Difference in the mechanism of balancing-side disclusion between 1st and 2nd molars.

This study investigates the cusp angle and movement variables related to balancing-side disclusion and compares the characteristics between the 1st and 2nd molar regions. Fifty-six normal young adults were divided into two groups according to balancing-side contact: a disclusion group consisting of 40 subjects (80 excursions), and a non-disclusion group consisting of 16 subjects (20 excursions). Lateral excursions were measured in six-degrees of freedom, and the inclinations of the frontal paths were calculated on the working-side canine, balancing-side 1st and 2nd molars and balancing-side condylar point. The cusp angle was measured using a three-dimensional digitizer. While there were no differences between disclusion and non-disclusion groups in the inclination of the balancing-side condylar path, significant differences were found in the cusp angle and the inclination of the working-side canine path. In the non-disclusion group, the cusp angle of the 2nd molar was markedly greater than that of the 1st molar. It was concluded that the inclination of the anterior guidance and the cusp angle of related teeth have a great effect on the occurrence of balancing-side disclusion and that the mechanism of high frequent balancing-side contacts at the 2nd molar was characterized by its greater cusp angle compared to the 1st molar.

Secretion patterns of Th1- and Th2-type cytokines in immune deviation caused by dendritic cells.

The expression of cytokine mRNAs in mice during immune deviation was examined. A subcutaneous injection of antigen-pulsed dendritic cells (DCs) induced strong delayed-type hypersensitivity (DTH) but not humoral immunity, but an intravenous injection of DCs increased the titer of specific antibodies while inducing weak DTH. There was more interleukin-4 and interleukin-5 mRNA in mice given DCs subcutaneously than in those given DCs intravenously. Therefore, synthesis of cytokines from type 2 helper T (Th2) cells was greater when there was DTH but little or no antibody production. This pattern of cytokine synthesis was in accordance with the pattern of isotypes of the specific antibodies produced. In the mice given DCs intravenously, there was more mRNA of Th1 cytokines, and the production of IgG2a, IgG2b, and IgG3 antibodies increased, but that of IgG1 antibody did not. In immune deviation induced by antigen-pulsed DCs, cross-regulation of Th1 and Th2 cells may be more complicated.

[Case of adult T-cell leukemia without antibodies for HTLV-I but with for pX gene region].

A 76-year-old woman had lymphocytosis with lymphocytes having convoluted or lobulated nuclei. These abnormal lymphocytes (leukemic cells) were positive for CD4, and some expressed IL-2R (CD25) and CD3 molecules, respectively. These morphologic and phenotypic features were compatible with adult T-cell leukemia, but serum antibodies to human T-cell lymphotropic virus type I (HTLV-I) were not detected by the particle aggregation method and an enzyme-linked immunosorbent assay. The polymerase chain reaction showed that the LTR, gag, pol, and env regions of HTLV-I proviral DNA had not been incorporated into the leukemic cells. Only the pX region was detected in these leukemic cells.

[Abnormality of CD4 molecule--OKT4 epitope deficiency].

The individuals with OKT4 epitope deficiency are identified as incomplete (heterozygote carriers) and complete (homozygotes) by the difference in the number of OKT4 epitopes on the surface of lymphocytes. The incidence of homozygotes in the Japanese population was found to be 0.47% by examination of 1,478 random samples, and on the basis of this value, the incidence of heterozygotes was estimated to be 12.8% by the Hardy-Weinberg's formula. This deficiency was transmitted as an autosomal codominant trait. DNA from the lymphocytes with complete OKT4 epitope deficiency from the members of three families was sequenced, and a single nucleotide base substitution (CGG-->TGG) was found. This mutation was confirmed to be responsible for OKT4 epitope deficiency by using the mouse L cells transfected with mutant CD4 cDNA. The mutation results in arginine being replaced by tryptophan. Analysis showed different hydrophobicity at positions 239 and 240 from the control, probably giving rise to a conformational change in CD4 accounting for lack of reactivity with the OKT4 monoclonal antibody. The lymphocytes with OKT4 epitope deficiency did not show any abnormality in their susceptibility to HIV infection, the internalization of CD4 molecules by TPA-treatment, the capability of producing IL-2 in vitro, and the expression of IL-2 receptors (alpha/beta-chain) by PHA-stimulation.

[Detection of HTLV-1 provirus DNA in T-cell neoplasms].

Using polymerase chain reaction (PCR) amplification and Southern hybridization, gag, pol, env and pX region genes of HTLV-1 provirus were detected in T-cell malignancy such as adult T-cell leukemia/lymphoma (ATLL), mycosis fungoides in leukemic phase (MF) and, CD8-leukemia. The gag, pol, and/or env regions, were not amplified in some cases of ATLL, which was considered to be induced by mutation, but not deletion. However, the pX-1 and pX-2 regions could be amplified in all cases examined. As it is suggested that the pX gene plays an important role in leukemogenesis, the mutation may not occur in this region gene. Interestingly, the pX-2 was amplified in the cases with MF and CD8-leukemia as well. The amplified products were hybridized to the HTLV-1 pX sequence, even though the products contained DNA fragments with a size larger than expected as well as those of an expected size. These results indicated the possibility that the virus having sequence identical with HTLV-1 pX is integrated in the tumor cells of MF and CD8 leukemia.

