Search

It has been suggested that bactrian camel milk and colostrum may be a good source of biologically significant oligosaccharides but, although the oligosaccharides found in bactrian camel milk and colostrum have been characterised, those in dromedary camel milk have not. In this study, seven oligosaccharides from commercially available pasteurised dromedary camel milk were characterised using 1H nuclear magnetic resonance spectroscopy. The following oligosaccharides were detected: Gal(β1-3)Gal(β1-4)Glc (3′-galactosyllactose), Gal(β1-4)GlcNAc(β1-3)[Gal(β1-4)GlcNAc(β1-6)]Gal(β1-4)Glc (lacto-N-neohexaose), Neu5Ac(α2-3)Gal(β1-4)Glc (3′-sialyllactose), Neu5Ac(α2-6)Gal(β1-4)Glc (6′-sialyllactose), Neu5Ac(α2-3)Gal(β1-3)Gal(β1-4)Glc (sialyl-3′-galactosyllactose), Neu5Ac(α2-3)Gal(β1-3)[Gal(β1-4)GlcNAc(β1-6)]Gal(β1-4)Glc (sialyllacto-N-novopentaose a) and Neu5Ac(α2-6)Gal(β1-4)GlcNAc(β1-3)[Gal(β1-4)GlcNAc(β1-6)]Gal(β1-4)Glc (monosialyllacto-N-neohexaose).

Functional electrical stimulation (FES) is a type of therapy used for paralyzed patients. In FES, the implant direct feeding method is an ideal stimulus method. In this method, small stimulators are implanted in the paralyzed limbs, and magnetic coupling is used to simultaneously power the implants and enable digital communication with the mounted system. To realize this method, we have developed an implant antenna (magnetic connective dual-resonance antenna) that can transmit as well as receive signals and a mounted communication system that is responsible for supplying power and communication from outside the body to the implanted antenna inside of the body. However, to guarantee safe stimulation, this system requires the closed-loop control function. For this purpose, we have proposed a communication protocol that is inexpensive, and a new communication system that supports bidirectional communication. In this paper, we present the new protocol, the composition and mechanisms of the proposed system, and the experimental results that verify the efficiency of this system.

Functional electrical stimulation (FES) is the therapy used in the rehabilitation of lost movement functions, and to apply stimulation, the implanted direct feeding method was adapted. In this method, stimulus energy and signals for controlling devices are applied to the devices by a mounted system using magnetic coupling. In a previous study, the mounted coil was developed to be able to generate the magnetic flux for supplying energy and communication with the time-division exciting method. However, this exciting method reduces the communication speed to half of the specified speed of the mounted communication coil. In addition, the previous driving method requires an equal number of inverters as communication coils, which consumes a lot of energy. To address these problems, a new driving and exciting method have been proposed, in which the communication speed is not reduced and it needs a single inverter to excite coils. In this report, these new methods are introduced, and the experimental results show that the possibility of the whole area communication for the direct feeding method and the single source driving method.

To estimate the contribution of uncultured bacterial groups to fiber degradation, we attempted to retrieve both ecological and functional information on uncultured groups in the rumen. Among previously reported uncultured bacteria, fiber-associated groups U2 and U3, belonging to the low-GC Gram-positive bacterial group, were targeted. PCR primers and fluorescence in situ hybridization (FISH) probe targeting 16S rRNA genes or rRNA were designed and used to monitor the distribution of targets. The population size of group U2 in the rumen was as high as 1.87%, while that of group U3 was only 0.03%. Strong fluorescence signals were observed from group U2 cells attached to plant fibers in the rumen. These findings indicate the ecological significance of group U2 in the rumen. We succeeded in enriching group U2 using rumen-incubated rice straw as the inoculum followed by incubation in an appropriate medium with an agent inhibitory for Gram-negative bacteria. Consequently, we successfully isolated two strains, designated B76 and R-25, belonging to group U2. Both strains were Gram-positive short rods or cocci that were 0.5 to 0.8 μm in size. Strain B76 possessed xylanase and α- l -arabinofuranosidase activity. In particular, the xylanase activity of strain B76 was higher than that of xylanolytic Butyrivibrio fibrisolvens H17c grown on cellobiose. Strain R-25 showed an α- l -arabinofuranosidase activity higher than that of strain B76. These results suggest that strains B76 and R-25 contribute to hemicellulose degradation in the rumen.

Functional electrical stimulation (FES) is a therapy used in the rehabilitation of lost-movement functions by applying electrical stimulation to paralyzed extremities. We adapted the implanted direct-feeding method to apply stimulation, in which small implanted stimulators were placed under the skin at a depth of 20 mm, and stimulus energy and signals to control the devices were applied to them with a mounted system using magnetic coupling. This method had two main advantages in that it had no percutaneous points and it provided highly precise stimulation. The sizes of the mounted coil and the implanted coil were quite different so that the coupling between each was extremely low. To retain this disadvantage, the implant coil had a high-aspect ratio ferrite core, which gave the implant coil a magnetic direction for easy feeding and communication. Therefore, the magnetic fluxes from the mounted coil for feeding and communication had to be generated in the same direction inside the mounted coil. We propose a mounted coil that is able to generate such a magnetic flux, and tested and verified the possibility of whole area feeding and communication with it.

