Mini review on chemotherapy of taeniasis and cysticercosis due to Taenia solium in Asia, and a case report with 20 tapeworms in China.

A 43-year-old Tibetan woman living in northwest Sichuan, China, confirmed to be a taeniasis carrier of Taenia solium was treated with pumpkin seeds combined with Areca nut extract in October 2009. All 20 tapeworms except one without scolex were expelled under good conditions. She was free of secondary cysticercosis within one year follow up. Although the first choice for treatment of taeniasis is still praziquantel, it may often cause serious side effect on asymptomatic cysticercosis cases to suddenly become symptomatic within a half day of the treatment. Therefore, the problems in treatment of taeniasis and/or cysticercosis in Asia are briefly overviewed, since other platyhelminthic diseases including schistosomiasis, opisthorchiasis etc. are more common and praziquantel is strongly recommended for mass treatment of these trematodiases with no idea on the co-infection with eggs of T. solium which cause asymptomatic cysticercosis.

Multiple neural origins of early auditory evoked potential of rat.

The multiple-origin hypothesis has been often considered for an unclear neurogenesis of a characteristic wave in various evoked potentials, none of which has been verified so far. Auditory evoked potential (AEP) in the temporal cortex of rodents has typical slow positive/negative (P1/N1) biphasic waves, which are occasionally associated with an additional 2-4-ms earlier small deflection (P0/N0). Despite previous extensive efforts, P0/N0 deflection is still discussed within the multiple-origin hypothesis. In this historical perspective, we hypothesized that observable AEP is an additive mixture of mutually temporally independent signals from different origins, and that the balance of the mixture impacts on the waveform of AEP. We attempted to verify this hypothesis for the first time by independent component analysis (ICA) of epidurally densely mapped AEPs in the primary auditory cortex of rats. The mapping showed that low amplitude AEPs tended to have more P0/N0 deflections in both pentobarbital- and ketamine/xylazine-anesthesia preparations. ICA of these AEP maps suggested that AEP consisted of at least three independent components and that the deflection appeared when subcortical contribution to AEP was equal to or larger than cortical contribution. In epicranially measured evoked potentials, subcortical and cortical contributions are mixed together because distances from electrodes to cortical sources approximate distances to subcortical sources. In such conditions, e.g. in human scalp-recording experiments or routine clinical screenings, our idea is specifically worth considering for the interpretation of signals.

In vitro and in vivo antibacterial activities of TAK-083, an agent for treatment of Helicobacter pylori infection.

The antibacterial activity of TAK-083 was tested against 54 clinical isolates of Helicobacter pylori and was compared with those of amoxicillin, clarithromycin, and metronidazole. The growth-inhibitory activity of TAK-083 was more potent than that of amoxicillin, clarithromycin, or metronidazole (the MICs at which 90% of the strains are inhibited were 0.031, 0.125, 64, and 8 microg/ml, respectively). The antibacterial activity of TAK-083 was highly selective against H. pylori; there was a >30-fold difference between the concentration of TAK-083 required to inhibit the growth of H. pylori and that required to inhibit the growth of common aerobic and anaerobic bacteria. Exposure of H. pylori strains to TAK-083 at the MIC or at a greater concentration resulted in an extensive loss of viability. When four H. pylori strains were successively subcultured in the medium containing subinhibitory concentrations of TAK-083, no significant change in the MICs of this compound was observed. TAK-083 strongly inhibited the formation of tryptophanyl-tRNA in H. pylori while exhibiting little effect on the same system in eukaryotes. TAK-083 was efficacious in the treatment of gastric infection caused by H. pylori in Mongolian gerbils. The results presented here indicate that TAK-083 is a promising candidate for the treatment of H. pylori infection.

Cardiac dysfunction because of secondary hemochromatosis caused by congenital non-spherocytic hemolytic anemia.

Most patients diagnosed with secondary hemochromatosis have had repeated blood transfusions. Cardiac failure accounts for approximately one-third of the deaths associated with hemochromatosis. Liver dysfunction or hormonal disorders such as diabetes generally precede cardiac failure. A 23-year-old woman with hemochromatosis had, despite significant left ventricular dysfunction, liver function within the normal range on biochemical evaluation. She was treated for congestive heart failure and given desferoxamine intravenously. She did not have primary hemochromatosis, and had not received multiple blood transfusions or iron supplement. As a child the patient had been diagnosed with congenital non-spherocytic hemolytic anemia not requiring transfusion; thus, this is a unique case of secondary hemochromatosis.

