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PurposeTo investigate the relationship between the background of preoperative cataract patients and bacterial conjunctival flora.MethodsA total of 990 cataract patients who had completed preoperative examinations in 2007 and 2008 were included. Patients using topical antibiotics at the preoperative examination or having a history of intraocular surgery were excluded. Conjunctival cultures had been preoperatively obtained. Patient characteristics were investigated via medical records. Risk factors for conjunctival flora of seven typical bacteria were analyzed by univariate and multivariate analyses.ResultsThe detection rate of alpha-hemolytic streptococci and Enterococcus faecalis increased with age (P=0.044 and P=0.002, respectively). The detection rate of Gram-negative bacilli was higher among patients with oral steroid use or lacrimal duct obstruction (P=0.038 and P=0.002, respectively). The detection rate of Corynebacterium species was higher among older patients and men, and lower among patients with glaucoma eye drop use (P<0.001, P=0.012 and P=0.001, respectively). The detection rate of methicillin-susceptible coagulase-negative Staphylococci was higher among men and lower among patients with a surgical history in other departments (P=0.003 and P=0.046, respectively). The detection rate of methicillin-resistant coagulase-negative Staphylococci (MR-CNS) was higher among patients with oral steroid use, a visit history to ophthalmic facilities, or a surgical history in other departments (P=0.002, P=0.037 and P<0.001, respectively).ConclusionsElderly patients, men, patients with lacrimal duct obstruction or immunosuppressed patients are more likely to be colonized by pathogens that cause postoperative endophthalmitis. Moreover, MR-CNS colonization was associated with healthcare-associated infection.

AbstractThe design studies of Atmosphere Detirtiation System (ADS) have been carried out in Japan Atomic Energy Agency (JAEA) as a contribution of Japan to ITER. The performance of ADS has also been investigated under accidental conditions such as fire and co-existing of a poison gas for catalyst like SF6. There is no degradation of Detritiation Factor (DF) under co-existing of CO or CO2up to 20% as a simulated fire condition. However, only 0.1% of SF6degrades the DF from more than 1000 to 50, following reduction of water by SF4etc. (decomposition products of SF6) at 773K of catalyst bed.For the tritium processing technologies, our efforts have been focused on the R & D of the tritium recovery system of breeding blanket. In case of ITER Test Blanket Module, a cryogenic molecular sieve bed system was designed and demonstrated. Furthermore, electro-chemical pumping system using a proton conductor is also investigated to design more effective system. The durability of electrolysis cell for Water Detritiation System (WDS) has been investigated and it is expected that the cell can endure more than 3 years’ operation under the ITER WDS design condition.A series of fundamental studies on tritium safety technologies has been carried out as another major activity of JAEA for ITER and future fusion demo reactors. Tritium behavior in various confinement materials, tritium monitoring & accountancy, and detritiation were studied under collaboration programs with universities, using Caisson Assembly for Tritium Safety study.

Abstract. Diffraction phenomena of gaseous detonation waves behind a backward-facing step in a tube are observed by using high-speed schlieren photography and soot-track records as well as by pressure measurements on the sidewall. Mixtures are stoichiometric oxyhydrogen and those diluted by argon at sub-atmospheric pressures. Three types of phenomena are observed, that is, continuous propagation of detonation, re-initiation after a temporal extinction of detonation and complete extinction of detonation. The continuous propagation means that the diffracted wave does not affect the main propagation although reflected shock waves from the bottom surface of the tube may affect it. The re-initiation occurs at a wall surface of the tube behind a reflected shock wave after the main detonation wave has been extinguished. Positions and conditions of the re-initiation are discussed. The complete extinction is defined as disappearance of detonation cells behind the step within a certain length of the tube. Cases exist where an ignition occurs after several reflections off the bottom and top surface of the tube.

: Abstract. A two dimensional numerical simulation has been performed to study reflection processes of detonation waves on a wedge. The numerical scheme adopted is the flux corrected transport scheme and a two-step chemical reaction is assumed for a stoichiometric oxyhydrogen mixture diluted with argon. Transverse wave structures of the detonation are produced by artificial disturbances situated in front of a one-dimensional Chapman-Jouguet detonation wave. Numerical grids are generated by solving a Laplace equation. Results show that in the case where Mach reflection occurs, the cells in the Mach stem are smaller than those in the incident wave and are distorted in shape. There is also an initiating stage during which the cells in the Mach stem are created. The critical angle beyond which Mach reflection cannot occur is discussed.