Objective: To evaluated the utility and safety of the Cavitron ultrasonic surgical aspirator (CUSA) for laparoscopic paraaortic lymphadenectomy in gynecologic malignancies.Methods: Between January 2007 and January 2008, we performed laparoscopic treatment of gynecologic cancer in 22 patients. In all patients, laparoscopic lymphadenectomy was included in the surgical procedures. In 10 of 22 patients, CUSA was used for the dissection of the left-sided para-aortic lymph nodes. The range of lymphadenectomy was up to the renal vein for patients with endometrial and ovarian cancers, and up to the inframesentric artery for patients with cervical cancer. We analyzed the number of removed lymph nodes and the time needed for the procedure. The results in the group with CUSA and those without CUSA were compared.Result: The number of lymph nodes removed was equivalent between the groups, irrespective of the range of lymphadenectomy. However, the operative time was shortened in the group with CUSA. We had no particular complications in either group.Conclusion: We safely performed laparoscopic lymphadenectomy using CUSA. There is a possibility that by using CUSA, the time required for laparoscopic lymphadenectomy may be shortened.

PurposeThis study aims to evaluate an organizational development programme (TQM) that was implemented at the tertiary‐care public hospital that showed the highest total factor productivity growth in Sri Lanka for the 1997‐2001 period.Design/methodology/approachBalanced score card approach is used to assess the performance of the hospital under study. Value chain analysis is conducted to identify the changes in organizational management following TQM implementation. Employee feedback is obtained by questionnaire‐based interviews.FindingsPerformance of the hospital with regard to service quality, employee‐performance, fixed‐asset‐performance, and social responsibility improved. Overall, value chain analysis shows that the differentiation was used to improve quality of services. Leadership, team‐work and continuous monitoring were the key factors that facilitated implementation of 5‐S based TQM.Practical implicationsThe 5‐S system‐based TQM appears to be a feasible and promising system to initiate management improvement of public hospitals in developing countries.Originality/valueThis paper is of value for hospital managers and policy makers of developing countries, where there are chronic resource shortage and managerial constraints, particularly in government sector health services.

We report anomalous Hall effects exhibiting a hysteresis loop as large as about 10 T in a ferromagnetic superlattice comprising ${\mathrm{La}}_{0.67}{\mathrm{Sr}}_{0.33}{\mathrm{MnO}}_{3}$ and ${\mathrm{SrRuO}}_{3}$ layers. The superlattices grown by pulsed laser deposition exhibit a strong antiferromagnetic interlayer coupling below 110 K, where both ${\mathrm{La}}_{0.67}{\mathrm{Sr}}_{0.33}{\mathrm{MnO}}_{3}$ and ${\mathrm{SrRuO}}_{3}$ layers show anomalous Hall effects. With increasing magnetic-field strength, the anomalous Hall resistivity in the superlattices changes its sign depending on the magnetization directions of the ${\mathrm{La}}_{0.67}{\mathrm{Sr}}_{0.33}{\mathrm{MnO}}_{3}$ and ${\mathrm{SrRuO}}_{3}$ layers. As a consequence of competition among the antiferromagnetic interlayer coupling, the Zeeman effect, and magnetic anisotropies, the width of the hysteresis loop in the anomalous Hall resistivity in the superlattices becomes larger than 8 T at 10 K, clearly greater than those observed in ${\mathrm{La}}_{0.67}{\mathrm{Sr}}_{0.33}{\mathrm{MnO}}_{3}$ and ${\mathrm{SrRuO}}_{3}$ single layer films.

In this paper, we provide a constitutive model for overall (macroscopic) plastic deformation behavior in a rubber-toughened polymer blend. A porous plasticity theory is employed as a basis for the constitutive modeling. In our investigation, the polycarbonate (PC) is chosen as a matrix material of polymer blend. First, the true uniaxial stress-strain relation for PC, which is an important part of the constitutive model, is carefully measured. Secondly, finite element analyses of neck propagation in a tensile specimen of PC are performed to test the efficiency of the introduction of the accurately measured true stress-strain relation into the model. Then, in order to investigate local and average deformation behavior of the matrix material (PC) around cavitated rubber particles in polymer blend, an axisymmetric unit cell analysis is carried out. Finally, finite element analyses of the neck propagation in a tensile specimen of a rubber-toughened PC are performed, and the numerical results are compared to experimental results. It is revealed that the present constitutive model has the ability to well reproduce the behavior of a rubber-toughened polymer blend with rather small volume fraction of rubber particles, which is up to about 10%. However, for blends with larger volume fraction of the rubber particles, the discrepancy between the computational and the experimental results increases. Several possibilities of enhancing the model are discussed.

