Extended-spectrum ß-lactamase-producing Escherichia coli strains in the feces of carriers contribute substantially to urinary tract infections in these patients.

INTRODUCTION: The current increase in the incidence of urinary tract infections (UTIs) worldwide caused by extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli may be due to the high number of ESBL-producing Enterobacteriaceae carriers in the community. However, whether ESBL-producing bacteria can cause UTIs in carriers remains uncertain. MATERIALS AND METHODS: In this study, 21 fecal carriers of ESBL-producing Enterobacteriaceae were assessed for UTIs caused by ESBL-producing E. coli. Bacterial isolates obtained from patients' urine and stool specimens were phenotypically and genotypically examined. Clonal similarities of isolates were assessed by multilocus sequence typing (MLST) and random amplified polymorphic DNA (RAPD) fingerprinting. RESULTS: The study revealed that 9 of 21 carriers developed UTIs, and genetic analysis showed that 44% of the UTIs developed were caused by the same ESBL-producing E. coli as that found in the feces of the patients. CONCLUSIONS: The ESBL-producing E. coli in carriers can cause UTIs.

Textures in thin films of nematic liquid crystals induced by strongly focusing a circularly polarized laser.

We investigate the rearrangement of the director in thin films of nematic liquid crystals caused by tightly focusing circularly polarized laser beams. We find either target or spiral patterns, depending on the topology of the director configuration at the position of the beam focus. The induced rearrangements of the director are governed by the viscosity of the media, the handedness of circular polarization, and the irradiation power of the laser. Experimental observations are interpreted using a model derived from nematic continuum theory.

Feeding at a high pitch: source parameters of narrow band, high-frequency clicks from echolocating off-shore hourglass dolphins and coastal Hector's dolphins.

Toothed whales depend on echolocation for orientation and prey localization, and source parameters of echolocation clicks from free-ranging animals therefore convey valuable information about the acoustic physiology and behavioral ecology of the recorded species. Recordings of wild hourglass (Lagenorhynchus cruciger) and Hector's dolphins (Cephalorhynchus hectori) were made in the Drake Passage (between Tierra del Fuego and the Antarctic Peninsular) and Banks Peninsular (Akaroa Harbour, New Zealand) with a four element hydrophone array. Analysis of source parameters shows that both species produce narrow band high-frequency (NBHF) echolocation clicks. Coastal Hector's dolphins produce clicks with a mean peak frequency of 129 kHz, 3 dB bandwidth of 20 kHz, 57 micros, 10 dB duration, and mean apparent source level (ASL) of 177 dB re 1 microPa(p.-p.). The oceanic hourglass dolphins produce clicks with mean peak frequency of 126 kHz, 3 dB bandwidth of 8 kHz, 116 micros, 10 dB duration, and a mean estimated ASL of 197 dB re 1 microPa(p.-p.). Thus, hourglass dolphins apparently produce clicks of higher source level, which should allow them to detect prey at more than twice the distance compared to Hector's dolphins. The observed source parameter differences within these two NBHF species may be an adaptation to a coastal cluttered environment versus a deep water, pelagic habitat.

In situ analysis of lignins in transgenic tobacco reveals a differential impact of individual transformations on the spatial patterns of lignin deposition at the cellular and subcellular levels.

Using tobacco transgenic lines altered in the monolignol biosynthetic pathway and which differ in their lignin profiles we have evaluated lignin deposition at the cellular and subcellular levels using several microanalytical techniques. Surprisingly, whereas a Cinnamoyl CoA reductase (CCR) down-regulated line with a strong decrease in lignin content exhibited an overall reduction in lignin deposition in the walls of the different xylem cell types, this reduction was selectively targeted to the fibers in a double transformant (down-regulated for both CCR and Cinnamyl alcohol dehydrogenase (CAD)) displaying a similar degree of global lignin content decrease. Fiber and vessel secondary walls of the transgenic tobacco line homozygous for the ccr antisense gene (CCR.H) down-regulated plants were dramatically destructured, particularly in the S2 sublayer, whereas the deposition of lignins in the S1 sublayer was not significantly modified. In contrast, cell wall organization was slightly altered in xylem cells of the double transformant. The relative distribution of non-condensed and condensed units in lignin, evaluated microscopically with specific antibodies, was differentially affected in the transgenics studied and, in a general way, a drop in non-condensed lignin units (beta- 0-4 interunit linkages) was associated with a loss of cohesion and extensive disorganization of the secondary wall. These results demonstrate that lignification is tightly and independently regulated in individual cell types and cell wall sublayers. They also show that down-regulation of specific genes may induce targeted changes in lignin structure and in spatial deposition patterns of the polymer.