Major depression and somatic symptoms in a mind/body medicine clinic.

This study examined the prevalence of somatic symptoms and psychiatric characteristics of major depression in a Japanese psychosomatic outpatient clinic. A total of 2,215 outpatients referred for mind/body complaints were assessed by DSM-III-R or DSM-IV. Somatic symptoms were rated using the Cornell Medical Index Questionnaire. Ninety-one outpatients (4.1%) were diagnosed with major depression. Prevalence of fatigue (86%), insomnia (79%), nausea/vomiting (50%), and back pain (36%) as well as degrees of psychosocial stress (DSM-III-R axis IV) were higher (all p < 0.05) and scores of global assessment of psychosocial functioning (DSM-III-R/DSM-IV axis V) were lower (p < 0.001) in the major depressive patients compared to the remaining outpatients. Among the major depressive patients, the total number of somatic symptoms was larger (p < 0.05) in patients with 'severe' major depressive episodes than in those with 'mild' depressive episodes. These findings suggest that the level of depression is closely linked to the reporting of somatic symptoms in a psychosomatic medicine population.

Aureusidin synthase: a polyphenol oxidase homolog responsible for flower coloration.

Aurones are plant flavonoids that provide yellow color to the flowers of some popular ornamental plants, such as snapdragon and cosmos. In this study, we have identified an enzyme responsible for the synthesis of aurone from chalcones in the yellow snapdragon flower. The enzyme (aureusidin synthase) is a 39-kilodalton, copper-containing glycoprotein catalyzing the hydroxylation and/or oxidative cyclization of the precursor chalcones, 2',4',6',4-tetrahydroxychalcone and 2',4',6',3,4-pentahydroxychalcone. The complementary DNA encoding aureusidin synthase is expressed in the petals of aurone-containing varieties. DNA sequence analysis revealed that aureusidin synthase belongs to the plant polyphenol oxidase family, providing an unequivocal example of the function of the polyphenol oxidase homolog in plants, i.e., flower coloration.

The efficacy of predeposited autologous blood transfusions in general pediatric surgery.

Allogeneic blood transfusions are associated with a risk of infection, immunological reactions, immunosuppression, and the induction of antibodies in blood cells. We report our results of giving predeposited autologous blood transfusions (PABT) to children when it was anticipated that transfusions would be required for an elective operation. Autologous blood was collected for deposit from 16 patients ranging in age from 1 to 11 years old (mean 5.6 years old, mode 4 years old), and weighing from 9.7 to 42 kg (mean 20.8kg). They included 12 patients with pectus excavatum (funnel chest) and 4 patients with choledochal cyst (CBD). Blood was collected once from 2 patients and twice from the other 14 patients, then centrifuged and stored in a freezer at -80 degrees C. Between 7 and 14 ml/kg was collected at one time, the total mean volume of predeposited blood being 21.0 +/- 3.3 ml/kg for the children operated on for funnel chest, and 16.2 +/- 4.5 ml/ kg for those operated on for CBD. None of the patients required allogeneic transfusions and no complications occurred. PABT was found to be a safe and effective means for elective general pediatric surgical procedures for avoidance of allogeneic blood transfusion.

Novel proteinaceous toxins from the box jellyfish (sea wasp) Carybdea rastoni.

During summer and autumn, the box jellyfish (sea wasp) Carybdea rastoni is one of the most bothersome stinging pests to swimmers and bathers on the Japanese coast. Two labile but potent hemolytic toxins from the tentacles of Carybdea rastoni were isolated in their active forms using newly developed purification methods. The molecular masses of the isolated C. rastoni toxin-A and toxin-B (CrTX-A and CrTX-B) are 43 and 46 kDa, respectively, as calculated from SDS-PAGE. In the present study, we sequenced the full-length cDNA (1600 bp), which encodes both CrTX-A and CrTX-B. The deduced 450 amino acid sequence of the CrTXs, showed no significant homology with any known protein. This report presents the first complete sequence of a proteinaceous jellyfish toxin. Furthermore, it was revealed that CrTX-A was primarily localized in the nematocyst, whereas CrTX-B was detected only in the tentacle. Because the nematocyst is the organ responsible for the cnidarian sting, the remainder of the study focused on the toxicity of CrTX-A. We found that CrTX-A was fatally toxic to mice at 20 microg/kg (i.v.) and crayfish at 5 microg/kg (i.p.). Subcutaneously injected CrTX-A (0.1 microg) caused inflammation of mouse skin. These results showed that CrTX-A is responsible for the cutaneous inflammation observed in humans stung by C. rastoni.

