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Study Design: Retrospective observational study.Purpose: In this study we identify risk factors, including patient demographics, sagittal parameters, and clinical examinations, affecting incomplete L5/S posterior lumbar interbody fusion (PLIF).Overview of Literature: The lumbosacral spine is considered to have an interbody fusion rate lower than that of the lumbar spine, but few studies have investigated the cause, including investigating the pelvis. We believe that pelvic morphology can affect L5/S interbody fusion of the lumbosacral spine.Methods: We observed 141 patients (61 men, 80 women; average age, 65.8 years) who had undergone PLIF and checked for the presence of L5/S interbody fusion. We investigated factors such as age, gender, the presence of diffuse idiopathic skeletal hyperostosis (DISH), fusion level, and grade 2 osteotomy, as well as pre-, post-, and post−preoperative L5/S disk height and angle, lumbar lordosis, Visual Analog Scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and pelvic incidence (PI), comparing those with and without L5/S interbody fusion. In addition, we analyzed the patients classified into short-level (n=111) and multi-level fusion groups (n=30).Results: Overall, the L5/S interbody fusion rate was 70% (short-level, 78%; multi-level, 40%). Age and pre- and post−preoperative L5/S disk angle were significantly different in each fusion level group. DISH presence, grade 2 osteotomy, and postoperative VAS and JOA scores were significantly different in the short-level fusion group, whereas PI was significantly different in the multi-level fusion group.Conclusions: Incomplete union after L5/S PLIF correlates with advanced age, many fusion levels, and a large value of preoperative and a small value of post−preoperative L5/S disk angles.

Background: Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation. Research question/aim/objectives: This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice. Research design/Participants and research context: We surveyed the basic attributes of and used the Ode’s Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors. Ethical considerations: This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors’ permission. Findings/results: Significant differences were found in the mean “ethical behavior” scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the “justice” subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without. Discussion: Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience. Conclusion: Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences.

The shapes of flowers and the cross-compatibility of Curculigo latifolia, which produces a taste-modifying protein, neoculin, were investigated for the purpose of setting fruits in Japan as a resource of neoculin. C. latifolia is an andromonoecious plant, that is, flowers in a lower position in an inflorescence are hermaphrodite with long styles, although flowers in higher positions are staminate with short styles. This shows that 22% of all flowers were hermaphroditic in an inflorescence. By the hand-pollination study, the largest rate of setting C. latifolia fruits was shown by the 5th day from the first flowering. The rates of fruit set were gradually reduced after that day. The number of fruits peaked by the 13th day from first flowering. On the other hand, the rate of fruit setting was shown to be 45% by cross-pollination and 4% by self-pollination. These results indicate that C. latifolia has self-incompatibility. To improve the rate of fruit setting of C. latifolia, it is necessary to pollinate compatible pollen by around the 15th day after the first flowering.

In this study, we analyzed the CYP3A inhibitory components of star fruit Averrhoa carambola L., using liquid chromatography-mass spectrometry (LC-MS). The stereoisomer of procyanidin B1 and B2 and/or the trimer consisting of catechin and/or epicatechin were suggested to be potent inhibitory components.

Treatment of proximal humeral fractures is very challenging in elderly patients with osteoporosis. Difficulty in obtaining a stable osteosynthesis remains the main problem for the surgeon. Knowing more details about the bone quality of the humeral head can be helpful for treatment. The purpose of this study was to evaluate the bone quality of the humeral head based on age, sex, and location. Three groups of patients were identified according to age: group A (aged30 years), group B (aged40 years but60 years), and group C (aged60 years). Computed tomography (CT) was performed on each patient to evaluate the humeral head bone quality. The distribution of bone density was assessed by the CT value expressed in Hounsfield units. The maximum, minimum, and mean CT values were calculated in the cancellous bone of the humeral head for each image. The humeral head was then divided into 3 equal zones, and a map of the 3 zones was made. The results showed that there was a significant difference between men and women in our series with regard to the percentage of bone tissue. There was also a significant difference among the 3 groups (age-related), as well as between the medial and lateral sides, with regard to the percentage of bone tissue. Osteopenic change in the humeral head has a negative correlation with aging. The medial side, especially the articular side, has more bone tissue than other areas. These results suggest that, when we treat humeral head fractures of elderly patients, we need to define bone quality for each case. We should then take care when establishing the site and angle of insertion for fixation to obtain optimal fixation on the lateral side.

