[Enteral nutrition for gastrointestinal disease in home care].

We report 5 patients given enteral feeding in order to continue its nutritional supportive care of our hospital. In patients 1, 2, and 3 who were malnourished, enteral nutrition was provided due to poor oral intakes after surgical treatment. In patients 4 and 5, enteral feedings were made via the proximal jejunum in order to bypass the duodenum, for nutrients in the duodenum enhanced their biliary infection or chronic pancreatitis, respectively. All patients' nutritional status was satisfactory, but two of five patients could not be discharged from the hospital. The reason was that the patients and their families wanted to continue the hospital care in spite of the improvement in the clinical problem. They had no help at home to care for the patient. We conclude that enteral nutrition is very useful for gastrointestinal disease, but that social problems affect home care with enteral nutrition.

Clinical and chronobiological effects of light therapy on nonseasonal affective disorders.

Light therapy (bright or dim light) was given at different times (morning or evening) to 27 unmedicated patients with nonseasonal depression (according to DSM-III-R criteria) and 16 normal volunteers. Circadian rhythms in body temperature were measured before and after light therapy. Bright light significantly improved clinical symptoms of depression, as measured by the Hamilton Rating Scale for Depression (HRSD), independent of the time of phototherapy. Dim light therapy had no effect on HRSD scores. Circadian rhythms of body temperatures in patients with affective disorder were more sensitive to the entraining effects of bright light than those of normal subjects, but these effects were not related to clinical improvement. Bright light exposure has an antidepressant effect on patients with nonseasonal depression, but the effect is unlikely to be mediated via the same circadian system that regulates body temperature.

Cloning and expression of a thermostable exo-alpha-1,4-glucosidase gene from Bacillus stearothermophilus ATCC12016 in Escherichia coli.

The gene coding for a thermostable exo-alpha-1,4-glucosidase (alpha-glucoside glucohydrolase: EC 3.2.1.20) of Bacillus stearothermophilus ATCC 12016 was cloned within a 2.8-kb AvaI fragment of DNA using the plasmid pUC19 as a vector and Escherichia coli JM109 as a host. E. coli with the hybrid plasmid accumulated exo-alpha-1,4-glucosidase mainly in the cytoplasm. The level of enzyme production was about sevenfold higher than that observed for B. stearothermophilus. The cloned enzyme coincided absolutely with the B. stearothermophilus enzyme in its relative molecular mass (62,000), isoelectric point (5.0), amino-terminal sequence of 15 residues (Met-Lys-Lys-Thr-Trp-Trp-Lys-Glu-Gly-Val-Ala-Tyr-Gln-Ile-Tyr-), the temperature dependency of its activity and stability, and its antigenic determinants.

Circadian rhythm abnormalities of deep body temperature in depressive disorders.

We investigated circadian rhythms of body temperature in 62 inpatients with major depressive episodes, by monitoring the deep body temperature through the abdominal skin every two hours for a consecutive 48-h period. The data were analyzed by both the least-squares method and the maximum entropy spectral analysis (MEM) and were compared with those in 29 normal volunteers who apparently had a regular 24-h sleep-wake schedule. Circadian rhythm phase disturbances in the depressed patients were likely to be manifested in a phase normal or a phase delay pattern rather than in a phase advance pattern. The amplitude of body temperature was significantly smaller and the mesor was higher in the depressed patients than in the normal subjects. Analysis by MEM revealed that the periods of circadian rhythm of body temperature tended to be longer in the depressed patients than in the normal subjects, though there was no significant difference. The power spectral density by MEM was significantly lower, and there were significantly more ultradian rhythm components in the depressed patients than in the normal subjects. These findings suggest that the fundamental rhythm disturbance in depression may be a weakening of the coupling processes between internal pacemakers and an abnormal sensitivity to environmental information.