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Glial cells are non-neuronal cells that make up the central nervous system, including astrocytes, oligodendrocytes, microglia, and ependymal cells, which play an important role in brain homeostasis. However, activated microglia and reactive astrocytes cause neuroinflammation, which is closely related to neurodegeneration. Neuronal loss, gliosis, and accumulation of misfolded proteins are commonly observed in the brain of many neurodegenerative diseases at autopsy. Therefore, in vivo imaging of glial cell responses by positron emission tomography (PET) would be useful not only for understanding pathological processes, but also for differential diagnosis and evaluation of disease-modifying therapeutics targeting glial cells. The gold standard marker for reactive astrocytes is glial fibrillary acidic protein (GFAP), but no specific ligands are available. To date, there are two targets of reactive astrocytes that are under intense investigation: Monoamine oxidase-B (MAO-B) and imidazoline 2 binding site (I 2 BS). PET radiopharmaceuticals for MAO-B and I 2 BS have been developed and are under clinical investigation. In this chapter, we review the MAO-B and I 2 BS as molecular targets for imaging reactive astrocytes and introduce the PET tracers and their clinical studies.

The role-play for pharmacological education has been developed by Yanagita et al. since 2010 and incorporated into the curriculum of more than 20 medical or pharmaceutical universities in Japan. This case and communication based active learning course provides the practice to acqire fundamental competences for drug therapy, through role playing of medical professionals and patients in simulated clinical settings. The online pharmacological role-play for the first time was performed at Tohoku Medical and Pharmaceutical University Faculty of Medicine during the state of emergency in Japan. We found that the online role-play was as useful as face-to-face role-plays to train appropriate drug prescriptions and communication skills in medical students. In this review, we described the course design, preparation, and operation of online role-play for pharmacological education. We also explained the differences, advantages, and disadvantages between online and face-to-face setting. Finally, we gave examples on-going challenges to the effective use of the online role-play as a core curricular model of pharmacological and pharmacotherapeutic education.

Background: Hyperventilation is a well-known risk factor of ischemic events in pediatric patients with moyamoya disease. For young children, it is important to avoid crying to prevent ischemic events because of their unstable postoperative hemodynamics. To prevent crying in pediatric patients, we used dexmedetomidine(DEX)for sedation immediately after revascularization surgery., Objective: We investigated the effects of postoperative DEX use on hemodynamic changes and the avoidance of crying and hypocapnia in pediatric patients with moyamoya disease., Case: Ten consecutive patients(5 boys and 5 girls)who underwent surgical revascularization were enrolled, and 16 hemispheres(8 boys and 8 girls)were sedated with DEX postoperatively between August 2011 and August 2016., Methods: During extubation after revascularization, DEX was started at 0.4μg/kg/hr under spontaneous breathing and its dose was increased depending on the degree of consciousness, to maintain sedation of at least 3 on the Ramsay scale. DEX administration was terminated the next morning., Results: Sedation was maintained well in all patients without hypocapnia, and no ischemic complications were observed. One patient cried and needed additional intravenous DEX injections and was immediately re-sedated;no hypocapnia developed. Respiratory depression did not occur and changes in respiratory rate and decreases in SpO 2 were not observed. No significant changes in systolic blood pressure and heart rate were observed., Conclusion: Dexmedetomidine is safe and useful for postoperative sedation in children with moyamoya disease.

Development of symptomatic treatment of Alzheimer s disease by cholinesterase inhibitors like donepezil was successful. However, it is a disappointment that development of disease-modifying drugs such as anti-amyloid drug based on amyloid-cascade theory has been interrupted or unsuccessful. Therefore, we have to be more cautious regarding inclusion criteria for clinical trials of new drugs. We agree that potentially curative drugs should be started before symptoms begin as a preemptive therapy or prevention trial. The concept of personalized medicine also is important when ApoE4-related amyloid reducing therapy is considered. Unfortunately, Japanese-ADNI has suffered a setback since 2014. However, Ministry of Health, Labour and Welfare gave a final remark that there was nothing wrong in the data managing process in the J-ADNI data center. We should pay more attention to worldwide challenges of speeding up new drug development.