The present study was conducted to identify cytochrome P450 3A (CYP3A) inhibitory components of Hyuganatsu, Citrus tamurana Hort., by investigating the effects on midazolam 1'-hydroxylase activity of human liver microsomes. As a consequence, limonin and nomilin were identified as CYP3A inhibitors from the endocarp of Hyuganatsu.

Erythrocyte acid phosphatase (EAP), esterase D (ESD) and phosphoglucomutase (PGM) phenotypes among the erythrocyte enzyme types of blood groups are surveyed and a modified cellulose acetate membrane isoelectric focusing (CAM-IEF) method for their exploration is described. The phenotyping procedures are usually classified as either equilibrium or non-equilibrium IEF. Equilibrium IEF, which is based on differences in pI values, includes three methods: (i) a narrow pH range of carrier ampholytes, (ii) a relatively narrow pH range of carrier ampholytes containing chemical separators and (iii) immobilized pH gradient gels. Among the three methods, immobilized pH gradients provide a better resolution of isozymes. Conversely, the disadvantages of immobilized pH gradients include longer focusing times and complex gel preparations. Moreover, immobilized pH gradients are unsuitable for stain analysis because of the insensitivity of PGM1 detection. A hybrid IEF system and a commercial immobilized pH gradient dry plate have overcome these problems. However, EAP typing is extremely expensive and ESD typing is not well distinguished by hybrid IEF. As each method has both merits and demerits, the most suitable technique should be selected based on the kind of erythrocyte enzyme types and sample conditions. On the other hand, non-equilibrium IEF is a rapid method because isozymes are detected on the basis of their charge differences under non-equilibrium conditions. Moreover, the appropriate addition of chemical separators increases the charge difference and provides a good resolution within a shorter time. Addition of more separators produces a narrow pH range in the gel and takes a substantially longer time to reach the optimum pH range for charge difference. Further, the viscosity due to the excess addition of separators results in poor reproducibility for high-field-strength CAM-IEF. Hence the amount of chemical separators is taken into consideration of obtaining optimum results. If the optimum conditions are established with primary experiments, the combination of chemical separator and non-equilibrium IEF is proposed as a readily available method for routine analysis of erythrocyte enzyme types in forensic science.

The relationship between spontaneous pregnancy of hyperprolactinemic patients after a first pregnancy induced by treatment and their serum prolactin levels was examined. Of the 100 patients with hyperprolactinemia studied, 74 became pregnant after treatment; namely, 20 transsphenoidal adenomoidectomy for pituitary prolactinoma (group 1), 26 on treatment with bromocriptine for pituitary prolactinoma (group 2), and 28 on treatment with bromocriptine for hyperprolactinemia without prolactinoma (group 3). After delivery in the first pregnancy, the rates of menstrual restoration and subsequent spontaneous pregnancy in group 1 (72.2% and 75.0%) were significantly (p less than 0.05) higher than those in group 2 (32.0% and 25%) and group 3 (13.6% and 18.2%). The serum levels of prolactin after the first pregnancy and weaning were significantly (p less than 0.05) lower in patients with subsequent spontaneous pregnancy than in patients without spontaneous pregnancy in each group, and the levels in patients with spontaneous pregnancy were significantly (p less than 0.05) lower in group 1 (15.2 +/- 8.8 ng/ml) than in group 2 (46.6 +/- 2.9 ng/ml). These data suggest that the transsphenoidal adenomoidectomy for pituitary prolactinoma may be better than bromocriptine treatment for recovery of reproductive function.

Six phenolic compounds were isolated from the flowers of Trachelospermum asiaticum var. intermedium (Apocynaceae). These structures were determined on the basis of spectral data.

The gene encoding the specific glycosyltransferases which catalyze the conversion of the H antigen to A or B antigens shows a slight but distinct variation in its allelic nucleotide sequence and can be divided into 6 genotypes when digested with specific restriction enzymes. We extracted DNA from formalin-fixed, paraffin-embedded tissues using SDS/proteinase K treatment followed by phenol/chloroform extraction. The sequence of nucleotides for the A, B and O genes was amplified by the polymerase chain reaction (PCR). DNA fragments of 128 bp and 200 bp could be amplified in the second round of PCR, using an aliquot of the first round PCR product as template. Degraded DNA from paraffin blocks stored for up to 10.7 years could be successfully typed. The ABO genotype was deduced from the digestion patterns with an appropriate combination of restriction enzymes and was compatible with the phenotype obtained from the blood sample.

