On-ground detection of an electron-positron annihilation line from thunderclouds.

Thunderclouds can produce bremsstrahlung gamma-ray emission, and sometimes even positrons. At 00:27:00 (UT) on 13 January 2012, an intense burst of gamma rays from a thundercloud was detected by the GROWTH experiment, located in Japan, facing the Sea of Japan. The event started with a sharp gamma-ray flash with a duration of <300 ms coincident with an intracloud discharge, followed by a decaying longer gamma-ray emission lasting for ∼60 s. The spectrum of this prolonged emission reached ∼10 MeV, and contained a distinct line emission at 508±3(stat.)±5(sys.) keV, to be identified with an electron-positron annihilation line. The line was narrow within the instrumental energy resolution (∼80keV), and contained 520±50 photons which amounted to ∼10% of the total signal photons of 5340±190 detected over 0.1-10 MeV. As a result, the line equivalent width reached 280±40 keV, which implies a nontrivial result. The result suggests that a downward positron beam produced both the continuum and the line photons.

Hardening and termination of long-duration γ rays detected prior to lightning.

We report the first observation of 3-30 MeV prolonged gamma-ray emission that was abruptly terminated by lightning. The gamma-ray detection was made during winter thunderstorms on December 30, 2010, by the Gamma-Ray Observation of Winter Thunderclouds experiment carried out in a coastal area along the Sea of Japan. The gamma-ray flux lasted for less than 3 min, continuously hardening closer to the lightning occurrence. The hardening at energies of 3-10 MeV energies was most prominent. The gamma-ray flux abruptly ceased less than 800 ms before the lightning flash that occurred over 5 km away from the experimental site. In addition, we observed a clear difference in the duration of the 3-10 MeV gamma rays and those >10 MeV, suggesting that the area of >10 MeV gamma-ray emission is considerably smaller than that of the lower-energy gamma rays. This work may give a manifestation that a local region emitting prolonged gamma rays connects with a distant region to initiate lightning.

Detection of high-energy gamma rays from winter thunderclouds.

A report is made on a comprehensive observation of a burstlike gamma-ray emission from thunderclouds on the Sea of Japan, during strong thunderstorms on 6 January 2007. The detected emission, lasting for approximately 40 sec, preceded cloud-to-ground lightning discharges. The burst spectrum, extending to 10 MeV, can be interpreted as consisting of bremsstrahlung photons originating from relativistic electrons. This ground-based observation provides the first clear evidence that strong electric fields in thunderclouds can continuously accelerate electrons beyond 10 MeV prior to lightning discharges.

[Development of professional competence in public health nurses].

PURPOSE: Significant changes that are occurring in the community health care system, require that public health nurses who work for local governments to not only provide direct care but also to coordinate health care teams and participate in policy making. The purpose of this study is to investigate the current system of developing professional competence in public health nurses, and to consider ways to improve it. METHOD: The subjects, randomly chosen, were 100 chief public health nurses and 298 staff nurses in Hokkaido. Sixty-four chief nurses, 44 beginner nurses, 87 proficient nurses and 88 expert nurses responded. The data were collected with a self-administered questionnaire which necessitated the subjects to make a self evaluation of their practical competence and circumstances of its development. RESULT: Self evaluated competence, in making accurate assessments of individual needs and initiating direct care, developed with their experiences in the job, and was generally high. However, the questionnaire showed that self evaluation of their work and ability to do theoretical analysis and research was low and did not progress in conjunction with the length of work experience. Policy making experience was limited and policy making competence was evaluated as low, but there was an expectation that this competence would develop in time. Almost all of the respondents expected their professional competence to progress to higher levels. In particular, beginner nurses wanted to gain practical care competence; proficient and expert nurses wanted to develop their powers of theoretical analysis and do more research, while chief nurses were keen to gain competence in the area of policy making. The respondents reported that they sometimes attended academic conferences, but hardly did any research. CONCLUSION: Low self-evaluation of public health nurses reflect a basic immaturity as a profession. They need to establish their profession and to increase their self-evaluated competencies as their careers develop. These findings showed the importance of establishing a system of continuing education that will cultivate competence in various aspects of their job and also motivate self study. These findings also reveal the importance of collaboration between the university as a vehicle for theoretical work and research and the work place as the embodiment of practical application.

