Nitrogen and phosphorus effluent loads from a paddy-field district adopting collective crop rotation.

Japanese paddy rice systems commonly adopt the rotation of vegetables, wheat and soybeans with paddy rice. Crop rotation may, however, increase the nutrient load in effluent discharged from the district because more fertilizer is applied to the rotation crops than is applied to paddy crops. We investigated a paddy-field district subject to collective crop rotation and quantified the annual nutrient load of effluent from the district in three consecutive years. The total annual exports of nitrogen and phosphorus over the investigation period ranged from 30.3 to 40.6 kg N ha(-1) and 2.62 to 3.13 kg P ha(-1). The results suggest that rotation cropping increases the effluent nutrient load because applied fertilizer is converted to nitrate, and surface runoff is increased due to the absence of shuttering boards at the field outlets.

Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal.

SETTING: Directly observed treatment for tuberculosis using a short-course regimen (DOTS) was introduced in a rural area of Nepal. All new patients assigned to DOTS from mid-December 1997 to mid-June 1999 were eligible for the study. OBJECTIVE: To examine delays in tuberculosis (TB) diagnosis and compare health care seeking behaviour between men and women. DESIGN: A cross-sectional analysis of patient interviews. RESULTS: Women were found to have a significantly longer total delay before diagnosis of tuberculosis (median 2.3 months for men, 3.3 months for women). When they visited traditional healers first, women had a significantly longer delay than men from the first visit to health care providers to diagnosis (median 1.5 months for men, 3.0 months for women). More women (35%) visited traditional healers before diagnosis than men (18%), and were more likely to receive more complicated charms from traditional healers. Men tended to visit the government medical establishment first if they knew that free TB treatment was available, but women did not. CONCLUSION: Women were more likely to visit and to believe in traditional healers; this might lead to the longer delays experienced before TB diagnosis.

[Transcatheter arterial embolization for advanced hepatocellular carcinoma--indications and limitations].

Many patients with advanced hepatocellular carcinoma (HCC) in stage IV have no surgical indications. Transcatheter methods such as transcatheter arterial embolization (TAE) and hepatic arterial infusion chemotherapy play a main role of the treatment for advanced HCC. Conventional TAE (from proper hepatic artery) is performed for patients without liver dysfunction. Patients with severe liver dysfunction could not in the past be treated with TAE, but lately it has become possible to treat them with the method of segmental TAE or subsegmental TAE due to the development of a microcatheter and advances in equipment. Although technical progress is remarkable, there are no fixed guidelines for advanced HCC. Suitable methods for individuals need to be discussed.

Hyperintense basal ganglia on T1-weighted magnetic resonance images following postoperative parenteral nutrition in a pancreatoduodenectomized patient.

The authors reported the magnetic resonance imaging (MRI) detection of manganese (Mn) deposition in the basal ganglia of a pancreatoduodenectomized patient following 30-day parenteral nutrition. A multi-trace element supplement solution including 20 micromol Mn/day was parenterally administered for 30 days postoperatively. The serum level of total bilirubin normalized on the 3rd postoperative day, while the level of alkaline phosphatase continued to exceed the higher limit of normal controls even 2 months after operation. T1-weighted MRI on the 49th postoperative day demonstrated bilateral and symmetrical hyperintense lesions in the globus pallidus. The whole-blood Mn level on the 67th postoperative day was 3.1 (normal range 0.8-2.5) microg/l. T1-weighted MRI on the 103rd postoperative day revealed improvement in the hyperintense lesions, and MRI on the 225th postoperative day revealed no abnormality. The blood Mn level normalized on the 194th postoperative day. Even short-term postoperative parenteral nutrition may result in Mn deposition in the brain, especially in patients with cholestasis following pancreatoduodenectomy.

Manganese deposition in the brain following parenteral manganese administration in association with radical operation for esophageal cancer: report of a case.

We report herein the case of a patient in whom manganese (Mn) deposition in the basal ganglia was detected by magnetic resonance imaging (MRI) subsequent to thoracic esophagectomy, performed following perioperative parenteral nutrition. A multi-trace-element supplement solution which included 20 micromol of Mn per day had been parenterally administered for 7 days preoperatively and 21 days postoperatively. The serum level of total bilirubin reached a maximum value of 5.1 mg/dl postoperatively. The T1-weighted MRI on the 32nd postoperative day demonstrated bilateral and symmetrical hyperintense lesions in the globus pallidus and the whole-blood Mn level on the 34th postoperative day was 4.9 microg/l, the normal range being 0.8-2.5 microg/l. This hyperintensity on T1-weighted MRI was gradually improved following normalization of the blood Mn level. This case report serves to demonstrate that even short-term perioperative parenteral nutrition may result in Mn deposition in the brain following radical surgery for esophageal cancer, especially in patients with hyperbilirubinemia.

Inhibition of hypersensitivity reactions by soluble derivatives of baicalein.

Baicalein, a flavonoid, is anti-allergic but only slightly soluble in water. The soluble derivatives of baicalein, disodium baicalein-6-phosphate (BPS) and sodium baicalein-6-sulfate (BSS), were synthesized and examined regarding their effects on hypersensitivity reactions. These derivatives inhibited type I and II reactions as classified by Coombs and Gell. The Arthus reaction belonging to type III reaction, however, was hardly affected with either BPS or BSS. The experimental asthma caused by passive systemic anaphylaxis in guinea pigs was prevented with application of BPS. Thus even by the oral route, BPS appears to be clinically applicable to extensive allergy related diseases.