Risk factors for dysbaric osteonecrosis.

OBJECTIVES: Dysbaric osteonecrosis (DON) is a complication of ineffective decompression following exposure to high-pressure environments. This study was designed to determine risk factors for the occurrence of DON in divers. METHODS: Fifty-six male divers received skeletal examinations by radiography to assess the occurrence of DON. A questionnaire was used to obtain clinical and diving information, including diving experience and maximum diving depth. Blood samples were collected to analyse the levels of plasminogen activator inhibitor (PAI)-1, cholesterol, triglyceride, low-density lipoprotein, very low-density lipoprotein, high-density lipoprotein, apolipoprotein A1 and apolipoprotein B. RESULTS: Lesions of DON were detected in 31 of the 56 (55%) divers. Multivariate logistic regression analysis showed that high levels of PAI-1, a coagulation marker (odds ratio 4.281; P=0.0296) and great maximum diving depth (odds ratio 5.627; P=0.0231) were independent predictors of DON. CONCLUSIONS: This study has shown the presence of coagulation abnormality in divers with DON. This result suggests that a pharmacological approach incorporating the use of an anticoagulant may represent a potential strategy for the prevention of DON.

Human T-cell leukemia virus type I tax transactivates the interleukin-6 gene in human rheumatoid synovial cells.

OBJECTIVE: To determine the effect of the human T cell leukemia virus type I (HTLV-I) tax gene on interleukin-6 (IL-6) production and gene transcription in synovial cells, we established the synovial cell line, E-11, from a patient with rheumatoid arthritis. METHODS: E-11 cells were transfected with tax expression vector using the calcium phosphate coprecipitation method. IL-6 production and gene expression were investigated by ELISA and Northern blot analysis, respectively. To clarify how tax induces IL-6 gene expression, we used deletion analysis and chloramphenicol acetyltransferase (CAT) assay, and electrophoretic mobility shift assay (EMSA). RESULTS: Transfection of the tax gene induced markedly high levels of IL-6 mRNA. Furthermore, the tax gene strongly transactivated IL-6 gene promoter activity assayed by CAT assay. By using deletion and site specific mutations, we have identified a nuclear factor (NF)-kappa B sequence (positions -73 to -63) which is essential for tax transaction. EMSA demonstrated the induction of specific binding of nuclear extracts to the NF-kappa B sequence by HTLV-I tax. CONCLUSION: The HTLV-1 tax gene may transactivate IL-6 gene in the synovial cells through NF-kappa B and may contribute in the pathophysiology of HTLV-I associated arthritis.

Isolation and characterization of alginate-derived oligosaccharides with root growth-promoting activities.

Lytic digestion of poly(mannuronate), poly(guluronate), and alginate with an alginate lyase from Alteromonas macleodii was used to prepare mixtures of unsaturated oligosaccharides. Four oligosaccharides isolated from the alginate lyase-lysate by anion-exchange chromatography on Q-Sepharose were found to be the major components of the root growth-promoting lysate. The oligosaccharides were analyzed by NMR and SIMS and identified as di- and tri-saccharides having O-(4-deoxy-L-erythro-hex-4-enopyranosyluronic acid)-1--> at the nonreducing terminus. The trisaccharides from the lysate were found to have root growth-promoting activity in a barley bioassay.

[Effect of 1 alpha-OH-D3 on the bone metabolism after high tibial osteotomy].

The effect of 1-hydroxycholecalciferol (1 alpha-OH-D3) on bone metabolism during osteotomized bone healing was investigated. The study based on 19 female patients with gonarthrosis who underwent the high tibial osteotomy. In 10 selected randomly from these patients 1 alpha-OH-D3 (1.0 micrograms/day) was administered before and after the surgery. After operation the changes in bone density (by MD-method) and biochemical parameters were followed. In the non-treated group the serum level of [Ca] x [P] product temporarily decreased at 3 days after surgery. Average bone density at two months after the surgery was 8.8% lower than the preoperative value. In contrast, 1 alpha-OH-D3 treated group showed significantly less decrease of serum [Ca] x [P] product at the third day than the control group and no significant decrease of bone density at two months after the operation. From these results, it was concluded that the 1 alpha-OH-D3 suppresses the decrease of serum Ca and P level and systemic osteopenia after osteotomy and may have an beneficial effect on fracture healing.

Dental fear of Japanese residents in the United States.

The purpose of this study was to investigate dental fear in a sample of Japanese adults and to make preliminary comparisons with a previously described US sample. The survey instrument was translated into Japanese and then translated back into English and was sent to 839 Japanese residing in the Seattle area. A total of 419 (49.9%) usable questionnaires were returned. Results indicate a level of fear higher than the US population (only 17.9% were not at all afraid). Fear level did not vary by age; most respondents (73.3%) acquired their fear in early childhood. While reported utilization was lower than the American sample, the percentage of Japanese respondents who reported being hurt at the last appointment was high (68.0%). Japanese respondents indicated that 35% of dentists appeared to be in a hurry, hurry being associated with being hurt. Japanese coping practices appeared to differ from the American sample. For example, 14.7% of the Japanese whereas 28.2% of the US sample requested the dentist to stop treatment.