Deposition of diamond-like carbon (DLC) film and mass spectrometry measurements were carried out in a closed-space CH4 rf (13.56 MHz) plasma (without both gas injection and vacuum pumping during the process). At pressures less than 0.6 Torr, the thickness of the DLC film deposited increased with increasing elapsed deposition time, and reached a maximum value, but after this the film thickness started to decrease, which was considered to be caused predominantly by ion-induced sputter etching. The maximum film thickness appeared at larger elapsed time for higher deposition pressure. The mass concentrations of hydrocarbon ions indicated anomalous behavior at early deposition times, but those of higher hydrocarbon ions are clearly increased at the point where the film thickness started to decrease. These results suggested that the ratio of precursor CH3al density to the total hydrocarbon ion density (ΦCH3/Φion in the CH4a was an important factor for the carbon film formation, and when this ratio reduced to a certain critical value with increasing elapsed deposition time, the deposited film was then re-etched predominately by the secondary higher hydrocarbon ions. At 1.0 Torr where a polymer-like soft carbon film was deposited, such re-etching of the deposited film was not observed.

Therapeutic electrical stimulation (TES) is electrical stimulation to treat disorders caused by abnormalities in nerves. We have been researching implanted TES that stimulates objective nerves directly inside the body. Prior to this, separate coils were used in implanted TES to transmit power and signals. However, the two-coil system presents several problems. For example, it is necessary to carefully design both coils because the one for power transmission is more powerful than the one for signal transmission, and the power magnetic field interferes with the signal magnetic field. That makes it extremely difficult to design these coils flexibly. To solve this problem, we have begun research on establishing a different method that would increase the flexibility with which coils could be designed. The concept underlying this new approach was to transmit power and signals simultaneously with the same magnetic field. To achieve this, we superimposed the signal on the power. In the first step in this research, we ascertained that this superimposed system of transmission could drive the system for implanted TES.

We report a case of mos 45, X/46, X,+mar, diagnosed prenatally by amniocentesis, whose physical examination, including external and internal organs, along with serum testosterone values were normal five years after delivery. The mosaic karyotype was seen in 146 of 240 cells examined (amniotic fluid cells, 110/65; placental chorionic villi: 5/4; cord blood, 21/81; cultured skin fibroblasts, 10/90) from 386 metaphases, and the marker chromosome appeared as a small non-fluorescent acrocentric chromosome. All autosomes appeared normal, and no normal Y chromosome could be demonstrated. Analysis of 26 Y-chromosome loci by molecular techniques such as PCR, Southern analysis using multiple Y-specific DNA probes, and Hae III restriction endonuclease assessment of male-specific repeated DNA in the heterochromatic region of the Y chromosome, and fluorescence in situ hybridization (FISH), revealed the marker was derived from a Y chromosome including p terminal to q11.23, and paracentric inversion in the remaining Y long arm. The formation of testes can be considered as existence of SRY (sex-determining region of Y) as a testis-determining factor. The present report illustrates the importance of FISH and molecular techniques as a complement to cytogenetic methods for accurate identification and characterization of chromosome rearrangements in prenatal diagnosis. Copyright © 1998 John Wiley & Sons, Ltd.

The transcriptional activity of the hexafluorinated derivative of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3], 26,26,26,27,27,27-hexafluoro-1,25-dihydroxyvitamin D3 [F6-1,25-(OH)2D3], was examined in cultured cells by a transient expression assay (CAT assay) using expression vectors for the rat nuclear vitamin D3 receptor (VDR) and the rat 9-cis-retinoic acid receptor (RXR beta), and a reporter plasmid containing a consensus vitamin D3 response element (VDRE) consisting of two directly repeated AGGTCA motifs spaced by 3 bp (DR3). At physiological concentrations, the transcriptional activity of F6-1,25-(OH)2D3 was 2-4 times more potent than that of 1,25-(OH)2D3 in both nontarget (HeLa) and target (UMR106) cells for 1,25-(OH)2D3. The transcriptional activity of F6-1,25-(OH)2D3 was also higher when the endogenous target gene (osteopontin), which has a VDRE related to the DR3 in its promoter, was induced. A gel-shift assay using DR3 as a probe and in vitro synthesized receptors showed that the ligand-induced DNA binding of VDR required RXR to form a heterodimer. Moreover, in this assay we found that F6-1,25-(OH)2D3 induced the receptor-DNA complex at a 10-fold lower concentration than 1,25-(OH)2D3 without influencing the dissociation kinetics. However, the binding affinity of F6-1,25-(OH)2D3 for VDR was slightly lower than that of 1,25-(OH)2D3. The increased DNA binding of ligand-bound VDR by introducing hexafluorines into 1,25-(OH)2D3 may potentiate the transcriptional activity. Thus, the higher biological activity of F6-1,25-(OH)2D3 may be exerted at least in part by enhanced transcriptional activity.

