QSART in idiopathic pure sudomotor failure

Abstract QSART (quantitative sudomotor axon reflex testing) was performed in a patient with idiopathic pure sudomotor failure. Generalized reduction in thermoregulatory sweating and complete absence of axon reflex sweating were observed, suggesting a deficit of sweat gland cholinergic synaptic transmission or receptors. QSART responded promptly to treatment. Putative pathophysiological mechanisms are discussed.     

Induction by mercury compounds of brain metallothionein in rats: Hg0 exposure induces long-lived brain metallothionein

Metallothionein (MT) is one of the stress proteins which can easily be induced by various kind of heavy metals. However, MT in the brain is difficult to induce because of blood-brain barrier impermeability to␣most heavy metals. In this paper, we have attempted to induce brain MT in rats by exposure to methylmercury (MeHg) or metallic mercury vapor, both of which are known to penetrate the blood-brain barrier and cause neurological damage. Rats treated with MeHg (40 μmol/kg per day × 5 days, p.o.) showed brain Hg levels as high as 18 μg/g with slight neurological signs 10␣days after final administration, but brain MT levels remained unchanged. However, rats exposed to Hg vapor for 7 days showed 7–8 μg Hg/g brain tissue 24 h after cessation of exposure. At that time brain MT levels were about twice the control levels. Although brain Hg levels fell gradually with a half-life of 26 days, MT levels induced by Hg exposure remained unchanged for >2␣weeks. Gel fractionation revealed that most Hg was in the brain cytosol fraction and thus bound to MT. Hybridization analysis showed that, despite a significant increase in MT-I and -II mRNA in brain, MT-III mRNA was less affected. Although significant Hg accumulation and MT induction were observed also in kidney and liver of Hg vapor-exposed rats, these decreased more quickly than in brain. The long-lived MT in brain might at least partly be accounted for by longer half-life of Hg accumulated there. The present results showed that exposure to Hg vapor might be a suitable procedure to provide an in vivo model with enhanced brain MT. Received: 25 June 1997 / Accepted: 4 November 1997     

Ontogeny of the transplantation immunity of mice for rejecting ascitic allogeneic tumors

Ontogeny of the murine transplantation immunity for rejecting ascitic allogeneic tumors (chemically-induced RG lymphoma and L1210 leukemia) as a model of $\text{in vivo}$ cytotoxic T cell immunity was studied. challenge by 10⁶ to 10⁷ allogeneic tumor cells per 20 g body weight (b.w.) of the mouse was fatal to 1–3 day-old mice, whereas 7–30 day-old mice rejected the tumor. In newborn mice however some yet undetermined mechanism worked to temporally depress the initial tumor growth. Injection of low (10⁶ cells per 20 g b.w.) to moderate (10⁷) doses of semiallogeneic spleen cells into newborn mice prepared for second set rejection of the tumor carrying the same alloantigens as the spleen cells, although injection of high dose (3 × 10⁸) cells reduced the tumor rejecting immunity. This second set rejection occurred even against the allogeneic tumor inoculated as early as 3 days old, if the mice had been primed with the alloantigens at birth. It appears therefore that newborn and early suckling mice are protected from tumor invasion by cytotoxic immunity more powerfully than expected from earlier $\text{in vitro}$ works.     

Mechanism of urinary excretion of methylmercury in mice

To elucidate the mechanism by which methylmercury (MeHg) is eliminated from organisms, male C57BL/6N mice were orally administered with MeHg chloride (5 mg/kg) and the chemical forms of its metabolites in plasma, urine and the kidney were determined by column chromatographic analysis. Orally administered MeHg rapidly entered the circulation, accumulated in the kidney and other tissues, and was slowly excreted in the urine. Ultrafiltration and gel filtration analysis revealed that most of plasma MeHg was accounted for by its albumin conjugate. Cell fractionation analysis revealed that about 80% of renal MeHg was recovered from the 15 000 g supernatant fraction of the kidney homogenate. If the kidney was homogenized in the presence of serine-borate complex, a potent inhibitor of -glutamyltranspeptidase (-GTP), about 50% of the MeHg in the supernatant fraction was recovered as its glutathione S-conjugate while the rest was bound to cytosolic protein(s). The major part of urinary MeHg was accounted for by its cysteine conjugate. However, urinary excretion of its glutathione conjugate increased significantly if animals were pretreated with acivicin, an affinity labeling reagent for -GTP. These and other results suggested that MeHg bound to albumin accumulated in the kidney predominantly via some non-filtrating peritubular mechanism, and localized in renal cytosolic compartment as its glutathione- and protein-bound forms. The glutathione S-conjugate of MeHg in the tubule cells might be transferred to the lumenal space, hydrolyzed to the cysteine S-conjugate, and then excreted in urine. These sequential events might constitute an important eliminatory pathway for a hazardous mercurial metabolite in mice.     

