Using underwater cameras to assess the effects of snorkeler and SCUBA diver presence on coral reef fish abundance, family richness, and species composition.

The results of underwater visual fish censuses (UVC) could be affected by fish changing their behavior in response to the snorkeler or diver conducting the survey. We used an underwater video camera to assess how fish abundance, family richness, and community composition were affected by the presence of snorkelers (n = 12) and self-contained underwater breathing apparatus (SCUBA) divers (n = 6) on a coral reef in Thailand. The total number of families, abundance of some fish families, and overall species composition showed significant differences before and during snorkeling disturbances. We did not detect significant and consistent changes to these parameters in the presence of a SCUBA diver; however, this could be a result of lower statistical power. We suggest that the use of a stationary video camera may help cross-check data that is collected through UVC to assess the true family composition and document the presence of rare and easily disturbed species.

The importance of supratidal habitats for wintering shorebirds and the potential impacts of shrimp aquaculture.

Intensive black tiger shrimp (Penaeus monodon) aquaculture ponds have replaced significant areas of coastal wetlands throughout tropical Asia. Few studies have assessed potential impacts on avian foraging habitats. At Khao Sam Roi Yod National Park, Thailand, seminatural wetlands have been converted to either shrimp ponds or to salinization ponds that provide saline water for shrimp aquaculture. Although shorebirds cannot feed in aquaculture ponds, hypersaline ponds can provide productive foraging areas. Thus, the overall impact of the shrimp industry on shorebirds depends partly on the relative quality of the salt ponds compared to seminatural wetlands. In this study, we examined wintering shorebird use of tidal (N = 5 sites) and supratidal areas (four wetland sites, four salt pond sites) and compared the shorebird community (14 species), prey availability, profitability, and disturbance rates between wetlands and salt ponds. Two shorebird species fed in higher densities in wetlands, whereas seven species were more abundant in salt ponds. Large juvenile fish and dragonfly larvae were more abundant in wetlands, whereas there were more small Chironomid midge and fly larvae in salt ponds. We conclude that salt ponds might provide higher-quality foraging habitats compared to wetlands for small shorebirds species because of the abundance of small larvae. However, the shrimp aquaculture industry reduces habitat availability for shorebirds feeding on larger prey. This study demonstrates a comprehensive, multispecies approach to assess the impacts of a large-scale change in coastal habitats for wintering shorebirds.

A vertical stomach reconstruction after pylorus-preserving pancreaticoduodenectomy.

BACKGROUND: Pancreatic fistula (PF) and delayed gastric emptying (DGE) is a leading cause of morbidity after pylorus-preserving pancreaticoduodenectomy (PPPD), occurring in 20% to 40% of patients. METHODS: Between August 1994 and March 2000, 30 consecutive patients underwent our modified PPPD and were evaluated on their incidence of PF and DGE. The major modification of our technique was an antecolic reconstruction and setting the transverse colon between pancreaticogastrostomy and duodenojejunostomy RESULTS: Operative time and blood loss were, respectively, 5.2+/-0.93 hours and 730+/-330 mL. Hospital mortality was 0%. Postoperative morbidity was 23%. Delayed gastric emptying and pancreatic fistula were observed in 3 (10%) and 0 (0%) of 30 patients. Nasogastric suction was required for 7+/-2 days, and a solid diet could be tolerated on postoperative day 11+/-4. CONCLUSIONS: The results show that our reconstruction can minimize DGE.

[Analysis of 200 university hospital hearing aid clinic patients].

We statistically studied patients who visited our hearing aid clinic to determine what segment of the population may benefit from hearing aids. Subjects were 200 patients from 5 to 89 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, Nagoya University Hospital, between January 1998 and March 2000. This clinic lent out hearing aids. Subjects were divided into 2 groups those having their own hearing aids either new or earlier (HA group) and those giving up hearing aids after a trial (non-HA group). Mean better hearing levels in pure tone average were 50.6 dB in the HA group and 44.5 dB in the non-HA group. Mean better maximum speech recognition scores were 81.5% in the HA group and 85.3% in the non-HA group. The distribution of better hearing has shown that patients with mild hearing loss (better pure tone average < 40 dB) account for more than a quarter of all hearing aid clinic patients. Among patients with mild hearing loss, 60% had their own hearing aids. The need for rehabilitation in the mild hearing loss population thus appears large. Their intent to wear hearing aids influenced whether patients agreed or declined hearing aids after a trial. The period from use until patients made a decision was 2 weeks in 65% of those declining use and 35% of those agreeing to use. Over 15% of those agreeing called for a trial period longer than 8 weeks. Hearing aid trials provide useful information for both patients and surgeons before choosing surgery for a difficult ear condition. In this research, 18 patients needed counseling about both amplification and surgery. Bridging between ear surgery and hearing aid wearing is a vital role of hearing aid clinics at university hospitals.