Oligodeoxynucleotide (ODN) conjugates with the polylysine comb-type copolymer having an ability to promote and stabilize duplex and triplex DNA formation were prepared. 5'-Aminated ODN was succinylated with succinic anhydride. The resulting ODNs having carboxyl terminus were coupled with epsilon-amino groups of the comb-type copolymer using water soluble carbodiimide. The conjugate free from unconjugated ODNs was obtained by gel permeation chromatography. The resulting conjugate maintains ability to form duplex and triplex DNA as estimated by melting curve analysis. Both specificity and stability of the triplex DNA formation were increased by employing the ODN-copolymer conjugates compared to those with their mixture.

The ABO blood group antigens were discovered at the beginning of this century. Although the biochemical and molecular-biochemical nature of the ABH and related antigens is now quite well characterized and it is presumed that they are concerned with oncodevelopmental and/or cell recognition phenomena(1), no clear explanation of the biological significance of these antigens has been proposed. Characterization of cells with regard to their surface and secretory glycoconjugates is important in order to understand the basis of their physiological and interactive behaviour. The taste buds of vertebrates are covered by mucous substances and it has been suggested that the carbohydrate residues of the mucous substances are essential for chemoreceptor processes in the function of taste buds. Therefore, in the present study, we examined the distribution of different types of carbohydrate antigens in the taste buds cells and lingual glands using monoclonal antibodies(MoAb) against blood group antigens and lectins conjugated with horseradish peroxidase(HRP).

Blood group A has been divided into the major subgroups, A1 and A2, since it was first described by von Dungern and Hirszfeld in 19111).

Forty-six cases of child abuse/neglect autopsied during the period of 1967 to 1990 were investigated. The weight and histological findings of the thymus were compared with those of control children. In most abused and/or neglected children, the weight of the thymus decreased conspicuously. Involution correlated well to the degree and period of maltreatment. In cases without weight loss of the thymus, i.e. spasmodic abuse by a mentally deranged parent or foster parent, a short history of maltreatment was noted. On the other hand, marked involution was observed in cases of prolonged physical abuse and/or neglect. Microscopically, a decrease in the number and pyknosis of lymphocytes were observed in the involuted thymus. Atrophy of the thymus was more conspicuous in the cortex than in medulla. Immunohistochemically, CD-1a positive cells (immature thymocytes) decreased in cases with thymic involution. This involution appears to be an important index of the degree and duration of child abuse/neglect. Furthermore, thymic involution in the early stage of childhood may also be related to insufficiency of the immune system.

The localization of ABH related antigens in human male reproductive tract was examined using monoclonal antibodies and an avidin biotin complex method. No positive reaction with blood group antibodies on spermatozoa was observed in testis and ductus epididymidis apart from erythrocytes and endothelial cells. The expression of ABH and ABH related antigens in ductuli efferentes testis, ductus epididymidis, seminal vesicle and prostate was complexly coded by a combination of H, Se, Le and X genes. The results obtained in this study indicate that the ABH antigens detected on spermatozoa of seminal stains are coating antigens and not inherent to the cell membrane, and the ABO, H, Se, Le and X genes are subjected to a tissue-dependent differential expression.

The satellite is a complex family of tandemly repeated DNA located at the centromeric regions of human chromosomes. Each chromosome contains some tandem copies of a higher — order repeat unit, comprised of tandem monomer units of 171 bP. It is also reported that the satellite DNA shows RFLPs based on site variations within and between monomer units (Waye 1987: Willard 1986, 1987).

Many kinds of forensic biological materials found at scenes of murder and traffic accidents are brought to forensic scientists for identification. Although various immunological methods and DNA techniques for the species identification from blood and bloodstains are now available, there are few investigations for blood grouping and species identification from tissue particles or tissue debris(Fechner et al 1989). In this study we report a method for species identification from tissue particles using lectin- and immuno-histochemical techniques.

