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Objective To determine bispectral index (BIS) values produced by equipotent concentrations of commonly used volatile anaesthetics.Methods Female patients undergoing thyroidectomy were randomly assigned to receive isoflurane, sevoflurane or desflurane anaesthesia. After induction, anaesthesia was maintained by the volatile agent at 1 minimum alveolar concentration and supplemented with remifentanil infusion. BIS values were recorded during 1 h surgical anaesthesia after a 15 min equilibrium phase.Results Time-averaged BIS value during the study period was significantly lower in the desflurane group (n= 29) than the sevoflurane group (n= 27) (37.0 ± 4.9 vs 41.5 ± 5.9). Duration of deep hypnosis (BIS < 40) was significantly longer in the desflurane group than the sevoflurane group (40.2 ± 20.7 vs 24.3 ± 22.5 min). There were no significant differences in any parameter between the isoflurane group (n= 27) and any other group.Conclusions Desflurane produces a greater hypnotic effect than sevoflurane during equipotent anaesthesia. Management of volatile anaesthesia using predetermined minimum alveolar concentration targets can lead to an unnecessarily long duration of deep hypnosis.

X-linked hypohidrotic ectodermal dysplasia (XLHED), which is characterized by hypodontia, hypotrichosis, and hypohidrosis, is caused by mutations in ED1, the gene encoding ectodysplasin-A (EDA). This protein belongs to the tumor necrosis factor ligand superfamily. We analyzed ED1in two Japanese patients with XLHED. In patient 1, we identified a 4-nucleotide insertion, c.119-120insTGTG, in exon 1, which led to a frameshift mutation starting from that point (p.L40fsX100). The patient’s mother was heterozygous for this mutation. In patient 2, we identified a novel missense mutation, c.1141G>C, in exon 9, which led to a substitution of glycine with arginine in the TNFL domain of EDA (p.G381R). This patient’s mother and siblings showed neither symptoms nor ED1mutations, so this mutation was believed to be a de novomutation in maternal germline cells. According to molecular simulation analysis of protein structure and electrostatic surface, p.G381R increases the distance between K375 in monomer A and K327 in monomer B, which suggests an alteration of overall structure of EDA. Thus, we identified two novel mutations, p.L40fsX100 and p.G381R, in ED1of two XLHED patients. Simulation analysis suggested that the p.G381R mutation hampers binding of EDA to its receptor viaalteration of overall EDA structure.

X-linked hypohidrotic ectodermal dysplasia (XLHED), which is characterized by hypodontia, hypotrichosis, and hypohidrosis, is caused by mutations in ED1, the gene encoding ectodysplasin-A (EDA). This protein belongs to the tumor necrosis factor ligand superfamily. We analyzed ED1 in two Japanese patients with XLHED. In patient 1, we identified a 4-nucleotide insertion, c.119-120insTGTG, in exon 1, which led to a frameshift mutation starting from that point (p.L40fsX100). The patient's mother was heterozygous for this mutation. In patient 2, we identified a novel missense mutation, c.1141G>C, in exon 9, which led to a substitution of glycine with arginine in the TNFL domain of EDA (p.G381R). This patient's mother and siblings showed neither symptoms nor ED1 mutations, so this mutation was believed to be a de novo mutation in maternal germline cells. According to molecular simulation analysis of protein structure and electrostatic surface, p.G381R increases the distance between K375 in monomer A and K327 in monomer B, which suggests an alteration of overall structure of EDA. Thus, we identified two novel mutations, p.L40fsX100 and p.G381R, in ED1 of two XLHED patients. Simulation analysis suggested that the p.G381R mutation hampers binding of EDA to its receptor via alteration of overall EDA structure.

To evaluate the interactive effect of methylenetetrahydrofolate reductase (MTHFR) genotype and dietary factors on the development of breast cancer, a hospital based case-control study was conducted in South Korean study population consisting of 189 histologically confirmed incident breast cancer cases and their 189 age-matched controls without present or previous history of cancer. A PCR-RFLP method was used for the genotyping of MTHFR (C677T) and statistical evaluations were performed by unconditional logistic regression analysis. Consumption of some dietary factors, such as green vegetables (OR=0.3, 95% CI: 0.2-0.6), white vegetables (OR=0.3, 95% CI: 0.1-0.7) mushrooms (OR=0.4, 95% CI: 0.3-0.7), and meats (OR=1.7, 95% CI: 1.1-2.8) significantly decreased or increased the risk of breast cancer. Although the breast cancer risk was 1.7-fold (95% CI: 0.8-3.2) increased in women with MTHFR TT genotype, the association was not statistically significant. Women with MTHFR TT genotype and low green vegetable intake increased 5.6-fold (95% CI: 1.2-26.3) risk of breast cancer compared to high green vegetable intake group containing MTHFR CC/CT genotype. However, the interaction was not significant (p for interaction=0.96). Our findings suggest that MTHFR polymorphism did not influence individual susceptibility to breast cancer. However MTHFR (C667T) genotype and green vegetable intakes appeared to have the interactive effect in breast cancer development.