Several promising tau imaging probes have been developed by Tohoku University ([18F]THK series), National Institute of Radiological Sciences([11C]PBB3), Eli Lilly ([18F]T807), and Hoffman-La Roche ([18F]R06958948). In this paper we discussed some of the criteria required for the tau imaging probe in Alzheimer's disease. It will be certain that tau imaging plays an important role in an accurate diagnosis and as companion diagnostics.

A 70-year-old woman with severe respiratory distress was admitted to our hospital by ambulance. Chest X-ray revealed marked elevation of left diaphragm and invagination of megacolon. Colectomy was performed to improve the respiratory distress, but continuous mechanical ventilation was necessary after operation due to hypoxia and hypercapnea. Therefore, plication of diaphragm was additionally performed. With 10 rows of nonabsorbable sutures, 6 to 8 pleats were formed. The following day of operation, she was successfully relieved from the ventilator.

In recent years, it is necessary to acquire knowledge not only about medicine but also over-the-counter (OTC) drugs and health food for children, because lowering trend in the age of the health hazard by improper use of health food is reported. Therefore, in order to estimate the extent of use of OTC drugs and health food, the school pharmacists administered a questionnaire to students in grade-school (n=123), junior high school (n=303), and high school (n=115) in Fukuyama city. As a result of the questionnaire survey, surprisingly, the usage ratio of OTC drugs and health food showed the most increase in grade-schooler. The trigger of use of health food is "parents' recommendations" in the lower grades, otherwise the ratio of "use by themselves" was increased in the higher grades. Moreover, a remarkable difference was observed by the kinds of use in students with or without exercise. Interestingly, exercise group expected "physical strength" effects than no exercise group. In addition, the ratio of consultation to the pharmacist at the time of purchase of OTC drugs and health food was low in all grade students. In particular, the ratio of consultation to the pharmacist at the time of purchase of health food was very low in high school students. Therefore, to provide accurate information of medicine and health food for students, the school pharmacist should engage not only in routine work but also in positive guidance about OTC drugs and health food in the future.

In recent years, self-medication is promoted to control the health care cost of aged people in Japan. On the other hand, there are many pharmacists who are perplexed in diversification of work with promotion of self-medication because of shortage of information, including the knowledge of an over-the-counter drug, health food, etc. It is therefore needed to design an efficient education program for pharmacists, especially in aging society such as Fukuyama. In this study, we investigated the needs for self-medication of local residents and community pharmacists in order to clarify the high-priority education themes for promotion of self-medication in Fukuyama. The pharmacist's needs were extracted by the KJ method and prioritized by the two-dimensional developed leaf method, and the local resident's needs were extracted by questionnaire survey from 420 general populations who live in Fukuyama. As a result, we found that the community pharmacists were especially in need of acquisition of the knowledge about "health food" and "food", and the local residents were especially in need of consultation with community pharmacists about "medicine", "side effect of medicine", "health food" and "food". Moreover, we also found that sixty percent of local residents did not have knowledge about interaction of "medicine" and "health food" while the half of them was taking in "health food". From the above result, knowledge improvement of "health food", "food" and "interaction of medicine and health food" in addition to "medicine" and "side effect of medicine" is the high-priority education themes for local residents and community pharmacists to promote self-medication in Fukuyama.

To estimate the extent of use of over-the-counter (OTC) drugs and health food, we administered a questionnaire to the parents of children in a nursery school and to elderly people in a daycare center in Fukuyama city. The aim of the questionnaire was to determine the percentage of children and elderly people who use OTC drugs and health food, the purpose of using them, and the types of OTC drugs and health food used. Other questions concerned the person advising them on the use of OTC and health food, the side effects of OTC drugs and health food, and the awareness of children and elderly people regarding possible interactions between prescription drugs and OTC drugs. In children, the most frequently consumed OTC drugs were cold medicines (32.1%), followed by topical creams (22.6%) and eye lotion (14.3%). In elderly people, the most frequently consumed OTC products were eye lotion (18.0%), followed by laxatives (14.8%) and fomentation agents (13.1%). The purchase ratio of health food for children and elderly people were 4.8% and 11.5%, respectively. These results suggest that the need for OTC drugs and health food in children are very different from those in elderly people. In addition, in promoting self-medication, the demand for the opinion of a specialist occupied about 80% or 70% of the total specialist time among children and elderly people, respectively. Therefore, when providing information on health food and OTC drugs, the needs of each generation should be taken into account. The information obtained from the responses received will allow us to provide better pharmaceutical care for both children and elderly people in Fukuyama city.

