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Errors in the daily routine work of a hospital laboratory vary. Therefore, measures to prevent errors must be devised. It is important to perform Total Quality Control (TQC) and to provide reliable diagnostic information and this does not stop at quality control of mere assay value, but extends to consideration of the correspondence to a patient. It is absolutely necessary to reduce errors in a laboratory and to perform TQC steadily. Therefore, the concept of TQC is divided roughly as follows 1) Safe management, 2) Technical management, 3) Information management, 4) Materials management. These categories are then subdivided even further. These categories relate to error management because it is considered that the manuals for technical and information management are important. It is necessary to create an error processing ledger to collect information for error management for TQC and for prevention of errors in investigating causes and to record all processes according to the contents of the error. Such records can be used to prevent recurrences. Thereby, not only prevention of errors but also improvements in the accuracy and reliability of information offered are thought to become possible.

Microwave tissue coagulation (MTC) therapy was given patients with recurrent hepatocellular carcinoma (HCC) of the caudate lobe of the liver, in which radical surgery for deteriorated liver function was impossible. A total of 40 MTC sessions was applied to two tumors under laparotomy. MTC was administered for 20 seconds in each session. Microwave energy output was 70 watts for 15 mm needle-electrodes and 100 watts for 30 mm electrodes. Alpha-fetoprotein levels in serum had decreased after surgery. Abdominal computed tomography showed no blood flow whatsoever in tumors undergoing MTC. There are fewer limits to the sites and angles for insertion of electrodes under laparotomy. Thus, the surgical approach provides access to all parts of the liver for treatment. We conclude that intraoperative MTC is highly effective in tumor necrosis, and can be a useful local treatment for nonresectable HCC.

The present study was carried out to ascertain the seroprevalence rate in different geographical areas in Central and Western Regions in Nepal. A total of 1,237 serum samples collected from Nuwakot (217), Kathmandu valley (402) and Chitawan (159) districts in Central Region, and Mustang (143), Surkhet (64) and Banke (252) districts in Western Region in Nepal were included in this study. Toxoplasma antibodies were detected by micro-latex agglutination (MLA) and enzyme linked immunosorbent assay (IgM-ELISA) methods. The seropositive rate in Central and Western Regions were found to be 48% and 49%, respectively; with an overall positive rate of 48 percent. Districtwise, the seropositive rate in Nuwakot, Kathmandu valley, Chitawan, Mustang, Surkhet and Banke districts were 38, 46, 64, 51, 67 and 44%, respectively. Interestingly, the relatively newly inhabited Surkhet district in Western Region and Chitawan district in Central Region showed significantly higher seropositive rate compared with those of two other districts in the respective Regions (p0.05). Ethnically, Tibeto-Burmans showed higher seropositive rates in Central Region (p0.05). In contrast, Indo-Aryans showed higher seropositive rate in Western Region (p0.05). Age related increase in seropositivity was observed only in Central Region. One percent of Toxoplasma antibody positive samples also showed Toxoplasma IgM antibody positivity.

Single photon emission tomography (SPECT), MRI and EEG were studied in two infants with lissencephaly. One infant had generalized tonic convulsions at 7 month of age and continuous high voltage fast activities on EEG. The other infant developed infantile spasms at the age of 2.5 months, and showed low voltage disorganized background with pseudorhythmic high voltage sharp waves on EEG. Cranial CT and MRI in both infants revealed abnormally thick cortex, dilatation of the lateral ventricles, and smooth or relatively smooth cerebral surface. In SPECT studies, a diffuse increase of tracer uptake was shown at the cerebral cortex compared with the basal ganglia or cerebellum in both infants. The SPECT finding might reflect the abnormal cortical architectures in this cerebral malformation.

