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Maximal H-reflex amplitude (Hmax) compared with maximal M-response (Mmax) has been generally used to assess the efficacy of the monosynaptic transmission from Ia afferents to alpha motoneurons in spinal cord. In previous studies, it has been demonstrated that H-reflex in soleus muscle (SOL) is inhibited during free standing due to an increase in presynaptic inhibition of the Ia afferent terminals to SOL motoneurones (Katz et al. 1988, Koceja et al. 1993). Transcranial magnetic stimulation (TMS) of human motor cortex excites the corticospinal system monosynapticaly connecting to spinal alpha motoneurones. However, it is not clear whether or not the motor evoked potentials (MEPs) in SOL and tibialis anterior (TA) muscles induced by TMS are modulated during standing (Ackermann et al. 1991, Lavoie et al. 1995). Considering that postural control functions change with exposure to weightlessness, we supposed that the excitability of SOL and TA spinal motoneurons from Ia afferents and/or corticospinal tracts during free standing would change after long-term bed rest (BR). The aim of this study was to investigate the effect of BR on H-reflex and MEP in SOL and TA during free standing.

Recent work has shown that the H-reflex excitability of the human soleus motoneurones is modulated in reduced gravity and accompanied by a corresponding change in electromyographic (EMG) activity during space flight mission or different gravitational load. Spinal reflexes are often viewed as stereotyped motor patterns with limited scope for modification. However, recent evidence suggests that even short-latency, largely monosynaptic reflexes show a high degree of modulation during simple human motor activities such as walking and standing, and that the pattern of modulation can be specifically altered for the different functional requirements of each activity. Capady and Stein have demonstrated that H-reflex amplitude of the soleus increases progressively during the stance phase and reaches its peak amplitude late in the stance phase during walking. However, during running, the H-reflex is found to be significantly smaller than during walking, suggestion a modified spinal reflex gain for the different functional requirements of the motor behaviors. It is well documented that gravitational loads on the human body, spinal cords are much higher during standing in the water than standing in land. Little is known about the occurrence and influence of neural modulation in spinal cord during different gravitational load, which was not induced by posture but by voluntary background activity. The purpose of the present study was consequently to investigate how to effect is controlled H-reflex modulated during reduced gravity standing in a water in normal subjects.

We evaluated the stretch reflex activities of the elbow flexor and extensor muscles considering the relationship between the reflex electromyographic (EMG) responses and their corresponding standardized muscle stretch velocities. Specifically, muscular stretch velocity was estimated by using ultrasonograms. Stretch reflex EMG responses were elicited in the biceps brachii, brachioradialis and triceps brachii with a ramp-and-hold rotation at the elbow joint, which consisted of various angular velocities for the extension- or flexion-direction. The whole muscle stretch velocity induced by each ramp-and-hold rotation was calculated on the basis of fibre length changes associated with the elbow joint angle. A linear regression equation was fitted to the relation between the whole muscle stretch velocity and the reflex EMG responses, and the variables from the equation were used to quantify sensitivity of each reflex EMG component. The reflex EMG responses were increased as the ramp-and-hold rotational velocity increased. There were no significant differences in the recorded magnitudes of reflex EMG responses with equivalent joint rotational velocity between the brachioradialis and the triceps brachii medial head. These muscles showed the highest reflex responses in the flexor and extensor muscles, respectively. To the contrary, the reflex EMG response elicited by the standardized muscle stretches was significantly greater in the extensor muscles, indicating a higher reflex sensitivity. This was because of the lower muscle stretch velocity of the triceps brachii with an equivalent elbow joint rotation. The stretch reflex sensitivity in both the elbow flexor and extensor muscles might be regulated so as to make the reflex responses the same when the equivalent joint rotational velocity is applied to these muscles.

A double-hyperfragment event has been found in a hybrid-emulsion experiment. It is identified uniquely as the sequential decay of ( 6)(LambdaLambda)He emitted from a Xi(-) hyperon nuclear capture at rest. The mass of ( 6)(LambdaLambda)He and the Lambda-Lambda interaction energy DeltaB(LambdaLambda) have been measured for the first time devoid of the ambiguities due to the possibilities of excited states. The value of DeltaB(LambdaLambda) is 1.01+/-0.20(+0.18)(-0.11) MeV. This demonstrates that the Lambda-Lambda interaction is weakly attractive.

The efficacy of gas exchange during partial liquid ventilation (PLV) may be affected by positive end-expiratory pressure (PEEP), tidal volume (TV) and perflubron (PFOB) dose. The purpose of the present study was to clarify which factors were important for improving gas exchange during PLV. Fourteen rabbits were anesthetized and tracheostomized. Lung was introduced with intravenous oleic acid combined with saline lung lavage. After obtaining control data, PFOB 7.5 ml.kg-1 was instilled into the trachea, and ventilation settings were changed sequentially [1. TV: 10 ml.kg-1 (mTV), 2. mTV with PEEP, 3. TV: 15 ml.kg-1 (hTV), 4. hTV with PEEP]. PEEP level was set to the lower inflection point. The PFOB dose was increased to 15 ml.kg-1 and measurements were repeated under each ventilation setting. PEEP increased PaO2 in all ventilation settings. In hTV ventilation settings, incremental dose of PFOB significantly increased PaO2. The PaO2 values of all hTV ventilation settings were significantly higher than those of corresponding ventilation setting of mTV. Pulmonary compliance was significantly decreased with PEEP in hTV ventilation in addition to 15 ml.kg-1 PFOB. The results suggested that adequate gas tidal volume was the most important factor for improving gas exchange during PLV. However, PEEP or larger dose of PFOB should be avoided because they may decrease pulmonary compliance.