Neocortical deposition of amyloid plaques is one of the pathological hallmarks of Alzheimer's disease (AD). In vivo detection of amyloid plaques in the brain enables early identification of AD patients. Many beta-sheet binding agents have been developed as amyloid-binding radiotracers for PET. Currently, the most successful amyloid-binding agent is 11C-PIB. PET amyloid-imaging studies in human subjects have shown a robust difference between the retention pattern in AD patients and healthy controls. In vivo amyloid-imaging enables early and accurate detection of AD patients in the stage of MCI. The demonstration of abnormal tracer retention in a proportion of the elderly normal subjects supports post mortem observations that the amyloid deposition predominantly occurs before the onset of dementia. For presymptomatic diagnosis of AD, longitudinal studies are needed to elucidate the relation between amyloid deposition and time course of AD. AD and many other neurodegenerative disorders belong to the family of protein misfolding diseases, characterized by protein self-aggregation and deposition. Molecular PET imaging using beta-sheet binding agents has the potential to be extended to these wide spectrums of protein misfolding diseases.

It is well known that the amplitude and latency of P300 in event-related brain potentials (ERPs) evoked by performing the oddball paradigm reflect the extent of individuals' selective attention. The purpose of this study was to examine whether P300 is a reliable measure for evaluating mental fatigue. In addition to the measurement of auditory ERPs derived from Fz, Cz and Pz, the concentrations of lactic acid, cortisol in plasma and the reaction time of the oddball paradigm, which are believed to reflect fatigue, were measured. In an attempt to cause mental fatigue, 12 healthy college students (8 males, 4 females; 19.5 +/- 0.5 yr; mean +/- S.D.) were forced to perform a continuous addition task using the Uchida-Kreperin test paper for about 2 h. Before the task, the latencies of P300 in Fz, Cz and Pz were 295.6 +/- 8.7 msec, 298.8 +/- 8.5 msec and 297.5 +/- 7.2 msec (mean +/- S.D.), respectively, and after the task they were 312.6 +/- 11.2 msec, 314.6 +/- 10.1 msec and 315.8 +/- 8.7 msec, respectively. A significant difference in the latency before and after the task was detected (p<0.01). In all subjects, the latency of P300 was prolonged in all recording positions, Fz, Cz and Pz. In a control experiment where the continuous addition task was not loaded, a significant change of the latency was not detected. The amplitude of P300 didn't change significantly in all recording positions after the task. In the control experiment, the amplitude of P300 did not change significantly. On the other hand, the changes in the concentrations of lactic acid and cortisol and the reaction time were not induced by the continuous addition task. The prolongation of the latency of P300 would originate from a decline in brain function. In this study, a prolongation of the latency of P300 after the task was detected in all subjects. It is well known that the value of P300 changes with modification of the recording condition, therefore a recording of P300 under the same conditions is required for qualitative evaluation.

Molecular imaging is a visualization of quantity and dynamics of molecules to understand the process of gene regulation and physiological function of the proteins in living tissue or cells. Examples of the research include the development and application of fluorescent proteins, quantum dots, nanoparticles for optical imaging, micro bubbles for ultrasound, ferromagnetic compounds for MRI and radiopharmaceuticals for positron emission tomography (PET). PET is most promising in this field, because of its high sensitivity of the measurement and easy applicability to humans. In this general remark, the topics will be concentrated on molecular imaging with PET for the diagnosis of Alzheimer's disease (AD) in early stage. 11C-MP4P (N-methlpiperidyl-4-propionate), is a probe for the measurement of acetylcholine esterase (AchE) activity in the human brain by PET. The AchE activities (k3) in early onset AD measured with PET was low in hippocampus, amygdale and wide spread neocortex including parietal and temporal cortex compared to those in age-matched control. The results indicated that the decrease of AchE activities is preceded by the decrease of blood flow. One of the topics in this research field is an imaging of aggregated amyloid Abeta in the AD brain. Kudo et al, screened more than 2,600 compounds and found several good probes for amyloid Abeta imaging, including BF-168 and BF-227. Okamura demonstrated that BF-168 specifically bind to the amyloid plaques in the brain of a transgenic mouse (PS1/APPsw). Furumoto et al successfully labeled BF-227 with C-11, and clinical PET studies using 11C-BF-227 is now ongoing at Tohoku University. Preliminary clinical study revealed that the compound accumulated in the tempo-parietal region of the brain in AD patient, although non-specific accumulation in the thalamus, basal ganglia and white matter was observed. The goal of this project is to detect AD at pre-clinical stage.