[Acinic cell tumor of the bronchial gland].

The patient was a 29-year-old male with a history of recurrent pulmonary infection for the past two years. Bronchoscopy showed complete obstruction of the left sixth bronchus by a submucosal tumor. Biopsy of the tumor revealed clear cell neoplasia suggesting bronchial gland origin. Left sixth segmentectomy was done. Grossly, the tumor was 1.5 cm in diameter, solid, yellowish white in color, round in shape and protruding into the lumen and covered by the bronchial mucosa. The lung tissue and mediastinal lymph nodes were free of tumors. Histologically, the tumor consisted of sheets of clear or granular basophilic cells. Mucicarmine-negative, diastase-resistant PAS positive granules were evident in the tumor cells. Immunohistochemical stain of amylase (salivary gland type) was positive in the tumor cells. Multiple psammoma bodies were present. Histological diagnosis was acinic cell tumor of the bronchial gland. The patient is alive and well one year after removal of the tumor.

[Double-blind comparative trial of cefroxadine and cephalexin in the treatment of acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media].

A double-blind controlled trial of cefroxadine (CXD) 250 mg t.i.d. was undertaken to objectively evaluate its safety and effectiveness in the treatment of acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media, using cephalexin (CEX) 250 mg q.i.d. as a control drug, and the following results were obtained. In the treatment of acute suppurative otitis media, the 2 drugs produced almost equal outcomes, showing no significant difference in assessments of both overall effects and usefulness. In the treatment of acute exacerbation of chronic suppurative otitis media, the 2 drugs exhibited no significant difference as well in overall effects by Wilcoxon's two-sample test. However, the CEX group had significantly more nonresponsive patients, i.e. 35.5% as compared with 9.7% of the CXD group (chi 2-test, P less than 0.05). In the assessment of clinical usefulness as well, no significant difference was observed between the 2 groups. In the assessment of overall effects based on the patients whose isolated organisms were sensitive to the drugs, CEX group had more patients not responding to the treatment of acute exacerbation of chronic suppurative otitis media (chi 2-test, P less than 0.05). Bacteriological effects were not significantly different between the 2 drugs in both acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media. Overall safety rating was not significantly different between the 2 drugs. Side effects occurred as the symptoms of digestive organ in 2 patients each in both groups (equally an incidence of 2.6%). As for the improvement of each symptom after treatment (assessed on day 3), CXD was superior in the improvement rate of otorrhea volume as the main symptom of acute exacerbation of chronic suppurative otitis media, while CEX was superior in that of otoobstruction feeling. From the above findings, it is presumed that CXD is a safe drug which can exhibit equal or superior therapeutic effects to CEX in the treatment of acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media, at 3/4 of the CEX dose level.

[Therapeutic evaluation of an ampicillin suppository (KS-R1) used against acute suppurative otitis media in children: a comparison with an oral preparation].

A comparative well-controlled study was performed to evaluate the efficacy and tolerability of KS-R1 (ampicillin rectal suppository, 125 mg X 4/day) administered to the rectum as compared with those of orally administered ampicillin (ABPC) with same dosage. The results obtained were as follows. The clinical effect of the drug was judged in 100 cases (suppository group in 45 cases, oral group in 55 cases) out of 111 cases. The overall efficacy rates evaluated on standard criteria were 93.3% for the suppository group and 89.1% for the oral group. There was no statistically significant difference between 2 groups. Evaluation by stratification according to the dose, disease type and age also revealed a slightly higher efficacy rate on each parameter in the suppository group, but no significant difference between 2 groups. The bacteriological effects evaluated in 84 cases (suppository group in 38 cases, oral group in 46 cases) were 94.7% and 93.5%, respectively. There was no statistically significant difference between 2 groups. Side effects were evaluated in 101 cases (suppository group in 46 cases, oral group in 55 cases), but the incidence rate showed no significant difference between the 2 groups; 3 cases (each 1 of abdominal pain, periproctal redness and periproctal erosion) were observed in suppository group and 2 cases (each 1 of stomach pain + soft stool and diarrhea) in oral group. The results indicate that KS-R1 is equally effective and tolerable against acute suppurative otitis media compared to oral administration of ABPC, and considered to be useful.

[Pharmacokinetics and clinical studies of cefmetazole in the otorhinolaryngological field].

Cefmetazole (CMZ), a new cephamycin preparation, has been investigated to give following results. 1) Pharmacokinetics: Serum and tonsil concentration of CMZ were determined by micropore method in humans. The mean concentrations in 5 cases about 30 minutes after administration of 0.5--1.0 g intravenously were 55.4 micrograms/ml in serum, 21.7 micrograms/g in tonsil. 2) CLINICAL STUDIES: Seventy-one patients with ear, nose and throat infections were treated with CMZ receiving 1 to 6 g per day intravenously (one shot and drip infusion). Thirty-eight of 70 patients were cured excellent, 19 were good, 8 were fair and 6 were failure and effective rate was 80.3%. Adverse reaction was observed in 4 cases. Three cases showed exanthema and 1 case showed fever elevation.