Sensitivity of self-reports of cancer in a population-based prospective study: JPHC Study Cohort I.

The sensitivity of self-reports of cancer may differ among cultures, and not many studies have dealt with it. The authors measured the sensitivity of 615 individuals from the JPHC Study Cohort I in Japan who responded to a questionnaire in 1995 and had had a cancer registry report since 1990. Sensitivity as calculated using registered cancer as the gold standard was 0.36 for any cancer, but varied considerably by site: 0.81, 0.42, 0.41, 0.26, 0.14 and 0.08 for breast, uterus, stomach, lung, colorectum and liver, respectively. This sensitivity by site relates positively with the cancer incidence/death ratio (an index of prognosis) of each site. A false name was reported in 71% of colorectal cancer cases (namely polyp) and in 51% of stomach cases (ulcer and/or polyp). In conclusion, the sensitivity of self-reports of cancer was much lower in this cohort than in the US results except for breast cancer.

Lignification in transgenic poplars with extremely reduced caffeic acid O-methyltransferase activity.

Transgenic poplars (Populus tremula x Populus alba) were obtained by introduction of a sense homologous transgene encoding caffeic acid O-methyltransferase (COMT) under the control either of the cauliflower mosaic virus double 35S promoter or of the eucalyptus cinnamyl alcohol dehydrogenase promoter. Although these constructs conferred a moderate overexpression of COMT in some lines, a transgenic line with the double 35S promoter was found where COMT activity in woody tissues was close to zero due to a gene-silencing phenomenon. For the first time in COMT down-regulated trees, this alteration substantially reduced lignin level in 6-month-old trees (17% decrease). Lignin structure was found to be strongly altered, with a two times higher content in condensed bonds, an almost complete lack of syringyl units, and the incorporation of 5-hydroxyguaiacyl units to the most remarkable extent reported so far. Consistent with the higher cellulose content and with the higher condensation degree of the lignin, the impact of the transformation on the kraft-pulping performances of the poplar trees positively affected the pulp yield (10% relative increase), but made lignins less amenable to industrial degradations.

Life-threatening haemorrhage following obturator artery injury during transurethral bladder surgery: a sequel of an unsuccessful obturator nerve block.

In spite of prior blockade of the obturator nerve with 1% mepivacaine (8 ml) utilizing a nerve stimulator, violent leg jerking was evoked during transurethral electroresection of a bladder tumour approximately 1 h after the blockade in a 68-year-old man. The patient became severely hypotensive immediately following the jerking, and a large lower abdominal swelling concurrently developed. The urgent laparotomy indicated that the left obturator artery was severely injured by the resectoscope associated with the bladder perforation, causing acute massive haemorrhage. The patient recovered uneventfully after adequate surgery. Investigation of the literature suggested that both our nerve stimulation technique and anatomical approach were appropriate. It was therefore unlikely that our block resulted in failure because of an inappropriate site for deposition of the anaesthetic. However, consensus does not appear to have been obtained as to the concentration and volume of the anaesthetic necessary for prevention of the obturator nerve stimulation during the transurethral procedures. The concentration and volume of mepivacaine we used might have been too low and/or small, respectively, to profoundly block all the motor neuron fibres of the nerve. Alternatively, stimulation of the obturator nerve might occur because of the presence of some anatomical variant, such as the accessory obturator nerve or its abnormal branching. In conclusion, some uncertainty appears to exist in the effectiveness of the local anaesthetic blockade of the obturator nerve. In order to attain profound blockade of the motor neuron fibres of the obturator nerve and thereby prevent the thigh-adductor muscle contraction which can lead to life-threatening situations, we recommend, even with a nerve stimulator, to use a larger volume of a higher concentration of local anaesthetic with a longer duration in the obturator nerve block for the transurethral procedures.

Growth hormone stimulates follicular development by stimulating ovarian production of insulin-like growth factor-I.