Progressive accumulation of amyloid plaques in the brain is a characteristic pathological change in Alzheimer's disease (AD) and precedes the presentation of cognitive impairment. In vivo detection of amyloid deposits using molecular imaging technique would thus prove useful for early diagnosis of AD and tracking disease progression. Several imaging agents have been developed that can noninvasively detect amyloid plaques in the brain and successfully differentiated AD patients from healthy normal individuals using positron emission tomography. Although validation remains required as to whether retention of these agents in the neocortex truly reflects the level of amyloid deposition, such findings suggest the potential usefulness of amyloid imaging technique for early diagnosis of AD.

The presence of fluoroquinolone resistance-associated mutations within the quinolone resistance-determining region of DNA gyrase and topoisomerase IV was investigated genetically in clinical isolates of Proteus mirabilis recovered from patients with urinay tract infections. Two isolates of fluoroquinolone-resistant P. mirabilis possessed the mutations in GyrA (Ser-83 --> Arg or Ile), GyrB (Ser-464 --> Tyr or Phe) and ParC (Ser-80 --> Ile). A novel mutation with Glu-87 --> Lys in GyrA, where suggested to be responsible for fluoroquinolone resistance, was identified. These results demonstrate that the presence of an additional mutation at Glu-87 in GyrA may contribute to high-level fluoroquinolone resistance, too.

The pathological hallmark of Alzheimer's disease (AD) is the deposition of senile plaques (SPs) and neurofibrillary tangles. The deposition of SPs, which initially occurs in the neocortex, is regarded as the critical event for the pathogenesis of AD. Previous pathological studies indicated that the earliest deposition of SPs is suspected to occur before any detectable cognitive decline. Therefore, noninvasive imaging of brain SPs is considered to be an ideal diagnostic method for presymptomatic detection of AD. For in vivo detection of SPs in the brain, a lipophilic probe that can selectively binds SPs is indispensable to the examination using positron emission tomography (PET) or single photon emission computed tomography (SPECT). For this purpose, many kinds of amyloid binding agents have been developed, such as FDDNP, BTA-1, IMPY. We have also developed a series of promising compounds for in vivo imaging of amyloid deposits. One of these compounds, compound-A, achieves high binding affinity for A beta fibrils. This agent also showed abundant initial brain uptake and short brain clearance half-life in normal mice. Furthermore, to investigate the in vivo binding property of compound-A to amyloid plaques, compound-A was intravenously administered to APP transgenic mice. Brain slices at 120 min post injection demonstrated specific binding of compound-A to amyloid plaques in the brain. These data emphasize the potential usefulness of compound-A as in vivo imaging probe for early diagnosis of AD.

Recently, it has become important to diagnose Alzheimer's Disease (AD) at an early stage due to the development of AD therapy. Also, there is increasing recognition of a class of elderly people with complaints of memory loss but who nevertheless do not meet the criteria for dementia. "Mild cognitive impairment" (MCI) is the term used for this disorder, and amnestic MCI is highly converted to AD. In this study we evaluated the accuracy of diagnosis of amnestic MCI by cerebrospinal fluid total-tau protein (CSF/total-tau), cerebrospinal fluid amyloid beta 1-42 protein (CSF/A beta 1-42), and cerebral blood flow in the posterior cingulate cortex using SPECT. CSF/total-tau was the most appropriate to discriminate between normal cognitive individuals and those with amnestic MCI. We also evaluated the CSF/total-tau and MRI images between patients with stable MCI and those with progressive MCI, including those who converted to AD in the following two years. The stable type was characterized by normal CSF/total-tau levels and relatively high grade periventricular white matter lesions (PWML). Conversely, the progressive type was characterized by high CSF-tau levels and relatively low grade PWML. We speculate that stable MCI is due to ischemic change with in the white matter lesion, while progressive MCI may represent a previous stage of AD.