Isolation and characterization of a novel protein toxin from the Hawaiian box jellyfish (sea wasp) Carybdea alata.

The box jellyfish (sea wasp) Carybdea alata Reynaud, 1830 (Cubozoa) is distributed widely in the tropics. The sting of C. alata causes severe pain and cutaneous inflammation in humans. We successfully isolated C. alata toxin-A (CaTX-A, 43 kDa) and -B (CaTX-B, 45 kDa) for the first time from the tentacle of C. alata collected at a site along the Hawaiian shore. The experimental results showed that CaTX-A, but not CaTX-B, is present in the nematocyst, the organ responsible for stinging. Both CaTX-A and -B showed potent hemolytic activity, with CaTX-A being lethally toxic to crayfish when administered via intraperitoneal injection. Furthermore, we sequenced the cDNA encoding CaTX-A. The deduced amino acid sequence of CaTX-A (463 amino acids) showed 43.7% homology to Carybdea rastoni toxins (CrTXs) but not with any other known proteins. Therefore, these jellyfish toxins potentially represent a novel class of bioactive proteins. Secondary structure analysis of CaTX-A and CrTXs suggested the presence of amphiphilic alpha-helices, which are also seen in several known hemolytic or cytolytic protein toxins, including peptide toxins.

Blood pressure biofeedback treatment of white-coat hypertension.

OBJECTIVE: The objective of the study was to compare blood pressure (BP) biofeedback treatment (BF) effects between white-coat hypertension and essential hypertension. METHODS: Fifteen white-coat hypertensive out-patients and 23 essential hypertensive out-patients were randomly assigned to groups A or B. Subjects in group A underwent BF once a week for a total of four sessions. Those in group B visited the clinic only to measure BP and later underwent the same BF. RESULTS: In group A, BPs of white-coat hypertensives and essential hypertensives were significantly reduced by 22/11 and 14/8 mmHg, respectively. In group B, they were unchanged during the same period but later suppressed by BF. Under BF, pulse and respiratory rates were significantly higher, and elevation of diastolic BP due to mental stress testing was better suppressed in white-coat hypertensives than in essential hypertensives. CONCLUSION: This treatment was effective in both types of hypertension, and pressor response to stress seems to be important in the differentiated BF effect.

Blood pressure biofeedback treatment, organ damage and sympathetic activity in mild hypertension.

BACKGROUND: Although biofeedback treatment is reported to be useful for patients with mild hypertension as an adjunct to medication, it is not certain whether the presence of organ damage affects its efficacy. The aim of this study is to clarify the clinical effects of biofeedback on mild hypertension in the absence and presence of organ damage. METHODS: Eleven mildly hypertensive outpatients without damage to the heart, brain, retina or kidney (4 men and 7 women), aged 40-65 years, and 11 mildly hypertensive outpatients with target organ damage and matching variables for age, sex and medication were included in this study. They underwent biofeedback treatment once a week for a total of four sessions. RESULTS: As a result of these sessions, mean blood pressures (MBP) in the organ-damage-negative (-) group and in the organ-damage-positive (+) group were significantly reduced by 12 +/- 11 and 12 +/- 8, respectively. The decrease was still significant 3 months after the treatment in the organ-damage (-) group, whereas no significant change was found 1 or 3 months after the treatment in the organ-damage (+) group. Throughout these sessions, the ratio of low frequency to high frequency of heart rate variance as well as systolic and MBP gradually decreased in each group (p < 0.01); this ratio of heart rate variance was smaller, and the alpha-wave amplitude on the electroencephalogram was larger in the organ-damage (-) group (p < 0.05). CONCLUSION: These results suggested that biofeedback intervention may be effective in mild hypertension, especially when the patient is organ damage (-). Sympathetic activity seems to play an important role in the differentiated response.

Alkylperoxyl radical-scavenging activity of various flavonoids and other phenolic compounds: implications for the anti-tumor-promoter effect of vegetables.

