG, and HDL cholesterol. RESULTS: While the consumption of brewed coffee was unrelated to any parameter of serum lipids and lipoproteins, instant coffee consumption showed a highly significant positive association with serum LDL cholesterol levels and an inverse association with serum TG levels. After adjustment for body mass index, smoking, alcohol use, green tea consumption, rank, and hospital, for each cup of instant coffee per day, LDL cholesterol levels were 0.82 mg/dl (95% confidence interval (CI) 0.29-1.35) higher, and TG levels in a natural log-scale were 0.014 mg/dl (95% CI 0.006-0.022) lower. There was also a tendency for a positive association between instant coffee intake and serum TC levels (trend p = 0.09). HDL cholesterol levels were unrelated to instant coffee consumption. These associations did not change after additional adjustment for selected foods and beverages associated with serum lipids and lipoproteins. CONCLUSIONS: The findings suggest that instant coffee, not brewed coffee, may be associated with raised levels of serum LDL cholesterol and decreased levels of serum TG.

Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males.

Consumption of caffeine-rich beverages, which have diuretic properties, may decrease serum uric acid concentrations. We examined cross-sectionally the relationship of coffee and green tea consumption to serum uric acid concentrations in 2240 male self-defence officials who received a pre-retirement health examination at four hospitals of the Self-Defence Forces between 1993 and 1994. The mean levels of coffee and green tea consumption were 2.3 and 3.1 cups/d respectively. There was a clear inverse relationship between coffee consumption and serum uric acid concentration. When adjusted for hospital only, those consuming less than one cup of coffee daily had a mean serum uric acid concentration of 60 mg/l, while that of those drinking five or more cups of coffee daily was 56 mg/l (P < 0.0001). No such relationship was observed for green tea, another major dietary source of caffeine in Japan. The relationship between coffee consumption and serum uric acid concentration was independent of age, rank in the Self-Defence Forces, BMI, systolic blood pressure, serum creatinine, serum total cholesterol and serum HDL-cholesterol concentrations, smoking status, alcohol use, beer consumption and intake of dairy products. These findings suggest that coffee drinking may be associated with lower concentrations of serum uric acid, and further studies are needed to confirm the association.

Fibroblast-migration in a wound model of ascorbic acid-supplemented three-dimensional culture system: the effects of cytokines and malotilate, a new wound healing stimulant, on cell-migration.

To assess the migratory response of fibroblasts in vitro, normal human dermal fibroblasts (NHDF) were cultured in the presence of L-ascorbic acid 2-phosphate to induce a multilayered structure. Round wounds were made by punching, and the migratory response was evaluated by counting the number of migrating cells in the wounded areas. Collagenase activity in the culture-medium was then measured. When the wound model was treated with bFGF, IL-1 alpha or PDGF, the migratory response was facilitated with increased collagenase secretion. In contrast, treatment with TGF-beta reduced the migratory response and collagenase secretion. Since the multilayered structure is rich in collagenous matrix, degradation of the matrix by secreted collagenase is probably necessary for the cells to migrate into the wounded areas. Furthermore, malotilate, which is now under development as an agent for wound therapy, facilitated the migratory response of NHDF with increased collagenase secretion in this wound model, suggesting that the wound healing effect of malotilate is in part attributable to stimulated migration of fibroblasts to wounded areas subsequent to extracellular matrix-degradation.

Hyperbaric oxygenation prevents delayed neuronal death following transient ischaemia in the gerbil hippocampus.

The mechanism of the neuroprotective effect of hyperbaric oxygenation remains unclear although its clinical benefits have been well recognized for human ischaemic neuronal disease. The preventive effect of hyperbaric oxygenation against delayed neuronal death was investigated in the gerbil following transient forebrain ischaemia. Delayed neuronal death in the gerbil was produced by clips on both the common carotid arteries (10 min). Morphological examination was carried out after several protocols of hyperbaric oxygenation, modified from the protocols for human ischaemic neuronal disease. Neurons in the hippocampal CA1 were well preserved in the gerbils treated with hyperbaric oxygenation, more so than in the gerbils with no hyperbaric oxygenation. Moreover, more neurons were preserved in the CA1 treated with hyperbaric oxygenation within 6 h of the ischaemia, than when the hyperbaric oxygenation was started 24 h after the ischaemia. The induction of heat shock proteins (HSP72 and HSP27) became weaker in the gerbils with hyperbaric oxygenation than in those without hyperbaric oxygenation, as seen immunohistochemically. We also observed an increase in dense bodies, that were shown to be lysosomes and myelinoid structures in the cytoplasm of the neurons ultrastructurally, in the hippocampus with hyperbaric oxygenation. However, no oxygen toxicity to the neurons was detected, up to at least two atmospheres absolute. This experimental system was useful to investigate the preventive mechanism of hyperbaric oxygenation against delayed neuronal death in the gerbil, and to determine the clinical indications and the most effective protocol for hyperbaric oxygenation for ischaemic neuronal damage in the human brain.