We have carried out a hybrid-emulsion experiment E373 at KEK to study a double strangeness nuclear system. By 11% data analysis of all, we uniquely identified the formation and the decay sequence of a ΛΛ6He double hypernucleus as; Ⅺ−+12C→ΛΛ6He+4He+t, ΛΛ6He→Λ5He+π−+p. The ΛΛ interaction energy has been confirmed to be 1.01±0.20 (measured) −0.110.18(syst.) MeV using the most probable Ⅺ− binding energy of 0.13 MeV which would be the level energy of 12C atomic 3D state. This value demonstrates the ΛΛ interaction is attractive but not so large as 4∼5 MeV which has been believed for forty years.

A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. Angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura. The fistula was successfully obliterated by coil embolization, resulting in rapid improvement of the signs and symptoms. Mechanical compression to the nerve roots by the engorged epidural veins with arterial pressure was considered to be the major cause of radiculopathy. Vertebral artery dissection induced by chiropractic manipulation is most likely responsible for the development of the fistula.

Radiation safety management condition in Japanese nuclear medicine facilities were investigated by the questionnaire method. The first questionnaire was asked in all Japanese 1,401 Nuclear Medicine facilities. Answers from 624 institutes (44.5%) were received and analyzed. The radiation-safety management in nuclear medicine institutes was considered to be very well performed everyday. Opinion for the present legal control of nuclear medicine institutes was that the regulation in Japan was too strict for the clinical use of radionuclides. The current regulation is based on the assumption that 1% of all radioactivity used in nuclear medicine institutes contaminates into the draining-water system. The second questionnaire detailing the contamination of radioactivity in the draining-water system was sent to 128 institutes, and 64 answers were received. Of them, 42 institutes were considered to be enough to evaluate the contamination of radioactivity in the draining-water system. There was no difference between 624 institutes answered to the first questionnaire and 42 institutes, where the radioactivity in the draining-water system was measured, in the distribution of the institute size, draining-water system equipment and the radioactivity measuring method, and these 42 institutes seemed to be representative of Japanese nuclear medicine institutes. Contamination rate of radioactivity into the draining system was calculated by the value of radioactivity in the collecting tank divided by the amount of radionuclides used daily in each institute. The institutes were divided into two categories on the basis of nuclear medicine practice pattern; type A: in-vivo use only and type B: both in-vivo and in-vitro use. The contamination rate in 27 type A institutes did not exceed 0.01%, whereas in 15 type B institutes the contamination rate distributed widely from undetectable to above 1%. These results indicated that the present regulation for the draining-water system, which assumed that 1% of all radioactivity used in nuclear medicine institutes contaminated into draining-water system, should be reconsidered in nuclear medicine facilities where radionuclides are used only in in-vivo studies.

We reported a 24-year-old Thai woman who developed primary CNS lymphoma (PCNSL) associated with acquired immunodeficency syndrome. It was difficult to distinguish PCNSL from toxoplamic encephalitis in this case by clinical symptoms, findings of CT and MRI, and therapeutic responses for toxoplasmosis. It is important to make a definite diagnosis of PCNSL by brain biopsy to treat appropriately, because this disorder could be fatal if it is not treated by corticosteroid, radiation, or other proper methods.

Recent studies have demonstrated that coordinated stepping movements can be induced in patients with complete para-/tetraplegia, when they were standing on a moving treadmill with their body weight partially unloaded and external assistance. The aim of this study was to determine which part of the spinal cord generated the locomotor pattern. In patients with complete paraplegia due to lesions at different levels of the spinal cord, the locomotor pattern was compared with that of healthy subjects. Any similarities in electromyographic (EMG) activity of gastrocnemius and tibialis anterior muscles between the patients and healthy subjects were reflected by the analysis of the variation ratio and amplitudes of the EMG activity. It was found that the higher the level of spinal cord lesion the more "normal" was the locomotor pattern. This suggests that neuronal circuits underlying locomotor "pattern generation" in man are not restricted to any specific level(s) of the spinal cord, but that an intricate neuronal network contributing to bipedal locomotion extends from thoracolumbal to cervical levels.

A multicenter study was performed to evaluate the success of endotracheal intubation using an intubating laryngeal mask (ILM, Fastrach) in patients in ASA status I or II, aged 20 years or more, who underwent general anesthesia. A total of 191 patients were studied, and 24 of them were estimated difficult to intubate by the ordinary method with laryngoscope. Endotracheal intubation was successfully performed through ILM in 162 of the 191 (success rate of 84.8%). The mean time required for intubation in these successful cases was 19.1 seconds. The success rate did not depend on the clinical experience of anesthesiologists, and the individual success rate was improved as they became more experienced. Of the 24 patients who had been estimated difficult to intubate with laryngoscope, 23 were successfully intubated with success rate of 95.8%. In summary, endotracheal intubation through ILM was easy regardless of the anesthesiologist's experience, and seemed to be valuable for patients who were difficult to intubate.

Although endoscopic surgery has become widespread and is currently used in a wide range of general, thoracic, urologic, gynecologic, and orthopedic procedures, many major difficulties remain because sensorial information is restricted to a two-dimensional image, and effector instruments have limited maneuverability due to the rigid shaft axis fixed to the abdominal wall by the entry trocar. To overcome these problems, advanced engineering technology has been introduced in laparoscopic surgery which includes three-dimensional video imaging, robotic laparoscopic cameraholders, telemanipulated flexible effector instruments, and tactile feedback. A voice-controlled robotic laparoscopic holder (AESOP200, Computer Motion Inc. USA) provides stable support for the laparoscope during laparoscopic surgery performed by a single surgeon. A new computer-assisted telemanipulation robot (Intuitive Surgical Inc. USA) permits the performance of completely endoscopic coronary artery bypass and Nissen fundoplication. Furthermore, price reductions and technological advances in telecommunications have made telementoring in endoscopic surgery available for routine clinical use, and intercontinental surgical video teleconferences fruitful opportunities for discussing technical details. The fusion of medicine and technology in endoscopic surgery would overcome difficulties in the conventional endoscopic approach.

