Cardiac hamartoma in a young squirrel monkey who died suddenly.

A case of cardiac hamartoma in a 2-month-old squirrel monkey is reported. The monkey showed a loss of appetite and died suddenly. Microscopically, an encapsulated nodular lesion was found at the right atrial wall. The lesion consisted of irregularly shaped, slender myocytes intermingled with a few fibroblasts and collagen fibers. Neither nuclear atypia nor inflammatory cell infiltrate was seen. The constituting cells had stratified striations in the cytoplasm and reacted immunohistochemically for desmin, indicating the nature of myocytes. Based on the above findings, a diagnosis of cardiac hamartoma was made. This is the first case of cardiac hamartoma in this species.

Image processing methods to obtain symmetrical distribution from projection image.

Flow visualization and measurement of cross-sectional liquid distribution is very effective to clarify the effects of obstacles in a conduit on heat transfer and flow characteristics of gas-liquid two-phase flow. In this study, two methods to obtain cross-sectional distribution of void fraction are applied to vertical upward air-water two-phase flow. These methods need projection image only from one direction. Radial distributions of void fraction in a circular tube and a circular-tube annuli with a spacer were calculated by Abel transform based on the assumption of axial symmetry. On the other hand, cross-sectional distributions of void fraction in a circular tube with a wire coil whose conduit configuration rotates about the tube central axis periodically were measured by CT method based on the assumption that the relative distributions of liquid phase against the wire were kept along the flow direction.

Distribution and prevalence of Wolbachia in Japanese populations of Lepidoptera.

Wolbachia are cytoplasmically inherited bacteria that are reported to infect at least 18-30% of all insect species. Our survey of Lepidoptera indicated that 44.9% of forty-nine species and 77.8% of nine families tested positive for Wolbachia using PCR with wsp primers. Nineteen species had not been described previously as infected. In particular, although Pieris rapae, which is a common species in Japan, is infected by Wolbachia, the prevalence was very low (3.4%) and there were some localities where Wolbachia could not be detected. The probability of detection of Wolbachia depends on the number of screened individuals of P. rapae. The results indicate that the actual number of species that are positive for Wolbachia may be higher than previously reported.

Normalization of low biotinidase activity in a child with biotin deficiency after biotin supplementation.

We report findings in a Japanese boy with severe skin rash attributable to biotin deficiency. The patient had an intracranial malformation and developed biotin deficiency due to tube feeding with a single formula for over one year. Results of urinary organic acid analysis were consistent with multiple carboxylase deficiency, and low biotinidase activity was also observed. After biotin supplementation, the skin rash improved and biotinidase activity normalized. We speculate that biotin is one regulating factor in the biosynthesis of biotinidase.

Glistening formation in an AcrySof lens initiated by spinodal decomposition of the polymer network by temperature change.

PURPOSE: To examine the effect of temperature change on the structural alteration and glistening formation in an AcrySof intraocular lens (IOL). SETTING: Department of Chemical Science and Engineering, Faculty of Engineering, Kobe University, Kobe, Japan. METHODS: The equilibrium water content of a Wagon-Wheel-packaged AcrySof IOL was determined at various temperatures by the gravimetrical method. Alterations in the microscopic structure of the lens were analyzed in situ with a reflecting microscope without staining, while the temperature of the lens was changed at different rates. RESULTS: Microvacuoles of 1.0 to 20.0 microm formed in the bulk of a swollen AcrySof IOL as the temperature decreased. The morphology of the vacuoles was similar to that of glistening particles observed in vivo. The size and density of the glistening-like vacuoles varied depending on the magnitude and rate of the temperature decrease. The glistening-like vacuoles were imprinted in the bulk of the IOL during the preceding cooling process in aqueous humor. CONCLUSIONS: Glistenings formed in the bulk of an AcrySof IOL as the medium temperature decreased. The mechanism may involve spinodal decomposition of the swollen polymer network, which initiates the formation of microvacuoles consisting of water and loosely packed network chains.

How does infection with parthenogenesis-inducing Wolbachia reduce the fitness of Trichogramma?