[Clinical usefulness of the autopsy in elderly patients].

To determine the clinical usefulness of the autopsy in elderly patients, we studied a total of 231 autopsies performed during 1986 and 1995 at Jikeikai hospital. Autopsies were done after 231 of 609 deaths (38%). The autopsy rate in our hospital fell from 63% in 1986 to 17% in 1995. Most primary causes of deaths as established by clinicians before autopsy were pulmonary, neoplastic, and cardiovascular diseases. The probability of a major unexpected finding at autopsy was higher in acute pneumonia, acute myocardial infarction, and cerebrovascular disease. No primary pathological cause of death was established by pathologists at autopsy in 13 cases (The clinical diagnoses in those patients were acute pneumonia in 5 patients, acute myocardial infarction in 2 patients, sepsis in 2 patients, bronchiale asthma, cerebral infarction, uremia, gastrointestinal bleeding each in 1 patient.) The mean age of these 13 patients was higher by 5 years than the age of the group as a whole. This indicate that elderly patients have many complications and that these deaths were caused by many small changes that were not be detected at autopsy. Latent cancer was found in 23 cases (12%): thyroid and colon cancer in 6 patients each, gastric cancer in 4, prostate cancer in 3, ovarian cancer in 2, and other cancers (renal, uterine, lung, urethral, pancreatis and liver) each 1 in patient.

[Gastric and duodenal ulcers and their complications in elderly patients].

Among 1470 patients over 65-year-old who were treated for various diseases, 50 had gastric ulcer and 10 had duodenal ulcer. About half the gastric ulcers were located in the body and fundus (n = 24, 48.0%). One third of the patients with gastric or duodenal ulcers had as their chief complaints hematemesis and hematochezia (n = 20, 33.3%), and a greater number had atypical gastrointestinal complaints (general malaise, fever etc, n = 25, 41.7%). In 10 patients (16.7%) the ulcers were due to non-steroidal anti-inflammatory drugs, in 5 (8.3%) they were due to steroid hormones, both of which had been given to treat other conditions; in 45 (75.0%) the origin of the ulcers was unknown. Complications of gastric and duodenal ulcers were hematemesis and hematochezia (n = 20, 33.3%), and perforation (n = 2, 3.3%). Duodenal ulcers tended to be severe, and were associated with death due to bleeding and peritonitis.

[A questionnaire survey on urinary incontinence and urinary disturbances in the institutionalized elderly with senile dementia].

We carried out a questionnaire survey concerning urinary disturbances, among nursing home patients. The answers were obtained from 1,038 elderly including 355 males and 683 females. Ages, spanned 50-99, with an average age of 79.1. Of the 1,038 respondents which we obtained through our survey for management of urination, 35.8% of the total said that they are able to urinate without incontinence. Those able to urinate with incontinence accounted for 23.6% of the total. However, 40% of all patients required an adult diaper throughout the day to control their urinary functions. Patients suffering from neurological disorders accounted for 70% of respondents, and a correlation was seen between the extent of dementia and ADL, and excretory control. Urinary functioning in both men and women was found to grow increasingly difficult with age, and medical problems involving urinary difficulty appear to increase with the advance of the aging process. The representative groups for this survey were limited to elderly people in nursing homes, many of whom suffer from neurological disorders such as cerebral infarction. It was found that both male and female patients experience a variety of urinary disturbances.

[Immunological study on Alzheimer's disease using anti-beta-protein monoclonal antibodies].