Although it has been suggested that humoral immunity plays a role in the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage, there has been no quantitative assay for cellular immunity. We studied the kinetics of immune cells in the subarachnoid space after subarachnoid hemorrhage in the rat. One hundred fourteen Sprague-Dawley rats were used in this study. The animals were divided into two groups and injected with either autologous blood (0.3 mL) or saline into the major cistern. They were killed at the specified time: 10 minutes or 1, 2, 3, 5, or 7 days after subarachnoid hemorrhage. For immunohistochemical analysis, the rats' whole brains were frozen, and cryostat sections were prepared. For flow cytometric analysis of immune cell presence, their whole brains underwent enzymatic digestion. Histopathologic study revealed pathological change of the arterial wall, and immunohistochemical study revealed the existence of macrophages and T cells in the subarachnoid space in animals with a survival time of 2 to 5 days after subarachnoid hemorrhage. A flow cytometric study revealed the peak of appearance of T cells and macrophages 2 days after subarachnoid hemorrhage. The helper-suppressor T cell ratio also reached a peak 2 days after subarachnoid hemorrhage. A serial response of immunoreactive cells, which resembles that of the chronic allergic reaction observed in autoimmune diseases or delayed-type hypersensitivity, exists in the subarachnoid space after subarachnoid hemorrhage. The present results suggest that the initial response in cellular immunity, which is followed by humoral immunity and eicosanoid reactions, plays a role in eliciting the development of cerebral vasospasm.

A new energy extraction scheme of a chemically pumped pulsed large-scale iodine laser based on a high-pressure pulsed singlet oxygen generator is proposed. In previous investigations only low-pressure oxygen generators have been considered. Since they require a high iodine density for an efficient amplifier operation, the lifetime of the stored energy is correspondingly small and thus only small-sized iodine amplifiers appear to be technically feasible. We found, however, that when the singlet oxygen is generated at high-pressure, the iodine density required can be considerably reduced so that the lifetime of the stored energy becomes sufficiently long to fill up large amplifier cells. A numerical model is developed and the extractable energy is theoretically estimated. It is shown that 0.2J/1·pass can be extracted when an input pulse of 20 ns duration (FWHM) and 1 J/cm2 fluence is fed into the amplifying medium.

A theoretical and experimental study was conducted aimed at achieving laser oscillation in the (a-X) electronic transition of oxygen molecules. Although this transition is highly forbidden by rigorous selection rules, it may nevertheless concede stimulated emission, if the population inversion is high enough. The idea is based on a recently developed apparatus, namely, a porous pipe type high-pressure chemical singlet oxygen generator. A numerical model which describes the characteristics of this generator was developed to estimate the population inversion and small-signal gain achievable in a laser cavity using this source. The calculations showed that the small-signal gain ought to be sufficient to achieve laser oscillation. Preliminary experiments were conducted, but lasing was not yet observed. It is shown that the scattering losses caused by water droplet aerosols are mainly responsible for preventing our system from laser oscillation.

The effect of whole-body hyperthermia on the development of peritumoral brain oedema and intracranial pressure was studied in cats with intracerebral transplanted tumour. Whole-body hyperthermia was achieved by means of extracorporeal circulation. The temperature within the brain tumour tissue was increased to 41.8 +/- 0.15 degrees C (mean +/- SD) for 2 h. Measurements of brain water content revealed that hyperthermia worsened the degree of peritumoral brain oedema. Microscopical observation demonstrated that extravasation of horseradish peroxidase, indicating disruption of the blood-brain barrier in the oedematous region, was more severe in animals exposed to hyperthermia than in non-treated animals. Intracranial pressure significantly increased from 13.5 +/- 5.26 mmHg to 25.8 +/- 6.16 mmHg (p0.05) during hyperthermia, although it was controlled at 20.7 +/- 2.60 mmHg by continuous infusion of glycerol. The results suggest that whole-body hyperthermia acting on a brain-bearing tumour caused an increase in intracranial pressure due to worsening of the degree of peritumoral vasogenic type of brain oedema. We emphasize that whole-body hyperthermia may be performed with careful monitoring of intracranial pressure for patients who have brain tumour.