We analyzed the survival rate of the immature stages of Trichogramma species and lines that differed in their mode of reproduction. Specifically, we compared the mortality of arrhenotokous (W(-)), irrevertable thelytokous (W(-)), and Wolbachia-associated thelytokous (W(+)) forms. The embryonic mortality of the W(+) strains was significantly higher than that of the W(-) lines. The embryonic mortality was negligible for the arrhenotokous Trichogramma evanescens and the thelytokous Trichogramma cacoeciae, which is not infected with Wolbachia. Only 30% of the eggs of the Wolbachia-infected strains developed to adults, while the emergence rate of the Wolbachia-free strains was more than 78%, irrespective of the origin of the strains. More than 78% of the overall mortality in W(+) strains happened during the early stages of development. About 35% of embryos of W(+) strains remain in the mitotic stage even 48 h after oviposition. Most embryos of W(-) strains had already developed to cellular blastoderm after 6 h, regardless of strains. The mortality of immature stages in W(+) strains was mainly caused by the failure of the mitotic divisions.

Improved synthesis of paroxetine hydrochloride propan-2-ol solvate through one of metabolites in humans, and characterization of the solvate crystals.

Paroxetine, a potent and selective inhibitor of 5-hydroxytryptamine (serotonin) uptake, was prepared through a piperidine derivative, which was reported to be one of the paroxetine metabolites in humans. Thus, the piperidine derivative was converted to its N-tert-butoxycarbonyl (N-Boc) derivative, which was then converted to N-Boc paroxetine. Paroxetine hydrochloride propan-2-ol (isopropyl alcohol (IPA)) solvate crystals were directly obtained from the N-Boc paroxetine by adding hydrogen chloride to the N-Boc paroxetine IPA solution. The amount of IPA content in the crystals was reduced by drying with a continuous change of powder X-ray diffraction patterns. Other characterizations of the solvate crystals were also conducted.

Optical and atomic force microscopy of an explanted AcrySof intraocular lens with glistenings.

PURPOSE: To assess the surface morphology and cause of glistenings in an explanted AcrySof intraocular lens (IOL). SETTING: Shakai Hoken Kobe Central Hospital, Kobe, Japan. METHODS: A 63-year-old Japanese man had implantation of an AcrySof IOL in the capsular bag. One month postoperatively, he had a neodymium:YAG laser capsulotomy for posterior capsule opacification, which changed the IOL's position in the capsular bag. A few months later, the patient developed disabling night glare from intralenticular glistenings and progressive hyperopic refractive error. The IOL was explanted and then analyzed by optical microscopy and atomic force microscopy (AFM). Laboratory analysis of control AcrySof IOLs kept in a balanced salt solution at steady room and body temperature for 2 months was also performed to evaluate the cause of the glistenings observed clinically. RESULTS: Optical microscopy showed that the explanted AcrySof IOL had several microvacuoles; no abnormalities were observed in the control AcrySof IOLs before or after folding at the room and body temperatures. The AFM analysis showed a significant change in the surface morphology of the explanted IOL, including vacuolar formations in the posterior surface as well as numerous anterior surface irregularities. No microvacuoles or surface morphology alterations were observed in the control AcrySof IOLs by AFM analysis. CONCLUSIONS: The glistenings in the explanted AcrySof IOL were likely caused by temperature changes and not mechanical stress from folding.

Can three-dimensional helical CT cholangiography before laparoscopic cholecystectomy be a substitute study for endoscopic retrograde cholangiography?

The study investigated the usefulness of three-dimensional helical computed tomography (3D-CT) before laparoscopic cholecystectomy (LSC) when compared with that of endoscopic retrograde cholangiography (ERC). Forty-five patients referred for LSC, who had undergone 3D-CT cholangiography and ERC simultaneously, participated in the study. Endoscopic retrograde cholangiography and 3D-CT cholangiography were compared in each patient with regard to opacification of the biliary tree, stones, and anatomic variations. Three-dimensional helical CT cholangiography and ERC imaging for predicting operative difficulties in LSC also were compared. The common bile duct and cystic duct were shown in the patients by the images, but the gallbladder was shown in 43 patients (96%) with use of 3D-CT cholangiography and in 36 patients (80%) with use of ERC. A third or more peripheral branches were shown completely with use of 3D-CT cholangiography in 33 patients (73%) and in 32 patients (71%) with use of ERC. Cystic duct stones were found in two of three patients with use of 3D-CT cholangiography and ERC. Common bile duct stones in five of seven patients were detected with use of 3D-CT cholangiography, but all of the common bile duct stones were detected with use of ERC. Anatomic variations of the bile duct were shown in three of four patients by 3D-CT cholangiography and in all patients with use of ERC. No significant differences in findings of the angle of bifurcation and presence of Heister valves between operative easy and complex cases were shown by 3D-CT cholangiography and ERC, despite the more accurate assessment of the cystic duct anatomy with use of 3D-CT cholangiography than with use of ERC. Three-dimensional helical CT cholangiography is useful clinically in preoperative assessment of biliary anatomy, but it is not reliable in the detection of common bile duct stones, and it is not helpful in predicting technical difficulty during LSC.