Monoclonal antibodies (TB1 & TB2), which were obtained by immunization of 24 amino acids in BALB/c mice, bound specifically to the amyloid senile plaque and amyloid-angiopathic lesions of brain tissues of patients with Alzheimer's disease (AD) or with senile dementia of Alzheimer type (SDAT), and strongly reacted with the 1st part (Asp-Ala-Glu-Phe-Arg-His-Asp) of beta-protein. Western blotting and two-dimensional immunoelectrophoresis of cerebrospinal fluid (CSF) and serum revealed bands of 125 and 20 kilodaltons. The positive frequency of 125 and 20 KD bands detected by two-dimensional immunoelectrophoresis was higher in the serum of AD and SDAT patients (12 cases) than in that of normal control patients. ELISA employing various anti-amyloid precursor protein (APP) antibodies was performed using the extract of the human neuroblastoma cell line (NB39) which produces APP. In the near future, we hope to measure APP in CSF and sera from patients with Alzheimer's disease.

[Immunological functions and clinical course of elderly patients with cerebrovascular diseases].

In the elderly, cerebrovascular diseases (CVD) are often complicated by severe infections such as pneumonia. This study aimed to examine the possible relationship at various timepoints of observation between immunological functions and the clinical course and to correlate the changes of immunological functions with CVD lesion side. The study was based on 25 right-handed patients (14 male and 11 female, mean age; male 69.0 years and female 74.9 years) with acute, focal neurological deficits of CVD (5 cerebral bleeding, 20 cerebral infarction; 11 right cerebral lesioned subjects, 14 left cerebral lesioned subjects). All patients were evaluated in terms of lymphocyte counts, T, B cell counts, T cell subsets, lymphocyte transformation and natural killer activity in peripheral blood as indices of immunological functions at various timepoints during the clinical course. Some of these immunological functions decreased within two months (acute stage) after onset of CVD, and some cases with decreased immunological functions developed complications of severe infection such as pneumonia. Patients who had both decreased immunological function and severe infection were 1 out of cases with 7 right cerebral lesions and 6 out of with 9 left cerebral lesions. This study suggests that the decreased immunological function in CVD subjects may be correlated with the site of the CVD lesion. In all left cerebral lesioned subjects, a reduction of immunological functions and a susceptibility to severe infection were not observed in the acute stage of CVD, however, some left cerebral lesion cases may be more closely related than in right cerebral lesion cases. The mechanism remains to be clarified.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunologic characterization and molecular profile of carcinoembryonic antigen detected by monoclonal antibodies.

Four distinct monoclonal antibodies, which reacted with CEA preparations but not with nonspecific cross-reacting antigen or with nonspecific cross-reacting antigen 2, were established. Except for monoclonal antibody AS001 , all of these monoclonal antibodies immunoprecipitated molecular forms of 200K and 180K daltons that are not bridged by disulfide bonds. Immunodepletion experiments and sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis revealed that these monoclonal antibodies recognized the same antigenic structure when 125I-CEA preparation was used. Monoclonal antibody AS001 is of particular interest, because this antibody reacted only with a 200K dalton molecule which is a part of the molecules recognized by the other three monoclonal antibodies. The rosette inhibition assay and the immunoprecipitation experiments suggest that each monoclonal antibody recognizes a different antigenic determinant. The antigenic determinants recognized by monoclonal antibodies YK013 and AS001 may be peptides in nature, whereas the determinants recognized by antibodies YK024 or AS005 might be carbohydrate. The radioimmunoassay with monoclonal antibody AS001 was established, and the results clearly indicate that the incidence of positivity for the sera from digestive tract cancer patients and from lung cancer patients obtained by monoclonal antibody AS001 was higher than that obtained by the polyclonal antibody. Monoclonal antibody AS001 was able to detect the corresponding antigen in the sera, which the polyclonal antibody failed to detect. This study therefore suggests that monoclonal antibodies may enhance and improve the diagnostic value in cancer patients with undetectable or lower CEA levels detected by conventional anti-CEA antibodies.

