Early serial Q-switched ruby laser therapy for medium-sized to giant congenital melanocytic naevi.

BACKGROUND: Medium-sized to giant congenital melanocytic naevi (CMN) are difficult to treat, especially if the lesions appear on the face or extremities where treated areas are visible and cosmesis is important. OBJECTIVES: In infants, nests of pigmented naevus reside more superficially and the skin is more transparent than in adults, so we treated medium-sized to giant CMN with early serial Q-switched ruby laser therapy from infancy. PATIENTS AND METHODS: We treated nine patients with medium-sized to giant CMN on the face or upper limbs from 1 month of age with early serial Q-switched ruby laser therapy. The laser power was initially 5 J cm(-2) and increased in 0.5 J cm(-2) steps to a maximum of 10 J cm(-2). There were three treatment sites on the forehead, one on the temple, one on the cheek and four on the upper arm. RESULTS: It took 8-15 treatments for the CMN to become a colour similar to the surrounding skin. The mean number of treatments was 9.6. The colour was reduced to 0-20% of the colour of the baseline lesion in all nine patients. Partial slight repigmentation occurred in eight of these patients. These naevi were treated with an additional one or two Q-switched ruby laser irradiations and successfully lightened for at least 1 year. In the remaining patient, pigmentation returned to a level similar to the original lesion within 1 month of the last treatment. Therefore, the lesion was excised for cosmetic reasons. After the treatment series, the skin texture was fine and no patients had hypertrophic scarring. CONCLUSIONS: Although treatment of one patient with the Q-switched ruby laser therapy failed, the remaining patients responded well and had good to excellent skin texture without hypertrophic scarring. Early serial Q-switched ruby laser treatment, starting from infancy, is a promising treatment method for this condition.

[Effects of low concentration of styrene monomer vapor on pregnancy].

To investigate the effects of exposure to styrene vapor on pregnancy, mice proved to be pregnant were exposed to 0, 2, 20 and 100 ppm styrene continuously for 24 hours during the period from day 0 to day 15 of gestation. A special small exposure chamber which can accurately maintain a constant low concentration of styrene vapor was made and used in the experiment. 1) In the 100 ppm group, hyperkinesis was presented in the chamber during the exposure period and inhibition of body weight gain was found (p < 0.01). No deaths occurred in any of the groups. 2) At necropsy of dams, no significant difference was found between the styrene exposed groups and the control group in any of the fertility indices, number of implantations, number of live fetuses, percentage of resorptions, or in the percentage of dead fetuses. The 100 ppm group showed lower fetal and placental weights (p < 0.01). 3) Gross necropsy of dams in the 100 ppm group showed significantly decreased adipose tissue. The liver, kidney and spleen weights were also low (p < 0.01). 4) When exposed to 100 ppm, which corresponds to 5 times the permissible concentration, i.e., 20 ppm, for 24 hours, non-pregnant dams showed no abnormality, while pregnant dams showed inhibition of body weight gain and significantly lower fetal and placental weights and maternal organ weights. Therefore, careful consideration should be given to exposure of women of childbearing age to styrene.

Effect of intestinal helminthiasis on nutritional status of schoolchildren.

This study was conducted in a rural agricultural area in Siniloan, Republic of the Philippines. The subjects were the school children. The nutritional status of 58 children infected with helminthiasis (Ascaris lumbricoides and Trichuris trichiura) was compared with that of 19 uninfected controls. Prevalence of Ascaris and Trichuris was 40.3% and 71.4% respectively, and 36.4% of infected children had both Ascaris and Trichuris infections. Statistically significant evidence of an adverse effect of helminthiasis on serum albumin levels was found, but no child had inadequate levels of other nutrients. Although helminthic infections increase the level of immunoglobulin E (IgE) in children endemically exposed to these parasites, there was no significant difference in the serum IgE among Ascaris or Trichuris infected groups in this study.

Itai-itai disease is not associated with polymorphisms of the estrogen receptor alpha gene.

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

Dust concentration around the sites of demolition work after the Great Hanshin-Awaji Earthquake.