Prevention of B220+ T cell expansion and prolongation of lifespan induced by Lactobacillus casei in MRL/lpr mice.

We examined the therapeutic effect of heat-killed Lactobacillus casei (LC) on MRL/lpr mice. Ingestion of a diet containing 0.05% (w/w) LC from the weaning period prolonged the lifespan and tended to reduce the proportion of B220+ T cells in the spleen and mesenteric lymph nodes (MLN) of MRL/lpr mice. When LC was intraperitoneally injected once a week after the age of 8 weeks, I-A- macrophages accumulated in the spleen as well as the peritoneum and macrophage progenitors increased in the bone marrow. Moreover, the amount of IL-6 mRNA in peritoneal macrophages was reduced by LC injection. Splenocytes from LC-injected MRL/lpr mice exhibited lower proliferative responses to mitogens than those from control MRL/lpr mice and the increase in number of B220+ T cells in the spleen and MLN was prevented by LC injection. However, LC injection affected neither expression of interferon-gamma (IFN-gamma) and IL-4 mRNAs nor proliferative capacities of splenic T cells. Our findings demonstrate that LC injection accelerates macrophage recruitment and prevents the expansion of B220+ T cells without affecting the functions of T cells in MRL/lpr mice. These immunological modulations induced by LC may lead to prolongation of the lifespan of MRL/lpr mice.

Survival of a probiotic, Lactobacillus casei strain Shirota, in the gastrointestinal tract: selective isolation from faeces and identification using monoclonal antibodies.

Lactobacillus casei strain Shirota (LCS) is a probiotic bacterium used in the production of fermented milk products and lactic acid bacteria preparations. To investigate the survival of LCS in the gastrointestinal tract, we have developed a selective medium and specific monoclonal antibodies to isolate and identify this strain. Selective LLV agar medium was prepared by modifying LBS medium, a selective medium for lactobacilli, through the replacement of glucose with lactitol as a carbon source and vancomycin as a selective antibiotic. Culture in LLV agar medium followed by ELISA using monoclonal antibodies specific for LCS was able to detect the organism in faeces. Using this method, we studied the faecal recovery of LCS in individuals who drank 125 ml of fermented milk which contained 10(10) live LCS for 3 days. The mean recovery was about 10(7) live bacteria per gram of faeces, indicating that LCS survived transit through the gastrointestinal tract after ingestion of the fermented milk.

International cooperation in neonatal screening: technical training course for newborn and infant screening.

We report the outline and results of our experience with a group training course of neonatal screening for health care professionals in developing countries. Sapporo City Institute of Public Health (SCIPH) has been offered a training course on neonatal screening once a year since 1991 under the Technical Training Program of the Japan International Cooperation Agency (JICA). The aims of this training course are to enhance the participants' technical knowledge and skills, and also to deepen their understanding of the principle of neonatal screening as well as the relevant diseases. Lectures and laboratory practice on phenylketonuria (PKU), congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH) and neuroblastoma are included in the 3-month program. After the completion of the training, participants are expected to play a major role in establishing and expanding neonatal screening system in each of their countries. We have received a total of 67 participants from 25 countries until March 1998: 58 pediatricians; 2 gynecologists; 6 biochemists; 1 administrative officer. After they returned to their countries, 11 engaged in neonatal screening and started PKU and CH screening in their institute, city or province in Argentina, Brazil, Mexico, Peru and Thailand. We believe that these results fulfilled our objectives. Also, for follow-up, SCIPH has been giving information and consultation to the participants on requests. This international cooperation network could also benefit our present network of the International Society Screening in the future.

Around-the-clock nursing care for the elderly in Japan.

PURPOSE: To describe the first phase of creating a Japanese model of community-based long-term care, called around-the-clock care (ACC), by operationally defining the components of ACC, identifying those eligible for the program, clarifying methods of planning and organization, and exploring outcomes. DESIGN: Exploratory evaluation for the population of frail elderly Japanese citizens living at home. A convenience sample of 44 patients receiving care from four visiting-nurse-service stations during 3 months in 1994 was used. METHODS: Needs assessments; record reviews of patient encounters; evaluations by patients, families, and visiting nurses; and reviews of administrative data. FINDINGS: Nurses perceived that ACC stabilized medical status, reduced the emotional and physical burden of treatment, and improved hygiene. It also reduced family caregiving burdens and the stress of family caregivers' employment responsibilities. The highest rating of ACC by patient and families was for those with the most complex physical needs. Skilled nursing at home permitted early identification and treatment of problems before they became crises or required hospitalization. CONCLUSIONS: Early findings suggest 24-hour nurse-home helper teamwork may be an effective system of community-based long-term care and should be considered a key element of future Japanese health policy.