Conformational change accompanying formation of oligomycin-induced Na(+)-bound forms and their conversion to ADP-sensitive phosphoenzymes in Na+,K(+)-ATPase.

Oligomycin reduced the fluorescence intensity of an N-(p-(2-benzimidazoly)phenyl) maleimide (BIPM) probe at Cys-964 of the alpha-chain of pig kidney Na+,K(+)-ATPase with increase in the concentration of Na+ with a Hill coefficient of nh = 0.77 with Kh = 231 mM. The maximum fluorescence decrease was around 80% of the value observed after accumulation of ADP-sensitive phosphoenzyme (E1P) in the presence of 2 M Na+. The addition of Mg2+ and ATP with Na+ or choline chloride to give the same final ligand concentration to the Na(+)-enzyme-oligomycin complex formed with 16 mM Na+ + 1,984 mM choline chloride or 2 M Na+ induced rapid phosphorylation (20 or 21/s) and slower fluorescence decrease (12.1 +/- 1.2 or 10.1 +/- 3.2/s). These additions to the Na(+)-enzyme complex formed under the former or the latter conditions induced slow phosphorylation (13/s) prior to a much slower fluorescence decrease (3.4 +/- 0.3 or 8.6 +/- 0.7/s). The addition of Ca2+ and ATP to these enzyme complexes induced rapid fluorescence changes (21-11/s) followed by one order of magnitude slower rates of phosphorylation (1.5-1.3 s). These data suggest that the decrease in BIPM fluorescence induced by ATP with Ca2+ or with Mg2+, reflects the change of the Na+ binding state before or after the formation of E1P, respectively.

Historical trends in status attainment.

Inquiry into the question of historical trends in status attainment will, in this article, involve the comparison of different age groups and different age groups across time. Mindful of limitations in interpreting differences between age groups as historical trends, this study provides such an analysis. Data for this study are from the NORC General Social Survey (July 1988, University of Chicago) and cover the time period from 1973 to 1988. The data offers an opportunity to both examine certain features of historical change as well as to ascertain its stability.

Microenvironment of two different extrinsic fluorescence probes in Na+,K+-ATPase changes out of phase during sequential appearance of reaction intermediates.

Na+,K+-ATPase from pig kidney was sequentially modified with N-[p-(2-benzimidazolyl)phenyl]maleimide (BIPM) at Cys-964 and fluorescein isothiocyanate (FITC) at Lys-501. The resulting preparation showed little Na+,K+-ATPase activity with retention of nearly 90% of phosphorylation capacity from acetyl phosphate. The addition of acetyl phosphate to the preparation induced phosphoenzyme formation with a sequential decrease in the fluorescence intensities in the presence of 2 M NaCl and 4 mM MgCl2; the BIPM fluorescence decreased with a simultaneous increase in the amount of phosphoenzyme; there was a significant delay in a decrease in the FITC fluorescence. The extent of the decrease in the BIPM fluorescence and the increase in the amount of phosphoenzyme both showed monophasic kinetics with a similar dependence on the concentration of acetyl phosphate (K0.5 = 4 mM), while that of FITC fluorescence showed a biphasic decrease (K 0.5 greater than 10 mM). The phosphoenzyme formed was insensitive to ADP but sensitive to acetate (K0.5 = 2 M). These data and those of others (Taniguchi, K., Suzuki, K., Kai, D., Matsuoka, I., Tomita, K., and Iida, S. (1984) J. Biol. Chem. 259, 15228-15233) showed that the extent of the decrease in the BIPM fluorescence reflects an increase in the amount of a precursor of E1P and E1P, irrespective of the FITC treatment. They also suggest the presence of at least two conformationally different E1Ps; one gave little and the other gave a large FITC fluorescence decrease.

A note on elderly living arrangements in Japan and the United States.

