Down-scattered neutron imaging detector for areal density measurement of inertial confinement fusion.

A custom developed (6)Li glass scintillator (APLF80+3Pr) for down-scattered neutron diagnostics in inertial confinement fusion experiments is presented. (6)Li provides an enhanced sensitivity for down-scattered neutrons in DD fusion and its experimentally observed 5-6 ns response time fulfills the requirement for down-scattered neutron detectors. A time-of-flight detector operating in the current mode using the APLF80+3Pr was designed and its feasibility observing down-scattered neutrons was demonstrated. Furthermore, a prototype design for a down-scattered neutron imaging detector was also demonstrated. This material promises viability as a future down-scattered neutron detector for the National Ignition Facility.

Enhancement of topical delivery of drugs via direct penetration by reducing blood flow rate in skin.

The purpose of this work was to investigate the effect of blood flow in the skin on the direct penetration of topically applied drugs into the muscular layer, and to show that the skin blood flow could also be one of the important factors determining the direct penetration of drugs to the muscular layer. In vivo percutaneous absorption study was performed for antipyrine, salicylic acid or diclofenac by using rats with tape-stripped skin. Phenylephrine, which is well known to reduce the local blood flow by vasoconstrictor action, was topically applied to decrease the local blood flow in the skin. The concentrations of drugs in viable skin and muscle, and the local blood flow in the skin under the applied and the contralateral sites were determined to evaluate the effect of the local blood flow on the delivery of topically applied drugs into the muscular layer. Dose dependency for the effect of phenylephrine was, first of all, investigated for antipyrine in the range from 0.4 to 10 micromol. The distribution of antipyrine into the viable skin and muscular layer 2 h after topical application significantly increased, but the effect of phenylephrine was saturated around 2 micromol and the dose-dependent profiles for both tissues were almost superimposed. On the other hand, the fraction dose absorbed, plasma concentration and concentrations in viable skin and muscular layer under the contralateral site showed the decreasing tendency and the saturation of the effect around 2 micromol. To confirm the effect of phenylephrine on the local blood flow in the skin, the skin blood flow was measured 2 h after topical application of 2 micromol phenylephrine, and the significant decrease in the blood flow was recognized. In vivo percutaneous absorption studies were performed for salicylic acid and diclofenac, too. Extensive enhancement of penetration into the viable skin and muscular layer was observed for both drugs, although total absorption from the donor cell showed the decreasing tendency. In conclusion, direct penetration of drugs applied topically is enhanced by reducing the local blood flow in the skin, which would be a possible approach to improve the local delivery of drugs applied topically.

Classification of Ralstonia pickettii biovar 3/'thomasii' strains (Pickett 1994) and of new isolates related to nosocomial recurrent meningitis as Ralstonia mannitolytica sp. nov.

Strains isolated independently from two patients could be recognized as Ralstonia pickettii biovar 3/'thomasii'. The 16S rDNA sequences of these strains and two other strains of R. pickettii biovar 3/'thomasii' clustered at less than 98% similarity versus all other described Ralstonia species and at less than 97 % versus the two other R. pickettii biovars. The separate species status of R. pickettii biovar 3/'thomasii' was confirmed by DNA-DNA hybridization, indicating less than 60% DNA homology with the R. pickettii biovars Va-1 and Va-2 and with two as-yet unclassified but biochemically similar Ralstonia strains. Phenotypically, this Ralstonia species can be distinguished from all described Ralstonia species by its acidification of D-arabitol and mannitol and by its lack of nitrate reduction and of alkalinization of tartrate and from two as-yet unclassified Ralstonia strains only by its lack of nitrate reduction. The name Ralstonia mannitolytica sp. nov. is proposed, reflecting the characteristic acidification of mannitol. Resistance to desferrioxamine is another difference from R. pickettii and Ralstonia solanacearum. Although several nosocomial outbreaks have been associated with R. mannitolytica, life-threatening infections have not yet been reported, possibly due to misidentification as Pseudomonas fluorescens or Burkholderia cepacia. In at least one of the two cases reported here, the R. mannitolytica isolate was found to be clinically relevant, causing recurrent nosocomial meningitis, with an infected implanted catheter as the source. The type strain of R. mannitolytica is NCIMB 10805T (= LMG 6866T), which was isolated during the first described outbreak as 'Pseudomonas thomasii' at St Thomas' Hospital, London, UK, in 1971.