To examine the difference in functional brain imaging between mild cognitive impairment (MCI) and normal aging, we measured rCBF on functional brain imaging using 123I-IMP single photon emission computed tomography (IMP-SPECT) in 19 MCI patients who progressed to develop AD on follow-up and 23 probable Alzheimer's disease (AD) patients as well as 15 age-matched normal subjects. Baseline MMSE score was 25.3 (SD 1.2) in the MCI group and 17.5 (SD 3.3) in the AD group. The regions of interest (ROI) in the posterior cingulate gyrus, frontal, temporal and parietal cortices were drawn on the image of IMP-SPECT with reference to an individual MRI image. The rCBF ratio was calculated using ROI value in the cerebellum as a reference. Voxel-based analysis was also preformed using statistical parametric mapping (SPM). The rCBF ratio in the posterior cingulate gyrus was significantly reduced in the MCI group (mean 0.956, SD 0.080) and the AD group (mean 0.833, SD 0.118) compared to that in the normal group (mean 1.083, SD 0.084). In the frontal, temporal and parietal cortices, the rCBF ratio was significantly reduced only in the AD group compared to the normal group. At a fixed specificity of 80%, the diagnostic sensitivity in the discrimination between MCI patients and normal subjects was 80.5% when using rCBF ratio in posterior cingulate gyrus. In the SPM analysis, significant reduction of the rCBF in MCI group was observed only in the posterior cingulate gyrus, compared with normal subject group. Our results suggest that MCI patients presenting with a posterior cingulate hypoperfusion are at higher risk for transition from MCI to clinically recognizable AD.

Antihistamines are the efficacious drugs to be used for the symptomatic relief of allergic diseases. The safety issue of antihistamines is of central importance because of their widespread use in current medical practice. Positron emission tomography (PET) was used to better understand the pharmacological effects of antihistamines on the central nervous system. The H1 receptor occupancy was examined in young male volunteers with [11C]-doxepin after the oral or intravenous administration of antihistamines. In other studies, the cognitive performance was also measured tachistoscopically before and after taking antihistamines. The H1 receptor occupancy in the human cortex caused by antihistamines is significantly correlated with the reported values of incidence of sleepiness in clinical trials, and the occupancy is well proportional to the impaired cognitive performance. To understand the brain mechanism of antihistamine-induced "sleepiness and impaired cognition", the regional cerebral blood flow (rCBF) during the task was measured using 3D-PET and H2(15)O before and after administration of d-chlorpheniramine. After its administration, the rCBF was significantly decreased on the bilateral middle temporal gyrus, midbrain and anterior cingulate. These findings suggest that H1 receptor blockade would be affected on the activity of the attention and cognitive system in the brain.

We examined the influence of physical load placed on high school baseball managers during midsummer games under extremely hot and humid conditions. The factors used to determine physical load were the following: body weight, oral temperature, amount of walking, pedometer count, heart rate, and serum biochemical elements. These factors were measured before and after the games. Twenty-two managers participated in this study. All games were played under high temperatures of 32.4 +/- 3.5 (mean +/- S.D) degrees Celsius dry-bulb, 27.1 +/- 3.0 degrees Celsius wet-bulb, 33.8 +/- 3.6 degrees Celsius black-glove, 29.1 +/- 3.3 degrees WBGT, which are likely to cause heart-related illness. The results were as follows. 1. After the games, significant body weight loss and oral temperature rise were found. Those findings were thought to be caused by the rise in oral temperature in a hot environment which was accompanied by hyperhidrosis. 2. The average hemoconcentration ratio based on the changes in total protein during the games was 105 percent, suggesting that hemoconcentration and dehydration were caused by sweating in a hot environment. 3. A significant increase in total protein, albumin, LDH, high density lipoprotein cholesterol, calcium, hemoglobin, and a decrease in triglyceride were observed after the games, which were thought to be influenced by sweating and by increased metabolism in a hot environment. 4. The values of triglyceride, Fe, uric nitrogen, calcium and hemoglobin after the games which were adjusted by the hemoconcentration ratio were significantly lower than those before the games. 5. A prolonged game time caused a significant increase in total protein value during the games and a decrease in hemoglobin between the level before the games and the adjusted level after the games compared with those values in the short game time group. From the above, even though high school baseball managers join in practices in a hot environment and become accustomed to it, we found that they had a great physical load on their bodies during the games in midsummer.