Estimation of fluoride intake in relation to F, Ca, Mg and P contents in infant foods.

The purposes of this present study were to determine F, Ca, Mg and P contents of infant foods available in Thailand and Japan in relationship to ionization of F from dietary sources and also to estimate the daily F intake of infants during the first six months of life. Samples of 31 and 24 foods from Thailand and Japan were analysed. Microdiffusion technique was used to separate F from food samples. The combination of an F electrode with an ion analyzer was used to determine F. Determination of Ca and Mg of ashed samples were carried out by the atomic absorption spectrophotometry and Chen, Toribara and Warner method was used in P analysis. F content found in infant formulas and supplemented foods were generally low, especially in infant foods in Thailand, while Ca, Mg and P contents were high in various food items tested. The estimation of daily F intake showed that foods cannot provide an infant with a daily F intake at the optimal level. The results of this study indicate that some food constituents play significant roles in daily F intake by influencing F absorption.

[Clinical effect of the combined therapy of arbekacin and imipenem/cilastatin against methicillin-resistant Staphylococcus aureus].

We evaluated the efficacy of combined therapy of arbekacin (ABK) and imipenem/cilastatin (IPM/CS) against infections by methicillin-resistant Staphylococcus aureus (MRSA). The MICs of ampicillin, cefmetazole, cefotiam, cefuzonam, flomoxef, fosfomycin, ofloxacin, minocycline, ABK and IPM/CS against clinically isolated strains of MRSA were examined. Almost all strains of MRSA were resistant to these antibiotics except ABK. Furthermore, combination of ABK and IPM/CS showed smaller MICs than that of ABK or IPM/CS alone. All fractional inhibitory concentration indices (FIC indices) of ABK plus IPM/CS were lower than 0.75. The efficacy rate of combined therapy of ABK and IPM/CS in 22 patients with MRSA infections (15 patients with pneumonia, 3 patients with chronic bronchitis, 2 patients with sepsis, a patient with subcutaneous abscess and a patient with DPB) was 68%. And no patients had adverse reactions. Six (27%) of 22 strains of MRSA were eradicated. Significant correlations were found between bacteriological effect and severity of disease, and between serum albumin level and clinical effect.

[A case of endometrial tuberculosis diagnosed by polymerase chain reaction].

A 30-year-old female was admitted to our hospital for further investigation of infertility. The menstrual culture and polymerase chain reaction (PCR) of the endometrial tissue for detection of Mycobacterium tuberculosis were both positive. The pelvic CT scan and hysterosalpingography showed a slightly expanded uterus and irregularity of the endometrium. Barium enema and pyelography showed no abnormality. Since these data established a diagnosis of early primary endometrial tuberculosis, the combined therapy of three antituberculous agents was commenced. Menstrual smear, culture and PCR for M. tuberculosis were examined monthly throughout the therapy. The mycobacterial culture became negative soon after the start of therapy, followed by a negative PCR result 3 months later. We conclude that PCR is useful for the rapid detection of M. tuberculosis not only in pulmonary but also in endometrial tuberculosis.

Interstitial radiofrequency hyperthermia for brain tumors--preliminary laboratory studies and clinical application.

An interstitial radiofrequency (RF) hyperthermia system for brain tumor was evaluated in cranial phantoms and cat brains. An intracranial RF applicator and thermocouple microprobes were emplaced in the brain and a headband-type flexible extracranial electrode fixed over the scalp. An 8 MHz RF capacitive-type heating machine provided power. The temperature distribution was measured by thermography. In phantom and animal studies, the RF power had good penetration into the tissue and generated uniform and easily controllable high-temperature fields within the intracranial cavity. There was little change in temperature near or in the cranium itself. Six cases of human malignant glioma were treated with this interstitial RF hyperthermia system, achieving therapeutic temperature without adverse effects.

A comparison of daily fluoride intakes from food samples in Japan and Brazil.

