Relationship between results of electrocochleography and caloric test in Menière's disease

The relationship between an increase in the negative summating potential (-SP) and the results of caloric tests was examined in 35 patients with unilateral Menière's disease. The -SP was recorded by extratympanic electrocochleography. The quantitative bithermal caloric test was performed by irrigating with cool (30 degrees C) and hot (44 degrees C) water. An increased -SP was recorded in 20 of 35 patients (57%). Abnormal unilateral weakness (UW) on the involved side and abnormal directional preponderance (DP) to the involved side were observed in 16 of 35 (46%) and in 4 of 35 patients (11%), respectively. No significant correlation was found between an increased -SP and an abnormal UW and DP in Menière's disease.     

Difference between visual feedback and visual suppression upon the stabilization of body sway in normal subjects

We developed a system to feedback the center of foot pressure by vision using a microcomputer. The subjects were instructed to adjust the center of foot pressure (displayed on the computer display at real time) to the point of intersection of the two stable (horizontal and vertical) lines on the computer display. The peak of the power spectra of body sway shifted significantly to the higher frequency range in the Y component (the lateral direction) in the visual feedback condition. Thus, we conclude that the visual feedback of body sway depends mainly on the error signals between the fovea and the image in the lateral direction to stabilize body sway.     

ICAM-1 and LFA-1 Expressions in the Lesional Skin of Annular Erythema Associated with Sjögren Syndrome

ICAM-1 and LFA-1 expression was studied in the lesional skin of ten cases of annular erythema associated with Sjögren syndrome. Most of the infiltrating mononuclear cells around blood vessels expressed LFA-1 in addition to its strong expression on vascular endothelial cells and focal expression on the epidermal basal cell layer in 3 cases. ICAM-1 expression on vascular endothelial cells was similar to LFA-1, although relatively focal and weak expression was observed on mononuclear cells. ICAM-1 expression on keratinocytes was focal and limited to the basal cell layer in annular erythema. These findings suggest that strong expression of ICAM-1 on endothelial cells but not keratinocytes and LFA-1 on mononuclear cells might play some role in the induction of skin lesions in annular erythema associated with Sjögren syndrome.     

Nedaplatin and 5-FU combined with radiation in the treatment for esophageal cancer

A series of patients with esophageal cancer was treated with chemotherapeutic regimens of the new antitumor platinum preparation nedaplatin plus 5-FU in combination with radiation therapy, and the therapeutic responses, side effects, and complications were clinically assessed. There were 2 patients with a complete response and 11 patients with a partial response, hence, a response rate of 76.5%. Major adverse reactions were those of hematological toxicity and included leukopenia (13 patients, 76.5%), thrombocytopenia (8 patients, 47.1%), and lowered serum hemoglobin concentration (9 patients, 52.9%). The leukopenia and thrombocytopenia, though of a grade 3 severity in 3 and 2 patients, respectively, subsided spontaneously in all affected cases. Gastrointestinal adverse reactions were mild and included appetite loss in 7 patients (41.2%) and nausea in 2 patients (11.8%). The only abnormality in renal function observed was a slight elevation of serum creatinine in one patient. The combined therapy of chemotherapy with nedaplatin and 5-FU plus radiation produced a high response rate in the treatment of carcinoma of the esophagus and was associated with reduced gastrointestinal and renal toxicity. The results indicate the combined therapy with nedaplatin to be clinically useful.     

Evaluation of cross-circulation through circle of Willis using an ultrasonic Doppler technique. Part II. Comparison between blood flow velocity by ultrasonic Doppler flowmetry and cerebrovascular resistance

The correlation between the increase in velocity of blood flow in both the internal carotid and vertebral arteries during a carotid compression and the cerebrovascular resistance (CVR) was investigated in 11 patients with chronic ischemic cerebrovascular disease and 4 without organic brain lesions. The velocity of blood flow was measured by an ultrasonic Doppler flowmeter. CVR was calculated from cerebral blood flow and arterial blood pressure. There was no correlation between the increased velocity of blood flow in the internal carotid and vertebral arteries and CVR. The increased velocity of blood flow in patients with low CVR was, however, significantly higher than that of patients with high CVR. The investigation of cross-circulation by ultrasonic Doppler flowmetry is a useful non-invasive method for the detection of changes in cerebral vascular resistance.     

Lichen planus annularis: an immunohistochemical study.

Lichen planus annularis is a relatively rare skin manifestation of lichen planus. The mechanisms in the formation of annular lesions are not fully understood. We reported here a 57-year-old female with this disease. The eruption initially occurred as lichen-papules, then enlarged (bean-sized, umbilicated small plaques), and finally developed annular manifestations. We performed immunohistochemical examinations of specimens taken from different types of eruptions. In all specimens, HLA-DR was expressed in the focal keratinocytes adjacent to the dermal HLA-DR positive cell infiltration. Both in the initial papule and in the final annular lesion, expression of ICAM-1 was present only in the keratinocytes above the dermal cell infiltration, similar to HLA-DR. It is of interest that, in the umbilicated small plaques, the peripheral epidermis other than the central site extensively reacted to ICAM-1. LFA-1 expression was most prominent in the mononuclear cells impinging on the dermo-epidermal junction in all specimens. In addition, in the periphery of the umbilicated small plaques, which showed no bandlike dense cell infiltration nor degeneration of basement membrane, TNF-alpha, but not LFA-1, was positive in the infiltrated cells of the upper dermis. These results suggest that expressions of ICAM-1 and TNF-alpha in the peripheral keratinocytes and dermal infiltrated cells are important molecular events in the mechanisms of formation of the annular lesions.     

C-19393 S2 and H2, new carbapenem antibiotics. II. isolation and structures

Two new beta-lactam antibiotics, C-19393 S2 (1) and H2 (2), were isolated from the culture filtrate of Streptomyces griseus subsp. cryophilus nov. subsp. The structures were determined by spectral analysis as shown in Fig. 2. The antibiotics have broad antimicrobial activity and strongly inhibit beta-lactamases. The minor product (2) is more stable than cephalosporin C in aqueous solution.