Introduction Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is a rare disorder. The etiology remains unknown and the treatment is still empirical. Synovitis is one of the major manifestations, but information on histopathological features is still lacking. In this case, we investigated the histopathological features of SAPHO syndrome synovitis. Case presentation We present the case of a 53-year-old Japanese woman with SAPHO syndrome accompanied by marked knee synovitis and palmoplantar pustulosis. We found abundant sterile joint fluid in the right knee, and a blood test showed abnormally high values of C-reactive protein (17.26 mg/dl) and matrix metalloproteinase-3 (800 ng/ml). Arthroscopic surgery revealed marked proliferation of villous synovial tissues similar to rheumatoid arthritis and standard microscopic findings were also similar to rheumatoid arthritis. Furthermore, for the first time, we demonstrated by immunohistochemistry the expression of tumor necrosis factor-alpha (TNF-α) converting enzyme, TNF-α and matrix metalloproteinase-3 in the proliferated synovial lining cells. After arthroscopic synovectomy, her knee symptoms immediately diminished and laboratory data (matrix metalloproteinase-3 and C-reactive protein) normalized within 2 weeks of surgery. Conclusion We demonstrate the expression of TNF-α converting enzyme, TNF-α and matrix metalloproteinase-3 in SAPHO syndrome synovitis for the first time and also show, both macro- and microscopically, the similarity between SAPHO syndrome and rheumatoid arthritis synovitis. These new findings support the recently reported successful treatment of SAPHO syndrome with antirheumatic drugs, especially with anti-TNF-α agents.

Phenotyping of erythrocyte acid phosphatase (EAP) and esterase D (ESD) by cellulose acetate membrane isoelectric focusing (CAM-IEF) under a nonequilibrium condition is described. In an attempt to improve the method of CAM-IEF, we shortened the electrode distance to provide a higher field strength at a given (low) voltage. Various carrier ampholytes for EAP typing and various chemical separators for ESD typing were also tested. Good separations were obtained after 30 min IEF for EAP typing and 25 min for ESD typing. When applied to blood stains and stored for various periods at room temperature, the stains up to 8 months old could still be phenotyped for EAP and those up to 4 weeks old for ESD. CAM-IEF is suitable for routine forensic work of EAP and ESD phenotyping.

The histamine contents were very low in the whole bodies of various types of mutant mice ( W v / W v , W v / W , W / W ), in which the number of mast cells was decreased, but the L-histidine decarboxylase activities in these mutant mice were not much lower than in control wild type mice. These findings suggest the presence of high histidine decarboxylase activity in cells other than mast cells. Histidine decarboxylase in the whole body of mice was difficult to assay, because the enzyme was rapidly destroyed by proteases, but inclusion of a protease inhibitor, such as Leupeptin, Antipain, Chymostatin, or Pepstatin in the assay mixture permitted the accurate assay of histidine decarboxylase in crude extracts.

Histidine decarboxylase ( l -histidine carboxy-lyase, EC 4.1.1.22) of an extract of rat stomach was inactivated by a pancreatic extract. This inactivation was prevented by the protease inhibitors leupeptin, antipain, chymostatin, pepstatin, Trasylol and phenylmethanesulfonyl fluoride. Leupeptin, antipain, chymostatin and pepstatin together and phenylmethanesulfonyl fluoride alone prevented complete inactivation of the enzyme, while Trasylol had a weak protective effect. The inactivation and protection of histidine decarboxylase purified from whole fetal rats were similar to those of the stomach enzyme: both enzymes were strongly inactivated by trypsin and chymotrypsin, but not by elastase or carboxypeptidase Y. The histidine decarboxylase activities of various rat tissues were assayed in the presence of protease inhibitors: activity was highest in mast cells followed by the whole bodies of fetal rats and the stomach, while the activities were lower in decreasing order in the brain, spleen, lung and liver. Heart and kidney had no activity.

Histidine decarboxylases from the stomach and brain of adult rats were purified 380- and 160-fold, respectively, and their properties compared with those of the enzyme from whole bodies of fetal rats (7600-fold purification). The molecular weights (about 90,000) and the apparent Km values for L-histidine (3 X 10(-4) M) of the three enzymes were similar. The pI value of the fetal enzyme was 5.0, and that of the brain enzyme was 5.4. Histidine decarboxylase of the stomach showed two peaks of activity corresponding to those of the fetal and brain enzymes (pI's of 5.0 and 5.4) on isoelectric focusing. Anti-fetal-histidine decarboxylase antiserum inhibited the stomach and fetal enzymes extensively, but the brain enzyme only slightly. These results indicate that there are at least two types of histidine decarboxylase in rat tissue.

Bovine brain tubulin treated with urea and SDS partially recovered colchicine binding capacity after removal of SDS in the presence of urea followed by stepwise dialysis against urea solutions of lower concentrations. Tubulin subjected to the above procedure showed the same circular dichroism spectrum between 215 and 260 nm as the native one but showed a slightly different fluorescence spectrum when excited at 290 nm.