The characteristics of a high‐pressure pulsed singlet oxygen generator is investigated. This generator was designed for the energy source of new pulsed chemical lasers. A ceramic porous pipe is devised in it to attain the high‐pressure pulsed operation. New methods were developed to measure a water vapor pressure and a reaction efficiency in the pulsed singlet oxygen generator system. The maximum singlet oxygen pressure obtained was 35 Torr, and the estimated initial excitation efficiency was 70%–80%

We studied the impairment of autoregulation of cerebral blood flow (CBF) and its effect on the electrical activity of the brain during the development of chronic cerebral vasospasm after subarachnoid hemorrhage, using a vasospasm model in primates. Fourteen animals were divided into two groups: a clot group (8) and a sham-operated group (6). To induce subarachnoid hemorrhage, all the animals underwent craniectomy, and in the clot group, the autologous blood clot was located around the arteries dissected free from the arachnoid membrane. Cerebral angiography was performed before subarachnoid hemorrhage and 7 days after (Day 7). On Day 7, regional CBF in the parietal lobe—measured by the hydrogen clearance method—and central conduction time were studied during either graded hypertension or hypotension. In the clot group, the mean vessel caliber of the cerebral arteries on the right side (clot side) of the circle of Willis showed significant (P

Objective: To report a case of tubal pregnancy in a unicornuate uterus with rudimentary horn on the side of the rudiment and its pathology. Design: Case report. Setting: University hospital. Patient: An 18-year-old woman, primigravida, with tubal pregnancy. Intervention(s): Systemic administration of methotrexate, salpingectomy by laparotomy, and laparoscopic surgery for resection of rudimentary horn. Main Outcome Measure(s): Emergent laparotomy revealed that the intraperitoneal hemorrhage was caused by the rupture of the tubal pregnancy on the same side as the rudimentary horn of the unicornuate uterus. A corpus luteum was found at the ipsilateral ovary of the rudimentary horn. Result(s): Image diagnosis and pathological examination of the rudimentary horn revealed that this uterine malformation was a unicornuate uterus with a noncommunicated, noncavitary rudimentary horn, corresponding to class IIc of the American Fertility Society classification of mullerian anomalies. Conclusion(s): This is the first report of a tubal pregnancy on the side of the noncommunicating rudimentary horn with the ipsilateral ovary carrying a corpus luteum in a unicornuate uterus.

Shortening the treatment phase of complex decongestive physiotherapy (CDP) is extremely important both for individual patients and medical economics. In 83 patients with stage II unilateral secondary extremity lymphedema (31 upper extremities and 52 lower extremities), the daily changes in the volume of affected extremities during the treatment phase of CDP were prospectively investigated. For the upper extremity lymphedemas, the biggest change was seen between days 1 (100% residual edema rate) and 2 (46.0 +/- 2.7%; mean +/- SD) of therapy with a 54.0% reduction (p0.0001). Between days 2 and 3 (38.0 +/- 2.6%) of therapy, there was an 8.0% reduction (p0.05). From days 3 to 6 of therapy, slight changes ranging from 0.2 to 3.2%/day were seen. For the lower extremity lymphedemas, the biggest change was seen between days 1 (100%) and 2 (44.5 +/- 2.1%) of therapy with a 55.5% reduction (p0.0001). Between days 2 and 3 (33.5 +/- 2.6%) of therapy, there was an 11.0% reduction (p0.001). The daily volume changes from days 4 to 6 were slight, ranging from 0.1 to 1.0%/day. During the treatment phase of CDP, the largest volume changes were seen soon after the start of therapy.

Malignant neoplasms arising in the broad ligament are quite unusual. Although tens of broad ligament cancers of low potential malignancy have been documented, there have been only two reports of high-grade cases. Furthermore, it remains controversial whether broad ligament tumors are mesonephric (wolffian) or paramesonephric (mullerian) in origin. This case study reports a 49-year-old nulliparous woman who, during her follow-up for breast cancer, demonstrated a 39- × 32-mm solid and poorly differentiated adenocarcinoma within the broad ligament of the right adnexa. Because of its rarity and poor differentiation, immunohistochemical analysis was performed to identify the primary malignancy and determine its origin. Positive expression of WT1, CA125, and ER and negative expression of GCDFP-15, HER-2, and PgR in broad ligament cancer, in conjunction with positive expression of GCDFP-15 and ER and negative expression of WT1, HER-2 and PgR in the previous breast cancer, suggested broad ligament cancer to be a gynecological primary malignancy with serous characteristics rather than a metastasis from the previous breast cancer. In addition, EMA-positive and CK7-negative expression indicated a mullerian origin. Broad ligament cancers of mullerian origin occur predominantly in women of reproductive age, most of whom are infertile or nulliparous. This feature, together with the positive expression of ER in this case, may raise the possible hormonal influence on the etiology of broad ligament cancer of mullerian origin.

Transverse thermoelectric effects in response to an out-of-plane heat current have been studied in an external magnetic field for ferromagnetic superlattices consisting of La0.67Sr0.33MnO3 and SrRuO3 layers. The superlattices were fabricated on SrTiO3 substrates by pulsed laser deposition. We found that the sign of the transverse thermoelectric voltage for the superlattices is opposite to that for La0.67Sr0.33MnO3 and SrRuO3 single layers at 200 K, implying an important role of spin Seebeck effects inside the superlattices. At 10 K, the magnetothermoelectric curves shift from the zero field due to an antiferromagnetic coupling between layers in the superlattices.