Proliferation of vascular smooth muscle cells (SMC) is a crucial event in the formation of atherosclerotic tissues and is regulated by nuclear transcriptional factors including nuclear factor-kappaB (NF-kappaB). We constructed a reporter gene assay to measure NF-kappaB-dependent transcriptional activity in SMC. Thrombin receptor-activating peptide (TRAP) and basic fibroblast growth factor (bFGF) stimulated SMC proliferation and rapidly enhanced the NF-kappaB transcriptional activity in a dose-dependent manner. 4-Cyano-5,5-bis-(methoxyphenyl)4-pentenoic acid (E5510) significantly inhibited SMC proliferation and also suppressed NF-kappaB transcription stimulated by TRAP and bFGF. In contrast, although tumor necrosis factor (TNF)-alpha activated NF-kappaB transcription, E5510 had no effect on TNF-alpha-induced activation. NF-kappaB was activated after the stimulation of TRAP, bFGF, and TNF-alpha in electrophoretic mobility shift assay, and E5510 suppressed the NF-kappaB activation induced by TRAP and bFGF but not the activation by TNF-alpha. Western blot analysis of I-kappaBalpha and I-kappaBbeta, inhibitors of NF-kappaB, indicated that I-kappaBalpha degradation, rather than I-kappaBbeta degradation, was important in NF-kappaB activation after the stimulation of TRAP and bFGF. PD98059, an inhibitor of extracellular signal-regulated kinase (ERK) kinase, suppressed NF-kappaB transcriptional activity and SMC proliferation. The phosphorylation of ERK1/2 was rapidly induced by TRAP and bFGF but not by TNF-alpha. These results indicate that TRAP and bFGF induced I-kappaB degradation and NF-kappaB activation through a distinct pathway from TNF-alpha and that ERK1/2 may play an important role in NF-kappaB activation induced by TRAP and bFGF.

Summary:  CSF rhinorrhea due to a transsphenoidal approach usually follows accidental or intentional arachnoid opening. We report a patient with an intrasellar arachnoid cyst, who developed delayed onset of CSF rhinorrhea. A sixty-two-year-old man presented with bitemporal type visual field defect for the last 3 years. With the diagnosis of arachnoid cyst or Rathke's cleft cyst, based on MRI findings of intra-and supra-sellar cyst with CSF intensity, he successfully underwent transsphenoidal surgery without evidence of intra-operative CSF leakage. He developed CSF rhinorrhea one week later. This needed another operation for sellar floor repair. The pathomechanism of this delayed onset is explained as follows. Incomplete or one-way communication of subarachnoid space to cyst cavity, unrecognized during surgery, might cause delayed onset of CSF rhinorrhea. By using MRI, identification of the residual gland, which was compressed posteriorly, is useful for differentiating an arachnoid cyst from other cystic lesions. In highly suspect cases, even without evidence of intra-operative CSF leakage, peri-operative measures to prevent occurrence of postoperative CSF rhinorrhea are required.

Recent advances in tumor carbohydrate biochemistry have demonstrated antitumor effects of locally administered GM3 ganglioside on mouse MBT-2 tumor. When intravesical therapy inN-butyl-N(4-hydroxybu-tyl)nitrosamine (BBN)-induced rat bladder tumor is attempted, it is essential to identify the tumor, to classify its size before therapy and to monitor the effect of the therapy. To establish a more reliable experimental therapeutic system, we assessed the development of BBN-induced rat bladder tumor by endoscopic observation. BBN-induced bladder tumors in rats were observed serially using a 4.2-F flexible fiberscope. The endoscopic findings were compared with the histopathological findings. Intravesical tumor growth varied greatly between individual rats. The smallest change detected by endoscopy was a small edematous lesion histologically proved to be papilloma. The largest nodular lesion was determined to be a papillary, transitional cell carcinoma. This noninvasive method makes the BBN rat experimental system more reliable by allowing confirmation of tumor formation and classification of the tumor volume prior to therapy.

Previous virological and immunological studies have suggested that multiple sclerosis (MS) is an auto-immune disease triggered by a virus infection. In order to inhibit the growth of measles virus in the patient's jejunum, we obtained an IgA-rich cow colostrum containing anti-measles lactoglobulin resistant to proteases. This colostrum was orally administered to patients with MS to investigate its effect on the course of the disease.

Summary Five monoclonal antibodies against the haemagglutinin-neuraminidase (HN) molecule of Taka virus, a variant of Newcastle disease virus (NDV), were established to compare the antigenicities of several avian paramyxoviruses including NDV. From the results of the cross haemagglutination-inhibition (HI) test with the monoclonal antibodies, the HN molecule of Taka virus seemed to have at least three different antigenic determinants; one was specific for all NDV strains tested, the second was for Taka virus and Komarov strain of NDV and the third was for Taka virus, Komarov strain, Bangor and Yucaipa. Furthermore, the differences in the ratio of HI to neuraminidase-inhibition titers suggested that the separate active sites involved in haemagglutinin and neuraminidase activities might exist at least in close proximity.