We determined the 5'-flanking sequences of two nuclear genes (SodCc1 and SodCc2) encoding cytosolic copper/zinc-superoxide dismutase in rice (Oryza sativa L.). Utilizing transient beta-glucuronidase (GUS) reporter assays, functional promoter-GUS analysis was performed in rice protoplasts exposed to the phytohormone abscisic acid (ABA) or the antioxidant sulfhydryl reagent, dithiothreitol (DTT). Transcriptional activities from both SodCc-GUS fusions were stimulated by DTT, which induces the promoter activity of the tobacco SodCc gene [Proc. Natl. Acad. Sci. USA 90 (1993) 3108-3112]. ABA had no effect on SodCcl-GUS expression but specifically induced the gene expression of the SodCc2-GUS fusion. The simultaneous application of ABA and gibberellin A3, however, abolished the enhancing effect of ABA. These results indicated that two rice SodCc promoters differentially respond to externally supplied ABA and that one of the regulatory factors for plant SodCc expression is ABA in addition to cellular redox-modulating antioxidants.

A total of 302 serum samples collected from Chitawan (159) and Mustang (143) districts of Nepal were included in this study. Anti-toxoplasma antibody was detected using micro-latex agglutination (MLA) and ELISA methods. An overall positive rate was found to be 57.9%. The positive rate in Chitawan was significantly higher (64.1%) (less than 1,000 m altitude) compared to that in Mustang (51.0%) (more than 3,000 m altitude) (p0.05). Females in Chitawan showed significantly higher positive rate (71.2%) compared to males (56.9%) (p0.05). On the contrary, though insignificantly, males showed higher positive rate (57.9%) compared to that of females (43.3%) in Mustang. Almost equal positive rate was observed among males in both study area. Females in Chitawan showed significantly higher (71.2%) positive rate compared to their counterparts in Mustang (43.3%) (p0.001). A slight increase in positive rate with age was observed in Chitawan while in Mustang a decreasing trend was noticed. Ethnically though statistically not significant, Indo-Aryans showed a higher positive rate (69.2%) compared to the positive rate shown by Tibeto-Burmans (63.1%) in Chitawan while the reverse was true in Mustang (Tibeto-Burmans: 53.8% and Indo-Aryans: 38.4%). Interestingly, 2.9% and 1.3% of MLA positive samples showed toxoplasma IgM antibody. None of the IgM positive samples were positive for toxoplasmic antigens.

Topological structure of quinoprotein glucose dehydrogenase in the inner membrane of Escherichia coli was determined by constructing protein fusions with alkaline phosphatase or beta-galactosidase. Analysis of the fusions revealed that the dehydrogenase possesses five membrane-spanning segments, and the N-terminal and C-terminal portions resided at the cytoplasmic and periplasmic side of the membrane, respectively. These results agreed with the hydropathy profile based on its primary structure. The topological structure suggests that the predicted binding site of the prosthetic group pyrroloquinoline quinone is located at the periplasmic side and that the amino acid residues corresponding to those that were presumed to interact with ubiquinone in one subunit of mitochondrial NADH dehydrogenase also occur at the periplasmic side. When the purified glucose dehydrogenase and cytochrome o ubiquinol oxidase were reconstituted together with ubiquinone into liposomes, a membrane potential could be generated by the electron transfer at the site of the ubiquinol oxidase but not of the dehydrogenase. These results suggest that glucose dehydrogenase has a ubiquinone reacting site close to the periplasmic side of the membrane, and thus its electron transfer to ubiquinone appears to be incapable of forming a proton electrochemical gradient across the inner membrane of E. coli.

Insecticidal activity data for third-instar larvae of Nilaparvata Lugens of a series of eighteen pyridine derivatives were subjected to Neural Networks(NN) analysis. Parameters used in this analysis are newly devised graph invariants which relate the shape of alkyl substituents of pyridines. The distinctive feature of these graph invariants different from other conventional shape parameters is that candidate structures with insecticidal activity can be generated more easily. High insecticidal activities of 9 candidate structures were predicted based on the NN model. The candidate insecticides were newly synthesized and show high insecticidal activities.