In this paper, we proposed a new contactless power-signal transmission device using electromagnetic coupling for a functional electrical stimulation (FES) system, which consists of two coils. With the primary coil outside and the secondary inside the body, the in vivo coil composed of a coupling of two parts, one to receive power and one to receive signal, each at a different radio frequency. In this study, our approach is based on a structure to implement a simultaneous power-signal transmission system, which enables power and signal for muscle stimulation to be concurrently transferred from outside the body, while allowing for the separation inside. Moreover, the induced voltage of the magnetic flux on signal transmission, suppressed to 0.15 V, the output signal voltage of 2 V or more was established at a signal frequency of 7.7 MHz, thus leading to stable operation. The study also aimed to reach for higher power output of the secondary coil.

A significant part of the strokes can result in hemispatial neglect. It is an attention disorder that leads to a loss of perception of the stimuli coming from the space contra-lateral to the brain lesion. The neglect occurs mainly for visual stimuli but other senses can also be affected. The rehabilitation of these patients is quite difficult as they usually suffer from anosognosia. Unfortunately, the opportunities to do experiments with a significant number of patients are rare. We propose to simulate the hemispatial neglect by using the virtual reality technology. Simulating this disorder not only allow us to determine the potential of a particular rehabilitation technique but can also help the rehabilitation staff and the relatives to get a better understanding of the patient's condition. We discuss the development of a simulated neglect in our system and compare the performance of healthy subjects, patients and simulated patients in a virtual replica of the line bisection test. The results suggest that our vision of the neglect is mostly accurate and that it could be a great tool to study new rehabilitation techniques

For the purpose of trunk stabilization in standing of paraplegic individuals induced by functional electrical stimulation (FES), the feasibility of feedback control of thorax inclination angle was examined. The sagittal and coronal inclination angles could be detected using pendulum sensors with less than three percent error. The contractile forces for the movement in an anti-gravitational environment were obtained in both the rectus abdominis and erector spinae muscles. The feasibility of the feedback control of thorax inclination angle was demonstrated. >

The feasibility of trunk stabilization was demonstrated during the standing of an individual with paraplegia by using functional electrical stimulation (FES). A control system was designed for the feedback control of the sagittal and the coronal trunk inclination angles. The system was constructed of two proportional-and-derivative (PD) controllers and a three-dimensional co-activation stimulation map. The clinical evaluation of the effect in disturbance suppression was performed by applying a step disturbance, in an individual with spinal cord injury at the thoracic eighth level. The pelvis and the lower extremities were fixed by using parallel bars and knee-ankle-foot-orthosis. The decrease of the backward sway magnitude by using the proposed system was confirmed.

We reported the technique of pathological diagnosis for minute lung cancer lesion of early stage during operation. Target lesion for our technique may be less than 1 cm in size and not be detected by palpation. Our technique may superior to usual method of frozen section of tissue specimen without fixation. At first, resected lung specimen was fixed by injection of 20% formalin solution subsequent warming by microwave oven for 40 seconds. Almost all lesions may be detected in proper thickness of specimen. Specimen was washed out and steeped in the 20% of sucrose solution for 30 to 60 seconds in order to avoid crystallization of water that was contained within lung specimen. Then thin sliced section of specimen was made by Cryostat in usual method. The minute cancer lesion was able to detect more easy than usual method of making frozen section of specimen. Formalin fixed and sucrose steeped frozen section may be able to evaluate the surgical margin from cancer exactly than the section made by non-fixed specimen.

A 63-year-old man with rapidly progressive glomerulonephritis of the immune-complex type showed typical findings of idiopathic retroperitoneal fibrosis involving the left ureter resulting in hydronephrosis. Treatment with steroid improved both conditions. Our case and previously reported cases showing the same association of conditions support the hypothesis that the association is not fortuitous but reflects a common immunological mechanism.

Recently, several advances in operative techniques and management of chronic cerebral vasospasm for patients with aneurysmal subarachnoid haemorrhage (SAH) have improved morbidity and mortality rates. However, even when the surviving SAH patients show no grossly evident neurological deficits, they frequently have subtle neurobehavioral problems [5, 9]. These problems have been suggested to result from widespread damage of neuronal cells from SAH [8], whereas ischaemic lesions observed by imaging study are not involved in such problems [9]. Though the details of the pathogenesis of this pathological condition is not obvious, possible causative mechanisms have been considered to explain: impairment of cerebral microcirculation at the onset of SAH and/or during chronic cerebral vasospasm [3], and secondary neuronal cell damage elicited by subarachnoid clot [6].

We report two patients with spiny keratoderma of the palms and soles characterized by multiple tiny keratotic plugs on the palms and soles. This disease was reported to be possibly associated with internal malignancies. We found a tumor from the esophagus to cardia in one patient. Another had no tumor but the lesion occurred soon after a severe bronchial asthma attack. Causal relation between spiny keratoderma of the palms and soles and bronchial asthma is obscure. Since this disease has been under-diagnosed and under-reported, it is important for dermatologists to keep spiny keratoderma of the palms and soles in mind in daily clinical examinations.