Rapidly enlarging dermoid cyst over the anterior fontanel: a case report and review of the literature.

A case report of a rapidly enlarging dermoid cyst over the anterior fontanel is presented. Our presentation demonstrates the course of rapid enlargement of the tumor with radiological images, which were examined at birth and during the process of the tumor enlargement. The literature is reviewed with respect to the nature of this tumor, especially to the relationship of tumor enlargement.

Circadian rhythm-modulated chemotherapy with high dose 5-fluorouracil against gastrointestinal cancers: evaluation and case report.

Circadian variations in chemotherapy toxicity and antitumor effects were investigated in experimental and clinical studies. In the experimental study, Balb/c mice bearing murine colon carcinoma Colon 26 were treated with 4 injections of 5-fluorouracil (5-FU) (80 mg/kg) at 0000 Hours After Light On (HALO), 0600 HALO, 1200 HALO and 1800 HALO. The antitumor effect of treatment at 0000 HALO (early resting phase) group was significantly better with lower toxicity than the 1200 HALO (early activity phase) group, resulting in significantly longer survival (p < 0.05). In the clinical study, the effect of circadian rhythm-modulated 5-FU plus leucovorin therapy was evaluated in an end-stage patient with recurrent gastric carcinoma. After continuous weekly infusion of 5-FU (1000 mg/m2/day x 2) was stopped because of its gastrointestinal toxicity, circadian rhythm-modulated chemotherapy (CRMC) was performed changing the dose of 5-FU to 666 mg/m2/day during the daytime (0500 to 1700) and to 1333 mg/m2/day from evening to night (1700 to 0500). The patient persevered with the 23 CRMC course without any signs of severe side effects and survived for nearly a year, suggesting the potential effect of CRMC in minimizing toxicity and prolonging survival.

Induction of allergic reactions in guinea pigs with purified house dust mite allergens.

To establish a guinea pig model for house dust mite allergy with purified mite allergens, we studied the immune response to two major mite allergens, native Der f 1 (nDer f 1) and recombinant Der f 2 (rDer f 2) and crude mite extract in Hartley guinea pigs. Animals were immunized with either mite extract, nDer f 1 or rDer f 2, four times at 2- to 3-week intervals. Then the guinea pigs were examined as to the status of sensitization to the sensitizing antigen. Intradermal injection of mite antigens to mite extract-, nDer f 1-, and rDer f 2-sensitized animals induced both immediate and late-phase cutaneous reactions. Allergic airway disease was also provoked by the intranasal instillation of rDer f 2 or mite extract. Anti-nDer f 1 and -rDer f 2 IgE as well as anti-mite extract IgE were produced in the sensitized guinea pigs and IgE titer for three mite antigens were comparable. We concluded that immunization of Hartley guinea pigs with nDer f 1 and rDer f 2 achieved sensitization to mite allergens, which was comparable to that obtained by the immunization with mite extract. A mite-allergic model suitable for immunological and pharmacological studies was established from rDer f 2-sensitized guinea pigs.

Large vestibular aqueduct syndrome treated by hyperbaric oxygen.

We report the case of a 14-year-old girl with a large vestibular aqueduct (LVA) in whom hyperbaric oxygen (HBO) therapy was effective for the treatment of sensorineural hearing loss. The patient was referred to Nagoya University Hospital for the treatment of hearing loss on 14 September, 1998, because her right hearing level had declined abruptly on 22 August, 1998, and had not changed for 3 weeks since then in spite of steroid and prostaglandin therapy. Her audiogram revealed bilateral profound deafness of more than 110 dB. She had had profound hearing loss on the left side since she was 9 years old. HBO therapy was performed on 22 occasions from 17 September until 19 October, 1998. During the HBO therapy, her right hearing ability returned almost to the level determined prior to the abrupt loss, 60 dB. We therefore recommend HBO therapy for the treatment of sensorineural hearing loss associated with large vestibular aqueduct syndrome if the hearing ability does not recover following conventional treatment.

Hyposensitization to allergic reaction in rDer f 2-sensitized mice by the intranasal administration of a mutant of rDer f 2, C8/119S.