We recently reported that alkylperoxyl radical (ROO(*)) enhanced carcinogenesis in rats treated with carcinogen (Sawa et al. Cancer Epidemiol. Biomarkers Prev. 1998, 7, 1007-1012), and the tumor promoting action of ROO(*) could be reduced by addition of hot-water extracts of vegetables (Maeda et al. Jpn. J. Cancer Res. 1992, 83, 923-928). Here we described the ROO(*)-scavenging activity of flavonoids and nonflavonoid phenolics and their role in anti-tumor-promoter effects. A model molecular species, ROO(*), was generated from tert-butyl hydroperoxide (t-BuOOH) and heme iron, and the scavenging of t-BuOO(*) was determined by (a) bioassay based on the bactericidal action of ROO(*), (b) luminol-enhanced chemiluminescence, and (c) electron spin resonance. Of 17 authentic plant phenolics tested, 9 compounds (including rutin, chlorogenic acid, vanillin, vanillic acid, neohesperidin, gallic acid, shikimic acid, rhamnetin, and kaempferol) showed remarkably high ROO(*)-scavenging activity. Some of them were detected and quantified in hot-water extracts of mung bean sprouts, used as the model vegetable, and their contents increased after germination, which paralleled very well to the ROO(*)-scavenging capacity of the vegetable extracts. Thus, a diet rich in these radical scavengers would reduce the cancer-promoting action of ROO(*). Consequently, the carcinogenic potentials of oxygen-related radicals may be suppressed.

Correlation between prevention of cataract development by disulfiram and fates of selenium in selenite-treated rats.

PURPOSE: We found a new pharmacological effect of disulfiram (DSF) against rat pups with cataract induced by selenite injection. The possible reactive mechanism is discussed in this present paper. METHODS: Wistar male and female rats aged 13 and 30 days, and male rats aged 7 weeks were used this present study. Cataract was induced by injection of selenite (19 micromol/kg, s.c.) to 13-day old rats. The lens opacification was monitored by using the slit lamp equipped with an anterior eye segment analysis system (EAS-1000, Nidek). The selenium contents in rat organs were detected fluorimetrically. Liposomes containing DSF (DSF-liposomes) were prepared by the reverse-phase evaporation method. Rat pups were instilled 5 microl of DSF-liposomes into both eyes 4 times per day. Adult rats were administered with DSF suspensions (100 mg/kg) by nasal cannulation. The changes of plasma concentration of diethyldithiocarbamate (DDC), which was a metabolite of disulfiram, were determined by HPLC method. RESULTS: Intraocular treatment with DSF-liposomes prevented the onset of cataract development in rat pups injected with sodium selenite. Treatment with DSF also significantly reduced the selenium contents in plasma at 1 h post-treatment and in the eye at 96 h post-treatment. No significant differences of selenium content in liver and kidney were observed in 13-day old rats instilled with DSF-liposomes or DSF free liposomes. Cataract could not be induced in the 30-days-old rats with the same dose of selenite (19 micromol/kg) and the liver, kidney, and especially eye of the older rats had lower levels of selenium than 13-day old rats. Diethyldithiocarbamate (DDC), an active metabolite of DSF, was decreased in the plasma following a subcutaneous injection of sodium selenite. The selenium concentration in the plasma was decreased by the intranasal administration of DSF suspensions. CONCLUSIONS: Instillation of DSF-liposomes into the eyes of rat pups given a subcutaneous injection of sodium selenite to induce cataracts prevented the formation of cataracts. The mechanism of inhibition may have resulted from a decreased level of selenium in the eyes following the treatment with DSF. On the other hand, as it is known that the cataracts may result from selenite-induced oxidative stress in the lens, DSF and DDC may react as anti-oxidants.

Longterm outcomes and quality of life after Z-shaped anastomosis for Hirschsprung's disease.

BACKGROUND: Z-shaped anastomosis is one of the modifications of Duhamel's procedure that was designed to eliminate the blind rectal pouch and to achieve complete resection of the colorectal septum. It has been the most widely performed operation in Japan for many years. The longterm postoperative function of evacuation and quality of life of the patients are considered important to evaluate this procedure. METHODS: At Kyushu University Hospital, from 1963 to 1997, 127 patients with Hirschsprung's disease underwent Z-shaped anastomosis. As a result, 122 out of 127 patients (96%) survived. The present status and symptoms, and anorectal functions, including a manometric study and barium enema, were evaluated during the clinical followup. RESULTS: A total of 99 of the 122 surviving patients (81%) were available for this study, and the mean postoperative period was 16 years. Evacuation scores in all patients were as follows; excellent, 62.2%; good, 28.6%; fair, 8.2%; and poor, 1.0%. The percentage of the patients who showed severe symptoms was 4.1% for diarrhea, 3.1% for constipation, 5.1% for incontinence, and 7.1% for soiling. The evacuation score improved chronologically and tended to reach a plateau at 10 to 15 years after operation, at which time 73% of the patients showed excellent outcomes and 95% were satisfactory (good or excellent). The appearance of a sense of defecation and an increase in the pressure difference between the anal canal and the rectum substantially contributed to the improvement in the defecation score. The appearance of the rectosphincteric reflex, including the atypical one, was seen in 40.5% of patients, but the appearance of a reflex did not seem to be related to the clinical status of defecation. Twenty-two of 30 patients older than 20 years were married, and 8 patients had children. CONCLUSIONS: The evacuation scores of in-patients undergoing Z-shaped anastomosis improved with age and were satisfactory (good or excellent) in most patients at least 10 years after operation. Most of the patients adapted to a normal social life.

