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Setting The number of patients with non-tuberculous mycobacterial lung disease (NTM-LD) worldwide has been increasing. Mycobacterium avium complex lung disease (MAC-LD) accounts for 90% of NTM-LD. MAC-LD necessitates long-term treatment, but adverse reactions with long-term administration of drugs are poorly understood. Objective To evaluate adverse reactions with long-term administration of drugs for MAC-LD. Design We conducted a retrospective single-centre medical chart review of 364 patients administered two or more drugs between July 2010 and June 2015. Results The prevalence and median time to onset of adverse reactions were as follows: hepatotoxicity 19.5%, 55 days; leucocytopaenia 20.0%, 41 days; thrombocytopaenia 28.6%, 61.5 days; cutaneous reactions 9.3%, 30 days; ocular toxicity 7.7%, 278 days; and increase in serum creatinine 12.4%, 430.5 days. Multivariate analysis showed that rifampicin use was independently associated with thrombocytopaenia, and ethambutol use was independently associated with increases in serum creatinine. Conclusion The main adverse reactions appeared within 3 months after start of treatment. Most patients were able to continue treatment with liver-supporting therapy, antihistamine agents or desensitisation therapy; however, ocular toxicity must be monitored for up to 1 year after start of treatment.

The number of patients with non-tuberculous mycobacterial lung disease (NTM-LD) worldwide has been increasing.To evaluate adverse reactions with long-term administration of drugs for MAC-LD.We conducted a retrospective single-centre medical chart review of 364 patients administered two or more drugs between July 2010 and June 2015.The prevalence and median time to onset of adverse reactions were as follows: hepatotoxicity 19.5%, 55 days; leucocytopaenia 20.0%, 41 days; thrombocytopaenia 28.6%, 61.5 days; cutaneous reactions 9.3%, 30 days; ocular toxicity 7.7%, 278 days; and increase in serum creatinine 12.4%, 430.5 days. Multivariate analysis showed that rifampicin use was independently associated with thrombocytopaenia, and ethambutol use was independently associated with increases in serum creatinine.The main adverse reactions appeared within 3 months after start of treatment. Most patients were able to continue treatment with liver-supporting therapy, antihistamine agents or desensitisation therapy; however, ocular toxicity must be monitored for up to 1 year after start of treatment.

Radioactive iodine, one of the radionuclides released in the nuclear power plant accident on 11 March 2011, was detected in purified water at water purification plants (WPPs). However, information about removal of radioactive materials in actual water purification process was limited. Therefore, we investigated the removal of radioactive materials (iodine and cesium) immediately after the detection. It is found that non-radioactive iodine in water could be removed by the combined use of pre-chlorination and powdered activated carbon (PAC) treatment. The same result was also obtained in terms of radioactive iodine. Removal of non-radioactive iodine in WPPs was also investigated. Approximately, 60% of iodine was removed by combination of pre-chlorination (0.5–1.0 mg/L) and PAC (15–30 mg/L) in coagulation and sedimentation processes. In water purification process, cesium was mostly removed by coagulation and sedimentation; hence, radioactive cesium was not detected in purified water. It was confirmed...

BACKGROUND AND PURPOSE Stem cell transplantation therapy is a promising option for treatment of severe ischaemic heart disease. Dimethyl sulphoxide (DMSO) differentiates P19CL6 embryonic carcinoma cells into cardiomyocyte-like cells, but with low differentiation capacity. To improve the degree of this differentiation, we have assessed several derivatives of the differentiation-inducing factor-1 (DIF-1), originally found in the cellular slime mould Dictyostelium discoideum, on P19CL6 cells. EXPERIMENTAL APPROACH P19CL6 cells were cultured with each derivative and 1% DMSO for up to 16 days. Differentiation was assessed by measuring the number of beating and non-beating aggregates, and the expression of genes relevant to cardiac tissue. The mechanism of action was investigated using a T-type Ca2+ channel blocker. KEY RESULTS Of all the DIF-1 derivatives tested only Br-DIF-1 showed any effects on cardiomyocyte differentiation. In the presence of 1% DMSO, Br-DIF-1 (0.3–3 µM) significantly and dose-dependently increased the number of spontaneously beating aggregates compared with 1% DMSO alone, by day 16. Expression of mRNA for T-type calcium channels was significantly increased by Br-DIF-1 + 1% DMSO compared with 1% DMSO alone. Mibefradil (a T-type Ca2+ channel blocker; 100 nM) and a small interfering RNA for the T-type Ca2+ channel both significantly decreased the beating rate of aggregates induced by Br-DIF-1 + 1% DMSO. CONCLUSIONS AND IMPLICATIONS Br-DIF-1 accelerated the differentiation, induced by 1% DMSO, of P19CL6 cells into spontaneously beating cardiomyocyte-like cells, partly by enhancing the expression of the T-type Ca2+ channel gene.