PIP: Kamo compares the living arrangements of the elderly in Japan to those in the US. Japan is known to have had extended families throughout its history. Before the industrial revolution, the prevalent family system in Japan was the stem family in which a married couple lived with their unmarried children, the eldest son, his wife, and their grandchildren. 3 surveys in the 1980s now show that roughly 50% of people aged 60 or older lived with their married children, about 20% lived with their unmarried children, another 20% lived with their spouses only, and 10% lived alone. In the US before the turn of this century, the nuclear family dominated. Only 1/6 of the American elderly lived with their adult children. However, extended family systems were once more prevalent in the US than they are today. In 1952, 1/3 of the aged lived with their children, 1/4 by 1957, and 1/5 by the mid-1960s. The dominant view of current social science seems to be that industrialization is the driving force behind change in family systems; industrialization requires geographical mobility and weakens the kin network. It lets public and voluntary systems instead of kin groups solve problems. Recent changes in Japan's family structure suggest that the effects of industrialization are so strong in Japan that the status of the elderly is steadily being undermined in favor of nuclear families. Care for older people is becoming an urgent problem, as it has become in the US and in most other industrialized countries.^ieng

Determinants of household division of labor: resources, power, and ideology.

PIP: Kamo examines factors that are correlated with amount of a husband's participation in domestic work. Data are from the American Couples Survey conducted in 1978 (n=3649). Subjects were asked to rate on a 9-point scale who did each of 15 domestic work items more often. Tasks were weighted various amounts and regression analyses and subanalyses were conducted. It was hypothesized that both spouses' earnings, work status, sex-role orientations, their power relationship, and the interaction between power and sex-role orientations were related to the husband's relative share in domestic work. Some study findings follow. 1) On the average, husbands carry 36% of the total domestic work load, or about 1/2 the domestic work load carried by their wives. 2) For couples in which both spouses work full time outside the home, the husband's input averages 41%; this increases to 43% when both earn approximately the same amount of money. 3) Neither an equal nor equitable relationship seems to exist between the 2 partners of most married couples. 4) Findings indicate that those who do not hold a full-time job will do relatively more domestic work than those employed on a full-time basis. 5) The more decisions the husband makes in a marital relationship, the more domestic work he does. 6) Both partners' sex-role orientations are associated with how much domestic work they do relative to each other; however, it is suggested that the husband's attitude toward the sexual division of labor has a stronger relationship than his wife's. 7) The wife's education has no direct relationship with the task-sharing pattern of the couple.^ieng

[Geometric total knee arthroplasty--follow-up for an average of six years].

Geometric total knee prosthesis was applied for reconstruction of 70 destructive knee joints in 56 patients from November 1973 through March 1979. The average follow-up period extended to six years and seven months. Eleven patients had died and four could not be located. Eighty-one percent of the remaining arthroplasties disclosed little or no pain at the time of the review. Pain in the patellofemoral joints was an insignificant problem in this series. The absence of radiolucent zone at the tibial cement-bone interface was noted in only 20.4% of the roentgenograms. New formation or progression of radiolucent zone after six months was found in 36.7%. Displacement of the marker wires seen in serial roentgenograms existed in 51.0% of the knees. The tibial component was fractured in one patient.

A new instrument for closed irrigation-suction treatment.

Orthopedic surgeons are often faced with the surgical complication of fulminating deep wound infection and bone and joint infection after complicated fractures. Two hundred and seventy patients were treated for bone and joint infection by closed irrigation-suction from 1970 to 1982. Obstruction of the drainage tube, solution leakage, and post-operative bleeding were the knotty problems. Our new instrument for irrigation-suction treatment resolved these problems. The instruments consists of a suction pump, a channel changer, and a double tube system.

The treatment of pyogenic bone and joint infections by closed irrigation-suction.

An improved method of closed irrigation-suction treatment of bone and joint infections is described. The method utilizes a crisscross flow-reversal system using a double tube which prevents obstruction of the tube. A series of 154 patients with acute and chronic bone and joint infections were treated with closed irrigation in 172 closed irrigation-suction procedures. One hundred forty-eight cases (86.0%) were treated successfully, 7 cases (4.1%) were improved, and 17 cases (9.9%) were failures. Blood concentration levels of antibiotics were examined during closed irrigation. Absorption of antibiotics from the wound was insignificant. Culture and sentivity tests of drainage during closed irrigation are used to monitor the cleansing of the wound. Serum hepatitis was seen in 4 cases within the hematogenous group and in 6 cases within the traumatic group. Postoperative bleeding during irrigation was an important complication.

Necrotizing myopathy as a remote effect of gastric cancer accompanied with Hashimoto's thyroiditis.

An autopsy case of a 74-year-old male who had shown clinically hypothyroidism due to chronic atrophic thyroiditis (Hashimoto's thyroiditis), and pathologically necrotizing myopathy as a remote effect of gastric cancer was reported. Morphological features of this necrotizing myopathy was those of carcinomatous myopathy rather than those of hypothyroid or diabetic myopathy. As for the pathogenesis of the necrotizing myopathy (as a Group IV of polymyositis of Walton and Adams), the malignancy might have played an important role as a trigger of the secondary immunological abnormality upon a pre-existing longstranding immune disorder of Hashimoto's thyroiditis. Pseudomembranous colitis, which was thought to be related to antibiotics. (Lincomycin), was also briefly discussed.