C8/119S is a mutant of recombinant Der f 2 (rDer f 2), and lacks a disulphide bond possessed by wild-type rDer f 2. In humans and mice, C8/119S has a very weak IgE-binding capacity compared with the wild-type, but possesses a T cell reactivity comparable to that of the wild-type. C8/119S may thus be a safe immunotherapeutic agent for house dust mite allergy. The aim of the present study was to evaluate whether the intranasal administration of C8/119S could suppress an immediate allergic reaction in mice sensitized with wild-type rDer f 2, possessing an allergic activity comparable to native counterparts purified from mite extract. Seven-week-old male A/J mice were immunized with wild-type rDer f 2 four times, and then intranasally administered 0.2-2 microg of wild-type, 0.2-20 microg of C8/119S, or PBS alone, three times a week for 4 weeks. Seven days after the last administration, the mice were examined for an immediate allergic reaction. The animals administered 2 microg of C8/119S (C2.0 group) showed significantly reduced immediate bronchoconstriction provoked by the i.v. injection of 1 and 10 microg of wild-type rDer f 2, compared with the PBS-treated mice. Similar results were obtained when we examined mice 10 weeks after the last administration. The reactions in the other groups given wild-type or C8/119S also tended to decrease in severity in comparison with the animals of the PBS group. The allergic phenotypes of the T cells, B cells, and basophils in the C2.0 group were shifted to that of naive mice without immunization. We conclude that C8/119S has hyposensitizing activities in mice sensitized with wild-type rDer f 2. C8/119S may be useful for immunotherapy of house dust mite allergy.

Effects of oral hyposensitization with recombinant Der f2 on immediate airway constriction in a murine allergic model.

Recombinant Der f2 (rDer f2) has recently been developed as a promising allergen for the diagnosis and immunotherapy of house-dust mite allergy, and studies in immunology. The aim of the present study was to evaluate whether oral administration of rDer f2 could suppress an immediate allergic reaction in mice sensitized with mite allergen. We developed a murine allergic model that showed bronchoconstriction after inhalation of rDer f2, and studied the effect of oral administration of rDer f2 on the reaction. Seven week old male A/J mice were intranasally immunized with rDer f2 12 times. Sensitized mice showed anti-rDer f2 immunoglobulin (Ig)E production and immediate airway constriction after inhalation of 10 mg.mL(-1) of rDer f2, as determined by the Konzett-Rössler method. Immunized animals were divided into three groups, and fed phosphate-buffered saline (PBS), 0.1 mg.day(-1), or 1 mg.day(-1) of rDer f2 for 4 weeks, respectively. Seven days after the last feeding, the mice were examined for their immediate response. Animals fed with 1 mg.day(-1) rDer f2 showed significantly reduced bronchoconstriction after inhalation of both 2 mg.mL(-1) and 10 mg.mL(-1) of rDer f2 compared with PBS-fed mice. Similar results were obtained when we examined mice 10 weeks after the last feeding. Reactions in the 0.1 mg.day(-1) rDer f2-fed group also tended to decrease in comparison with PBS-fed animals. Plasma anti-rDer f2 IgE, IgG1, IgG2a, and IgG2b levels were not changed by feeding with rDer f2. We conclude that recombinant Der f2 exhibits both sensitizing and hyposensitizing activities in mice. rDer f2 may be useful in immunotherapy and diagnosis of house-dust mite allergy.

Experimental monkey model sensitized with mite antigen.

BACKGROUND: Monkeys are considered to have an immune system very similar to that of humans, as compared with mice, rats, and guinea pigs. Although primate allergic models to several pollen allergens have been developed, no model of house dust mite allergy has been reported. In this study, we attempted to induce type I allergy to mite allergens in rhesus monkeys. METHODS: Six rhesus monkeys were immunized subcutaneously with crude mite extract adsorbed on aluminum hydroxide for 4 months. Then 5 monkeys positive for IgE production to mite extract were further immunized subcutaneously and conjunctivally with recombinant Der f 2 (rDer f 2). The status of sensitization to mite extract and rDer f 2 in monkeys was examined before and after the immunization. Plasma antigen-specific IgE and IgG levels, cutaneous reaction, and histamine release from peripheral blood leukocytes were measured. After conjunctival immunization, immediate conjunctivitis and leukocyte influx into conjunctiva after rDer f 2 challenge were examined. RESULTS: After immunization with crude mite extract, 5 of 6 sensitized monkeys showed IgE response to the mite, and 4 out of 5 rDer f 2-sensitized monkeys exhibited IgE production to rDer f 2. Three monkeys sensitized with rDer f 2 showed immediate conjunctivitis and conjunctival eosinophilia after applying rDer f 2 to their eyes. Sensitized animals also showed IgG response to mite antigens. CONCLUSION: Four rhesus monkeys were positive for IgE production and allergic reactions to both mite extract and rDer f 2. These monkeys could represent a useful model for studying the development and regulation of house dust mite allergy.