As the need for home health care has been increasing with the rising number of the elderly in Japan, the application of medical informatics to home health care delivery is considered to be useful. Therefore, development of a home health care support information system was planned. The system can collect patient's PHD (Personal Health Data) such as data of ECG, complaints, etc. at patient's home and can send the PHD to medical facilities. We designed and constructed two subsystems on a trial basis. One subsystem has function of gathering, recording and transmitting vital signs of the aged such as ECG, physical activity rate, oxygen saturation rate in arterial blood. Another subsystem can collect and send image data of the old people at their home. Experiments for trial use of the system was conducted and it was recognized that the PHD can be smoothly collected and recorded at home of the elderly and can be sent to the medical facilities with good success by using the system.

1. 5-Hydroxytryptamine (10 microM) enhanced ionic current mediated through the wild-type P2X2 receptor/channel expressed in Xenopus oocytes. 2. 5-Hydroxytryptamine (10 microM) inhibited a current mediated through P2X2 receptor/channel mutants when Thr330 or Asn333 was replaced with Ile (T330I and N333I). 3. Our results suggest that neutralization of Thr330 or Asn333 exposes a high-affinity, inhibitory binding site for 5-hydroxytryptamine. This implies that 5-hydroxytryptamine interacts with the P2X2 receptor/channel at their channel pores.

The authors report the case of a 68-year-old male who underwent emergency stenting for iatrogenic occlusion of the internal carotid artery while he was receiving percutaneous transluminal angioplasty. He presented with a 1-month history of transient ischemic attacks with right-sided hemiparesis. Carotid angiography revealed a 95% eccentric stenosis at the origin of the left internal carotid artery. As the stenotic lesion was higher than the level of the third cervical vertebral body, percutaneous transluminal angioplasty was performed instead of carotid endarterectomy. During the procedure, the left internal carotid artery was dissected, then obstructed completely with rapid deterioration of his neurological condition. The Palmaz-Schatz stent was successfully deployed over the site of dissection to restore normal patency through the dissected carotid artery. Following emergency stenting, his neurological signs quickly subsided. Since then, with oral administration of antiplatelet medication, he has suffered no recurrence of cerebral ischemic events. Echo-ultrasonography 4 months after stent implantation showed good patency of the stented segment. It has been reported that angioplasty is indicated for high-risk patients or surgically inaccessible lesions in stenotic disorders of the internal carotid artery. However, there are several complications reported, including intimal dissection and restenosis. The present case emphasizes the usefulness of emergency stenting when occlusion of the internal carotid artery is complicated during percutaneous transluminal angioplasty.

We evaluated the usefulness of the intubating laryngeal mask airway (ILMA) in patients who were predicted to have possible difficult airway. Patients with possible difficult airway were defined as those with limited head extension, Mallampati's classification of grade IV, thyro-mental distance4 cm, or Cormack grade III-IV on the laryngoscopy. The control group was consisted of the patients without these conditions or impaired mouth opening. Insertion of the ILMA was successfully performed in all patients of both groups. In the group of possible difficult airway, 83% of patients were intubated through the ILMA successfully, and in the control group, 86%. We conclude that the ILMA may become an additional tool in patients with difficult intubation.

Fourteen mongrel dogs were anaesthetized and mechanically ventilated with oxygen. After oleic acid was administered intravenously, amrinone 1 mg/kg was intravenously administered to one group followed by a continuous infusion of 10 μg/kg/min for one hour (amrinone group, n = 7). Isovolumetric saline was administered to the control group (n = 7). Amrinone slightly lowered PaO2 but significantly increased oxygen delivery and improved gastric intramucosal pH (pHi) during the first 30 minutes (7.33±0.13) compared with the control group (7.21 ±0.06, P

A patient with protein C deficiency associated with massive pulmonary embolism underwent open heart tromboembolectomy. The operation was successfully performed under cardiopulmonary bypass using a usual dose of heparin 3 mg.kg-1. The effect of heparin was successfully reversed by the administration of protamine sulfate 6 mg.kg-1. Perioperative administration of fresh frozen plasma or protein C concentrates might be necessary to manage hypercoagulability in a patient with protein C deficiency.

The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying multifunctional telephone set and an IC memory card, by which complaints, symptoms, and conditions by them can be collected, recorded, and transmitted to medical facilities. We also conducted an experiment for trial use of the system with the cooperation of elderly female volunteers. It was recognized that the elderly volunteers could operate the system with the help of public health nurses and their health information could be collected by the system. Although the developed system has some problems, it was suggested that the system would be useful for the support of health evaluation of elderly at home.

The purpose of this study is to evaluate keratin expression in neuroendocrine cells and carcinoid tumor of the gastrointestinal tract and lung. Neuroendocrine cells in the lung and the gastrointestinal tract reacted with low-molecular keratin strongly, but not with high-molecular keratin. The low-molecular keratin expression of carcinoid tumor in the lung and the gastrointestinal tract, which varied in degree, were identical to that of neuroendocrine cells. Keratin 8 and 18 were found abundantly in neuroendocrine tumor and carcinoid tumor of the gastrointestinal tract, and in a lesser amount in carcinoid tumor of the lung, whereas keratin 19 was found in all cases with variable amounts. Based on these results, the combination of antibodies for several types of keratin is useful for examining keratin expression as a marker of epithelium in carcinoid tumor.