This study attempted to measure the physical load on national high school baseball umpires during games played at Koshien stadium under extremely hot and humid conditions in the summer. Thirty-one umpires participated in this study. Thirteen of them were evaluated twice while eighteen were evaluated only once. The factors used to determine physical load were the following: body weight, oral temperature, blood pressure, heart rate, and serum biochemical elements. These were measured before and after the games. Heart rate was measured at one-minute intervals. The results were as follows. 1) All the games were played under conditions of extremely high temperatures--32.1 degrees celsius dry-bulb, 27.0 degrees celsius wet-bulb, 36.8 degrees celsius black-globe, 29.5 degrees--WBGT which are likely to cause heat-related illnesses. 2) The physical load of baseball umpires during the game showed a 1.69 percent decrease in average body weight due to perspiration, a 0.43 degrees C increase in oral temperature and an increase in heart rate. An examination of the serum biochemical elements showed that muscle deviation enzymes changed due to muscular activity and blood condensed due to perspiration. The physical load levels of baseball umpires were influenced by extreme heat and physical activity during the game. 3) There were no observable differences in either the amount of physical activity or the extreme heat environment among the umpires of different field positions. But the chief umpire's physical load showed a greater decrease in body weight, more blood condensation due to perspiration as a result of the heavier equipment he wore, more muscular activity and higher energy consumption than his counterparts on the bases. 4) The umpire's heart rates were higher during games than before games. The moment they were on the playing field. Their heart rates rose to an average of 134. It remained above 115 for about two hours, apparently caused by physical activity and heart load.

The enhancement of the in vitro invasive ability and the morphological changes caused by anti-E-cadherin antibody HECD-1 were investigated by in vitro invasion assay and electron microscopy in three human endometrial carcinoma cell lines. The cell lines were NUE-1 (E-cadherin negative and high in vitro invasive ability), HEC-1BE and HEC-108 (E-cadherin positive and low in vitro invasive ability). In NUE-1 invasive ability was not enhanced by HECD-1, but in HEC-1BE and HEC-108 invasive ability was enhanced to 223 +/- 41.2% and 307 +/- 173% by 5 micrograms/ml HECD-1. Morphologically NUE-1 invaded the extracellular matrix (Matrigel) with a long micro villis. But in HEC-1BE and HEC-108 the villis did not invade the Matrigel, the whole cell invaded it. Together with HECD-1, HEC-1BE and HEC-108 were changed to become similar to the NUE-1 cell line with high invasive ability and the micro villis invaded the Matrigel.

It has been considered that there is no useful serum tumor marker to diagnose endometrial cancer. But recently several reports describe how the serum CA125 value decreases in patients who have received bilateral oophorectomy and in postmenopausal women. In this study, we therefore determined a new cutoff level for serum CA125 and examined the usefulness of serum CA125 in the assessment of recurrence in 42 endometrial cancer cases. These cases were divided into 3 groups: one of 22 low risk cases, 10 moderate risk cases and 10 high risk cases cased by prognosis 1) In the low risk group, 5 cases had a higher serum CA125 level within 1 month after operation than before. 2) In 151 measurements, the mean CA125 value was 9.7 +/- 3.6U/ml, so we considered that 17 U/ml is the cutoff value for determining recurrence. 3) In the low risk group, the CA125 value was either lower than 17U/ml or it has not continued to increase. 4) We divided the high risk group into 3 subgroups into those who had died within 6 months, those who died within 13-14 months and those who died 2-5 years after the initial treatment. In the group who died 13-14 months after the initial treatment, the seurm CA125 level had continued to be high and there was no change in the value after the initial treatment. In the group who died 2-5 years after the initial treatment, the mean +/- S.D. for serum CA125 was 157.3 +/- 158.3U/ml, the maximum was 377U/ml and the minimum was 28U/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