The total dust concentration and the particle size distribution were determined around die sites of demolition associated with the Great Hanshin-Awaji Earthquake, which occurred on January 17, 1995. The total dust concentrations ranged from 0.20 to 0.23 mg/m(3), being about 1.2 to 2.2 times that in die non-demolition area, and intermediate particles (2.1-11.0µm) made up a large proportion of the dust. The dust concentrations were not influenced by the weather on the day preceding measurement around the sites of demolition of concrete buildings, whereas the values decreased to about half around die sites of demolition of wooden buildings, nearly the same concentration in the control areas, when it had rained on the previous day. The dust concentrations increased compared with that in an average year but to The degree of die upper limit of die environmental standard (1 hr-value<0.20 mg/m(3)) . The dust due to the smoke of Mt. Sakurajima in the surrounding areas accounted for a higher proportion of large particles (<11.0>m) than in the earthquake-devastated area. The concentration of respirable dust (<;7.07>m) in a worker engaged in demolition was 4.0 mg/m(3), being twice the recommended concentration (2 mg/m(3)) of the Japan Society for Occupational Health. It was thus considered that workers should use a respiratory protective device.

[Screening test by statistically reducing the number of the State-Trait Anxiety Inventory (STAI) items].

The purpose of the study is to find a method of mental examination which can be simply performed concurrently with physical examination during a regular check-up. On a regular check-up, the state-trait anxiety inventor (STAI) was administered to 264 construction workmen engaged in reconstruction work for the Hanshin Awaji Great Earthquake. Data on a total of 40 STAI items, i.e., 20 state anxiety (A-State) items and 20 trait anxiety (A-Trait) items were subjected to multiple regression analysis and five items were extracted from A-State and five from A-Trait items as a practical tool for a simple screening test. The contribution rates of the respective five items for the total score were 90.0% for A-State and 88.5% for T-State. The correlation coefficients, r, between predicted and observed values were 0.949 (p < 0.01) for A-State and 0.940 (p < 0.01) for A-Trait. Because of certain degrees of validity and reliability of each five-item system, it is considered that this method is useful as a simple screening test to roughly grasp the mental health of subjects and can be utilized for mental health care at offices.

Effect of cadmium administration and aging on the concentration of essential metals in liver and kidney.

To investigate the changes in the concentration of essential metals in organs caused by exposure to cadmium (Cd) and by aging, Cd was administered subcutaneously in single doses of 0.3, 0.9 and 2.7 nig/kg to female rats 10 and 40 weeks of age. The animals were sacrificed on the 7th day after the administration. The concentration of Cd, zinc (Zn), copper (Cu), iron (Fe) and manganese (Mn) in the liver and the kidney was determined and the relations between the concentration of Cd and that of other metals were investigated.1) In 10-week-old rats, the amount of Cd accumulated in the liver and the kidney increased linearly with increasing doses of Cd, while in 40-week-old rats, suppressed accumulation of Cd in the liver and increased accumulation of Cd in the kidney were found after administration of the high dose.2) The concentration of Zn in the liver and the kidney both increased with increasing doses of Cd. There was no age-related difference.3) The concentration of Cu in the liver increased in the animals which received the intermediate and the high dose, irrespective of age. The concentration of Cu in the kidney showed no changes caused by Cd administration or by aging.4) The concentration of Fe in the liver increased in both 10-week-old and 40-week-old rats which received the high dose. The concentration was higher in 40-week-old rats than in 10-week-old rats. The Fe concentration in the kidney and the Mn concentration in the liver and the kidney was not affected by Cd administration or by aging.5) Discriminant analysis, by age, suggested that the amount of metals in the liver and the kidney was more likely to be affected by exposure to Cd in young individuals and less likely to be affected by exposure to Cd with the increase of age.

Effect of iron as a new type of phosphate binder in hemodialysis patients.

