Prevalence of use of medically prescribed hypnotics among adult Japanese women in urban residential areas

Abstract Based on a population survey on insomnia among 3600 adult Japanese women living in urban areas, the prevalence of use of medically prescribed hypnotics is determined. The prevalence of use of medically prescribed hypnotics increases with an increase in age (<1.0% for those aged 49 or younger, while 14.3% for those aged 70 or older), in agreement with the results reported in many Western nations. The current sleep disturbance is mild in nearly half of these hypnotics users. More than one-third of the hypnotic users are receiving health care not for sleep problems but for depression, anxiety, or other reasons. More than one-third of the hypnotic users are found to be receiving hypnotics from non-psychiatrists. The percentage of this group is particularly high among those aged 60 or over, probably reflecting the fact that they are often consulting physicians for physical reasons. On the other hand, more than 80% of insomniacs are suggested to be untreated. Future public health research should focus on the quality of life and health care behaviors of untreated insomniacs and hypnotic users, especially among the elderly people, in order to assess the need for primary health care to prevent accidents, mortality, and psychiatric disorders related to sleep problems.     

Amino acid residues of core region of hepatitis B virus. Asymptomatic carriers versus patients with liver disease

Recent molecular biological studies have shown that mutations of hepatitis B virus (HBV) genes may have an important role in the pathogenesis of HBV-induced liver diseases. It has been suggested that the core antigen of HBV could be an immunologic target of cytotoxic T lymphocytes. In this study, nucleotide sequences encoding 183 amino acid residues of the core region of HBV were analysed in 4 asymptomatic healthy carriers and in 5 patients with chronic liver disease, in whom serum aminotransferase levels were fluctuating. A cluster of amino acid substitutions were found from codon 87 to 97 of the core region of HBV in all 5 patients with liver diseases. Such changes were not found in any of the asymptomatic carriers. These data suggest that the peptide sequence spanning 11 amino acid residues in this particular region may play an important role in the pathogenesis of B-viral liver disease, and could be an immunologic target of cytotoxic T lymphocytes.     

Flexible video cystoscope with built-in high-frequency cauterizing element for transurethral resection of bladder tumor

The major advantage of the flexible video cystoscope is that a digital signal can be obtained while high frequency cauterization is carried out. Cauterization while observing a digital signal picture was not possible before this new model was developed. We decided to use this new cystoscope to resect a bladder tumor and coagulate the bleeding because the patient could tolerate only local anesthesia due to severe heart disease complications. We successfully treated the patient with this technique and no complications were noted. This new flexible video cystoscope was found to be safe for resecting bladder tumor under local anesthesia.     

狼疮模型鼠各脏器中T细胞受体Vβ基因的表达

目的探讨MRL/lpr和(NZB×NZW)F1两种狼疮模型鼠中致病性T细胞克隆在系统性红斑狼疮(SLE)发病中的作用。方法用逆转录-聚合酶链反应(RT-PCR)扩增狼疮模型鼠各脏器中的T细胞受体(TCR)Vβ基因,单链构象多态性分析法(SSCP)分析TCRVβ的表达,并应用磁珠细胞分离法(MACS)确定广泛浸润于各脏器中的T细胞的表型。结果两种狼疮模型鼠在SLE发病时,多个脏器中出现相同的T细胞寡克隆扩增带;该广泛浸润的T细胞克隆扩增呈TCRVβ限制性;此共同的T细胞克隆大多来源于CD4+T细胞。结论两种狼疮模型鼠的CD4+T细胞被活化后呈克隆扩增,广泛浸润于多脏器。     

Antiemetic Efficacy of High-Dose Intravenous Metoclopramide and Dexamethasone in Patients Receiving Cisplatin-Based Chemotherapy: A Randomized Controlled Trial

