Psycho-physiological effects of the terrorist sarin attack on the Tokyo subway system.

The investigation describes the follow-up of the victims of the 1995 Tokyo sarin attack who were followed by a team at the St. Luke's International Hospital. A symptom questionnaire ("St. Luke's Questionnaire") was developed and given 2, 3, and 5 years following the sarin attack. Somatic and psychological symptoms have continued for 5 years after the incident. New post-traumatic stress disorder diagnostic criteria, which include physical symptoms, were developed and applied for assessment of the outcomes. The St. Luke's cohort was also compared with other Japanese sarin attack cohorts. Interventions, including counseling, medical treatments, and support group activities, were associated with fewer symptoms among the victims.

[Treatment of four cases of B-cell lymphoma].

Four cases of B cell lymphoma, seen at the Department of Dermatology, Miyazaki Medical College, for the previous approximately 10 years, were reviewed. Case 1 was characterized by a localized tumours lesion on the head; the histologic picture was of the follicular, medium sized cell type. Complete remission for 8 years has been obtained after electron beam therapy and surgical removal of the tumor. Cases 2 and 3 had a histologic picture of diffuse, large cell type and were assumed to have a bad prognosis with standard chemotherapy. In addition to conventional chemotherapy, they were placed on noncross-resistant alternating combination chemotherapy with medium dosages of MTX, VP-16, VDS, PCZ MXT, PEP and ACR, so as not to develop cross resistance. Case 2 has been in complete remission for 11 months and case 3 for 7 months. Case 4 was a nodal lymphoma with skin lesions. This patient was treated mainly by local radiation therapy, but later died with leukemic changes and renal failure. Cutaneous B cell lymphoma should be treated vigorously and carefully, since it has a poorer prognosis than that of lymphoma of lymph node origin.

[T-cell lymphomas of the skin: a study of 7 cases excluding mycosis fungoides and adult T-cell leukemia/lymphoma].

Seven cases of T-cell lymphomas of the skin, excluding mycosis fungoides and adult T-cell leukemia/lymphoma, treated at the Department of Dermatology, Miyazaki Medical College for the previous 5 years were studied. Five were males and 2 were females, with a mean age of 61 years. Six patients presented either multiple skin tumors or subcutaneous indurations. Histologically, all cases presented dense infiltrations of the tumor cells showing variable morphological characteristics. Surface markers were also variable, suggesting that these were not a single entity. Treatment consisted of chemotherapy in 5 cases and electron beam therapy in 5 (localized in 4 and generalized in 1). Complete remission was obtained in 5 cases. The mean period from the first examination to death in the three fatal cases was 11.7 months, and the mean period of observation from the first examination to the present time in 4 cases ranged from 12 months to 40 months. Clinicopathological characteristics of these cases were compared with those of adult T-cell leukemia/lymphoma.

Cellular blue nevus of the scalp associated with intracranial involvement.

The authors report a rare case of cellular blue nevus located in the right frontotemporoparietal area of the scalp with local extension to the central nervous system. The diagnostic value of computed tomography is discussed.

Outer membrane permeation of beta-lactam antibiotics in Escherichia coli, Proteus mirabilis, and Enterobacter cloacae.

Mutant strains lacking outer membrane protein(s) were isolated from Escherichia coli, Proteus mirabilis, and Enterobacter cloacae. The outer membrane protein(s) of P. mirabilis and E. cloacae corresponding to E. coli porin were identified on the basis of their function, namely, their ability to allow the permeation of glucose as demonstrated by [14C]glucose uptake by intact cells. P. mirabilis has only one outer membrane pore protein (molecular weight, 40,000), but E. cloacae has at least two such proteins (molecular weights, 37,000 and 39,000 to 40,000). When the bacteria lost these proteins or porin, the outer membrane permeation of cefazolin was found to be greatly reduced in these three species. Such a change in the outer membrane permeation closely correlated with a significant decrease in the bacterial susceptibility to cephalosporins, including cefoxitin. These results suggested that the main pathway for cephalosporin permeation is the pore made up of these proteins. The 39,000- to 40,000-molecular-weight protein in E. cloacae was also assumed to play an important role in the outer membrane permeation of tetracycline and chloramphenicol. On the other hand, the permeation route of penicillins was obscure. The susceptibility to penicillins, except in some cases, was little influenced by the absence of the proteins. Ampicillin was found to pass through the outer membrane via the same route as the cephalosporins, but the possibility that ampicillin and other penicillins possess another unknown route for outer membrane permeation could not be ruled out.