Assessment of patients by DSM-III-R and DSM-IV in a Japanese psychosomatic clinic.

BACKGROUND: The aim of this study was to investigate the clinical features of psychosomatic disorders in Japan. METHODS: A total of 1,432 outpatients (515 males and 917 females; 9-95 years of age, mean age 36) attending a psychosomatic clinic for the first time were assessed by the DSM-III-R or DSM-IV semistructured interview. RESULTS: Major ICD-10 diagnoses found were eating disorder, other anxiety disorders, autonomic nervous dysfunction, somatoform disorders, and irritable bowel syndrome. The most frequent diagnosis on the DSM-III-R and DSM-IV axis I was 'somatoform disorders not otherwise specified', followed by bulimia nervosa, 'depressive disorder not otherwise specified', anorexia nervosa, conversion disorder, major depression or depressive disorder, 'panic disorder with agoraphobia', and 'psychological factors affecting physical or medical condition'. On axis II, 11-17% of the patients met the criteria for personality disorder. On axis IV, 78-80% had mild or moderate psychosocial stress; major psychosocial and environmental problems classified by the DSM-IV were the problems with primary supports and occupation. CONCLUSIONS: The results seem to reinforce the belief that the diagnoses on the DSM-III-R and DSM-IV axis I are inadequate for describing psychosomatic phenomena. A new diagnostic system in combination with the multidimensional assessments by the DSM-III-R and DSM-IV is needed to form the common guidelines of diagnoses and therapies in psychosomatic medicine.

Clinical effects of blood pressure biofeedback treatment on hypertension by auto-shaping.

OBJECTIVE: Although biofeedback has been reported to be efficacious in the treatment of hypertension, the degree of response has varied. This study investigated the mechanisms of blood pressure reduction by biofeedback. METHOD: Thirty outpatients with essential hypertension (10 men and 20 women) aged 38 to 65 years were studied. Subjects were randomly assigned to group A or B. Subjects in group A underwent biofeedback treatment once a week for a total of four sessions. Those in group B self-monitored their blood pressure during the sessions as the control period and later underwent the same biofeedback treatment. RESULTS: Blood pressure measured by doctor was reduced by 17 +/- 18/8 +/- 7 (p < .01) and elevation of pressure induced by mental stress testing was suppressed by 8 +/- 9 (p < .05)/4 +/- 8 during the treatment period in group A (mm Hg). In group B, both blood pressure measured by doctor and elevation of pressure by mental stress testing remained unchanged during the control period and they were later suppressed by 20 +/- 15/9 +/- 7 (p < .01) and 11 +/- 10(p < .05)/5 +/- 9 by the biofeedback treatment. Self-monitored pressure in both groups tended to decrease by the biofeedback treatment. Systolic and diastolic pressures as well as pulse rate decreased, skin temperature increased, and alpha-wave amplitude on electroencephalography increased during the therapy (p < .05). CONCLUSION: This treatment was effective in suppressing the pressor response to stress. Patients whose blood pressure increases with stress may be suited for biofeedback intervention.

[Neo-adjuvant chemotherapy with cisplatin, 5-fluorouracil, vindesine in head and neck cancer].

Neo-adjuvant chemotherapy with CDDP combination was introduced into the treatment of advanced head and neck cancer. Twenty-three patients with s.c.c of head and neck were given combination chemotherapy consisting of CDDP, VDS and 5-FU before surgical treatment in our department. CR and PR of this trial in all patients were 4 and 35%, respectively. The WBC nadir occurred around 2 weeks later, but all the patients recovered prior to the next cycle or surgical treatment. Renal dysfunction, nausea, vomiting and depilation were generally mild. VDS is useful as one of the neo-adjuvant drugs for the treatment of head and neck cancer. Long-term observation in connection with this treatment is required.