Electrical treeing is often responsible for the breakdown of insulating materials used in power apparatus such as high‐voltage transformers, cables, and capacitors. Insulation, such as crosslinked polyethylene (XLPE), used in underground high‐voltage cables usually operates at temperatures above ambient. This paper describes the characteristics of luminescence, emitted prior to electrical tree inception, at a crosslinked polyethylene‐semiconducting material (XLPE‐semicon) interface held above room temperature. Use of a sensitive light detection system showed that XLPE subjected to elevated temperatures emits luminescence even without voltage application. This light was attributed to thermoluminescence which decreased with the decrease in the concentration of the crosslinking by‐products present in the polymer. The spectra of thermoluminescence were only in the visible range. On the other hand, electroluminescence occurred when the XLPE‐semicon interface was held above room temperature and subjected to hig...

Raman spectra of B ion-implanted glassy carbon (GC) and hydrogenated amorphous carbon (a-C:H) films have been measured as a function of polarization direction of the scattered light and excitation wavelength. Raman bands of GC implanted heavily with a fluence of more than 5\ifmmode\times\else\texttimes\fi{}${10}^{15}$ B ions/${\mathrm{cm}}^{2}$ and a-C:H films show a frequency-independent depolarization ratio, suggesting the existence of ${\mathit{sp}}^{2}$ carbon clusters in these samples. It was found that Raman spectra of GC implanted heavily with a fluence of more than 5\ifmmode\times\else\texttimes\fi{}${10}^{15}$ B ions/${\mathrm{cm}}^{2}$ varied with the excitation wavelength. From a comparative study of the heavily implanted GC and a-C:H films, the variation of the Raman spectra with the excitation wavelength observed for the heavily implanted GC is interpreted in terms of \ensuremath{\pi}-${\mathrm{\ensuremath{\pi}}}^{\mathrm{*}}$ resonant Raman scattering from ${\mathit{sp}}^{2}$ carbon clusters having various sizes.

Author for correspondence: Dr Mitsuru Matsuki, Department of MR Center, Tenri Hospital, 200, Mishima-cho, Tenri, Nara, 632, Japan. 11 Gordon MJ. Retroperitoneal emphysema from colonoscopy of the distal limb of Hartmann colostomy. Gastr Endosc 1975;22:101–102. 12 Meyers MA, Ghahremani GG. Complications of fiberoptic endoscopy. Radiology 1975;115:301–307. 13 Schwab G, Wetscher G, Waldenberger P, Bodner E. Retropneumoperitoneum: an unusual case after colonoscopy. Endoscopy 1993;25: 256–257.

Summary Background. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to enhance the symptoms of wheat-dependent exercise-induced anaphylaxis (WDEIA). In contrast to many reports on WDEIA, there have been only a few reports of wheat-dependent aspirin-induced anaphylaxis not induced by the combination of wheat and exercise. Methods. Two patients with wheat-dependent anaphylaxis underwent provocation tests to clarify the cause of their symptoms. Skin-prick testing (SPT) was also performed with and without administration of aspirin. Specific IgE antibody to wheat, gluten, and ω-5 gliadin were examined. Results. In the provocation tests, anaphylactic reactions were not induced by wheat or aspirin alone or by the combination of wheat and exercise, but were induced by the combination of wheat and aspirin. An increase in the blood histamine level was detected after provocation in both patients. Pretreatment with aspirin enhanced the SPT reactions to wheat and gluten in both patients. Specific IgE antibodies to wheat and gluten were expressed in the serum of both patients, and specific ω-5 gliadin IgE antibody was detected in the serum of one patient. Conclusions. We present two cases of specific wheat-dependent anaphylaxis induced by aspirin but not by exercise. We suggest that pretreatment with aspirin under controlled conditions is useful to confirm the diagnosis of food allergy when a challenge test with food alone or with food and exercise fails to induce positive reactions.