[Findings from slit lamp and histological examination of the anterior capsule in patients with severe anterior capsular shrinkage and opacities after implantation of intraocular lenses].

Seven pseudophakic patients with severe anterior capsular shrinkage and opacities after continuous curvilinear capsulorhexis as a severe anterior capsular shrinkage group and seven pseudophakic patients without the complication as control group were studied in a slit lamp examination of zonular fibers and anterior vitreus body with an indentation mirror. A light and electron microscopic study of the shrunken anterior capsular edge was performed in one case of the severe anterior capsular shrinkage group. No morphological findings suggesting weakness of zonular fibers such as cleavage or scarceness were observed, but reduction in elasticity of the zonular fibers was surmised and degeneration and liquefacation of the anterior vitreus body was observed in the severe anterior capsular shrinkage group. Histological study revealed several layers of proliferated spindle cells and also abundant extracellular matrix, consisting of collagen types I, III and IV, under the monolayer of lens epithelium attached to the anterior capsule. Spindle cells were epithelial cells and considered to be derived from lens epithelium, because the spindle cells were connected by junctional apparatus, which is a feature of epithelium. Severe anterior capsular shrinkage and opacities were due to low ability of the lens supporting system of zonular fibers and anterior vitreus and severe scarring and shrinkage at the anterior capsular edge.

[Perimetric glare test and evaluation of intraocular lenses].

Twelve normal control phakic eyes together with a number of other pseudophakic groups each consisting of 6 eyes were enrolled in this study of spatial and quantitative measurement of glare disabilities in the static visual field (Perimetric Glare Test) using an OCTOPUS 500E automated perimeter with an attached glare source. These groups were a 6 mm no hole lens group, a 6 mm 4 hole lens group, a 5.5 x 6.5 mm 2 hole lens group, a 5.0 x 6.0 mm no hole lens group and a diffractive multifocal group. Glare disabilities in the visual field were minimum in the control group. The 6 mm no hole lens group and the diffractive multifocal group showed no statistical significance compared the control group. Groups with the two types of ovoid lens and the 6 mm 4 hole lens group showed a statistically higher degree and a greater extent of glare disabilities in the static visual field than the control group. Careful selection of appropriate patients to receive implants of small efficient optic IOLs, such as IOLs with positioning holes and ovoid lenses, according to the preoperative pupil size under scotopic or mesopic condition and efficient lens optic size are important in order to reduce hole and edge glare. The diffractive multifocal IOLs group showed a slightly higher degree and a greater extent of glare than the control group and the 6 mm no hole monofocal lens group but the difference was very small and statistically insignificant. Therefore the effects of diffractive microstructure on glare disabilities were considered to be slight and clinically acceptable.

Measurement of glare disability using an automated perimeter.

We have developed a new system to measure glare disability spatially and quantitatively using an Octopus 500E automated perimeter with an attached glare source. We describe the method used for measuring glare disability with this system and the results in cataracts and pseudophakia with and without various postoperative complications.

[Presence of human epidermal growth factor (hEGF), basic fibroblast growth factor (bFGF) in human aqueous].

Thirty-eight cataract eyes and 15 artificial aphakic or pseudophakic eyes were enrolled in this study to determine levels of human epidermal growth factor (hEGF) and basic fibroblast growth factor (bFGF) in human aqueous, using a radioimmunoassay. Neither hEGF nor bFGF were detected in either congenital cataract eyes or senile cataract eyes without any complication. In cases of senile cataract complicated with glaucoma and traumatic cataract, bFGF range from 0.4 to 0.8 ng/ml whereas hEGF was not detected. In cases of senile cataract with myocardial or brain infarction and anterior subcapsular cataract, bFGF was detected ranging from 0.4 to 1.0 ng/ml and in some of the cases hEGF was detected at a level of 1.0 ng/ml. hEGF was detected at 1.0 ng/ml in some cases of secondary cataract after uveitis, cataract complicated with retinal detachment, cataract after scleral buckling or vitrectomy, and aphakic or pseudophakic eyes after extracapsular cataract extraction or phacoemulsification. These results showed that hEGF and bFGF exist at a level of about 1 ng/ml in human aqueous in some pathological states and it seems possible that proliferation of lens epithelial cells is promoted by the growth factors, with the result that after cataract, anterior capsular opacities and shrinkage become severe.