This study attempted to measure the physical load on high school baseball players during games played under extremely hot and humid conditions in the summer. The factors used to determine physical load were the following: body weight, oral temperature, blood pressure, heart rate, and serum biochemical elements. These were measured before and after the game. One hundred twenty-six baseball players from 7 high schools participated in this study. All the games were played under conditions of high temperature 34 degrees Celsius dry-bulb, 26 degrees Celsius wet-bulb, 41 degrees Celsius black-globe, 30 degrees WBGT, which are likely to cause heat-related illnesses. The results were as follows. 1) The physical load of baseball players during the game showed a 1.8 percent decrease in average body weight due to perspiration, a 0.35 degrees C increase in oral temperature and an increase in the heart rate. Examination of the serum biochemical elements showed that muscle deviation ferment changed due to muscular activity and blood condensed due to perspiration. The physical load levels of baseball players were influenced more by extreme heat than by exercise during the game. 2) The group of starting players showed higher body weight loss, oral temperature, heart rate, blood condensation and muscle deviation ferment levels than the group of players on the bench due to the difference in the length of exposure to summer heat and the amount of physical exertion. The changes in physical load levels during the game for the group of starting players were greater than those for the group for players on the bench. 3) Considering the changes in body weight, blood condensation and muscle deviation ferment, we can say that physical loads of players differed according to their positions, the pitcher having the greatest load, followed in descending order by the catcher, infielders, and outfielders. It has been recommended that high school baseball players should take different kinds of rest depending on their positions in order to recover from fatigue as soon as possible after a game.

An examination for endometrial cancer has been done by cytology. However, cytology is sometimes not possible because of closed or narrow cervix of postmenopausal woman. We did a retrospective study regarding the usefulness of CA125 or transvaginal ultrasonography in postmenopausal cases. The mean +/- S.D. of CA125 in normal menopausal women was 10.3 +/- 3.0 U/ml. The value of mean +/- 2S.D., the finding of Relative Operating Characteristic curve and the purpose that false positive was 0%, so we set 17 U/ml as the cut off value for CA125. In 46 cases with postmenopausal endometrial carcinoma, 23 cases were screened; and in 30 cases with surgical stage I, 10 cases were screened with this cut off value. The echoic patterns for uterine cavities which were observed by transvaginal ultrasonography were divided into 4 patterns (type I: anechoic pattern, type II: linear pattern, type III: clear mass pattern, type IV: unclear mass pattern). In 20 cases with postmenopausal endometrial cancer, 19 cases had type III or IV. In 41 normal postmenopausal women, 26 cases showed an anechoic pattern and 14 cases showed a linear pattern. It was found that 97.5% of cases with anechoic or linear patterns were normal endometrium. The screening by transvaginal ultrasonography was more useful than CA125. However CA125 was more useful than transvaginal ultrasonography in detecting lymph node metastasis.

The in vitro invasive ability, the expression of cell adhesion molecule E-cadherin, activity of matrix metalloproteinase (MMP) and K-ras point mutation were investigated in eight human endometrial carcinoma cell lines. 1) In vitro invasive abilities of endometrial carcinoma cell lines depend on the degree of cell differentiation and the origin of cell lines. A poorly-differentiated carcinoma cell line (NUE-1) and a cell line derived from metastatic lymph node (SNG-M) were more invasive than moderately-(HEC-1A, HEC-1BE) and well-differentiated (HEC-6, Ishikawa) cell lines. 2) Immunohistochemically, less or non-invasive cell lines expressed E-cadherin strongly, whereas a highly invasive cell line (NUE-1) expressed E-cadherin weakly. 3) When cultured on Matrigel-coated dishes, the tumor cells derived from moderately- and well-differentiated carcinoma aggregated with each other and did not invade Matrigel in the invasion assay. The aggregated cells expressed E-cadherin more strongly when cultured on Matrigel. 4) 72-kD gelatinase (MMP-2) was secreted in serum-free conditioned medium of all cell lines. In an invasive cell line (NUE-1,SNG-M), the activity of MMP-2 was stronger than in other cell lines. And the activity of 92-kDa gelatinase (MMP-9) was detected in most invasive cell line (NUE-1). 5) Point mutation of K-ras codon 12 was detected in four of eight (50%) cell lines by the PCR-RFLP method. The changes in the DNA sequence were identified, but K-ras point mutation was not correlated with in vitro invasiveness of the tumor cells.