High-dose intravenous (IV) metoclopramide has shown efficacywith few side effects for the treatment of nausea and vomitingon the day of cisplatin administration. From November 1984 toJanuary 1986, two randomized trials in an antiemetic study wereconducted. In trial I, the antiemetic effect of a short courseof high-dose dexamethasone was compared with that of high-dosemetoclopramide in 29 patients with lung cancer receiving chemotherapycon taining cisplatin (80 mg/m² IV) in a randomized controlledtrial. Dexamethasone was given IV at a dose of 16 mg 1/2 hrbefore and 8 mg, 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin.Metoclopramide was given IV at a dose of 2 mg/kg, 1/2 hr beforeand 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Major emeticcontrol (0–2 episodes of vomiting) during the 24 hr aftercisplatin administration was achieved in 55% (6/11) and 67%(12/18) of the patients receiving dexa methasone and metoclopramide,respectively, without serious toxicity. The dura tion of nauseaor anorexia was similar for the two treatment groups. In trial11, the combination of metoclopramide and dexamethasone wascompared with metoclopramide alone to assess the additive antiemeticeffect of the two drugs in 23 patients with lung cancer receivingcisplatin at a dose of 120 mg/m IV in a randomized cross-overstudy. A major antiemetic response was observed in 27% (3/11)and 92% (11/12) of the patients receiving metoclopramide aloneand metoclopramide plus dexamethasone, respectively (p <0.005). The duration of nausea and anorexia was similar forthe two treatment groups. Pa tients tended to prefer the combinationof metoclopramide and dexamethasone; however, the differencewas not statistically significant (p = 0.14) in the small numberof patients entered in this study. Despite excellent controlof acute chemotherapy-induced emesis, 45% of 52 patients experienceddelayed nausea and vomiting more than 24 hr after cisplatinadministration even among those who had had an excellent short-termresponse to the antiemetic agents.     

Effect of Activated Charcoal and Atropine on Absorption and/or Exsorption of Organophosphorus Compounds in Rats

Effects of activated charcoal and atropine for the removal of organophosphorus compounds, which remain in the gastrointestinal tract or have already been absorbed into the systemic circulation, were investigated in rats. Activated charcoal extensively adsorbed the organophosphates fenitrothion, tolclofos methyl, piperophos and salithion, and its immediate administration after oral ingestion of fenitrothion remarkably reduced serum fenitrothion levels, but had no effect on the serum levels of the compound which had been absorbed from the gastrointestinal tract. Thus, all of the organophosphorus compounds were poorly exsorbed (0.002-0.39% of the dose in 120 min) from the blood into the intestinal lumen probably due to their extensive protein binding and large distribution volumes. Atropine inhibited absorption of fenitrothion in the perfusion in-situ and also delayed the absorption of the compound in-vivo, but had no significant effect on exsorption of fenitrothion. The serum fenitrothion levels on treatment with both atropine and charcoal significantly decreased compared with those of the control. We conclude that, oral activated charcoal will not be able to enhance the elimination of organophosphorus compounds which have already been absorbed into the systemic circulation, but constitute a useful method for the removal of the compounds remaining in the gastrointestinal tract because of its excellent adsorptive capacity.     

Genetic analysis of isolated persistent hypermethioninemia with dominant inheritance

We describe a type of mild hypermethioninemia due to a point mutation in the MATA1 gene, which was inherited dominantly in a family. Three patients coming from the same family pedigree were detected by the presence of isolated hypermethioninemia on a mass-screening program. The measurement of methionine adenosyltransferase (MAT) activity in a patient's liver revealed a partial deficiency of hepatic MAT with a reduction in the Km for methionine. Single strand conformation polymorphism (SSCP) analysis and direct sequencing of the patients' genomic DNA revealed a G to A mutation at nucleotide 791 that converts Arg-264 to His (R264H) in one allele of MATA1 gene. The other allele was normal in all the patients examined. Gene tracking in the family revealed that the hypermethioninemia is associated with heterozygosity for the R264H mutation in the MATA1 gene.