Spontaneous regression of multiple emphysematous bullae.

The etiology of emphysematous bullae is not well known; thus, the management of bullous lung disease is often difficult because of concomitant underlying emphysema and coexisting cardiac conditions. The present paper reports a case in which near complete resolution of multiple emphysematous bullae in the right lung occurred spontaneously. This case is of interest, not only because of the rarity with which spontaneous regression of multiple emphysematous bullae has been reported in the literature, but also because of the accompanying dramatic improvements in radiological results and pulmonary function of the patients.

[Pulmonary tuberculosis presenting multiple nodular shadows in 4 patients].

Four cases of multiple nodular pulmonary tuberculosis simulating metastatic lung cancer were reported. These patients were asymptomatic, found by chance during physical checkups, and had no clinical findings indicative of inflammatory reactions. The nodules ranged from 15 to 50 in number, were spherical in shape, and 3-10 mm in diameter with sharp margins. In 2 patients, the size of the Mantoux reaction (using purified protein derivative) was 22 mm and 11 mm respectively; the other 2 patients were not given the skin test. The final diagnosis was made by video-assisted thoracoscopic surgery in 2 patients, percutaneous lung biopsy in 1, and open lung biopsy in 1. Epithelioid cell granulomas were found in all 4. Anti-tuberculous chemotherapy reduced the size of the nodules significantly in 2 patients and slightly in 1. One patient did not undergo chemotherapy. Although no acid-fast bacilli were detected, all 4 patients were given a diagnosis of pulmonary tuberculosis on the basis of the above findings. Whenever multiple nodular shadows are observed, it is common to suspect metastatic lung cancer at the outset. However, our experience indicated that pulmonary tuberculosis also should be kept in mind as a candidate for differential diagnosis. Computed tomographic findings suggested that the lesions were caused by hematogenous dissemination. Our report therefore devoted some attention to mechanisms of formation.

Roseateles depolymerans gen. nov., sp. nov., a new bacteriochlorophyll a-containing obligate aerobe belonging to the beta-subclass of the Proteobacteria.

Strains 61AT (T = type strain) and 61B2, the first bacteriochlorophyll (BChl) a-containing obligate aerobes to be classified in the beta-subclass of the Proteobacteria, were isolated from river water. The strains were originally isolated as degraders of poly(hexamethylene carbonate) (PHC). The organisms can utilize PHC and some other biodegradable plastics. The strains grow only under aerobic conditions. Good production of BChl a and caroterioid pigments is achieved on PHC agar plates and an equivalent production is observed under oligotrophic conditions on agar medium. Spectrometric results suggest that BChl a is present in light-harvesting complex I and the photochemical reaction centre. The main carotenoids are spirilloxanthin and its precursors. Analysis of the 16S rRNA gene sequence indicated that the phylogenetic positions of the two strains are similar to each other and that their closest relatives are the genera Rubrivivax, ideonella and Leptothrix with similarities of 96.3, 96.2 and 96.1%, respectively. The cells are motile, straight rods and contain poly-beta-hydroxybutyrate granules. Ubiquinone-8 is the predominant quinone. Vitamins are not required for growth. The G + C content of genomic DNA is 66.2-66.3 mol%. Genetic and phenotypic features suggest that the strains represent a new genus in the beta-subclass which is evenly distant from known genera. Consequently, the name Roseateles depolymerans gen. nov., sp. nov. is proposed for the strains; the type strain of Roseateles depolymerans is strain 61AT (= DSM 11813T).

Phylogenetic affiliation of soil bacteria that degrade aliphatic polyesters available commercially as biodegradable plastics.

Thirty-nine morphologically different soil bacteria capable of degrading poly(beta-hydroxyalkanoate), poly(epsilon-caprolactone), poly(hexamethylene carbonate), or poly(tetramethylene succinate) were isolated. Their phylogenetic positions were determined by 16S ribosomal DNA sequencing, and all of them fell into the classes Firmicutes and Proteobacteria. Determinations of substrate utilization revealed characteristic patterns of substrate specificities.

[Interstitial pneumonitis detected by bronchoalveolar lavage and transbronchial lung biopsy in adult-onset Still's disease].