Fallopian tube obstruction is one of the most difficult problems in the treatment of infertility. This report gives the results of a pilot study on the transcervical recanalization of the occlusive fallopian tube. Selective catheterization of the uterine cornu was applied through a balloon catheter, which was wedged at the internal uterine os. In 16 occlusive fallopian tubes of 11 cases, the catheterization procedure was attempted and accomplished with a 87.5% success rate. Recanalization was successful in 75.0% of the affected tubes. Subsequent pregnancy was confirmed in three cases. This convenient technique is safe and effective and it will be accepted as the first choice in the diagnosis and treatment of fallopian tube obstruction.

We measured bone mineral contents of lumbar vertebrae (L1, L2, L3, L4) in 58 post-menopausal female volunteers (49-76 years old), using a quantitative computed-tomography method. We investigated age-related changes of bone mineral content, and analyzed the relation of bone mineral content to vertebral deformity and to physical characteristics. The following results were obtained: (1) There were highly significant correlations and some significant differences among bone mineral contents of L1, L2, L3 and L4. (2) Bone mineral content showed an apparently linear decline with age. (3) A significant negative correlation was observed between bone mineral content and the central deformity index of the vertebral body, but not for the anterio-posterior deformity index. (4) It was difficult to verify an association of bone mineral content with physical characteristics, such as height, weight, and body mass index.

An 8 year-old female infant with the clinical and pathological characteristics of both progressive muscular dystrophy and mitochondrial myopathy was described. Her maternal cousin had clinical and pathological findings of Duchenne muscular dystrophy (DMD). Since the patient had markedly elevated serum CK and calf muscle hypertrophy, her muscle was biopsied and she was diagnosed as having female DMD at the age of 5 years. She had generalized tonic-clonic convulsions and alternate hemiconvulsions for recent 4 years which brought her our hospital. On admission, she had mild generalized muscle atrophy and weakness predominantly in the proximal limbs. The lactate and pyruvate levels in both serum and cerebrospinal fluid were elevated, but with no metabolic acidosis. Serum CK was elevated to 4464 IU/L. Brain CT and MRI showed the expanding arachnoid cyst in the left middle fossa of cranium. In the biopsied left biceps crachii muscle, in addition to numerous ragged-red fibers, there were active muscular fiber necrosis and regeneration and interstitial fibrosis similar to those seen in progressive muscular dystrophy. Biochemically, no decrease or defect in the respiratory chain enzymes was detected. On electron microscopy, a large number of fibers contained aggregates of giant mitochondria with proliferated complicated cristae. Scattered throughout were necrotic muscle fibers filled with phagocytes and regenerating fibers. This patient had the diagnostic features of mitochondrial encephalomyopathy and progressive muscular dystrophy. We supposed that the patient provided very interesting evidences to study the relationship between mitochondrial myopathy and progressive muscular dystrophy.

Both the dielectric and the dilatometric measurements were made under various pressures up to 2 kbar. With increasing pressure, the transition temperature (Tn) decreases rapidly with the pressure coefficient dTn/dp=13 degrees C kbar-1, and this decrease in Tn supports the tunnelling model of the proton as a microscopic model for the phase transition. The large anomaly of the strain along the a(c) and the b axes was found close to Tn.

The fire risk posed by soft furnishings such as bedding materials and upholstered furniture and the strategies being developed to reduce the number of fire-related casualities are reviewed from a Canadian point of view. Statistics from Canada, the United States and the United Kingdom indicate that a substantial reduction in the number of fire deaths would be possible if the ability of assemblies of materials to resist ignition by smokers' materials, such as cigarettes and matches, could be improved. The post-ignition performance of furnishings that results in generation of heat, smoke and toxic gases is also important from a safety point of view. A need exists for both full-scale and small-scale fire tests, and for mathematical modelling for present and future control strategies.