The purpose of this study was to examine the production of secretory component (SC) and immunoglobulin A (IgA) in the gastric mucosa with Helicobacter pylori infection and to investigate the influence of immunological reactions on various phases of infection (gastritis, intestinal metaplasia, gastric cancer). Production of SC and IgA was assessed by immunohistochemical staining in (1) endoscopic biopsy samples of H. pylori-eradicated cases (n = 25), and (2) surgically resected stomach tissues of H. pylori-positive gastric cancer cases, intestinal type (IGC, n = 25) and diffuse type (DGC, n = 25). Before eradication therapy, all samples showed positive staining of SC and IgA in epithelial cells, and IgA was also positive in plasma cells in the mucosal layer. H. pylori bacteria were positively stained for SC and IgA. After treatment, the degree of SC and IgA staining in epithelial cells was reduced with successful eradication; but with intestinal metaplasia, SC staining was positive regardless of the results of treatment. In nonmetaplastic mucosa, SC-positive cells were increased in the glandular neck zone to the surface mucosal layer; and the intensity of SC staining was increased in proportion to the degree of mucosal inflammation and IgA-positive cell aggregation. In intestinal metaplasia, SC was positive irrespective of the degree of inflammation. Most cancer foci also showed positive staining of SC, irrespective of histological type. Production of SC and IgA was thought to be a specific reaction against H. pylori infection, occurring from the early to the late stages and not limited to intestinal metaplasia. It was suggested that immunological reactions against H. pylori infection might generally be involved with the pathogenesis of intestinal metaplasia and both histological types of gastric cancer (IGC and DGC).

The relationship between Helicobacter pylori (H. pylori) infection and gastric cancer was evaluated clinicopathologically by histological types of gastric cancer (intestinal or diffuse type). Histological findings of resected stomach tissues and serum anti-H. pylori IgG antibody titers obtained in patients with early gastric cancer revealed H. pylori infection and associated inflammatory changes in all cases, irrespective of histological types of cancer, and suggested that diffuse type cancer occurs in the mucosa with marked inflammation at a relatively early stage of H. pylori infection, while intestinal type cancer occurs at a relatively late stage of infection in parallel with the progression of mucosal atrophy and intestinal metaplasia. Results of immunohistochemical staining showed high incidence of secretory components in and around cancer foci, suggesting that immunological mechanisms for H. pylori infection play a role in the development of gastric cancer regardless of its histological type.

A 68-year-old male admitted to our hospital because of fever, body weight loss and multiple mononeuropathy. He developed visual loss in his right eye due to anterior ischemic optic neuropathy (AION). Surgical treatment of jejunal perforation was performed and histological examination of jejunal ulcer confirmed the diagnosis of polyarteritis nodosa (PN). Combination therapy of steroid (prednisolone 50 mg/day) and cyclophosphamide (50 mg/day) was started, which saved him from any other ischemic change including that of his left eye. As long as we know, AION occurring in PN is very rare, that is, only 4 cases have been reported in Japan.

A 30-year-old man had been treated for malignant rheumatoid arthritis from 1989 with a non-steroidal anti-inflammatory drug, then bucillamine for six months and prednisolone. Mild proteinuria appeared in May 1994, 4 years after bucillamine therapy was conducted. The patient was admitted to our hospital for a renal biopsy in July 1994. The specimen revealed secondary amyloidosis and membranous nephropathy (MGN). These findings suggest that MGN unrelated to bucillamine therapy might have occurred with secondary amyloidosis in rheumatoid arthritis.

We report a case of mos 45,X/46,X,+mar, diagnosed prenatally by amniocentesis, whose physical examination, including external and internal organs, along with serum testosterone values were normal five years after delivery. The mosaic karyotype was seen in 146 of 240 cells examined (amniotic fluid cells, 110/65; placental chorionic villi: 5/4; cord blood, 21/81; cultured skin fibroblasts, 10/90) from 386 metaphases, and the marker chromosome appeared as a small non-fluorescent acrocentric chromosome. All autosomes appeared normal, and no normal Y chromosome could be demonstrated. Analysis of 26 Y-chromosome loci by molecular techniques such as PCR, Southern analysis using multiple Y-specific DNA probes, and Hae III restriction endonuclease assessment of male-specific repeated DNA in the heterochromatic region of the Y chromosome, and fluorescence in situ hybridization (FISH), revealed the marker was derived from a Y chromosome including p terminal to q11.23, and paracentric inversion in the remaining Y long arm. The formation of testes can be considered as existence of SRY (sex-determining region of Y) as a testis-determining factor. The present report illustrates the importance of FISH and molecular techniques as a complement to cytogenetic methods for accurate identification and characterization of chromosome rearrangements in prenatal diagnosis.