A multicenter study was undertaken in Japan to evaluate the correlation between the percentage of renal uptake of 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) estimated by the count-based gamma camera method and the blood clearance of 99mTc-MAG3. Twenty four centers were enrolled and 172 cases were finally analyzed in this study. The renal clearance of 99mTc-MAG3 (TER) was obtained by using a single blood sample taken at 44 min after injection. Comparison of TER and renal uptake provided a coefficient of correlation of 0.874; suggesting that sufficiently accurate quantification of renal function could be obtained from the renal uptake estimate by the gamma camera method. This study also showed that the comparison of renal function might be feasible among patients under the same protocols, although precise and careful consideration is required in each center.

The effect of thiopental and sevoflurane (1 MAC, 2 MAC) on hemodynamics was assessed in a randomized study involving 38 adult patients undergoing electroconvulsive therapy (ECT). Blood pressure, heart rate and electrocardiogram (ECG) were monitored during the ECT procedure. After oxygenation, hypnosis was induced with a bolus injection of thiopenal (TPS) 4 mg.kg-1. Muscle relaxation was achieved by succinylcholine, 1 mg.kg-1 intravenously before ECT procedure. Ventilation was assisted using a face mask with 100% oxygen (TPS group), 1.7% sevoflurane (1 MAC group) or 3.4% sevoflurane (2 MAC group), plus 50% nitrous oxide and 50% oxygen. Thereafter, an electrical stimulus was administered. A total of 150 treatment sessions were evaluated. The rate pressure product increased in every group right after ECT, but the use of sevoflurane (2 MAC) significantly diminished the response compared with sevoflurane (1 MAC) and thiopental. In the sevoflurane (2 MAC) group, no ventricular arrhythmias were observed. In general, it seems that sevoflurane (2 MAC) is as effective as thiopental and sevoflurane (1 MAC) as an induction agent for ECT.

Past atmospheric nuclear testing which have been conducted frequently, have caused environmental pollution due to the diffusion of radioactive substances into the atmosphere and from the radioactive fallout. The environmental pollution from nuclear testing into the atmosphere has resulted in the radioactive contamination in agricultural products and has continued for a long time. The radioactive contamination of agricultural products occurs through air, water and soil which were contaminated by radioactive fallout. In this paper, for the purpose of analyzing the extent of the radioactive contamination levels in the agricultural products of Saitama Prefecture, spinach, green soybeans, dried shiitake and welsh onion, were selected among products, as the amount of the harvest is abundant in all of Japan. Radioactivity concentration was investigated by gamma ray spectrometry and radiochemical analysis. The radioactivity concentrations of artificial radioactive nuclides, cesium-137 (137Cs) and strontium-90 (90Sr), were detected in the range which is considered to be the result of radioactive fallout. Moreover, in order to examine the effect on radioactivity concentrations in agricultural products by culinary processing, the raw agricultural products were boiled, and their radioactivity concentrations were compared with the raw produce. The radioactivity concentrations in the boiled were lower than those in the raw produce.

Tob (Transducer of ErbB-2) is a newly identified tumor suppressor that may interact/interfare with protein tyrosine kinase receptors including ErbB-2 [1]. ErbB-2 phosphorylates and interacts with Shc that participates inbetween active tyrosine protein kinases to Ras signaling pathway. A point mutation or an elevated expression of ErbB-2 results in oncogenic growth of cells.

The discovery of specific overexpression of a gatekeeper gene, ptch, in basal cell carcinoma (BCC) led to a hypothesis that the human homologue of patched (PTCH) normally functions as a negative regulator of the signaling pathway that is initiated by hedgehogs (HHs) and activated by the human homologue of smoothened (SMOH); however, no evidence for the involvement of smoh and hhs has been provided. Here, we show novel evidence that smoh is also preferentially overexpressed in BCC, together with ptch (P0.002), and that Sonic hh was expressed in only some BCCs. Our data, therefore, indicate that such overexpression of smoh may be associated with overexpression or mutation of PTCH and that this overexpression subsequently stimulates the PTCH/SMOH signaling pathway. In an investigation of a possible regulation of ptch and smoh, we demonstrated that expression of exogenous p21WAF1 in immortalized keratinocytes down-regulates both ptch and smoh and that the down-regulation is accompanied by growth arrest, which suggests the involvement of p21WAF1 in regulation of the PTCH/SMOH signaling pathway.

1. Block by philanthotoxin-343 (PhTX-343), a neurotoxin from wasps, of ionic currents mediated through neuronal nicotinic acetylcholine (ACh) receptor/channels was characterized in rat phaeochromocytoma PC12 cells, by use of whole cell voltage-clamp techniques. 2. In the cells held at -60 mV, PhTX-343 at 0.1 and 1 microM inhibited an inward current activated by 100 microM ACh. The current inhibition was relieved by depolarizing steps, and augmented at negative potentials, suggesting that PhTX-343 blocks the channel in a voltage-dependent manner. Joro spider toxin-3 (JSTX-3) also exerted voltage-dependent inhibition of ACh-activated currents in a similar concentration range, but argiotoxin636 did not affect the currents. 3. Analysis of the current decay during hyperpolarizing steps indicated that the current inhibition by 100 nM PhTX-343 develops in an order of several hundres of milliseconds. On the other hand, the recovery from the current inhibition during depolarizing steps developed in an order of about 100 ms. 4. The results suggest that PhTX-343 blocks neuronal nicotinic receptor channels in PC12 cells at concentrations lower than those required for channel block in non-mammalian cells, and the block exhibits clear voltage-dependence. Estimated from the voltage-dependence, the binding site of PhTX-343 may be located near the outer mouth of the channel.

