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To evaluate the diagnostic accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) relative to computed tomography (CT) for detecting metastatic cervical lymph nodes in patients with squamous cell carcinoma of the head and neck (HNSCC), and to ascertain the factors that affect this accuracy.A total of 1076 lymph nodes obtained from 35 neck dissections in 26 HNSCC patients who preoperatively underwent both FDG-PET and CT were retrospectively analyzed. For pathological metastatic lymph nodes, the lymph node size (short-axis diameter), the ratio of intranodal tumor deposits, and the size of intranodal tumor deposits (maximum diameter of metastatic foci in each lymph node) were histologically recorded.Forty-six lymph nodes from 23 neck sides were pathologically diagnosed metastases. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET evaluated individually per neck side were 74%, 92%, 80%, 94%, and 65%, respectively, whereas those of CT were 78%, 58%, 71%, 78%, and 58%, respectively. FDG-PET detected 100% of metastatic lymph nodesor =10 mm, intranodal tumor depositsor =9 mm, and intranodal tumor deposits with a ratio75%, whereas no nodes or tumor deposits smaller than 5 mm were detected. The spatial resolution limitations of FDG-PET were responsible for 16 of 20 (80%) false-negative PET results in lymph nodes.FDG-PET is a useful tool for preoperative evaluation of the neck because it accurately detects metastatic lymph nodesor =10 mm and has fewer false-positive cases than CT. The high specificity of FDG-PET for lymph node metastases may play an important role in avoiding unnecessary neck dissection.

Context: Natriuretic peptide receptor-B (NPR-B, GC-B in rodents; gene name NPR2) is a guanylyl cyclase-coupled receptor that mediates the effect of C-type natriuretic peptide. Homozygous mutations in human NPR-B cause acromesomelic dysplasia, type Maroteaux (OMIM 602875), an autosomal recessive skeletal dysplasia. NPR-B has an intracellular kinase homology domain (KHD), which has no kinase activity, and its functional significance in vivo is currently unknown.Objective: We examined the functional significance of a novel NPR-B KHD mutation in humans.Patients and Methods: A 28-yr-old Japanese male presented with marked short stature (118.5 cm, −9.3 sd). His limbs showed marked shortening in the middle and distal segments. His parents had relatively short stature with height z-scores of −2.75 and −0.98 (his father and mother, respectively). Direct sequencing of coding region of the NPR2 gene of the family was performed. The mutant receptor activity was investigated by saturation binding assay and cGMP measurement. Additionally, interaction between the mutant and wild type allele was investigated by the titration experiments.Results: We identified a novel missense mutation L658F in KHD of NPR-B in homozygous and heterozygous states in the patient and his parents, respectively. The mutation conferred normal binding affinity for C-type natriuretic peptide but no discernible ligand-induced cGMP production. Furthermore, L658F mutant impaired wild-type NPR-B-mediated cGMP production in a dose-dependent manner, suggesting that short stature found in L658F heterozygote can be caused by its dominant-negative effect.Conclusions: This study provides the first evidence that intact KHD of NPR-B is essential for skeletal development.

We report a case of DIC caused by a central-venous-catheter-related infection after surgery for tongue cancer. In a 61-year-old man with tongue squamous cell carcinoma, a central venous catheter was inserted percutaneously in the subclavian vein using aseptic technique in the operating room to deliver preoperative intra-arterial chemotherapy (CDDP 150mg) with concurrent radiotherapy (20Gy). After chemoradiotherapy, he underwent tumor resection and neck dissection. On the 3rd postoperative day, a high fever above 39 V developed, suggesting sepsis. The central venous catheter was removed on the same day. DIC was diagnosed on blood examination, showing CRP 15.6, platelet count 65000, and FDP 39.2 μg/ml. Heparin and FOY were administered. Fever resolved immediately, and the platelet count and FDP also returned to normal by the 10th postoperative day. A catheter-related infection was diagnosed because culture examinations isolated the same Staphylococcus genus from the catheter tip and arterial blood, as well as 3-day consecutive venous blood samples. Furthermore, susceptibility testing for Staphylococcus genus from the catheter tip, arterial blood, and venous blood samples consistently demonstrated the same sensitivities to antibiotics. Early recognition of central-venous-catheter-related infection and appropriate treatment including prompt removal of the catheter is of great importance in the perioperative management of high-risk patients.

