A novel rat model of incisional surgical site infection model developed using absorbable multifilament thread inoculated with Escherichia coli.

The development of an effective rat model of incisional surgical site infection (SSI) has so far proven difficult. In this study, we created a novel incisional SSI model and validated it in terms of both macroscopic and microscopic aspects including its response to treatment using antimicrobial wound-dressing, Aquacel Ag(®). Wounds were created on the dorsum of rats. 3-0 Vicryl(®) threads inoculated with Escherichia coli were inserted in the wound beds in the infection group (n = 6). The wounds were closed for two days to induce infection and then opened and covered with polypropylene sheets during the study. Aquacel Ag was placed under the polypropylene sheet in the infected wounds of the Aquacel Ag group rats (n = 6). The wounds in the control group (n = 6) contained sterile Vicryl thread that had not been inoculated with E. coli. The macroscopic appearance, wound area, bacterial counts, and histology of each group were evaluated. The infection group demonstrated significantly lower wound healing (p < 0.001), greater bacterial counts (median [interquartile range] ratings, 2.15 × 10(7) [0.51 × 10(7)-53.40 × 10(7)] vs 2.07 × 10(4) [0.60 × 10(4)-4.45 × 10(4)] CFU/g, respectively; p < 0.01), and severer histological inflammation (p < 0.001) than the control group. The Aquacel Ag group was only able to show significantly better wound healing than the infection group (p < 0.001). The new incisional SSI model exhibited all clinical manifestations of incisional SSI. It could be utilized to assess the effectiveness of newly developed treatments for incisional SSI.

Interaction between resting pulmonary ventilation function and cardiac autonomic function assessed by heart rate variability in young adults.

An association between ambient air pollution and reduced cardiac autonomic function assessed by heart rate variability (HRV) mainly in elderly persons has been suggested by a number of epidemiological studies, but the link between the HRV and pulmonary function in humans remains unknown although such air pollution should primarily affect pulmonary function. To clarify this link, pulmonary ventilation parameters such as oxygen uptake (V(O(2))) and carbon dioxide output (V(CO(2))), as well as the HRV with spectral analysis (high- and low-frequency components of HRV, i.e., CCV(HF) and CCV(LF), reflecting cardiac parasympathetic and sympathetic activities, respectively), were measured in 66 healthy women aged 19-20 years after an overnight fast of 12 h. Significant correlations were found between the CCV(HF) of HRV and both the end-tidal carbon dioxide concentration (FET(CO(2))) and gas exchange ratio (V(CO(2))/V(O(2))) in the subjects (partial correlation coefficients r = 0.354 and 0.320, respectively), whereas there was no significant connection between the FET(CO(2)) and the V(CO(2))/V(O(2)). Similarly, the CCV(LF) correlated significantly with the resting tidal volume of lung (r = 0.364). These findings suggest that resting pulmonary ventilation function interacts with cardiac autonomic function assessed by the HRV, at least in healthy young adults, which may be useful for explaining the pathophysiology concerning the short-term effect of air pollution such as fine particulate matter on cardiovascular function.

A case of infantile Alexander disease diagnosed by magnetic resonance imaging and genetic analysis.

We encountered a male infant with infantile Alexander disease presenting with megalencephaly and hydrocephalus as a neonate and subtle seizures at 3 months of age. At 6 months of age, bulbar paralysis appeared. Brain magnetic resonance imaging (MRI) showed abnormal findings with white matter involvement and a characteristic periventricular rim, satisfying the diagnostic criteria proposed by van der Knaap, except for MRI contrast. R239H mutation of glial fibrillary acidic protein gene was identified, representing a common cause of infantile-type Alexander disease.

Total mercury levels in hair, toenail, and urine among women free from occupational exposure and their relations to renal tubular function.

To investigate the relations among total mercury levels in hair, toenail, and urine, together with potential effects of methylmercury intake on renal tubular function, we determined their levels, and urinary N-acetyl-beta-D-glucosaminidase activity (NAG) and alpha1-microglobulin (AMG) in 59 women free from occupational exposures, and estimated daily mercury intakes from fish and other seafood using a food frequency questionnaire. Mercury levels (mean+/-SD) in the women were 1.51+/-0.91 microg/g in hair, 0.59+/-0.32 microg/g in toenail, and 0.86+/-0.66 microg/g creatinine in urine; and, there were positive correlations among them (P<0.001). The daily mercury intake of 9.15+/-7.84 microg/day was significantly correlated with total mercury levels in hair, toenail, and urine (r=0.551, 0.537, and 0.604, P<0.001). Among the women, the NAG and AMG were positively correlated with both the daily mercury intake and mercury levels in hair, toenail, and urine (P<0.01); and, these relations were almost similar when using multiple regression analysis to adjust for possible confounders such as urinary cadmium (0.47+/-0.28 microg/g creatinine) and smoking status. In conclusion, mercury resulting from fish consumption can explain total mercury levels in hair, toenail, and urine to some degree (about 30%), partly through the degradation into the inorganic form, and it may confound the renal tubular effect of other nephrotoxic agents. Also, the following equation may be applicable to the population neither with dental amalgam fillings nor with occupational exposures: [hair mercury (microg/g)]=2.44x[toenail mercury (microg/g)].

Effects of hair treatment on hair mercury-The best biomarker of methylmercury exposure?