The authors describe the characteristics of light emission at an XLPE a (cross-linked polyethylene)-semicon interface held above and below the temperature at which the crystallites of the polymer start to melt. The spectra of EL (electroluminescence) and the light inception voltage of degassed, an N/sub 2/- and SF/sub 6/-impregnated XLPE are reported. It is shown that XLPE subjected to elevated temperature emits luminescence even without voltage application. This light is attributed to TL (thermoluminescence) which depends on the concentration of the crosslinking by-products present in the polymer. The TL spectra are only in the visible range. On the other hand, the XLPE-semicon interface held above room temperature and subjected to high electric stress emits EL, and the spectra of this light are in the visible and the UV ranges. Although the intensity of EL emitted at high temperature is lower than that emitted at room temperature, the UV light can photodegrade the polymeric insulation, which can lead to electrical tree inception. >

The characteristics of EL (electroluminescence) at a semiconductor protrusion embedded in XLPE (cross-linked polyethylene) were studied for specimens containing different gases in their free volume. The spectra of EL and the tree inception voltage (TIV) of normal XLPE, containing air, are compared to those of degassed and N/sub 2/-impregnated polymer. The TIV of normal specimens, containing air, was lower than that of degassed or N/sub 2/-impregnated polymer. The results indicate that at room temperature the tree initiation mechanisms at a XLPE-semiconductor interface and at a metallic needle embedded in LDPE (low-density polyethylene) are similar and suggest that oxygen present in the free volume of the polymeric insulation could play an important role in the deterioration of XLPE insulation subjected to high electrical stress. >

In HV devices such as power cables, electrical stress enhancement can occur at the interface of semiconducting shields (semicon) and polymeric insulation. In this study, points of electrical stress enhancement are simulated by embedding semicon protrusions into the polymer. XLPE with two different concentrations of crosslinking byproducts and impregnated with various gases has been used. It it shown that, prior to electrical tree inception, electroluminescence occurs at the semicon tips and visible and ultraviolet light is emitted. The characteristics and the spectra of electroluminescence at semicon protrusions embedded in XLPE are similar to those previously observed at metallic needles embedded in LDPE. The ultraviolet light, emitted at points of electrical stress enhancement, can photodegrade the polymer, cause bond scission and lead to electrical treeing. Also, the results for XLPE impregnated with different gases indicate that, as in the case of LPPE/metal interface, oxygen in the free volume of the polymer plays an important role in the deterioration of XLPE insulation subjected to high electrical stress. >

Female adnexal tumour of probable Wolffian origin is a rare tumour that arises from remnants of the Wolffian duct. Clinical and pathological findings of this tumour have been documented, but the MR findings have not been previously reported. We report the MRI features of an adnexal tumour of probable Wolffian origin.

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) was introduced as a good technique to evaluate structural abnormalities in the white matter. In this study, we used DTI to examine anisotropic changes of the pyramidal tracts displaced by chronic subdural hematoma (CSDH). MATERIALS AND METHODS: Twenty-six patients with unilateral CSDH underwent DTI before and after surgery. We measured fractional anisotropy (FA) values in pyramidal tracts of bilateral cerebral peduncles and calculated the ratio of the FA value on the lesion side to that on the contralateral side (FA ratio) and compared the ratios with motor weakness. Moreover, the relationships between FA ratios and clinical factors such as age, sex, midline shift, interval from trauma, and hematoma attenuation on CT were evaluated. RESULTS: FA values of pyramidal tracts on the lesion side were significantly lower than those on the contralateral side (0.66 ± 0.07 versus 0.74 ± 0.05, P < .0001). The FA ratio was correlated to the severity of motor weakness ( r 2 = 0.32, P = .002). FA ratios after surgery improved significantly compared with those before surgery (0.96 ± 0.08 versus 0.89 ± 0.07, P = .0004). Intervals from trauma and the midline shift were significantly associated with decreased FA ratios ( P = .0008 and P = .037). CONCLUSIONS: In patients with CSDH, a reversible decrease of FA in the affected pyramidal tract on DTI was correlated to motor weakness. These anisotropic changes were considered to be caused by a reversible distortion of neuron fibers and vasogenic edema due to the hematoma.

Aquaporins (AQPs) are a family of small, hydrophobic, integral membrane proteins. In mammals, they are expressed in many epithelia and endothelia and function as channels that permit water or small solutes to pass. Although the AQPs reside constitutively at the plasma membrane in most cell types, the presence of AQPs in intracellular organelles such as secretory granules and vesicles has currently been demonstrated. The secretory granules and vesicles contain secretory proteins, migrate to particular locations within the cell close to the plasma membrane and release their contents to the outside. During the process, including exocytosis, regulation of secretory granule or vesicle volume is important. This paper reviews the possible role of AQPs in secretory granules and vesicles.