術前放射線化学療法は，口腔扁平上皮癌患者における器官および機能温存に重要な役割を果たしている。術前療法後に，縮小手術による器官温存手術を決断するためには，術前治療の正確な効果判定と残存腫瘍の有無の評価が大変重要である。そこで，われわれは口腔癌治療におけるFDG-PETの臨床的役割について検討した。口腔扁平上皮癌45例に対して放射線併用動注化学療法を行い，FDG-PETで治療前および6週後に評価した。治療前PETから治療効果の予測が，治療後PETから残存腫瘍の有無の評価や予後予測が可能であった。PET診断に基づいて器官温存がある程度可能になったことから，PETは口腔癌治療における極めて有用な診断法と考えられる。11C-メチオニンは，癌細胞のアミノ酸代謝を反映する新しいPETトレーサーとして有用性が期待されている。MET-PETおよびFDG-PETを同時期に撮像し得た口腔癌40例について，それぞれの診断能について検討した。原発部位におけるMET-PETの感度，陽性適中率は，それぞれ95%，100%でFDG-PETとほぼ同等であった。放射線化学療法の治療効果判定におけるMET-PETの診断的意義については，今後さらに検討が必要である。

Over a 2-year period between 2001 and 2003, a total of 115 conjunctival scrapings were collected from patients with keratoconjuctivitis from several hospitals in Yokohama, Japan. Out of 115, 94 (82.4%) cases of adenoviruses were detected by polymerase chain reaction (PCR); 60 (52.1%) by cell culture isolation; and 16 (14.0%) by enzyme-linked immunosorbent assay (ELISA). The serotypes were determined by PCR- restriction fragment length polymorphism analysis (PCR-RFLP) and by the neutralization test (NT). PCR-RFLP was performed using a combination of endonucleases such as HhaI, AluI, and HaeIII. Of the 94 PCR-positive samples, the serotypes of 91 (96.8%) were identified by PCR-RFLP analysis (adenovirus 3: 50%, 4: 11%, and 8: 32%). Out of the 115 samples, 60 samples were identified by the neutralization (adenovirus 3, 4, 7, and 8). When both PCR-RFLP and the neutralization techniques were used, 53.2%, 11.7%, 1.1%, and 34% of the samples were identified as adenovirus 3, 4, 7, and 8, respectively. In contrast to the results of a nationwide surveillance report, adenovirus 3 was found as a major cause of keratoconjunctivitis in the Yokohama area. The nationwide surveillance report did not reflect accurately the epidemiological situation in the local area. In order to obtain surveillance data that would be useful for the prevention of an adenovirus conjunctivitis epidemic, it seems that local epidemiology is more important than that nationwide surveillance. J. Med. Virol. 79:200–205, 2007. © 2006 Wiley-Liss, Inc.

This paper describes a microvalve which is actuated by electrostatic force for the flow control of fuel in portable direct methanol fuel cell systems. The microvalve is fabricated by using standard MEMS fabrication techniques including photolithography, wet etching, thin film deposition and anodic bonding. The microvalve is equipped with a novel pressure-balance mechanism for normally-closed operation against pressurized fuel. The pressure-balance mechanism is composed of a pressure-balance tank whose pressure is adjusted to the same pressure as inlet by a soft corrugated diaphragm. This balanced pressure pushes the boss, which is supported by a soft actuator diaphragm, to close the microvalve, enabling a low driving voltage operation. By applying 100 Vdc, the microvalve controlled the flow rate of methanol up to maximum flow rate of 100 μl/min at an inlet pressure of 40 kPa. The microvalve is expected to miniaturize the fuel delivery system, and eventually increase the practical energy density of portable fuel cell systems.

We report on a new type of high-throughput thermally driven microvalve fabricated by using micro-electromechanical system (MEMS) technology. A miniaturized Si–Ni bimorph actuator was incorporated into the valve structure. This allowed the realization of both larger force generation and a longer stroke (the actuation length) combined with shortened response time. Also, a low-voltage actuation (

A 65-year-old man visited our hospital on November 8, 2000 because of pain in the right cheek mucosa. He had diabetes mellitus and hypertension and was a carrier of hepatitis B virus. After excision of the tumor, right conservative neck dissection and microvascular reconstruction with a free rectus abdominis muscle flap, he received ventilatory assistance for 3 days. He was given antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) for postoperative pneumonia and a wound infection. On 17th postoperative day, the hemoglobin level suddenly decreased from 9.5g/dl to 8.0g/dl over the course of 2 days. Gastrointestinal examination showed no bleeding points. A new episode of massive bleeding occurred on the 21st day. The bleeding point could not be identified by colonoscopicexamination, radioisotope angiography, or angiography of the artery. However, a wide shallow ulcer of the rectum was finally found 2cm from the anal verge on another colonoscopic examination on the 28th day. The AHRU in this patient might have been caused by postoperative stress, a large dose of NSAIDs, underlying disease, or a combination of these factors.