OBJECTIVES: Exposure misclassification is a major obstacle to obtain accurate dose-response relationships. In order to solve this problem, the impact of hair treatment on total mercury in hair was assessed in Japanese women. METHODS: A cross-sectional study was carried out among 327 women at age 24-49 years to determine hair mercury levels and estimate daily mercury intakes from seafood by using a food frequency questionnaire. RESULTS: Hair mercury levels in the women and daily mercury intake ranged from 0.11 to 6.86 (median 1.63) µg/g and from 0.77 to 144.9 (median 15.0) µg/day, respectively. The hair mercury was positively correlated with the daily mercury intake (p<0.001). When the women were divided into two subgroups based on artificial hair-waving, hair coloring/dyeing, residence (non-fishing and fishing areas), and working status, a significant difference in the hair mercury level was observed between the women with and without artificial hair-waving only (p<0.001). The multiple regression analysis showed that the log-transformed hair mercury level was significantly related to the log-transformed daily mercury intake (standardized regression coefficient ßs=0.307) and artificial hair-waving (ßs=-0.276); but not to hair coloring/dyeing, residence, working status or age. Permanent hair treatment was estimated to reduce total mercury in hair by approximately 30%, after adjusting for daily mercury intake and other possible factors. CONCLUSIONS: These findings suggest that hair mercury is not the best biomarker of methylmercury exposure when a study population includes women with artificial hair-waving.

Effects of methylmercury on neurodevelopment in Japanese children in relation to the Madeiran study.

OBJECTIVES: A cross-sectional study was carried out to assess the effects of methylmercury exposure on neurodevelopment in Japanese children, in relation to the Madeiran cross-sectional study, and to estimate benchmark dose (BMD) levels using the data of two studies. METHODS: Mercury levels in hair samples obtained from 327 Japanese mothers and their 7-year-old children, and methylmercury levels in the umbilical cord, were determined. Neurodevelopmental examinations, including the brainstem auditory evoked potential (BAEP), were performed on the children. RESULTS: The medians of hair mercury were 1.63 (0.11-6.86) mug/g for mothers and 1.65 (0.35-6.32) mug/g for children, and a significant correlation was seen between the hair mercury levels in mothers and children. The maternal hair mercury was significantly correlated with the methylmercury in the umbilical cords obtained from 49 children. In 210 children whose mothers had not changed their dietary habits since pregnancy, most of the neurodevelopmental variables were not significantly related to hair mercury levels. The BAEP latencies were significantly shorter in the Japanese children than in the 113 Madeiran 7-year-old children, whose mothers had hair mercury of 1.12-54.5 (median 10.9) mug/g. Significant relationships between the maternal hair mercury level and BAEP latencies (peaks III and V, and interpeak I-III) were found only in the merged data of Japanese and Madeiran children. When the lower 95% confidence limit of BMD (BMDL) was calculated, the BMDLs of mercury exposure for BAEP latencies in the merged data were between 6.9 and 10.5 mug/g, and lower than those in the Madeiran children. CONCLUSIONS: It is suggested that Japanese children may ingest similar doses per body weight of methylmercury to their mothers. If maternal hair mercury was used as a proxy for mercury exposure at birth, no significant dose-effect associations with the BAEP latencies were observed in Japanese children with exposure levels below 6.9 mug/g of hair mercury, but only when higher-level exposures from Madeiran children were included. The BMDL was lower for the merged data than for Madeiran children alone.

Ideal body shape in young Japanese women and assessment of excessive leanness based on allometry.

The present study is aimed to clarify the degree of leanness desired by contemporary young Japanese women using questionnaires and to use allometry to define the body weight boundary between the excessively lean and the others for a given height. Questionnaires on ideal body shape were distributed to female college students living in Akita and the suburbs of Tokyo. Data for 578 respondents, aged 18 to 21 years-old, were analyzed. The questionnaire asked the subjects to report their current and ideal body shape and to make a qualitative self-assessment of their weight. On average, the perceived ideal weight was 5.2 kg lower than the current weight. The results also revealed that young women have a tendency to misunderstand their body shape and to regard themselves as heavier than they really were. Meanwhile, we defined leanness as a state of insufficient lean body mass (LBM, kg) in relation to height (Ht, cm). Allometric equation of LBM on Ht and the standard error of estimate (SEE) were calculated as LBM=3.87 x 10(-3) x Ht(1.826) and 1.09, respectively. The LBM boundary between the excessively lean and the others was determined using these values according to a statistical procedure comparing normal and abnormal values. The corresponding total body weight was estimated from the boundary LBM in the literature. Subsequently the body weight boundary for each height was tabulated in order to make young women reconsider weight control. The subjects were asked to assess the body weight boundary for their own height. The boundary values were found to be consistent with the sense of the subjects.

Use of skin staples to fix film dressings on scalp donor wounds in patients with burns.

Split-thickness skin grafts (STSGs) from the scalp have been used in large burns. The donor site wounds are usually covered using occlusive dressings, such as film dressings because they contribute to reduce donor site pain and infection under exudative crust and to enhance re-epithelialization. However, it is not always easy to fix such film dressings to the scalp because of the presence of hair. In this paper, we report the use of skin staplers to fix the film dressings. Eight donor sites in four patients were dressed in this way. The patients had 50-78% of the body burned, all of them survived. The mean healing time for the donor sites was 6.8 days. Three patients had their scalps re-harvested several times (range two to three times). There were no infections nor secondary skin ulcers at the donor sites. The technique of this dressing is very simple and speedy, thus we recommend the use of skin staplers to fix the film dressing to scalp donor wounds in patients with burns.