A 44-year-old woman was admitted to our hospital because of a high fever that had continued for three weeks. She complained of a sore throat and arthralgia, and had a salmon-pink rash, lymphadenopathy, liver dys-function, and hyperferritinemia. Tests for RF and ANA were negative. Adult-onset Still's disease was diagnosed. Despite administration of steroids, pericarditis, interstitial pneumonitis, and disseminated interavascular coagulation developed. After cyclophosphamide was given, the patient's condition improved, but reticular shadows and volume loss remained on the chest X-ray film. A chest CT scan showed ground-glass-like opacities and linear shadows, and irregular bronchovascular bundles. Bronchoalveolar lavage and transbronchial lung biopsy were done. Alveolar macrophages accounted for 71% of the cells in the bronchoalveolar lavage fluid, and lymphocytes (CD 4/ CD 8 ratio = 1.01) accounted for 29%. Examination of a specimen obtained by transbronchial lung biopsy showed thickened alveolar walls and infiltration of lymphocytes. Reports of cases of adult-onset Stills disease that include results of bronchoalveolar lavage and transbronchial lung biopsy are rare.

Tissue plasminogen activator (T-PA) and plasminogen activator inhibitor (PAI-1) levels in the conditioned medium of cultured porcine brain microvascular endothelial cells.

Vascular endothelial cells are known to produce tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1). However, the release kinetics of these substances by brain microvascular endothelial cells (BMEC) is less well known. BMEC prepared from porcine brains using enzymatic digestion and percoll gradient separation was exposed to culture medium containing thrombin (1.0IU/ml), histamine (10 mumol/ml), and TN-alpha (500, 1000, 2000U/ml). The supernatant obtained at respective time points was subjected to ELISA for t-PA, PAI-1 and t-PA-PAI-1 complex. The value of these substances were significantly higher than those of the controls at respective time points. It also proved that t-PA and PAI-1 production by BMEC increases in a parallel fashion. The present study suggests that t-PA production by BMEC cultured under given stimulation increases, however, it is accompanied by concomitant PAI-1 production.

Bacterial isolates degrading aliphatic polycarbonates.

Bacteria that degrade an aliphatic polycarbonate, poly(hexamethylene carbonate), were isolated from river water in Ibaraki. Prefecture, Japan, after enrichment in liquid medium containing poly(hexamethylene carbonate) suspensions as carbon source, and dilution to single cells. Four of the strains, 35L, WFF52, 61A and 61B2, degraded poly(hexamethylene carbonate) on agar plate containing suspended poly(hexamethylene carbonate). Degradation of poly(hexamethylene carbonate) was confirmed by gel permeation chromatography. Besides poly(hexamethylene carbonate), the strains were found to degrade poly(tetramethylene carbonate). The strains were characterized morphologically, physiologically, and by 16S rDNA sequence analysis. Strains 35L and WFF52 were tentatively identified as Pseudomonas sp. and Variovorax sp., respectively, while strains 61A and 61B2 constitute an unidentified branch within the beta subclass of the Proteobacteria.

Preoperative embolization for meningioma using lipiodol.

SUMMARY: Four patient (3 males, 1 female) with meningioma treated by preoperative embolization using lipiodol since January 1997 were included in this study. Almost the same procedure was performed on them; superselective catheterization into feeders from the external carotid artery, slow infusion of lipiodol, and proximal occlusion with liquid coils. Duration between embolization and direct surgery varied (5-13 days). Three meningiomas resected 5 days after the embolization were successful but one resected after 13 days needed transfusion. Post operative complications were seen in two patients, one is lockjaw due to ischaemia of the temporal muscles, and the other is transient dilatation of perifocal oedema. The ischaemic effect and safety of lipiodol as embolic material are discussed.

Rehabilitation of spinal cord injury in the national rehabilitation center for the disabled of Japan: profile of a spinal service.

The National Rehabilitation Center for the Disabled (hereunder abbreviated NRC) in Japan was established in 1979. It consists of four divisions: the hospital, the rehabilitation training center, the research institute, and the information service section. The spinal unit has been functioning and cooperating corelatively with all of these divisions. There were 1047 patients with a spinal cord injury treated in the 15 years from September, 1980 to August, 1994; consisting of 924 males (88.3%), and 123 females (11.7%). The breakdown of causes of injury were traffic accidents 44.9%, having a fall 14.7%, sports accidents 6.7%, and other causes of spinal paralysis 10.5%. The sites of the spinal cord lesions were cervical 372 (35.5%), thoracic 547 (52.5%), and lumbar spinal cord 128 patients (12.3%). The incidence of complete paralysis in those with a cervical spinal cord injury (SCI) was 68.8%, and for thoracic and lumbar SCI 79% each. The time for completion of activities of daily living (ADL) was 12.0 +/- 1.54 months in those with tetraplegia, and 5.6 +/- 1.71 months for those with paraplegia. The rate of employment for reentry into society was 59% in those with a cervical spinal cord injury, and 74% each in those with a thoracic or lumbar spinal cord injury.