The present study was undertaken to investigate the effects of GH on follicular growth, oocyte maturation, ovulation, and production of insulin-like growth factor-I (IGF-I) in the in vitro perfused rabbit ovaries. Ovulation did not occur in any ovaries perfused with GH at a concentration of 1, 10, 100, or 200 ng/ml, but the addition of GH to the perfusate increased the follicle diameter in a dose-dependent manner. The production of IGF-I by ovaries perfused with medium alone was very low throughout the perfusion period. The addition of 100 ng/ml GH to the perfusate significantly increased ovarian production of IGF-I at 4, 6, 8, and 12 h compared with the contralateral control ovaries. Changes in the tissue concentrations of IGF-I in ovaries perfused with 100 ng/ml GH paralleled those triggered by exposure to 50 IU human CG (hCG). When the effect of GH on the tissue concentration of IGF-I was determined at 4 h, GH stimulated the tissue concentration of IGF-I in perfused rabbit ovaries in a dose-dependent manner. The percent increase in follicle diameter in ovaries treated with GH was significantly correlated with the intraovarian IGF-I content. The mean number of ovulations per ovary and the ovulatory efficiency were significantly reduced in ovaries perfused with 5 IU hCG, compared with those in ovaries perfused with 50 IU hCG. The addition of 100 ng/ml GH to the perfusate significantly increased the ovulatory efficiency and follicle diameter in the 5 IU hCG-treated ovaries. Exposure to GH significantly stimulated the resumption of meiosis in the follicular oocytes compared with that in ovaries perfused with medium alone. Furthermore, GH significantly stimulated the resumption of meiosis in ovulated ova and follicular oocytes in ovaries treated with 5 IU hCG. Thus, exposure to GH-stimulated follicular growth, oocyte maturation, and production of IGF-I in the in vitro perfused rabbit ovaries, which indicates that the ovary is in fact a site of GH reception and action. Additionally, GH enhanced the effects of gonadotropins, acting synergistically to promote the ovulatory process. These observations suggest that GH may amplify gonadotropin actions in the process of follicular development and ovulation, at least in part, by stimulating ovarian IGF-I production.

Prolactin inhibits ovulation by reducing ovarian plasmin generation.

The present study was undertaken to investigate the effects of prolactin (PRL) on gonadotropin-induced ovulation and the biosynthesis of prostaglandin (PG), leukotriene (LT), and plasmin in in vitro perfused rabbit ovaries. The addition of PRL to the perfusate inhibited hCG-induced ovulation in vitro in a dose-dependent manner. Although exposure to hCG significantly increased PGF2 alpha, PGE2, and LTB4 production by perfused rabbit ovaries, PRL did not affect the secretion rates of PGs and LTB4 stimulated by hCG administration. The ovarian plasmin generation was determined by measuring the amount of plasmin bound to its major inhibitor, alpha 2-plasmin inhibitor (alpha 2PI-Plm). Exposure to hCG enhanced biphasically the ovarian secretion rate of alpha 2 PI-Plm, while PRL at a dose of 10(3) ng/ml significantly inhibited the hCG-stimulated generation of alpha 2 PI-Plm in ovaries throughout the entire perfusion period. A significant correlation was observed between ovulatory efficiency and ovarian plasmin generation in the PRL-treated ovaries. Additionally, PRL inhibited intrafollicular concentrations of alpha 2 PI-Plm in hCG-treated ovaries in a dose-dependent manner. These observations substantiate an essential role for a plasma-generating system in the cascade of events leading to ovulation. In conclusion, PRL may act directly on the ovary and block ovulation, at least in part, via the inhibition of ovarian plasmin generation.

Gonadotropin stimulates ovarian renin-angiotensin system in the rabbit.