It has been difficult to diagnose all but advanced cases of lymph node metastases with CT or MRI. It has been reported that the serum value of CA125 rises with the stage of endometrial cancer. This level is lower in the postmenopausal period than before menopause. In this study, we have examined the usefulness of CA125 for the assessment of lymph node metastasis in 43 postmenopausal endometrial cancer cases. There were significant differences in the CA125 level between lymph node metastasis positive cases and negative cases, between cancers occupying > or = 1/2 and < 1/2 of the uterine cavity, between lesions of > or = 1/3 and < 1/3 depth, and between surgical stages I, and III and IV. There was no significant correlation between serum CA125 levels and histological type. The serum CA125 value (mean +/- S.D., U/ml) was 179.0 +/- 291.0 (N = 6) in cases with lymph node metastasis and 15.8 +/- 8.5 (N = 37) in cases without metastasis (p < 0.001). We concluded that 32U/ml, which equals the mean + 2S.D., is a useful cut off value for suspicion of lymph node metastasis. The sensitivity and specificity of this cut off value were 100 (6/6) and 91.9% (34/37), respectively. This standard seems likely to considerably increase the accuracy of diagnosis of lymph node metastasis when taken in combination with the several factors already known to predict this. It may also be useful to diagnose lymph node metastasis in the preoperative period. Although the number of cases in this study was small, the data seem very promising for planning therapy for individual cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Shigella flexneri was isolated from 11 of 95 Japanese monkeys (Macaca fuscata) purchased by the Animal Research Center, Tokyo Medical and Dental University, during the period from 1988 through 1990. The serotypes of the isolates were 4a (5 isolates), 2a (4 isolates), 2b (1 isolate), and varY (1 isolate). Although some of the strains in the same serotypes were similar, others were different in their antibiotic susceptibility patterns or the plasmid profiles. Our results suggested that various types of Shigella flexneri had infected the Japanese monkeys. However, the source(s) and the routes of infection were unclear. Dysentery in the Japanese monkey has not yet been reported. So, to our knowledge, this may be the first report of dysentery among Japanese monkeys.

A lactose slow-fermenting, non motile Escherichia coli strain was isolated from a diarrheal patient returning from Indonesia. Examination of virulence of the strain showed that it penetrated into tissue culture cells, and were positive in Serény test and enzyme-linked immunosorbent assay for detection of enteroinvasive E. coli. A large plasmid responsible for virulence was also detected. Thus the strain was confirmed to be a typical enteroinvasive E. coli. Analysis of O serotype using the antisera against E. coli O1-O170 revealed that the strain had O121 antigen, whose antiserum is not included in the commercial serotyping kit for the diagnosis of diarrheagenic E. coli.

A bacterial strain was isolated that possessed the biochemical characteristics of Shigella dysenteriae but did not belong to any of the established S. dysenteriae serovars, from the feces of a diarrheal case who had travelled to Turkey, Pakistan, India and Thailand for about a month. This strain was invasive to tissue culture cells and gave a positive Serény test. Preparing antiserum against this strain and examining the antigenic relationship with the established O antigens of Shigella and Escherichia coli O1-O170, we found that the strain had O antigen identical to that of the E. coli O serogroups 150. The results indicated that this strain could be a provisional serovar of S. dysenteriae. Although our strain could probably be the same serotype as that of the strains reported in Israel, this may be the first report of isolation in Japan.

The purpose of this study was to examine the effect of umpires' intake of water during a summertime baseball game, on serum and urinary biochemical elements, body weight and physiological factors. Twenty-eight umpires were classified into two groups. Group W was composed of 14 umpires who had water while those who did not were group C. Group W had 250 ml of water that was cooled to about 5 degrees C after the 5th inning of the game. The game was played in the following environment: atmosphere temperature was 31 degrees C; wet-bulb temperature was 26 degrees C; blackglove temperature was 40 degrees C; the velocity of the wind was 1.18 m/sec in bright sunshine on a hot and moist day. The results obtained were as follows. In group W, more body weight was lost than in group C, but statistically there was no significant difference. Urinary volume in group W became smaller than in group C, but statistically there was no significant difference. Water in blood increased in group W and decreased in group C but statistically there was significant difference. In both groups, oral temperature decreased, but only in group C was there a statistically significant difference. Although the intake of water increased the volume of perspiration, it did not dilute the concentrated blood, suppress the rise of body temperature, or result in a rise of low blood pressure.