Hyperphosphatemia is one of the major problems requiring management in the majority of hemodialysis patients and they require phosphate-binding agents to control the hyperphosphatemia. Aluminum hydroxide and calcium compounds are used currently as phosphate-binding agents to treat hyperphosphatemia, but these compounds can cause undesirable side effects. Therefore, the development of new phosphate-binding agents is imperative. It is well known that oral and intravenous administration of iron causes hypophosphatemia. We hypothesized that this side effect of iron may be beneficial for the treatment of hyperphosphatemia in hemodialysis patients. Consequently, we conducted a fundamental and clinical investigation of the effects of iron administration. Membrane permeability of phosphorus in a mixture of sodium ferrous citrate and dessicated aluminium hydroxide in the presence of hydrogenated lecithin as a phosporic compound was examined. Fifteen patients undergoing hemodialysis were treated with 150 mg of sodium ferrous citrate given orally for eight weeks. The permeability of the filtering membrane to phosphorus decreased in accordance with the dosage of sodium ferrous citrate and dessicated aluminum hydroxide. The degree of phosphate-binding effect of sodium ferrous citrate was larger than that of dessicated aluminum hydroxide. Serum phosphorus decreased significantly during the experiment. These results suggest that the oral administration of sodium ferrous citrate as a new phosphate binder is a useful therapeutic method for hemodialysis in patients with hyperphosphatemia.

Evidence for an increased intracellular free calcium concentration in platelets of bronchial asthma patients.

The pathogenesis of bronchial asthma is not yet fully understood. Recently much attention has been given to the hypothesis that intracellular free calcium ([Ca2+]i) metabolism is abnormal in various diseases. In this study we investigated whether [Ca2+]i exists abnormally in subjects with bronchial asthma. The [Ca2+]i in 32 treated or untreated subjects with bronchial asthma were compared with 63 normal subjects. Resting levels of [Ca2+]i were estimated by loading the fluorescent indicator Fura-2 in washed platelets. The [Ca2+]i level in the control subjects was 129.7 +/- 18.0 nM (mean +/- SD). However, in that of the bronchial asthma patients was 152.7 +/- 44.1 nM, significantly higher than that of the control subjects (p < 0.05). It is well recognized that an increase of [Ca2+]i in vascular smooth muscle involves contraction. The findings suggest that the same phenomenon is quite possible in the tracheal smooth muscle and that it plays an important role in the pathogenesis of bronchial asthma.

Structural organization of the gene for CD40 ligand: molecular analysis for diagnosis of X-linked hyper-IgM syndrome.

CD40 ligand (CD40L) on activated T cells plays a crucial role for Ig heavy-chain class switching and the mutation of the gene for this ligand in the X-chromosome causes immunodeficiency with hyper-IgM (X-HIM). We isolated and characterized the human genomic clone for CD40 L to obtain information about the transcriptional regulatory regions of the gene and to develop a molecular diagnostic method for X-HIM patients. The genomic DNA isolated was over 12 kb long containing 5 exons that cover full sequence of mRNA for the ligand. DNA motif analysis based on transcription factor database revealed the presence of a GATA 1 box at around -265 bp. The typical TATA box, CAT site or GC rich region was not found in the 5' flanking region. However, two possible TATA like sequences were found at around -27 and -136 bp. Using the oligonucleotide primers corresponding to the introns, we performed a PCR-SSCP analysis of each exon from a patient with X-HIM syndrome and detected abnormality in exon 5. When sequenced, dinucleotide deletion in this exon was found in the patient and in one X allele of his mother as the only different sequence from that of the control gene. This procedure is simple and could be used for diagnosis of the X-HIM syndrome.

[Changes in metal distribution in organs of cadmium-administered and copper-deficient rats].

To investigate the effect of Cu deficiency on the distribution of metals in organs when Cd was administered, 8-week-old female rats of the SD strain were fed a Cu-deficient diet (0.5 ppm Cu) or a basal diet (3.5 ppm Cu) and given 50 oral doses of 200 micrograms/rat of Cd. Then, the concentrations of Cd, Zn, Cu, Fe, Ca, Mn and Mg in each tissue were determined. In the Cu-deficient state, the serum Cu concentration was decreased and it was further decreased by Cd administration to about 1/4 of the normal value. The accumulation of Cd in the liver and kidney was increased by Cu deficiency. Cu deficiency caused decreases in the Cu concentration of the liver, kidney, brain, lung and pancreas. The administration of Cd caused additional remarkable decreases in the Cu concentration in the blood as well as in the hematopoietic organs, such as liver and spleen. Fe was increased by the Cu deficiency in the brain, heart, pancreas and muscle, though this increase was inhibited by Cd administration. The changes in tissue Fe were more greatly affected by Cd administration than by Cu deficiency. The Zn concentration was increased in the liver and kidney by Cd administration but was not affected by Cu deficiency. Mn, Ca and Mg concentrations showed no changes caused by Cu deficiency or Cd administration.