Effects of Plasma Proteins on Degradation Properties of Poly(L-lactide) Microcapsules

The degradation rate of poly(L-lactide) microcapsules in an aqueous medium was accelerated by the addition of albumin, -globulins, and fibrinogen. These proteins form adsorption layers on the surface of poly(L-lactide) microcapsules. At the interface between the microcapsules and the adsorbed protein layers, the value of the electric potential is expected to increase in magnitude, i.e., become highly negative compared with that at the interface between the microcapsules and the bulk buffer solution containing no plasma protein. This potential increase causes an increase in H⁺ concentration at that interface, which may result in an acceleration of the hydrolytic degradation rate of poly(L-lactide) microcapsules. Also, the presence of plasma proteins can increase the solubility of poly(L-lactide), causing the poly(L-lactide) molecules to exist in an expanded form. This effect may also accelerate the degradation of poly(L-lactide) microcapsules.     

Accessory mitral valve in an elderly man on maintenance hemodialysis

This report describes a case of accessory mitral valve in an elderly patient on maintenance hemodialysis. Transesophageal echocardiography revealed a mobile sac-like structure with size of 12 × 10 mm², which attached to the left ventricular surface of base of the anterior mitral valve leaflet. Mobile stick-like structure with diameter of 21 mm was extending from this sac-like structure toward the left ventricular outflow tract and had a floating free edge. Peak pressure gradient across the left ventricular outflow tract was 32 mmHg. There were no other congenital cardiac anomalies. No clinical findings suggestive of bacterial or nonbacterial vegetation were seen. Also other possibilities of mobile thrombus or calcification were unlikely. These abnormal structures were diagnosed as accessory mitral valve with rudimentary chordae.     

Low back load and satisfaction rating of caregivers & care receivers in bathing assistance given in a nursing home for the elderly practicing individual care]

Since the public nursing care insurance system was enacted by the Japanese government, a transition from conventional group treatment to the individual care is required. In Japanese nursing homes for the elderly, bathing assistance methods have shifted from use of traditional mechanical bathtubs or a big bathtub to methods using small homestyle bathtubs, known as "individual bathing assistance". A study on the work load of caregivers with individual bathing assistance has never been conducted. Therefore, in a nursing home for the elderly practicing the individual bathing assistance method, we explored low back load using surface electromyography and trunk inclination angle measurement. Moreover, subjective evaluations by not only the caregivers but also the care receivers were investigated. The individual bathing assistance time per person was about 35 min. When caregiver used the mechanical lift equipment to assist getting into and out of the bathtub, trunk inclination angle and muscle load were lower than with manual handling. Mechanical lift equipment had the advantage of reducing low back load. When caregivers gave assistance with dressing and ablution of the lower limbs, and in setting wheelchair footrests, trunk inclination angle and muscle load showed high values. The satisfaction rating of using the mechanical lift equipment showed the best score, and ratings of perceived exertion were about the same. Thus, the importance of safe and comfortable care for both caregivers and care receivers should be stressed to make effective use of assistance products and care equipment.     

Long-term follow-up in japanese public office workers of the influence of blood pressure on ECG changes.

BACKGROUND: The relationship between annual changes in blood pressure (BP) and the electrocardiogram (ECG) was studied to clarity what factors give early detection of complications and predict the outcome of therapy. METHODS AND RESULTS: The influence of BP on the ECG was assessed in 830 Japanese office workers. Those with hypertension (HT) more frequently developed left atrial and ventricular overload compared with normotensive subjects. In addition, those with borderline HT (systolic pressure 140-160 mmHg and/or diastolic pressure 90-95 mmHg) and even those with lower blood pressure (systolic pressure 130-140 mmHg and/or diastolic pressure 85-90 mmHg) developed left atrial and ventricular overload more frequently than normotensive subjects. CONCLUSIONS: Based on these results, BP should be closely followed up when routine systolic and diastolic pressure levels exceed 130 mmHg and 85 mmHg, respectively, in persons in their 40 s to 50 s and the goal of antihypertensive therapy should be lower than reported previously.     

Therapeutic effectiveness of ranimustine chemotherapy for essential thrombocythemia in the elderly

We studied the therapeutic effectiveness of chemotherapy by ranimustine (MCNU) for essential thrombocythemia (ET) in 14 ET patients over 60 years of age. The median age was 73 years (range: 61-88 years), and the male/female ratio was 6:8. The mean platelet counts before chemotherapy was 1,157 +/- 28.4 x 10(3)/microliter. Five of them had been referred because of thrombotic episodes before admission to our hospital, while one was referred because of nasal bleeding. The platelet counts were maintained at a level below 500 x 10(3)/microliter by intravenous administration of MCNU in 12 patients and below 700 x 10(3)/microliter in two patients. One of the patients suffered cerebral infarction during MCNU therapy. No other patient suffered thrombotic episodes during MCNU therapy. The patient who was referred because of nasal bleeding had no hemorrhagic episode during control of platelet counts by chemotherapy. MCNU chemotherapy appears effective for the prevention of thrombosis and bleeding in ET.