Long-term aging tests were performed on semiconductor protrusions embedded in cross-linked polyethylene (XLPE) cables impregnated with different gases. During aging, electroluminescence emitted at the protrusion was monitored continuously until tree initiation. The results showed that oxygen in the free volume of the polymer plays an important role in the deterioration of XLPE insulation subjected to high electrical stress. Decreasing the concentration of oxygen by degassing or impregnating with N/sub 2/ or SF/sub 6/ increased the time to electrical treeing. While the results for N/sub 2/- and SF/sub 6/-impregnated XLPE were comparable, degassed XLPE had the longest time to tree inception. It is shown that ultraviolet light emitted during electroluminescence photodegrades the polymer and can account for the differences in the times to electrical tree inception in XLPE impregnated with different gases. >

We have developed a new chemical removing and air cooling technique for clean room recirculation air using a gas-liquid contact method that consists of a combination of chilled pure water showering and optimum packing material. We have tested a new treatment system using this technique in an actual photolithography clean room finding many kinds of chemical contaminants of water-solubility substances such as NH/sub 4//sup +/ and amine ions, and have found it to be a sufficiently practical wet-type filtration method having both functions of chemical cleanliness control and air cooling capacity control. In addition, this new system has a very simple structure, less power consumption and is maintenance free. Furthermore, the total cost including the initial and running cost of the new wet-type chemical filtration system for clean room recirculation air using our new technique can be reduced by about 30%, as compared with that of a conventional dry-type chemical filter removal system.

We have developed a new cooled-type 2-stage high-speed air washer treating technique to remove the high-concentration airborne molecular contaminants (AMC) in the outside air. This technique was applied in an air-conditioning system to treat the intake air of the clean room. The new air conditioning system can treat the AMC to a sufficiently lower concentration, which does not influence a semiconductor manufacturing process. By a new B-factor analysis, the effectiveness of the 1st-stage of the cooling condensation coil was found and the chemical ion removal mechanism of the new system was solved. The new system can remove both chemical contaminants of the water-solube and water-insolube variety. This new system can operate at almost the same initial and running costs as the conventional air-conditioning system without chemical contaminant countermeasures.

A non-contact laser flowmeter was used to measure the changing of the gingival blood flow. Five university students with healthy oral condition were selected in this study. The blood flow measurement on the extensor digitorum (above the head of third metacarpal), with the changing of distance and angle between the probe and the tissue was used as a pre-study experiment. Blood flow rate was determined in the labial gingiva (2 mm above the cervical line) of upper central incisor using a stent fixing the probe at a 3-mm distance from the tissue. A basal level of gingival blood flow was taken two times each day for 5 days. The effects of water of different temperatures on the gingival blood flow are discussed. With the changing of distance, the blood flow rate became smaller, but there was no significant effect from the angle. The reproducibility was acceptable through the 5-day measurement. After stimulating with warm and body temperature water, the blood flow first increased significantly and then went back to the basal line (faster with the body temperature water). With cold water, different reactions between the subjects were observed.

In severe ocular surface diseases, pathologic keratinization of the ordinarily nonkeratinized corneal and conjunctival mucosal epithelia results in severe visual loss. The expression in conjunctivalized corneas of various proteins known to play important roles in the physiological keratinization process in human epidermis was examined to better understand the mechanism of keratinization.Conjunctiva covering the cornea was examined in 12 eyes with ocular surface disease in the chronic cicatricial phase. These comprised four Stevens-Johnson syndrome, four ocular cicatricial pemphigoid, and four chemical injuries. Normal conjunctivas from four age-matched individuals served as controls. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to investigate transglutaminase 1 gene expression and immunohistochemistry to study the expression of transglutaminase 1 protein along with other keratinization-related proteins (involucrin, loricrin, filaggrin, and cytokeratins 1 and 10) and cytokeratin pairs 4/13 and 3/12.Semiquantitative RT-PCR showed that transglutaminase 1 mRNA expression was upregulated in keratinized conjunctiva compared with normal. Also, in this tissue, immunohistochemistry demonstrated elevated levels of transglutaminase 1, involucrin, filaggrin, and the cytokeratin pair 1/10. Levels of loricrin and cytokeratin pairs 4/13 and 3/12, however, remained the same.Various keratinization-related proteins, transglutaminase 1 included, are most likely involved in the pathogenesis of cicatrizing ocular surface diseases.