Relationship of cadmium accumulation to zinc or copper concentration in horse liver and kidney.

The concentrations of Cd, Zn, Cu, and metallothionein (MT) in the liver, renal cortex, and renal medulla were determined in 24 male and 15 female younger thoroughbreds (age 27 to 97 months) and two old male horses (age 154 months and 190 months). High correlations were found between Zn and MT in the liver (partial correlation coefficient 0.836), between Cd and MT in the renal cortex (partial correlation coefficient 0.786), and between Cd and Zn in the renal cortex (partial correlation coefficient 0.675), while the correlation between Cd and MT in the liver was low (partial correlation coefficient 0.124). In the renal medulla, high correlations were found between Cd and Zn (partial correlation coefficient -0.631), between Zn and Cu (partial correlation coefficient 0.881), and between Cd and Cu (partial correlation coefficient 0.785). Therefore, in the liver, the MT concentration is the most highly correlated with the Zn concentration and is not correlated with the CD concentration unless artificially exposed to Cd. In the renal cortex, the MT and Cd concentrations are very highly correlated with each other. The Zn concentration is about 20 micrograms/g when the Cd concentration in the renal cortex is the lowest.

Increased frequency of non-insulin-dependent diabetes mellitus among narcoleptic patients.

Forty-eight narcoleptic patients were randomly selected from a group of 197 narcoleptic outpatients, and a 50-g oral glucose tolerance test (OGTT) was performed. Blood glucose levels were determined by oximetry before and 30, 60, and 120 min after the glucose administration. Serum insulin concentrations (IRI) were determined by enzyme immunoassay, and an insulinogenic index (II) was calculated. (II = the ratio of IRI increment to blood glucose increment in 30 min following glucose load). From the results of the OGTT, six patients with definite diabetes mellitus (DM) were identified (12.5%, 4 men and 2 women) according to World Health Organization criteria (1980). The II of the DM patients was significantly low, with an average of 0.13 +/- 0.03. From recent data in the literature on the prevalence of DM in the general Japanese adult population (1.75-5.5%), it was concluded that the frequency of DM among our randomly selected narcoleptic patients was significantly increased. The positive results for diabetes in our six narcoleptic patients could not be attributed to obesity, because there was no difference between the obesity indices of DM and nonDM narcoleptic patients, nor was there a difference between the frequency of DM in obese and nonobese patients.

Microbial Resolution of alpha-Hydroxy Acids by Enantiospecifically Dehydrogenating Bacteria from Soil.

Thirty-three bacterial strains were isolated from soil, utilizing optically asymmetric degradation of dl-2-hydroxy-4-methylpentanoic acid (dl-HMPA) as the screening probe. Those strains were distributed in the following group and genera: Coryneform and Bacillus, Pseudomonas, and Streptomyces. Among them, the most potent strains, Bacillus freudenreichii NRS-137KH20B and Brevibacterium albidum NRS-130KH20B, could perform the resolution of more than 30 g of dl-HMPA per liter within 4 to 5 days of fermentation. Optically pure l- and d-HMPA enantiomers were obtained in more than 80% theoretical yield, whereas the transformed enantiomer was almost quantitatively recovered as 2-oxo-4-methyl-pentanoic acid in the culture broth. The enantiospecific dehydrogenation responsible for this resolution reaction had a rather wide substrate specificity on straight or branched aliphatic C(4) to C(16) 2-hydroxy acids, exhibiting the optima at chain lengths of either C(7) or C(5), although the enantiospecificity was not changed by chain length. The process was thus successfully extended to the preparation of optically pure C(5) to C(9) 2-hydroxy acids.