[Anesthetic management for bronchoscopy in patients with congenital tracheomalacia].

We experienced the anesthetic management for two patients with congenital tracheomalacia. Inhaled anesthetics are considered to worsen the respiratory condition of tracheomalacia because of its bronchodilating effect. Thus we tried awake intubation in one case, but it was difficult. In another case, we used slow induction with sevoflurane and the trachea was intubated smoothly. Inhaled anesthetics have possibility of worsening the degree of tracheomalacia and have been used very carefully. However, we considered that slow induction with inhaled anesthetics in children with congenital tracheomalacia is a safe and necessary technique, under careful observation of respiratory conditions.

[Simplified method of cultured brain microcapillary endothelial cells].

Many kinds of methods cultured brain microcapillary endothelial cells have been published, but these methods were not established. We designed the simplified methods with improvement of enzymatic treatment and Percoll gradient centrifugation.

Clinical evaluation of CYFRA 21-1 in malignant pleural fluids.

The diagnostic value of the novel tumor marker CYFRA 21-1 in malignant pleural fluid was assessed in comparison to carcinoembryonic antigen (CEA). CYFRA 21-1 and CEA were measured in pleural fluid obtained from patients with 108 malignant and benign diseases. The levels of pleural fluid CYFRA 21-1 in malignant diseases (median: 84.5 ng/ml) were statistically higher than those in benign diseases (median: 13.9 ng/ml; p < 0.01). The CYFRA 21-1 test was able to discriminate significantly between squamous cell lung cancer and pneumonia (p < 0.01), while pleural fluid CEA levels could not. Receiver operating characteristic (ROC) curve analysis showed that the CYFRA 21-1 test has an advantage over CEA because of its higher specificity. These results indicate that measurement of CYFRA 21-1 in pleural fluid is a new tool, in addition to cytologic examination, to discriminate between malignant and benign diseases.

A quantitative analysis of cerebrospinal fluid flow in post-traumatic syringomyelia.

Cerebrospinal fluid (CSF) flow within the syrinx in post-traumatic syringomyelia was studied by cardiac-triggered phase images of magnetic resonance imaging (MRI) to investigate the relationship between CSF flow in the syrinx and patients' symptoms.

[Clinical usefulness of serum assay of EIA-CYFRA 21-1 in lung cancer].

Enzyme immunoassay CYFRA 21-1, a novel lung tumor marker presented in serum (upper limit of normal values: 3.5 ng/ml) was measured in 84 patients with lung cancer and 141 patients with benign respiratory diseases. The positive rate for CYFRA 21-1 in primary lung cancer was 70.3% and the false positive rate in respiratory diseases was 24.1%. In respect to the histological types of lung cancer, CYFRA 21-1 was elevated in 85.0% of squamous cell carcinoma and in 64.8% of other cell types of primary lung cancer. Elevated CYFRA 21-1 levels were found in 40% of Stage I-II, in 80.0% of Stage IIIA-B, and in 73.5% of Stage IV. The overall diagnostic efficiency was 53.4% for CYFRA 21-1 and 44.5% for CEA, respectively. Receiver operating characteristic (ROC) curve analysis suggested that CYFRA 21-1 test has an advantage over CEA. From the results of this study, CYFRA 21-1 was more efficient than CEA as primary diagnostic marker in lung cancer.

[Comparison between ELISA and culture method for detection of Helicobacter pylori].

Detection of Helicobacter pylori (H. pylori) by ELISA was compared with that by the culture method in 115 patients with gastroduodenal diseases. Both the sensitivity and specificity were more than 85% for patients with histological gastritis with neutrophil infiltration. This indicated that the detection of H. pylori by ELISA is useful for the diagnosis of H. pylori-related gastritis. Although the sensitivity between the ELISA and culture method was 85%, the specificity was 58.8%. The false negative detection may have been caused by a sampling error during the endoscopic biopsy.