To assess the degree of residual neuromuscular blockade, double burst stimulation (DBS) is commonly applied in the clinical setting. However, fades in response to DBS3,3 can rarely be identified manually when train-of-four (TOF) ratios areor = 0.70, and, in contrast, fades in response to DBS3,2 are felt manually in an undesirably high proportion of cases, even at TOF ratios greater than 0.7. We investigated whether a new monitoring method, modified DBS, would be useful to determine an adequate degree of recovery from neuromuscular blockade. For modified DBS, two burst stimuli were applied at an interval of 750 ms. The first stimulation in the modified DBS consisted of two stimuli of 0.3 ms duration at 50 Hz and the second of two stimuli of 0.2 ms duration at 50 Hz.Forty-five adult patients undergoing elective nitrous oxide-oxygen-isoflurane anesthesia were randomly divided into one of three groups: DBS3,3 group (n = 15), DBS3,2 group (n = 15), or modified DBS group (n = 15). During recovery from vecuronium-induced neuromuscular blockade, on both forearms, DBS3,3, DBS3,2, and modified DBS were delivered in the DBS3,3 group, DBS3,2 group, and modified DBS group, respectively. One hand and forearm (fixed arm) were immobilized to quantify the degree of neuromuscular blockade mechanically, and the contralateral arm (free arm) was unrestrained. An observer determined tactiley on the free arm the presence or absence of fade in response to the three DBS patterns.Probabilities of detection of fade in response to the DBS3,3 were 67% (TOF ratio of 0.51-0.60), 40% (0.61-0.70), 19% (0.71-0.80), 5% (0.81-0.90), and 0% (0.91-1.00). Those to the DBS3,2 were 95% (0.51-0.60), 93% (0.61-0.70), 83% (0.71-0.80), 65% (0.81-0.90), and 38% (0.91-1.00). Those to modified DBS were 90% (0.51-0.60), 86% (0.61-0.70), 65% (0.71-0.80), 25% (0.81-0.90), and 3% (0.91-1.00). Those modified DBS was more sensitive in diagnosing residual neuromuscular blockade than DBS3,3 at the TOF ratio of 0.51-0.90, but was less sensitive than DBS3,2 at the TOF ratio of 0.81-1.00 (P0.05).Our results indicate that the modified DBS may be a useful stimulation pattern to diagnose the adequacy of recovery from neuromuscular blockade.

To analyze the effects of antidepressants on the GABAA receptor, we investigated how the chronic administration of antidepressants (10 mg/kg twice a day for three or seven days, ip) influenced the power-spectral changes induced by pentylenetetrazol (PTZ; a GABA antagonist; 27.5 mg/kg) or beta-carboline-3-carboxylic-acid-methylester (beta-CCM; an inverse agonist; 1 mg/kg) on rat hippocampal EEGs. PTZ and beta-CCM are known to inhibit the chloride ionophore and benzodiazepine receptor (GABAA receptor complex), respectively. After the ip injection of both compounds, the EEG power under 12 Hz increased to about five times that before injection. Between the rats that did not receive any antidepressants and all those injected with the drugs for 3 days or treated with desipramine (DMI) for 7 days, there were no apparent changes in the effect of PTZ or beta-CCM. However, in the rats treated with imipramine, fluoxetine or trazodone for 7 days, the increase in power after the injection of PTZ or beta-CCM was apparently suppressed. In these rats, the power values were less than three times those before the dosing of PTZ or beta-CCM. DMI is known to inhibit the re-uptake of norepinephrine (NE), while the other three antidepressants inhibit that of serotonin (5-HT). Trazodone is also reported to block the 5-HT2 sites. These observations might indicate that the chronic administration of antidepressants prompted the function of the GABAA receptor complex. Moreover, it is also suggested that, to that action, the effect of antidepressants on the 5-HT system or interaction between the 5-HT system and GABA receptors might play some role.

Telomerase activation plays a crucial role in the immortalization of human cells and carcinogenesis; however, the temporal and pathophysiological aspects of the activation in vivo are poorly understood. We found telomerase activity not only in malignant tumors (91%) but also in most benign (60%) and premalignant (89%) skin tumors. This suggests the involvement of telomerase activation in a crucial biological step of human skin carcinogenesis. Because UV light is a major factor in skin carcinogenesis, we further examined telomerase activity in normal skin samples and in normal skin samples adjacent to benign, premalignant, and malignant skin lesions. Data for chronically sun-exposed body sites were compared with those for covered sites. Among normal skin samples, 39% (26 of 67) had telomerase activity, and this activity was unrelated to neighboring lesions but strongly associated with the level of sun exposure. Fifty-four % (21 of 39) of normal skin samples from chronically sun-exposed sites were telomerase-positive, compared with only 12% (3 of 26) of samples from covered sites. When we examined telomerase activity and CC to TT mutations at codons 247/8 of the p53 gene (which are considered to be UV specific) in the same normal skin samples, only 43% (7 of 16) of telomerase-positive normal skin samples at sun-exposed sites contained the p53 mutations, whereas all (7 of 7) of the samples with UV-specific p53 mutations showed telomerase activity (P = 0.019). These data suggest that telomerase activation is involved at an early stage of human skin carcinogenesis and that activation may precede the acquisition of UV-associated p53 mutations in the skin. Telomerase activity was also found in plucked hair follicles and enzymatically separated epidermis, which may be associated with the presence of stem cells in the skin.