The average prevalence of reported foodborne illness from 1981 to 1995 was 2.44 per 100,000 population in Korea, and 28.01 in Japan. The mean case fatality rate in Korea was 0.74% and in Japan, 0.03%. When both prevalence and case fatality rates in Korea and Japan were compared during the same period, the prevalence in Japan was much higher than that in Korea. However, the case fatality rate of patients in Korea was much higher than that in Japan. The distribution of monthly and seasonal patterns of foodborne illness outbreaks strongly indicate the outbreaks may be associated with climatic conditions, frequencies of national holidays, and vacation seasons. Comparison study indicates that the foodborne illness outbreaks in Korea most frequently involved homemade foods (47% of the total cases); in Japan, restaurants accounted for 31.3%. Food-borne illness cases of bacterial origin in Korea were 59.3% of the total and included Salmonellaspp. (20.7%), Vibrio(17.4%), Staphylococcus(9.7%), pathogenic Escherichia coli(2.4%), and other species (9.1%); in Japan, 72.8% of the total cases and the majority of the bacterial foodborne illness was caused by Vibrio(32.3%), Staphylococcus(15.9%), Salmonella(14.2%), pathogenic E. coli(3.0%), and other species (7.2%). In conclusion, the outbreaks of foodborne illness in Korea and Japan may be mainly caused by improper food handling, and their occurrences may be differentiated according to food sources.

Most spinal muscular atrophy (SMA) patients lack the survival motor neurongene (SMN). However, the patients retain at least one copy of the cBCD541gene (BCD), which is highly homologous with SMN. Here, we determined the SMN/BCDcopy number ratios (the S/B ratios) of 12 parents of Japanese SMA patients with a homozygous SMNdeletion, using competitive oligonucleotide priming polymerase chain reaction. We identified an S/B ratio of 2 in 25% of the parents examined, whereas less than 2% of parents of SMA patients in Western populations have an S/B ratio of 2. The high incidence of an S/B ratio of 2 in Japanese parents of SMA patients may reflect the characteristic genetic background of SMA in Japan.

SummaryHyperhomocysteinemia has been reported as an independent risk factor for atherosclerotic cerebrovascular and coronary heart diseases. 5,10-Methylenetetrahydrofolate reductase (MTHFR) is one of the enzymes responsible for hyperhomocysteinemia. The C to T transition of the MTHFR gene at nucleotide position 677 results in decreasing the enzymatic activity and increasing the plasma homocysteine level. We studied the distribution of the MTHFR gene mutation among the Japanese population. The subjects were 129 Japanese males (aged 40–59 years). The allele frequency of the mutation was 0.38. The frequencies of the three genotypes were as follows: +/+, 11%; +/−, 54%; −/−, 35% (+ and − indicate the presence and absence of the mutation, respectively). We also studied the frequency of the MTHFR gene mutation in the middle-aged Japanese males with hypertension to investigate the possibility that this mutation is related to essential hypertension. The normotensive and hypertensive subjects were identical in the distribution of the mutated allele and the frequencies of the three genotypes. Furthermore, the prevalence of hypertension in each genotype group was same, although the mean diastolic pressure of the group with homozygous mutation was significantly higher than that of other groups (p<0.05). Therefore, we concluded that there was no significant relationship between the MTHFR gene mutation and hypertensive subjects studied in this study.

Osteonectin gene expression in relation to metallothionein mRNA expression was investigated in various tissues from Cd-treated rats. After a single 50 μmol/kg subcutaneous injection of CdCl2, Cd predominantly accumulated in the liver and metallothionein gene expression significantly increased concomitantly with Cd accumulation, but no alteration of osteonectin gene expression was observed. In the kidney and lung, both metallothionein and osteonectin mRNA increased significantly but the elevation of metallothionein mRNA levels (1 h after Cd administration) preceded that of osteonectin (3 h after administration). A significant elevation of osteonectin mRNA levels was also observed in the testis after 3 h, but that of metallothionein mRNA occurred after 6 h. Not only accumulation of Cd but also increments in both osteonectin and metallothionein mRNA were minimal in the brain, but a significant increase in gene expression was observed after 1 h for osteonectin and after 3 h for metallothionein. Since, except in the testis, metallothionein gene expression preceded osteonectin gene expression, the induced metallothionein might transpose Cd and thereby affect its levels immediately, thus reducing the levels of Cd available for accumulation in other tissues. Hence, the osteonectin-Cd interaction might be secondary to the metallothionein-Cd interaction. However, the fact that osteonectin mRNA was predominantly induced by Cd administration in the target tissues of Cd toxicity, such as the lung, kidney and testis, suggests the possible involvement of osteonectin in Cd intoxication/detoxication mechanisms.

Abstract: Itai-itai (or ouch-ouch) disease is a syndrome accompanied by bone mineral disorders, and which may be related to oral cadmium exposure. Itai-itai predominantly affects postmenopausal women with a history of multiple childbirths. Recently, it has been reported that polymorphisms of the estrogen receptor α (ERα) gene are associated with postmenopausal reduction of bone mineral density in Japanese women. However, estrogen receptors have never been studied in itai-itai disease. In this study, we examined the genotypic distributions of PvuII and XbaI restriction fragment length polymorphisms (RFLPs) of the ERα gene in patients with itai-itai disease and compared them with those of control subjects. The RFLPs are represented here as Pp (PvuII) and Xx (XbaI); the capital and small letters signify the absence and presence of restriction sites, respectively. The genotypic distributions of the patient group were: PP, 14.8%; Pp, 55.6%; pp, 29.6%; XX, 7.4%; Xx, 29.6%; and xx, 63.0%. These distributions were similar to those observed for the control groups, hence no pattern of genotypic distribution was observed that could be related to itai-itai disease. We conclude that RFLPs of the ERα gene may not be associated with itai-itai disease.

A prediction method for variable bit rate video traffic based on source information is presented. By analysing the source before encoding, any changes in the source traffic are detected and the bit rate of the current frame is predicted. In addition, a new channel rate for renegotiated constant bit rate service can be determined for future frames using the predicted bit rate and a bit rate updating algorithm. Simulation results show that the proposed method achieves a better prediction and requires a smaller buffer than the conventional approach.