The purpose of this study was to analyse the fluoride content of Japanese infant foods and foods in Brazil and to estimate daily fluoride intake calculated for a 6-month-old infant which reflects supplemental fluoride increased from infant foods and decreasing breast-feeding and commercial milk-feeding. Fluoride concentrations of 26 samples were assessed by a modified microdiffusion method and fluoride ion selective electrode. The fluoride content varied from 0.53 to 1.33 microgram/g for milk-base formulas, from 0.46 to 2.94 micrograms/g for infant foods in Japan, and from 0.06 to 0.25 microgram/g for foods in Brazil. The daily fluoride intake was calculated according to feeding pattern. The minimum and maximum fluoride values were 0.080 mg/day and 0.248 mg/day, respectively. These fluoride intakes, expressed in milligrams per kg of fluoride intake, ranged from 0.010 to 0.033 mg F/kg body weight. No significant differences in fluoride intake values were found between Japanese infant foods and foods in Brazil. The results of this study indicate that daily fluoride intakes of Japanese infant foods and foods in Brazil could be considered within the optimal recommended level.

Topical treatment of pulmonary aspergilloma by antifungals. Relationship between duration of the disease and efficacy of therapy.

Twelve patients with aspergilloma were treated with intracavitary or endobronchial administration of antifungals. Patients with successful therapy had significantly shorter mean duration of the disease course (3.6 months) than the less effective group (44.4 months, p < 0.01). Minimal inhibitory concentrations of antifungal agents against isolated strains of aspergilli were considerably lower than estimated intracavitary concentrations of the antifungals. A pathologic examination suggested that the old mycetoma was for the most part comprised of dead mycelial cells, against which antifungal agents were not effective. However, clinical improvement was obtained, regardless of the roentgenographic improvement. Our study suggested that early diagnosis and therapy are recommended to achieve better therapeutic effect.

[Fluoride contents in tea and Sakura-shrimp in relation to other inorganic constituents].

The purpose of this study is to determine the fluoride contents of shrimp and of tea samples obtained from Shizuoka prefecture which is famous for tea products area and fishery market and to examine the relations between fluoride and other mineral contents, such as calcium, magunesium and phosphorus. Fluoride contents in tea produced in this area have been reported by Matsuura and Kokubu and other investigators, but more recent data are scarce. Samples were taken from a kind of shrimp known as Sakura-shrimp and from 4 kinds of commercial tea (coarse tea, 2 kinds of green tea and refined green tea). After having been dried and powdered, 1g of each sample was reduced to ashes at 550 degrees C for 10 hours with Ca(OH)2 as a fluoride fixative. Fluoride was distilled from each ash sample at about 140 degrees C with HClO4, and about 200 ml of distillate was collected from each sample. Fluoride contents were determined by means of ion-specific electrode. Calcium and magnesium contents were determined by atomic absorption spectrophotometry, and phosphorus contents were determined by Chen, Toribara and Warner's method. Total fluoride contents of the samples were as follows: 61.73ppm in shrimp, 180.16ppm in coarse tea, 72.62ppm and 89.02ppm in the 2 kinds of green tea, and 71.11ppm in refined green tea. More than 99% of the total fluoride was obtained from 150ml distillate of each sample. Calcium contents were extremely high in shrimp (21,822ppm) and 2,106-2,693ppm in tea samples. Magnesium contents were highest in shrimp (3,088ppm) and lowest in coarse tea (1,333ppm).(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy of NY-198 against experimental Legionnaires disease.

The in vitro and in vivo effects of NY-198 against Legionella pneumophila were compared with those of ciprofloxacin. The MIC of NY-198 against 15 standard reference strains of Legionella of various species, between 0.03 and 0.125 micrograms/ml, was the same as that of ciprofloxacin. The peak concentration of NY-198 in the lungs and sera of guinea pigs with experimentally induced Legionella pneumonia was higher than that of ciprofloxacin after oral administration. The overall survival rate was higher in animals treated with NY-198 than in those treated with ciprofloxacin. Thus, NY-198 appears valuable in the treatment of Legionnaires disease.

The antimicrobial activity of ciprofloxacin against Legionella species and the treatment of experimental Legionella pneumonia in guinea pigs.

The antimicrobial activity of ciprofloxacin was tested against 15 standard reference strains, and 37 clinical and environmental strains of Legionella pneumophila by an agar dilution method, using a new growth medium (B-SYE agar) which we devised. The minimal inhibitory concentrations of ciprofloxacin were found to be inoculum dependent, and ranged from 0.02 to 0.06 mg/l at 10(4) cfu inoculum and 0.02 by 0.125 mg/l at 10(6) cfu inoculum. The most potent antibacterial activity was shown by rifampicin, followed by ofloxacin, ciprofloxacin, enoxacin, norfloxacin, erythromycin and pipemidic acid in that order. The therapeutic efficacy of ciprofloxacin in experimental guinea pig pneumonia due to L. pneumophila was fairly good with a survival rate of 80%. From other data of ours, its effectiveness in experimental pneumonia was equal to or greater than that of erythromycin. Further studies would be appropriate to investigate the possibility of using ciprofloxacin for the treatment of human L. pneumophila infection.