Summary form only given. Although ArF excimer laser lithography is expected to attain the highest resolution possible in optical lithography, its application to 0.13-/spl mu/m devices has not been adequately demonstrated. In next generation sub-0.10 /spl mu/m devices, it is believed that the mix and match process is indispensable with optical lithography and other types of lithography. One reason is the difficulty of fabricating contact holes with a larger process margin. Here, we demonstrate that it is possible to make 0.13-/spl mu/m patterns using a single layer resist in combination with resolution enhancement techniques, and to make sub-0.10 /spl mu/m contact holes using the Top Surface Imaging (TSI) process.

Stretch reflex responses of m. biceps brachii and m. brachioradialis of ten normal adults were studied before and after 20 days of strict bed rest. A standard torque perturbation (15 Nm, 170 ms) was applied to the forearm to induce reflex electromyographic (EMG) activities of the two muscles investigated. Totally 30 perturbations were applied during submaximal isometric elbow flexion movements at 80 deg flexed joint angle, and ensemble averaged EMG waveforms were calculated by aligning the signal to the onset of perturbations. All subjects showed that both short and long latency stretch reflex FMG activities of m. biceps brachii were reduced immediately after 20 days bed rest, and then recovered gradually to pre-bed rest levels at one- to two-months after bed rest, whereas there was no such variation in the stretch reflex induced in m. brachioradialis. It was demonstrated that the muscle stretch reflex gain might be reduced with long-term inactivity, but the effects on stretch reflex gains were different in the two tested muscles.

Development of high power gyrotrons and electron cyclotron heating (ECH) systems for the power modulation experiments in GAMMA 10 have been started in order to generate and control the high heat flux and to make the ELM (edge localized mode) like intermittent heat load pattern for divertor simulation studies. ECH for potential formation at the plug region (P-ECH) produces the electron flow with high energy along the magnetic filed line. From the power scaling of confining potential and electron flux in GAMMA 10, the higher ECH power generates the higher confinement potential and the higher electron flux. The peak heat-flux of more than 10 MW/m 2 has been obtained during the ECH injection within the available power of ECH. This value almost corresponds to the steady-state heat load of the divertor plate of ITER. However, we need substantial upgrade of the heating power to approach the ITER level ELM energy density. For this purpose, MW power gyrotrons at 28 GHz have been started and the development is undergoing efficiently in the ECH system upgrade program with the collaboration of Japan Atomic Energy Agency (JAEA). c

Perioperative airway management for sleeve pneumonectomy in a 66-year-old female with tuberculous tracheal stenosis which was 2 cm above the carina to the right main bronchial orifice is reported. Endotracheal intubation was required, because she complained of dyspnea due to airway stenosis in preoperative period for anti-tuberculous chemotherapy. A special tracheal tube developed for laryngomicrosurgery (MLT tube, Mallinckrodt Co. Ltd., 21 Fr size) was used in this patient. However, 13 days after intubation with an MLT tube, sleeve pneumonectomy was done because because of right lung atelectasis and progressive hypoxemia. Left one lung ventilation was successful by an MLT tube during right thoracotomy and a spiral tube (28 Fr) was inserted to the left main bronchus in the operative field during the resection of the carina. For this type of patient with tracheo-bronchial stenosis, it is essential to select an endotracheal tube with appropriate length and diameter.

The organ of Corti in the mammalian cochlea develops from a simple epithelium into a complex structure consisting of as many as ten highly specialized cell types. The purpose of the present study was to examine the possible role of a cell adhesion specific molecule (A-CAM) in mediating morphogenesis of the organ of Corti.The expression of A-CAM was studied in a series of inner ears collected from neonatal gerbils at two days intervals from 0 to twenty days after birth. Immunostaining was performed with a mouse monoclonal antibody raised against A-CAM isolated from chicken cardiac muscle.The adhesion molecule appeared just prior to opening of the tunnel of Corti and disappeared after full expansion of tunnel space. A-CAM was detected in the basal turn of the cochlea as early as two days after birth and its expression moved progressively toward the apex of the cochlear spiral. It was observed in all three cochlear turns at eight days after birth but disappeared after postnatal day twelve. Immunostaining for A-CAM was localized only to the region where inner and outer pillar cells separate to form the tunnel of Corti.A-CAM apparently plays a role in the formation of the tunnel space by modulating apical adhesion above the separation between inner and outer pillar cells.

We reported a case of juvenile cerebral infarction following minor head injury. The patient, a 12-year-old girl, developed right hemiparesis and aphasia almost immediately after having fallen from about 1 meter height during the exercise class at school. CT and MRI study showed lacunar lesions bilaterally and almost symmetrically in the paraventricular deep white matter on both sides. A new stroke area, responsible for the symptoms, was recognized about 24 hours later on CT scan just next to the lacuna of the left side. Although angiography revealed a rare anomaly of the right side aortic arch, associated with subclavian steal phenomenon, presumably of congenital in nature, no abnormality was found in the intracranial vessels. She made a rapid recovery during her hospital stay and showed no more than a slight motor weakness in her right upper extremity on discharge. The literature was reviewed on the embryology of the aortic arch and brachiocephalic arteries. We speculate that the lacunar lesions found bilaterally are dilated large normal Virchow-Robin space, and the pathogenesis of the stroke in this patient was discussed.