Immunohistochemical distribution of the antigenic determinants detected by monoclonal antibodies to carcinoembryonic antigen.

By using four distinct monoclonal antibodies to CEA, the molecular profile of which was clarified in our accompanying companion paper, immunohistochemical distribution of the antigenic determinants on both cancerous and noncancerous tissues as well as fetal tissues was studied with the use of the immunoperoxidase method. All of the monoclonal antibodies recognize different antigenic determinants on the tissue section. None of the antibodies stained granulocytes in the peripheral blood or in the normal liver tissues tested. Three of our monoclonal antibodies stained columnar epithelial cells in morphologically normal colonic mucosa; however, monoclonal antibody YK024 did not stain them. This antibody was also found to be unreactive with intestinal metaplasia lesions of the stomach, but reacted with a 16-wk-old fetal stomach as well as with cancerous parts of the colon and of the stomach. Moreover, it was found that this monoclonal antibody mainly reacted with moderately or poorly differentiated adenocarcinoma lesions of the colon and the stomach. Periodic acid treatment in this study, together with trypsin treatment on the antigen as described in our accompanying companion paper, may suggest that this antibody recognizes the carbohydrate antigenic determinant in nature.

Human gastric cancer-associated antigens and carcinoembryonic antigen detected by monoclonal antibodies.

The serologic and molecular characterization of four monoclonal antibodies to human gastric cancer cells and to CEA were described and the immunohistologic patterns of reactions with freshly obtained gastrointestinal tissues were examined. Monoclonal antibody YK004, which was secreted by the hybridoma constructed with the gastric carcinoma cell line KATO III, reacted with an antigenic determinant preferentially expressed on human gastric and colonic carcinoma cells, but it failed to bind any nonmalignant tissues tested except the stomach. Although this antibody reacted with fetal digestive tract tissues, it failed to immunoprecipitate CEA. Monoclonal antibodies YK013 and YK024 prepared in the same manner by immunizing with the gastric carcinoma cell line KATO III reacted with antigenic determinants on CEA, but not on NCA or NCA2. The antigenic profiles recognized by these two antibodies were found to be identical by sequential immunoprecipitation experiments. However, the antigenic determinant recognized by antibody YK013 may be different from that recognized by antibody YK024, since the immunohistologic reactivity patterns in carcinoma tissue sections were clearly different. Monoclonal antibody AS001, which was secreted by the hybridomas constructed with purified CEA as immunogen, immunoprecipitated CEA molecule with a single antigenic structure of 200 Kd, which was different from the antigenic profile detected by two other monoclonal antibodies, YK013 and YK024. The unique distribution of the antigenic determinants recognized by our monoclonal antibodies on cancerous tissues suggests that antibodies might be able to detect the unique determinants of the circulating CEA molecule or CEA-related molecules in the serum of cancer patients.

Studies on the CEA-like substance in gastric juice.

Concentration and heterogeneity of CEA-like substance in gastric juice were studied using radioimmunoassay. Statistically significant increase of CEA-like substance in gastric juice was found in advanced atrophic gastritis (P less than 0.01), early gastric cancer (P less than 0.05) and advanced gastric cancer (P less than 0.01) as compared with normal subjects. In cases with atrophic gastritis with a high degree of intestinal metaplasia, the concentrations above 300 microgram/dl were noticed. The results indicate that increased concentrations of CEA-like substance in gastric secretions may strongly suggest the presence of a marked intestinal metaplasia and/or cancerous changes of gastric mucosae, including the early cancer. The distribution of CEA activity in gel filtration fractions of gastric juice was compared using kits of two different radioimmunoassay systems. The patterns of CEA activities were different between the two different kits used, but the main peaks were located in the fractions with the molecular weight of 20x10(4) daltons corresponding to that of serum CEA. It is considered, however, that the CEA-like substance in gastric juice specimens may be more or less heterogenous when any of the methods is used.