Matsukawa geothermal area is covered by some lava of Marumori Volcano and Matsukawa andesite of Quaternary age. So, difficulty of geothermal exploitation was suggested because the geological sequence and structure of the underlying formations had been hidden under the above-mentioned younger volcanic materials. This area has such a characteristic feature that there are only a few thermal manifestations though a wide distribution of altered rocks. Geothermal exploitation has been carried out by the Nihon Metals and Chemicals Co. Ltd. (older name, Azuma Kako Co. Ltd.) with the co-operation of the Geological Survey of Japan since 1958. Based on the data obtained from geological mapping and logging, study of rock alteration, electric and seismic prospecting and drilling of four test holes 214–570 m deep and six productive wells 945–1500 m deep, the subsurface structure of this area is considered as follows. The basement rocks covered by younger volcanic rocks are composed of dacitic welded tuff named Tamagawa Welded Tuff Formation, marine sediments named Yamatsuda Formation and the so-called Green Tuff Formation of Neogene from upper to lower. Along the Matsukawa river, there may be a fractured zone with step faults trending from NE to SW. This has been assumed by stratigraphical correlation of core samples. Contrary to the physical property of rocks with low permeability, in Matsukawa andesite and in the upper part of Tamagawa Welded Formation, the lower part of the Welded Tuff Formation and the Yamatsuda Formation are rich in cracks. In the Yamatsuda Formation, especially, remarkable development of cracks was detected. From these data, it is summarized that hydrothermal water in Matsukawa area is reserved in cracks along welding planes of hard welded tuff formation and fractured marine sediments which were formed by crustal movement relating to the extrusion of Marumori Volcano. To know the detailed subsurface structure, seismic prospecting by reflection method is carried on in the altered rock area.

We report a 9 year-old boy with MELAS. High dosed oral thiamine administration and high fat diet induced remarkable neurological and biochemical improvement. His mother had episodic headaches and hemiplegia, probably MELAS. He complained muscle weakness and repeated episodes of vomiting started from 2 years of age. High levels of serum lactate and pyruvate were recognized, but with no metabolic acidosis. He developed generalized muscle weakness, growth retardation, generalized convulsions and stroke-like episodes at 5 years old. Optic nerve atrophy and mental retardation gradually appeared. A muscle biopsy at 5 years old revealed numerous ragged-red fibers with excess accumulation of lipid droplets and glycogen particles. Scattered fibers had no cytochrome c oxidase (CCO) activity representing focal CCO deficiency. An electron microscopy showed markedly increased number of giant mitochondria filled with markedly proliferated complicated cristae. Pyruvate dehydrogenase complex level in the fibroblasts was within normal ranges. Serum carnitine level was normal. With oral administration of thiamine hydrochloride (1000 mg) and high fat diet (60-70%), muscle weakness improved, and lactate and pyruvate levels in the serum reduced to normal ranges, whereas the mental deterioration, muscle atrophy, pes cavus progressed very slowly. He died from cardiac and renal failures at 9 years old. Autopsied muscles showed a marked decrease in cytochrome c oxidase activity (biochemically 12.8% of the normal level), and almost all muscle fibers had no cytochrome c oxidase activity histochemically. The progression of the MELAS was probably in parallel with the decrease in CCO activity.

Recently the extra-intracranial (EC/IC) arterial bypass operation has been introduced in the treatment of Moyamoya disease and excellent postoperative outcomes have been reported. To assess the cerebral hemodynamic changes after the bypass surgery, ultrasonic Doppler flowmetry was performed in 10 children with Moyamoya disease. Their surgical treatments included superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis or encephalo-duro-arterio-synangiosis. The flow velocity and pattern of the major cerebral arteries and STAs, the donor artery of the bypass, were studied both before and after the operation. The results of Doppler flowmetry were compared with clinical symptoms and angiographical findings. Though the Doppler sonography of the major cerebral arteries showed little change, the flow velocity of the STAs revealed a pronounced and rapid increase after the bypass surgery. The flow pattern of the STAs, which was of the external carotid type preoperatively, changed to the internal carotid type postoperatively. These ultrasonic Doppler findings were thought to be due to a decrease in the peripheral vascular resistance, and suggested a good patency of the bypass arteries. These results of the Doppler flowmetry were in good agreement with clinical and EEG improvement and the findings of the postoperative cerebral angiography. It is suggested that ultrasonic Doppler flowmetry is a noninvasive and reliable method of assessing the function of the EC/IC bypass in children with Moyamoya disease.