The present study was undertaken to assess the role of ovarian renin-angiotensin system (RAS) in the preovulatory cascade induced by gonadotropin exposure. In the in vitro perfused rabbit ovaries, exposure to human chorionic gonadotropin (hCG) enhanced the secretion rate of angiotensin II (Ang II) within 1 h. The secretion rate reached maximal levels at 6 h and then declined thereafter. The intrafollicular Ang II content and renin-like activity were also significantly increased at 2 and 4 h after exposure to hCG, compared with control ovaries perfused with medium alone. The level of intrafollicular Ang II after hCG exposure significantly exceeded the concentration of Ang II in an equivalent volume of plasma. The addition of 1 microM captopril to the perfusate significantly inhibited the secretion rate of Ang II stimulated by hCG; however, captopril affected neither the ovulatory efficiency nor prostaglandin production in ovaries treated with hCG. Captopril significantly inhibited the resumption of meiosis in the ovulated ova and follicular oocytes stimulated by hCG. The administration of 100 micrograms Ang II at 2-h intervals to the perfusate reversed the inhibitory effects of captopril on hCG-induced oocyte maturation. In conclusion, these data indicate that gonadotropin stimulates renin-like activity and Ang II production in the rabbit ovary. Ovarian renin-angiotensin system may play an important role in the process of oocyte maturation after exposure to gonadotropin.

Locally produced angiotensin II induces ovulation by stimulating prostaglandin production in in vitro perfused rabbit ovaries.

The present study was undertaken to investigate the role of exogenous and endogenous angiotensin II (Ang II) in ovarian steroidogenesis and production of prostaglandin (PG) in in vitro perfused rabbit ovaries. The addition of 100 or 10 micrograms Ang II at 2-h intervals to the perfusate did not stimulate progesterone production, but significantly stimulated estradiol (E2) production by perfused rabbit ovaries. When the specific antagonist of Ang II, saralasin at 2 x 10(-6) M, was added to the perfusate 30 min before the onset of Ang II administration, Ang II-stimulated production of E2 was significantly blocked. Ang II also significantly stimulated both PGE2 and PGF2 alpha production, while the addition of saralasin to the perfusate significantly inhibited the Ang II-stimulated production of PG. The levels of PGs in ovaries perfused with saralasin plus 100 micrograms Ang II did not differ significantly from those in control ovaries perfused with medium alone. Exposure to human CG (hCG) significantly stimulated production of progesterone and E2 by perfused rabbit ovaries, while the concomitant administration of 2 x 10(-6) M saralasin significantly reduced only E2 production. Addition of saralasin to the perfusate inhibited hCG-stimulated PG production in a dose-dependent manner. The ovulatory efficiency in ovaries treated with hCG alone or hCG plus saralasin was significantly correlated with PG production by perfused rabbit ovaries at 12 h after exposure to hCG. The production of PG stimulated by Ang II was completely reduced by indomethacin treatment during the entire perfusion period. Indomethacin completely blocked Ang II-induced ovulation, but not Ang II-stimulated oocyte maturation. Concurrent administration of staurosporine, a protein kinase C inhibitor, at 10(-6) M significantly inhibited Ang II-stimulated meiotic maturation of ovulated ova and follicular oocytes. In conclusion, these results indicate that Ang II has a direct role in ovarian production of E2 and PG. An intrinsic renin-angiotensin system in the rabbit ovary may act as an intermediary of gonadotropin-stimulated PG production. Locally produced Ang II may induce ovulation in the rabbit ovary, at least in part, by stimulating PG production.

Comparative study of hormonal dynamics in pregnant and nonpregnant cycles during pulsatile subcutaneous administration of human menopausal gonadotropin in anovulatory infertile women.

OBJECTIVE: To assess the clinical relevance of daily hormonal changes for achieving a successful pregnancy in anovulatory infertile women. DESIGN: A comparative study of hormonal dynamics in pregnant and nonpregnant cycles during the pulsatile subcutaneous administration of hMG. Subjects received subcutaneous injection of either 9.375 IU or 14.0625 IU of hMG diluted in 50-microL physiological saline (total daily dose, 150 or 225 IU) at 90-minute intervals by means of a portable peristaltic pump. SETTING: Kyorin University Hospital and Ichikawa General Hospital. PATIENTS: We analyzed 18 pregnant and 42 nonpregnant cycles in 17 patients with secondary hypothalamic/pituitary amenorrhea who conceived after receiving pulsatile hMG treatment. Another 14 women with normal spontaneous ovulation, including 14 pregnant and 15 nonpregnant cycles, served as controls. MEASUREMENTS: Serum concentrations of LH, FSH, E2, and P were measured, and the P:E2 ratio was determined. RESULTS: Serum concentrations of LH and FSH did not differ significantly between the pregnant and nonpregnant cycles. Serum levels of P and E2 were significantly higher during the hMG treatments than those of the spontaneous ovulatory cycles throughout the follicular and luteal phases. Up to the midluteal phase, the P and E2 values in the nonpregnant cycles during the hMG treatments did not differ significantly from those in the pregnant cycles. The P:E2 ratios were comparable between the pulsatile stimulatory cycles and the normal spontaneous ovulatory cycles. However, the P:E2 ratio in the early and midluteal phases was significantly greater in the pregnant cycles than in the nonpregnant cycles. CONCLUSION: The P:E2 ratio in the early and midluteal phases is a more important indicator of hormonal function for implantation than the absolute levels of either P or E2.