We report an unusual case of a 55 year old Japanese woman with a seminoma but relatively normal menses. The patient was a phenotypic female with late onset menarche (18 years of age), who was amenorrhoeic for the first year, followed by menses of one to three days' slight flow with dysmenorrhoea, but an otherwise normal menstrual history. A typical seminoma was removed from the left adnexal region and an immature testis was identified separately as an associated right adnexal mass. Repeated karyotypic studies on peripheral blood lymphocyte cultures showed only 46,X,-Y,t(Y;15)(q12;p13). Cytogenetic examination of the patient's younger brother, who had fathered three healthy children, showed an identical karyotype. Mosaicism of 46,X,-Y,t(Y;15)(q12;p13)/45,X cell lines was found in skin samples from the patient's elbow and genital regions, although there were no clinical stigmata of Turner syndrome. An androgen receptor binding assay of cultured genital skin fibroblasts was negative. Molecular analysis using Southern blot hybridisation, PCR, and direct DNA sequencing showed that neither the patient nor her brother had a detectable deletion or other abnormalities of Y chromosome sequences, including the SRY (sex determining region of the Y chromosome) gene sequence. These findings suggest that Turner mosaicism of the 45,X cell line may have contributed to this atypical presentation in an XY female, although we cannot exclude abnormalities of other genes related to sex differentiation.

The major purpose of this study was to evaluate the association of Helicobacter pylori and diffuse type gastric cancer (DGC) clinicopathologically (study 1). The second aim was to investigate genetic differences of H. pylori in patients with DGC and intestinal type cancer (IGC) (study 2). The prevalence of H. pylori and the types of histopathological changes were evaluated in resected early gastric cancer (DGC; 25 patients, IGC; 25 patients). Genetic differences of H. pylori in DGC patients (n = 19) and IGC patients (n = 22) were analyzed by polymerase chain reaction (PCR) methods in terms of restriction fragment length polymorphism patterns of the ureB gene and cagA gene positive rates. All patients had evidence of H. pylori infection in the resected stomach, but the positive rate for H. pylori in the area surrounding cancer was 52% (in DGC; 56%, IGC; 48%). But in 40.0% of DGC cases (10/25), mucosal atrophy and intestinal metaplasia were rarely seen in the area surrounding cancer and the positive rate of H. pylori was 80.0% (8/10), in contrast, in 60.0% of IGC cases (15/25), atrophy and metaplasia were progressed and positive rate of H. pylori was 26.7% (4/15) in the area. UreB gene products from 89.5% of DGC cases (17/19) were unable to be digested by Spe I. 31.8% of products from IGC cases (7/22) were also unable to be digested by Spe I, but the positive rate of cagA gene in this group was higher than other groups. The high prevalence of H. pylori infection in DGC patients suggests that H. pylori plays a role in the pathogenesis of DGC, but in the stomach with DGC, it is considered atrophy and intestinal metaplasia are not so implicated in H. pylori, compared with IGC. A genetic specificity of H. pylori in DGC and IGC was indicated by the results, suggesting that H. pylori may play different roles in the pathogenesis of DGC and IGC.

Cervical anterior fusion with iliac bone crest has become a popular surgical technique for cervical spondylotic disease. Since about 10 years ago, we have substituted hydroxyapatite ceramic spacer for autologous graft because of postoperative painful hip syndrome. Fourteen patients who underwent cervical anterior fusion with ceramic spacer were evaluated by plain radiographs for over eight years postoperatively. In six among the fourteen patients plain films demonstrated minimal stenosis of intervertebral disc height, of which the ratio ranged from 15% to 28% (mean 22%). The increase in mobility of the adjacent segment after fusion was noted in ten of the fourteen patients, although the ratio ranged only between 12% and 24% (mean 18%). In none of all the patients did dynamic plain films show cervical instability such as slippage and swan neck deformity. It seems that anterior fusion with ceramic spacer is a useful and safe method for a cervical spondylotic disease.

The technology for functional neuromuscular stimulation (FNS) as a means of providing upper limb function to people with tetraplegia has been under development by three clinical research groups for almost two decades. This paper presents the current status of the clinical trials of three FNS systems: a noninvasive system built into a cosmetic forearm splint, a 30-channel percutaneous system, and an 8-channel implantable system. The complexity of FNS systems and the unique characteristics of the individuals to whom they are applied combine to create many clinical and technical challenges that must be addressed before the devices can be deployed. The emerging challenges to widespread clinical introduction of FNS systems for hand and arm function are identified and analyzed. In addition to the demands of designed and conducting the clinical trials to satisfy regulatory requirements, the lack of knowledge, skepticism, and the complacency on the part of potential FNS recipients, as well as of rehabilitation professionals, must be overcome through education and careful consideration of economic and societal factors in the design of clinical systems.