In the past five years we experienced 9 fatigued disabled children who were intermittently or persistently absent from school.They had been suspected to be burdened with psychosomatic disorders, having orthostatic hypotension, postural tachycardia, or other autonomic dysfunction symptoms.Investigating the cause of moderate orthostatic proteinuria in some of them, we found by chance severe typical nutcracker phenomenon (NC), which was present in all 9 children complaining of chronic fatigue.Their symptoms filled the criteria of chronic fatigue syndrome or idiopathic chronic fatigue (CFS/CF). An association between severe NC and autonomic dysfunction symptoms in children with CFS/CF has been presented.

Ectopic ureter draining into seminal vesicle cyst is very rare congenital anomaly, which is thought to be caused by ectopic ureteral bud arising on the mesonephric duct. It is often associated with ipsilateral renal agenesis. We experienced a case of ectopic ureter draining into seminal vesicle cyst that is associated with ipsilateral renal agenesis. Generally, an invasive modality, that is, cyst puncture, cystography, or seminal vesiculography, is essential in the confirmative diagnosis of ectopic ureter. However, we could establish a definitive diagnosis with magnetic resonance imaging.

We experienced an adult case of cellulitis in the prevertebral space with retropharyngeal and danger space, and, which was suspected to be due to a fish bone stuck in the throat. Its lesion could not be demonstrated on plain radiograph, postcontrast computed tomography, or laryngoscopy, but noncontrast magnetic resonance imaging demonstrated the lesion and was useful in assessing the efficacy of medication.

Guillain-Barré syndrome (GBS) is characterized as an acute, symmetrically progressive, inflammatory demyelinating polyneuropathy. We report a case of GBS in which gadolinium-enhanced magnetic resonance (MR) imaging showed marked enhancement of nerve roots of the conus medullaris and cauda equina. On enhanced MR imaging, the spinal cord and nerve roots in the thecal sac generally do not take up much gadolinium because of the blood-nerve barrier or blood-brain barrier. Therefore, in our case, marked enhancement of nerve roots indicates a breakdown of the blood-nerve barrier. It is thought to correlate with the inflammatory infiltration of GBS.

We describe here a case in which a retained surgical sponge progressed into the perirenal space and posterior pararenal space from the pelvic cavity. Sonography, CT, and T1-weighted MR image analyses could not show clearly the characteristic structure of the surgical sponge, but T2-weighted MR imaging showed a folded fabric appearance within the cystic mass. Surgical findings confirmed a lobulated cystic mass containing yellowish fluid and a surgical sponge.

Small bowel volvulus is usually secondary to conditions such as malrotation, congenital bands, postoperative adhesions, and internal hernias. Primary small bowel volvulus in an adult is rare, and only 14 cases had been reported in Japan as of 1994. Preoperative diagnosis is difficult, because clinical examinations and plain films are of limited diagnostic value. In our cases, CT showed signs of small bowel volvulus such as a U-shaped configuration or radial distribution of distended and fluid-filled loops of the small bowel converging toward the point of torsion, tightly twisted mesentery around the point of torsion (whirl sign), fusiform tapering loop (triangular sign in the cross section or beak sign in the longitudinal section), and signs of bowel ischemia or infarct such as attached mesenteric fluid and blurred mesenteric folds. CT enabled us to diagnose not only small bowel volvulus but also bowel ischemia or infarct.

Serum concentrations of soluble interleukin-2 receptor (IL-2R) were found to be high in patients with autoimmune diseases, lung cancer, malignant lymphoma, tuberculosis, and other diseases. Serum-soluble IL-2R was evaluated as a tumor maker in patients with gastric cancer.Preoperative concentrations of serum-soluble IL-2R were examined in 40 patients with gastric cancer. The authors investigated the correlations of serum-soluble IL-2R concentrations with various characteristics of this cancer (disease stage, gross appearance, depth of the tumor, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic grade, serum carcinoembryonic antigen (CEA), alpha-fetoprotein (alpha-FTP), carbohydrate antigen 19-9 (CA19-9), and immunosuppressive acidic protein (IAP). Serum soluble IL-2R concentrations were measured with an enzyme-linked immunosorbent assay.Levels of serum-soluble IL-2R in patients with gastric cancer were significantly higher than those of normal control subjects. Serum concentrations of IL-2R in patients with lymph node metastasis were also significantly higher than those of patients without lymph node metastasis. There were no significant differences in histopathologic findings (grade, lymphatic invasion, venous invasion). Moreover, serum concentrations of soluble IL-2R in patients who were IAP positive were significantly higher than those who were IAP negative.Preoperative serum-soluble IL-2R concentrations in patients with gastric cancer reflect the occurrence of regional lymph node metastases. Preoperative evaluation of serum soluble IL-2R concentrations may be a valuable parameter of indicating the probability of lymph node metastasis preoperatively.