PLASMA levels of endotoxin and various cytokines were assessed in 70 patients with gastrointestinal tract perforation. Sepsis developed in 29 of them, and eight of these (27.6%) had on admission endotoxin levels higher than 9.8 pg ml-1 . The clinical outcome correlated with the level of tumour necrosis factor α (TNFα), rather than with the endotoxin level. The high interleukin 6 (IL-6) level was shown in septic patients and no correlation was observed between the IL-6 level and the clinical outcome. Plasma TNFα levels tended to change independently from endotoxin levels, suggesting that TNFα may have been locally produced in inflammatory lesions.

Among 231 patients with cervical injuries treated over 12 years, 15 had cervical spinal cord injury associated with ossification of the posterior longitudinal ligament. All of them were male and most had injuries due to a relatively weak external force. Four of them underwent surgery. There was little difference in improvement of paralysis between the conservatively and the surgically treated group.

The asparagine-linked sugar chains of human erythropoietin produced by recombinant Chinese hamster ovary cells and naturally occurring human urinary erythropoietin were liberated by hydrazinolysis and fractionated by paper electrophoresis, lectin affinity chromatography, and Bio-Gel P-4 column chromatography. Both erythropoietins had three asparagine-linked sugar chains in one molecule, all of which were acidic complex type. Structural analysis of them revealed that the sugar chains from both erythropoietins are quite similar except for sialyl linkage. All sugar chains of erythropoietin produced by recombinant Chinese hamster ovary cells contain only the NeuAc alpha 2—-3Gal linkage, while those of human urinary erythropoietin contain the NeuAc alpha 2—-6Gal linkage together with the NeuAc alpha 2—-3Gal linkage. The major sugar chains were of fucosylated tetraantennary complex type with and without N-acetyllactosamine repeating units in their outer chain moieties in common, and small amounts of 2,4- and 2,6-branched triantennary and biantennary sugar chains were detected. This paper proved, for the first time, that recombinant technique can produce glycoprotein hormone whose carbohydrate structures are common to the major sugar chains of the native one.

Two forms of erythropoietin, EPO-bi and EPO-tetra, with different biological activities were isolated from the culture medium of a recombinant Chinese hamster ovary cell line, B8-300, into which the human erythropoietin gene had been introduced. EPO-bi, an unusual form, showed only one-seventh the in vivo activity and 3 times higher in vitro activity of the previously described recombinant human EPO (standard EPO). In contrast, EPO-tetra showed both in vivo and in vitro activities comparable to those of the standard EPO. EPO-bi, EPO-tetra, and the standard EPO had the same amino acid composition and immunoreactivity. However, structural analyses of their N-linked sugar chains revealed that EPO-bi contains the biantennary complex type as the major sugar chain, while EPO-tetra and the standard EPO contain the tetraantennary complex type as the major sugar chain. From examination of various preparations of recombinant human EPO, we found a positive correlation between the in vivo activity of EPO and the ratio of tetraantennary to biantennary oligosaccharides. These results suggest that higher branching of the N-linked sugar chains is essential for effective expression of in vivo biological activity of EPO.

The patient was a 62 year old woman who presented with a visual field defect. Magnetic resonance images showed an intra-and supra-sellar low intensity mass on T1 weighted images. The preoperative diagnosis was craniopharyngioma, Rathke’s cleft cyst (RCC) or arachnoid cyst. The patient underwent transsphenoidal surgery & the pathological diagnosis was RCC. We conclude that although RCC has a round, ovoid or dumb-bell shaped configuration, it may present a unusual shape in cases with preconditions, as were seen in our patient. Copyright 2000 Harcourt Publishers LtdCopyright DUMMY

Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation.

Dislocation of the interphalangeal joint of a toe is a rare injury, and when it does occur it usually involves the great toe. Dislocation of other toes without fracture is quite rare. We present here a case of dorsal dislocation of the proximal interphalangeal (PIP) joint which was reduced by manipulation.

Dislocation of the shoulder joint is a rare occurrence in children. This paper reports on traumatic anterior dislocation of the shoulder in a 3-year-old boy and a 9-year-old boy, together with a discussion of the relevant literature.

Traumatic dislocation of in children occurs less frequently than in adults, and bilateral dislocation is extremely rare. Manual reduction was performed in a 3-year-old girl with bilateral traumatic hip dislocation. The recovery course has been favorable for about 1 year.

Plasma levels of endotoxin and various cytokines were assessed in 70 patients with gastrointestinal tract perforation. Sepsis developed in 29 of them, and eight of these (27.6%) had on admission endotoxin levels higher than 9.8 pg ml-1. The clinical outcome correlated with the level of tumour necrosis factor α (TNFα), rather than with the endotoxin level. The high interleukin 6 (IL-6) level was shown in septic patients and no correlation was observed between the IL-6 level and the clinical outcome. Plasma TNFα levels tended to change independently from endotoxin levels, suggesting that TNFα may have been locally produced in inflammatory lesions.

p‐Dibromobenzene (I) reacts with dichlorotetramethyldisilane (II) after metallation with butyl lithium to yield the bis(bromophenyl)disilane (III).