[Relation of the difference between blood pressure before and after 5 minutes' rest to blood pressure status one year later in an epidemiological setting].

The relationship of the difference between blood pressures before and after 5 minutes' rest (before minus after) to resting blood pressures one year later was studied on 439 subjects, aged 35 to 44 years, not being treated for hypertension, in an epidemiological setting. Multiple regression analysis was applied to systolic (SBP) and diastolic blood pressure (DBP) separately. Both the resting SBP level and the SBP difference were significant predictors of the resting SBP one year later in both sexes. For resting DBP one year later, the resting DBP level and DBP difference were found to be significant in females. Multiple logistic analysis was used to identify the factors which predict development from normotension to above borderline hypertension one year later. The SBP difference as well as the resting DBP level were significant predictors in males. These findings suggest that BP difference between before and after 5 minutes' rest may be an important indicator of subsequent BP status, and therefore there would be value in measuring blood pressure before as well as after rest with particular attention to BP difference.

[Trends, risk factors, and prevention of ischemic heart disease in Japan].

The mortality from ischemic heart disease has increased steadily in most industrialized countries from the 19th century up to 1970. In some developed countries, such as the U.S.A. and Australia, it started to decrease in the nineteen seventies and accelerated recently. However, it has increased in some East European countries, such as Rumania, Poland and Hungary. The mortality had been extraordinarily low and the age standardized rate declined since the nineteen seventies in our country as in the U.S.A. These finding strongly suggests the possibility of prevention of ischemic heart disease worldwide. Among the risk factors, hypertension has gradually decreased due to treatment and lower intake salt in Japan. However, the compliance of antihypertensive treatment could be improved and the average intake of salt further decreased. The frequency of hypercholesterolemia was quite low for many years, but increased recently in Japan. However, the national average level of serum cholesterol is probably close to 200 mg/dl, and the new cholesterol level data will be revealed by the national survey in 1990. The world-famous high figure of smoking among Japanese men has been declining for these 20 years down to 61.2% in 1988, along with an exceptionally low rate for women in industrialized countries. The average figure of body weight by stature was in line with the desirable body weight for Japanese and the average intake of lipids has leveled off recently according to the National Nutrition Survey. After all it can be concluded that incidence of ischemic heart disease could be reduced further, even in Japan.

[Left high R wave amplitude and blood pressure levels before and after 5 minutes' rest in a mass screening program].

In order to evaluate the implication of blood pressures measured without 5 minutes' rest in mass screening programs, blood pressures were measured before and after 5 minutes' rest on 820 subjects in a rural community, aged 35 to 65 years and not receiving hypertensive treatment. Although the systolic blood pressure showed a significant drop of an average of 3 mmHg among males and 4 mmHg among females after rest, 23.3% of 820 subjects had higher systolic blood pressure reading after rest than before. The relationship between left high R (LHR) in electrocardiograms and blood pressure (BP) before and after rest was studied. The presence of LHR was significantly related to BP both before and after rest among males, but more strongly associated to BP before rest. The relationship of the difference between BP before and after rest to the prevalence of LHR was analyzed by multiple logistic method. A significantly higher prevalence of LHR with greater difference between systolic BP before and after rest was observed among males, even with age and systolic BP level after rest taken into account. These findings suggest the potential significance of blood pressure readings before 5 minutes' rest which may be a response to mental stress of having the initial blood pressure reading taken by the observer. It would seem worthy to obtain blood pressure before rest as well as after rest in detecting blood pressure abnormalities.