Valid therapeutic means have not been established for treatment of disseminated peritoneal metastasis of carcinoma. Continuous hyperthermic peritoneal perfusion (CHPP) with high-dose of mitomycin-C (MMC) was applied to 26 patients with peritoneal metastasis from gastric, rectal or ovarian cancers. Levels of MMC in the sera and in the perfusate were measured. The results obtained were: 1. Approximately a half of the dose of MMC added into the perfusion fluid was recovered. 2. When perfused with 100 mg of MMC, the maximum serum concentration of MMC was equivalent to 1/3 of the maximum serum level when injected with 10 mg of MMC intravenously. Therefore, MMC which could not be detected in CHPP seemed to be retained in the abdominal cavity. 3. Bone marrow inhibition caused by CHPP was observed in only 2 of 26 patients. 4. The total dose of 300 mg of MMC, consisting of the maximum dose of 100 mg each, is acceptable in CHPP without any severe side effect. 5. CHPP exerts antitumor effects when utilizing hyperthermia and a high-dose of MMC on the disseminated peritoneal foci of carcinoma.

The application of the results of any fire toxicity test is extremely difficult because of the complexity of the problem and the limitations of the test. This paper will discuss the potential use of test data in the decision-making process., Reprinted from: Fire and Materials, v. 8, no. 1, 1984, p. 1-5. ISSN: 0308-0501. DOI: 10.1002/fam.810080102

The patient, a 5-year-old male, was diagnosed as having pernicious anemia at our hospital in 1969. By means of an upper G-I series, he was found to have a gastric protruded lesion on the greater curvature of the upper corpus in 1983. After an endoscopic polypectomy, a type II a early gastric cancer was diagnosed which, histologically, showed a well-differentiated adenocarcinoma and a total gastrectomy was performed. From the histologic findings of the resected stomach, the were multiple endocrine cell micronests, that coincided with the distribution of intestinal metaplasia localized in the fundic gland area.

Die aus den silylierten Cyclopropancarbonsaureestern (I) mit Phenylmethylsulfon (II)/ Amyliodid (III) zuganglichen Cyclopropylketone (IV) werden mit BF3/Essigsaure unter Abspaltung der Silylfunktion zu den Enonen (V) ringgeoffnet, die sich mit PdClz/CuCl/Og zu den Diketonen (VI) oxidieren lassen.

A new vaginal contraceptive in the form of a film containing the spermicide, polyoxyethylene nonylphenyl ether (C-Film) was put into clinical trials. To evaluate spermicidal activity of C-film, an in vitro test was performed. After 1 minute, no motile sperm could be seen in the C-film solution which was diluted 32 times by a 5% glucose solution. When the sperm contacted the C-film solution diluted 8 times, the sperm stopped moving. C-film was used by 168 women for 1 and one-half years from December 1977 to May 1979 for a total period of 2161 months. Only 1 pregnancy occurred, thus giving a pregnancy rate of 0.56/100 women-years. During the use of C-film, 16 cases (9.5%) complained about an increase of vaginal discharge, 8 cases (4.8%) felt unfamiliar with the insertion, and 7 cases (4.2%) complained about unusual feelings caused by the presence of the C-film. A total of 9 cases (5.4%) stopped using C-film; 3 due to irritation, 2 due to troublesome use; and others due to vaginal discharge, burning sensation, pregnancy, and reasons unknown. No significant changes were observed in the vaginal bacteriology, cervical cytology, liver function, or renal function. The study indicates that C-film is very effective, well-tolerated, and has a low incidence of side effects. (Authors' modified)