[Surgery and multidisciplinary treatment for colorectal cancer].

Evaluation of surgery and multidisciplinary treatment for colorectal cancer was performed based on the review of the results of clinical trials. Although most improvement in prognosis for colorectal cancer patients was obtained by the development of surgical techniques until the mid-70's, further extended surgery could not have demonstrated the obvious improvement in survival after the 80's. In this regard, various multidisciplinary treatments were evaluated by a meta-analysis of clinical trials. Among those modalities, preoperative irradiation for rectal cancer, postoperative adjuvant chemotherapy for resected colorectal cancer and biochemical modulation of 5-fluorouracil by methotrexate or leucovorin for advanced colorectal cancers proved to be significantly effective for improvement of prognosis. Clinical trials of immunochemotherapy using either levamisole or PSK for resected colorectal cancers, a trial of hepatic artery infusion for liver metastasis, and a trial of an adjuvant monoclonal antibody treatment, were also reported to demonstrate significant effects. For further progress in multidisciplinary treatment for colorectal cancers, standardization of the appropriate surgical technique for each stage of the disease is much anticipated.

Comparison of sensitization to crude and purified house dust mite allergens in inbred mice.

To establish a murine model for house dust mite allergy to purified mite allergens, we studied the immune response to two major mite allergens, native Dermatophagoides farinae 1 (nDer f 1) and recombinant Der f 2 (rDer f 2), and crude mite extract in four mouse strains, A/J, BALB/c, C57BL/6, and C3H/He. Mice were immunized with mite extract, nDer f 1 or rDer f 2, three times at 2-week intervals. Then mice were examined to determine status of sensitization to the antigen. Anti-mite extract IgE production was induced in all strains, and plasma IgE concentration did not differ much among the four strains. In contrast, IgE response to nDer f 1 and rDer f 2 indicated an intra-strain difference. The A/J mice had high responses to both antigens, whereas BALB/c did not respond to rDer f 2. The C57BL/6 and C3H/He mice had moderate to low IgE responses to nDer f 1 and rDer f 2. Immediate airway constriction was provoked by inhalation of mite extract or rDer f 2 in sensitized mice, and the degree of the immediate response was almost proportional to antigen-specific IgE concentration. We concluded that immunization of inbred mice with nDer f 1 and rDer f 2 achieved sensitization to mite allergens. Among the four strains, A/J mice with H-2a haplotype were the highest responder to mite allergens.

Thromboxane A2, released by the anti-tumour drug irinotecan, is a novel stimulator of Cl- secretion in isolated rat colon.

1. A camptothecin derivative, irinotecan (Cpt-11), is a topoisomerase I inhibitor and has a strong activity against a broad range of human cancer. One of the side-effects of this drug is diarrhoea. Here, we tried to determine the mediator of the irinotecan-induced Cl- secretion which may underlie this diarrhoea, using isolated mucosae of rat distal colon. 2. Irinotecan increased Cl- secretory current in a concentration-dependent manner across the mucosa, set between Ussing chambers. Thromboxane A2 (TXA2) has not been reported to date as a physiological stimulant of Cl- secretion in the distal colon. However, the major part of the present irinotecan-induced current was inhibited by selective thromboxane A2 receptor antagonists (KW-3635 and ONO-3708), and a selective thromboxane synthase inhibitor (Y-20811). In fact, we found that irinotecan stimulated the release of TXA2 in a concentration-dependent manner from the isolated mucosa into the bathing solutions. 3. Furthermore, 9,11-epithio-11,12-methano-thromboxane A2 (STA2), a stable analogue of TXA2, induced Cl- secretion, which was almost completely inhibited by the TXA2 receptor antagonists. 4. In single cells of isolated crypts, STA2 depolarized the cell and increased the membrane conductance, indicating that STA2 opened the apical Cl- channel of the crypt cells. 5. We conclude, therefore, that the irinotecan-induced endogenous TXA2 is a novel stimulant of the Cl- secretion from the crypt cells of distal colon.

Inhibition of airway inflammation in rDer f 2-sensitized mice by oral administration of recombinant der f 2.