A rare subcutaneous leiomyosarcoma metastatizing to the sphenoid bone and presenting exophthalmos is reported. A 56-year-old female presented with protrusion of the right eye and a slowly growing lump on the right temporal region. Six years previously, she had undergone removal of a subcutaneous mass in the back, which was histologically diagnosed in another hospital as leiomyosarcoma. She had undergone four other operations, including removal of local recurrences and a right renal metastasis. On admission, physical examination showed no neurological deficits. Craniogram revealed an osteolytic lesion without marginal sclerosis in the right sphenoid bone. CT showed an inhomogeneously enhanced mass with irregular expansion of the diploic space, which was partly invading the right orbit. MRI demonstrated an extradural mass in the right sphenoid region, which was slightly low-intense in T1-weighted image, high-intense in T2-weighted image, and inhomogeneously enhanced by Gd-DTPA. Right external carotid angiogram showed a highly vascular stain fed by meningeal arteries. Radionuclide bone scintigram showed multiple high-uptake areas in the left femoral head, the ribs, and the sphenoid bone. Preoperative embolization of the tumor vessels fed by the external carotid artery was performed. Following this procedure, the tumor stain disappeared completely. The tumor was totally excised with minimal bleeding through an orbitozygomatic approach. The tumor was loosely adherent to the dura and periorbit. The bone defect was covered with a methylmethacrylate resin plate. the histological examination demonstrated fascicular arrangement of the spindle shaped cells with mitotic figures. Immunohistochemical studies showed that most tumor cells were positive for actin and myosin, but negative for desmin.(ABSTRACT TRUNCATED AT 250 WORDS)

Urinary excretion of leukotrienes is greater in patients with aspirin-induced asthma (AIA) than in other patients with asthma in remission, and is greater still during an aspirin-induced attack. We therefore hypothesized that increased phospholipase A2 (PLA2) activity leads to increased leukotriene synthesis when non-steroidal antiinflammatory drugs inhibit cyclooxygenase in patients with AIA, and that PLA2 activity increases further during an aspirin induced attack. To test this hypothesis, we measured the serum PLA2 activity in adult asthmatic patients, and compared the activity in those with AIA to the activity in those without AIA. The subjects were 43 patients with asthma in remission, 17 with AIA and 26 without AIA. Serum PLA2 activity was also measured before and after intravenous administration of lysine-aspirin in three patients with AIA and in one without AIA. Serum PLA2 activity was measured by radioimmunoassay. Serum PLA2 activity in patients with AIA, in those without AIA, and in healthy controls was 300.9 +/- 52.9, 294.4 +/- 65.3 and 171.7 +/- 41.8 pmol/ml/min, respectively. Serum PLA2 activity in asthmatic patients was significantly higher than in healthy controls (p0.01), but there was no difference between patients with and without AIA. Intravenous lysine-aspirin provoked asthmatic attacks in three patients with AIA. However, intravenous lysine-aspirin did not significantly change serum PLA2 activity in the three patients with AIA or in the patient without AIA. These results indicate that although PLA2 may be involved in the pathogenesis of bronchial asthma, it is not specific to AIA. Thus, the pathophysiology of AIA remains unclear and further investigation is needed.

Ten cases of primary oculomotor nerve palsy due to head injury are presented. All ten patients had a dilated, non reactive pupil. Seven had complete oculomotor palsy. Two had partial extraocular palsy or blepharoptosis and one had neither extraocular palsy nor blepharoptosis. The initial ophthalmoplegia was recognized immediately after trauma. Nine patients had severely impaired consciousness on admission, but eight patients recovered fully within two months after the traumatic event, while one patient remained disoriented. Emergency CT scan on admission showed mass lesions in no patients except one who had a hematoma measuring 3 cm in the frontal lobe, but had no herniation sign. Patients with complete oculomotor palsy had a high incidence of traumatic SAH (71%) or skull fracture (57%). Recovery from third nerve palsy was not so good. The follow-up period extended from 3 months to 18 months. Of the 10 patients, none recovered completely from third nerve palsy. The prognoses of blepharoptosis, external ophthalmoplegia and internal ophthalmoplegia were analyzed separately. The recovery rates were 78%, 44% and 20%, respectively, the internal ophthalmoplegia showing poorest recovery. We discuss the mechanism of direct injury to the oculomotor nerve.

1. The facilitation by zinc (Zn2+) of neurotransmission and the mechanisms underlying it were electrophysiologically investigated in rat cultured hippocampal neurones using whole-cell voltage- and current-clamp techniques. 2. Under whole-cell voltage clamp with an intracellular solution containing CsCl as a major salt, inward postsynaptic currents were observed at -40 mV in a cell culture where a neuronal network had been formed. The postsynaptic currents appeared to be mediated by gamma-aminobutyric acid (GABA) because the inward currents were abolished when intracellular CsCl was replaced with caesium phosphate and they were blocked by bicuculline (10 microM), an antagonist to GABA-gated channels. The currents were, however, also blocked by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 30 microM), an antagonist to non-NMDA glutamate-gated channels, suggesting a contribution of a glutamatergic mechanism to the generation of the currents. Zn2+ (10 and 100 microM) potentiated the postsynaptic currents. 3. In addition to the potentiation of the postsynaptic currents, Zn2+ shifted net membrane current at -60 mV in an outward direction. The current-voltage relationship obtained under various ionic conditions indicated that Zn2+ inhibits a current component which is mainly carried by extracellular Na+. 4. Under whole-cell current clamp, Zn2+ (10 microM) induced a small hyperpolarization (up to 20 mV), which was accompanied by potentiation of the postsynaptic potentials and spike potentials. Tests were carried out to examine whether changes in resting potential by different protocols mimic responses observed with Zn2+. Hyperpolarization induced by current injection through patch pipettes increased the amplitude of postsynaptic currents, but did not enhance the appearance of spike potentials. In contrast, when extracellular K+ concentration was decreased from 5 to 2.5 mM, cells were hyperpolarized and spike potentials of large amplitude appeared. 5. The results suggest that Zn2+ potentiates neurotransmission and inhibits a background cationic current mainly carried by extracellular Na+ under physiological conditions. The inhibition of the Na+ permeation may increase membrane excitability and thereby contribute to the potentiation of neurotransmission.