The antinociceptive effects of 20 triterpene sapogenins from cacti were examined by the acetic acid-induced writhing method. The isolation of some triterpenes from the hydrolysate of MeOH extracts of three cacti was also described, and alamosenogenin, bridgesigenins B and C, gummosogenin, thurberogenin and pachanol C, showed the activity.

During the period from January 1984 to December 1991, 118 strains of Yersinia enterocolitica were isolated from the specimens which were requested for bacterial examination from various medical practitioners. The results of bacteriological examination of these isolates showed that 11 of Y. enterocolitica serotype O:8 sporadic infections were confirmed at Hirosaki district in Aomori Prefecture. Of the eleven isolated strains, nine were from feces, two were from contents of extracted appendix. These strains were biovar (Wauters) 1, harboring 42 megadalton virulence plasmid, positive for autoagglutination and calcium dependency. Patients were under fifteen years old except one case of a 45 year old. Seven patients were living in the inter-mountain area, three in the urban area and one in the plain area. The infectious source was not found.

A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission. HIV RNA was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.

Increased blood polyamine levels, often observed in cancer patients, have negative impacts on patient prognosis and are associated with tumor progression. The purpose of our study was to examine the effects of polyamines on cellular immune function. Peripheral blood mononuclear cells (PBMCs) from healthy volunteers were cultured with the human natural polyamines spermine, spermidine, or putrescine, and the effects on immune cell function were examined. The correlation between post-operative changes in blood polyamine levels and lymphokine-activated killer (LAK) activity was also examined in cancer patients. Spermine decreased the adhesion of non-stimulated PBMCs to tissue culture plastic in a dose- and a time-dependent manner without affecting cell viability or activity. This decrease in adhesion capacity was accompanied by a decrease in the number of CD11a bright-positive and CD56 bright-positive cells. Upon stimulation with interleukin 2 to activate LAK cytotoxicity, PBMCs cultured overnight with 100 or 500 microM spermine showed decreased cytotoxic activity against Daudi cells (91.5 +/- 1.7 and 84.9 +/- 3.0%, respectively (n = 6) compared to PBMC cultured without polyamines). In a group of 25 cancer patients, changes in blood spermine levels after surgery were negatively correlated with changes in LAK cytotoxicity after surgery (r = -0.510, P = 0.008: n = 25). Increased blood spermine levels may be an important factor in the suppression of anti-tumor immune cell function.

Sucrose-negative colonies were isolated on TCBS agar plate from otorrhea specimens from otitis media patient in the Adult Diseases Examination Center, Hirosaki Medical Association. The isolate was identified as Vibrio vulnificus by nested PCR method which amplify V. vulnificus-specific sequences directed against 23S rRNA genes. The PCR method was applied to identify 6 strains originally isolated from septicemia patients in Kurashiki Central Hospital and formerly identified as V. vulnificus by phenotypic characteristics. When examined by the API20E system, the above PCR confirmed-V. vulnificus isolates were correctly identified as V. vulnificus with % ID 99.8, though this gave 3 different profiles. Cytotoxin-hemolysin gene was detected in otorrhea strain as well as septicemia strains by PCR method. The above results suggest that PCR method targeted cytotoxin-hemolysin gene is suitable for rapid and accurate identification of the isolate, because the result is obtained in less than 4 h. To our knowledge this is the first report on the V. vulnificus infection in Aomori Prefecture and the isolation from otorrhea.

We report a case of left renal cell carcinoma with bilateral ovarian metastasis which was demonstrated 3 years after radical nephrectomy. The patient is alive without any evidence of disease 36 months after bilateral salpingo-oophorectomy.