Recombinant Der f 2 (rDer f 2) is a promising new allergen expected to improve the diagnosis and immunotherapy of house dust mite allergy and to further immunological studies. To evaluate the hyposensitizing activity of rDer f 2 to mite allergy, we examined the effect of its oral administration on allergic inflammation in A/J mice immunized with mite allergens. A/J mice immunized with rDer f 2 alone or rDer f 2 + crude mite extract were orally given 0 (control), 0.01, 0.1, or 1 mg/day of rDer f 2 for 4 weeks, followed by an antigen inhalation challenge. Twenty-four hours after rDer f 2 inhalation, control animals experienced severe leukocyte influx into the airway. The infiltrating cells were mainly neutrophils, with some eosinophils and lymphocytes. The concentrations of IL4, IFNgamma, and soluble ICAM-1 in the bronchial alveolar lavage fluid increased twofold compared with values before rDer f 2 inhalation. In contrast, inflammation was significantly suppressed in mice given 1 mg/day of rDer f 2 orally for 4 weeks and partially suppressed in those fed 0.1 mg/day of the antigen. Plasma anti-rDer f 2 antibody levels were unchanged by oral rDer f 2 treatment. Mite extract inhalation challenge provoked neutophilia in rDer f 2 + mite-sensitized control mice, and this allergic reaction tended to decrease in sensitized mice fed 1 mg/day of rDer f 2 orally for 4 weeks. We conclude that rDer f 2 has hyposensitizing activities and may be useful in immunotherapy for house dust mite allergy.

Engineering of the major house dust mite allergen Der f 2 for allergen-specific immunotherapy.

A major problem with allergen-specific immunotherapy involving repeated injection of allergens is the risk of an anaphylactic reaction. We engineered the major house dust mite allergen, Der f 2, to reduce its capacity to induce skin test reactivity and histamine release from peripheral blood basophils in allergic patients. The engineered allergen, in which the disulfide bond that linked the N- and C-terminal sequences of Der f 2 was disrupted, retained T-cell epitopes essential for immunotherapy and ability to stimulate T-cell proliferation. Such engineered allergens are potentially useful for safer and more effective immunotherapy for allergies.

Immunohistochemical analysis of the poorly differentiated stomach adenocarcinoma with medullary growth pattern.

Poorly differentiated gastric adenocarcinoma with medullary features (poor medullary) is distinguished by a propensity for hepatic metastasis. To classify it antigenically, we compared it to poorly differentiated adenocarcinoma with scirrhous growth pattern (poor scirrhous), well and moderately differentiated adenocarcinoma (differentiated adenocarcinoma), and normal gastric mucosa (foveolar and deep epithelium) using immunohistochemistry with antibodies against CEA, AFP, NSE, and Lewis-type antigens. Lewis(a) antigen was significantly associated with differentiated adenocarcinoma and foveolar epithelium, although Lewis(x) antigen was significantly expressed in poor medullary, poor scirrhous, and deep gland epithelium. From the viewpoint of expression of Lewis(a), there was no significant differentiation between poor medullary and differentiated adenocarcinoma, but it was definite between poor scirrhous and differentiated adenocarcinoma. Therefore, we conclude that in antigenic expression, poor medullary carcinoma is allied with differentiated adenocarcinoma rather than poorly differentiated scirrhous carcinoma.

MIB-1 immunostaining and DNA flow cytometry in meningiomas.

The correlation between S- and G2/M-phase fractions and MIB-1 index in meningiomas was investigated. Flow cytometric analyses were performed on cell suspensions from 81 samples of paraffin-embedded tissue from 29 patients with a total of 28 meningiomas and 1 hemangiopericytoma using the modified Hedley's method. Sections from the paraffin-embedded tissues were stained with anti-MIB-1 monoclonal antibody after microwave oven processing. Five hundreds cells were scored. Correlations between data were estimated using linear regression. DNA aneuploidy was present in 4/29 tumors. Mean S- and G2/M-phase fractions in the 25 nonrecurrent tumors were 1.77 and 4.76%, and in the recurrent tumors were 2.41 and 5.81%, respectively. The proliferative index (PI = S + G2/M fraction) was 6.52% in the nonrecurrent tumors and 8.29% in the recurrent tumors. The mean MIB-1 score in the nonrecurrent tumors was 1.25% and in the recurrent tumors was 2.69%. There was a linear correlation between percentage of S-phase fraction or PI and the MIB-1 score. Both methods are useful to assess the proliferative activity in meningioma.