We report an unusual case of non-traumatic cerebrospinal fluid rhinorrhea associated with aqueductal stenosis and hydrocephalus. The patient was a 10-year-old girl who suddenly developed massive CSF rhinorrhea following severe edema of the left side of her face. CT scan showed marked dilatation of the lateral and third ventricles and enlarged sphenoid sinus of water density, extending to the lateral wall of the left orbit and to the left pterygoid fossa. Immediately after the onset of CSF rhinorrhea, ventricular drainage was performed, but the rhinorrhea persisted. Ventriculography revealed predominant flow of the contrast medium into the left temporal horn and abnormal collection in the sphenoid sinus. Coronal CT scan did not show any focal bony defect, but a thin layer was seen in the base of the left middle fossa. Exploration of the skull base in the left middle fossa was performed through a left frontotemporal craniotomy. An irregular bony defect measuring 7 x 12mm was then found in the anterolateral floor of the middle fossa and the dura was also perforated there. Brain tissue including the temporal horn protruded through the bony defect into the sphenoid sinus. After excision of the herniated brain tissue, repair was accomplished by packing muscle into the bony defect and covering the dural defect with fat reinforced by coating with fibrin glue. Postoperatively, the CSF rhinorrhea has stopped and the edema of her face has disappeared. We discuss the etiology of this unusual spontaneous CSF leakage through the middle fossa and the abnormally enlarged sphenoid sinus.

Effects of suramin and reactive blue 2 (RB2), compounds known as antagonists at P2-purinoceptors, on ionic currents mediated through GABA and glutamate receptor channels were investigated in rat hippocampal neurons. Under whole-cell voltage-clamp, suramin (30 to 300 microM) and RB2 (10 to 100 microM) inhibited a current activated by 10 microM GABA in a concentration-dependent manner. Suramin (100 and 300 microM) and RB2 (10 and 30 microM) also inhibited an inward current activated by kainic acid (100 microM), an agonist at non-NMDA type glutamate receptor channels, and an inward current activated by N-methyl-D-aspartate (NMDA; 100 microM), an agonist at NMDA type glutamate receptor channels. The inhibition by suramin or RB2 did not exhibit voltage-dependence between -30 and -90 mV in the case of the GABA- or the kainate-evoked current. In contrast, the inhibition by these compounds of the NMDA-evoked current exhibited voltage-dependence and was enhanced by hyperpolarization. When the concentration of agonists was increased by 5- or 10-fold, the magnitude of the inhibition by suramin of the kainate-evoked current and the magnitude of the inhibition by RB2 of the NMDA-evoked current were attenuated. alpha,beta-Methylene ATP (100 microM) did not affect the GABA-, kainate- or NMDA-activated current. The results suggest that suramin and RB2 inhibit GABA receptor channels and glutamate receptor channels. The blockade of these channels must be taken into account when these compounds are used as pharmacological tools to examine an involvement of P2-purinoceptors, especially in preparations where GABAergic or glutamatergic neurotransmission is expected.

1. Effects of substance P (SP) and other tachykinins on membrane currents were investigated using whole cell voltage clamp in cultured sensory neurons isolated from rat dorsal root ganglia. 2. SP (100 nM) evoked an inward current in two-thirds of the cells at negative potentials. In most of the cells that generated the inward current in response to SP, capsaicin also activated an inward current. The SP-evoked inward current was not observed in cells loaded with 2 mM guanosine 5'-O-(2-thiodiphosphate) (GDP beta S). 3. Neurokinin A (NKA) or neurokinin B (NKB) also activated an inward current. At 100 nM of each agonist, the order was NKB > NKA > SP with respect to activated current amplitude. 4. The tachykinin-activated current was reversed around +10 mV with a standard extracellular solution containing 140 mM NaCl. The reversal potential became more negative when extracellular NaCl was reduced by substituting with sucrose. The inward current was also activated in cells bathed in an extracellular solution containing Cs+, tetraethylammonium (TEA) or N-methyl-D-glucamine (NMDG) as a major cation instead of Na+. The order of permeability, determined from the reversal potential of the current, was Cs+ not equal to Na+ > TEA > NMDG. The amplitude of the inward current activated by NKB was increased when extracellular Na+ was replaced with Cs+, TEA or NMDG. 5. Permeability of Ca2+ was tested using an extracellular solution containing Ca2+ as the only cation (111.8 mM Ca2+ outside). Under this condition, NKB evoked an inward current that reversed around +30 mV. 6. The results suggest that SP and other tachykinins activate nonselective cation channels, which are also permeable to Ca2+, through receptors which are more responsive to NKB than to SP or NKA. The channel activation may serve as a mechanism underlying tachykinin-mediated excitatory neurotransmission in sensory neurons.

The purine repressor (PurR) consists of two functional domains: an N-terminal DNA-binding domain and a C-terminal corepressor-binding domain. Recently, the structure of PurR-corepressor-operator ternary complex was determined by X-ray crystallography. In the complex the DNA-binding domain, consisting of 56 amino acids, was composed of four helices. Here, we have determined the solution structure of the DNA-binding domain in its DNA free state by NMR. It consists of three helices and the fourth helix (the hinge helix) region is diordered. The architecture of the first three helices of its DNA free state is very similar to that of its DNA-bound form. The hinge helix is induced by the specific DNA binding and by the dimerization of PurR which is provided by the corepressor-binding domain.