ニホンアカガエル（Rana faponica）の卵から得られたlectin（RJ-lectin）およびウシガエル（Rana faponica)の卵から得られたlectin（RC-lectin）について，マウスのEhrlich固型癌に対する増殖抑制作用を検討した．ddY系雄マウスの右後肢大腿部に106個のEhrlich腹水癌細胞を接種し，lectinは1回投与では1日後，3回投与では1，3，5日後に注射し，10日後の腫瘍重量を調べ，腫瘍増殖の抑制率を求めた．RJ-lectinは10，20および40mg/kgについて検討した結果，ほゞ同量依存的に増殖抑制作用がみられ，1回投与よりも3回投与の抑制作用が強く，皮下注射よりも腹腔内注射の抑制作用が強かった．すなわち，腹腔内への3回投与では，10mglkg×3で35%，20mg/kg×3で56%，40mg/kg×3では69%の腫瘍抑制率を示した．RC-lectinは10あるいは20mg/kgの腹腔内1回投与により増殖抑制作用が認められた．Concanavalin Aにも増殖抑制作用を認めたが，用量および投与方法と作用の強さとの関係がはっきりとしなかった．RJ-lectinの連続投与によりマウスの食作用係数に大きな変動は認められず，網内系（RES）の食作用活性に対する影響はないと思われる．マウスの尾静脈からpontamineskyblueを注射して，RJ-lectinを腹腔内へ投与すると，腹腔内への色素漏出量が増加し，腹腔内血管透過性の充進を示した．Hydrocortisone処理で免疫抑制状態にしたマウスでも，RJ-lectin 1mg/animal投与により腹腔内血管透過性の元進作用が認められた．RJ-lectinは動物由来のlectinとして抗腫瘍性が認められた最初のものである．RJ-lectinがマウスのEhrlich固型癌に対して増殖抑制を示すのは，免疫機構が関与するものではなく，直接に腫瘍細胞に働き，その表面構造に何らかの変化を与えて，細胞毒作用をあらわすことに基づく可能性が強い．

The transient performance of an engine generally depends on the volume of wall flow and behavior of fuel in the induction system which is composed of the intake manifold and the intake port. An experimental technique has been developed for estimating these phenomena in a gasoline engine, which employs a meter for measuring the air-fuel mixture ratio. Using this technique the authors analyzed single point and multipoint injection systems, and determined the differences in the volume of fuel associated with wall flow. The effects of the shape and specifications of fuel supply system components on the volume of wall flow and fuel behavior in these systems were established.

We report on the development of a thermally isolated bimorph structure based on a Ni|Si pair. A 1-mm-long beam of the bimorph was thermally isolated by a polyimide comb from the rest of the Si structure. The Si and Ni layers of the bimorph were 20 µm thick. This geometry enabled us to generate the bending displacement (the stroke) of the free end of the bimorph up to 100 µm at about 100°C with a generated force of about 15 mN. Electrical power consumption for the 100°C working point was lower than 0.2 W and the response time was 0.5 s. This design entitles further miniaturization of micro-electromechanical systems (MEMSs) such as commercial microvalve structures and sensors. The principles of design and experimental results of temperature distribution for the bimorph are presented and discussed.

Effect of lentinan on the hepatic drug-metabolizing system was studied in ddY mice (unless otherwise stated). On the assay in vivo, lentinan (1 mg/kg, i.p.) decreased cytochrome P-4 5 0 content and the activities of aminopyrine N-demethylase, aniline hydroxylase, 7-ethoxycoumarine O-deethylase and biphenyl 2- or 4-hydroxylase in the hepatic 9,000 x g supernatant or microsomes. Decreases in the activities of aminopyrine N-demethylase, aniline hydroxylase and biphenyl 2-hydroxylase were not observed in vitro. On the other hand, the effect of lentinan was weak on the hepatic drug-metabolizing enzymes in C57BL/10, C3H/He and DBA/2 mice which are nonsensitive to lentinan or do not respond to aryl hydrocarbon hydroxylase. Furthermore, the depression by lentinan on the cytochrome P-448-dependent drug-metabolizing enzymes induced by 3-methyl-cholanthrene was more greater than that on the cytochrome P-450-dependent drug-metabolizing enzymes induced by phenobarbital. This result suggests that the depression by lentinan on the hepatic drug-metabolizing system was more specific to the cytochrome P-448 induced by 3-methylcholanthrene.