1.3-μm uncooled cylindrical and receptable lasers are on the threshold of large-scale implementation for fiber-in-the-loop application. This demands a high-performance chip that can operate over a wide temperature range, can achieve sufficient fiber-coupled power by using low-cost packaging and optics, and can be manufactured at low cost. We achieved a solution to this challenge by using a compressively strained deep-quantum-well AlGaInAs structure combined with a ridge-waveguide (RWG) chip.

Detailed unsteady flow surveys were conducted before, within and after the second-stage stator passage of a 1.5-stage axial flow turbine by using a single slanted hot-wire anemometry. Among the results reported in the present paper, of particular interest are the behavior of the rotor wakes and the rotor free-streams within the stator passage, and the spacially three-dimensional and time-dependent convection or mixing process between lower- and higher- energy fluids. Effects of the rotor-stator interaction causing unsteady secondary flows and tip-leakage flow are also discussed.

The authors developed a high expansion ratio radial inflow turbine for a helium liquefier of 100 L/h capacity for use with a 70 MW superconductive generator. The following results were obtained from this development work: 1)Very stable and highly reliable operation was maintained through use of a externally pressurized thrust bearing and a tilting pad journal bearing. 2)It was found that in the case of a high expansion ratio turbine, a large nozzle loss is inevitable. 3)It was confirmed that the application of a conformai transformation method in modification of the nozzle setting angle is effective with a small cryogenic turbine having a large expansion ratio. 4) Approximately 70% efficiency was obtained, notwithstanding the high expansion ratio.

Insertion torque and removal torque of fixtures were measured using human cadaver temporal bone and human living bone. The torque level for fracturing the threads of the bone was also measured. The maximum insertion torque exerted without causing a break in bone threads was 70.0 Ncm in bicortical bone and 50.0 Ncm in unicortical bone. The relationship between insertion torque and removal torque indicated a positive correlation between both sites. However, removal torque was lower than insertion torque in all measurements. The fracture points of bone threads were 77.0 Ncm in bicortical bone and 57.7 Ncm in unicortical bone by mean. Microfractures were observed mainly in the thread bases and were directed upward in the histologic specimens examined.

20639 Background: It remains controversial whether or not administration of calcium (Ca) and magnesium (Mg) can reduce the neurotoxicity specific to FOLFOX therapy. In addition, little is known abo...

Some patients with spinal cord injury complain of a severe intractable pain. This intractable pain places new hurdles on the road to return to the ordinary daily life in these patients. The effective therapy for the intractable pain has not been established. Dorsal root entry zone (DREZ) lesion was originally reported by Nashold et al to alleviate deafferented pain syndrome. Three male and one female patients with intractable pain following spinal cord injury were treated with DREZ-lesions. One month after operation, all 4 patients obtained good pain relief. However, at a follow-up period till February 1989 (ranging 11 months from 2 years and 6 months), 2 patients had subjective pain relief. When other therapies on intractable pain following spinal cord trauma are not effective, the DREZ-lesion might be considered.

The molecular and biochemical regulation of phenolic synthesis can be summarised as: (1) carbohydrates are partitioned in a manner ensuring growth; (2) carbohydrates are available for phenolic synthesis mainly during cell differentiation and after leaf maturation as the 'overflow'; (3) synthesis of a particular phenolic compound is specific to cell type and developmental stage; and (4) synthesis of certain phenolic compounds can be induced, independently of cell type, by factors such as wounding, microbial infection, and UV light. Recent advances in the understanding of the regulation of phenolic synthesis raises the question as to whether between-site and temporal variation in the amount and type of plants phenolics is due mostly to selection pressure by herbivores. Interdisciplinary studies by biochemists and ecologists are needed for a better understanding of the regulation of phenolic synthesis and plant-herbivore interactions mediated by secondary metabolites.