Effects of short duration morning bright light in healthy elderly subjects. I:Subjective feeling and ophthalmological examinations

Abstract Seven aged subjects aged 61–78 years were exposed to 6000 lx bright light for 30 min during morning hours at their homes for 1 week. Visual analog scale was recorded before bedtime and after rising to assess subjective feelings. Ophthalmological examinations were made before and after light exposure, to exclude pre-existing ocular disorders and to detect ocular damage. Furthermore, ocular fatigue was self-evaluated immediately before and after exposure. Visual analog scale results indicated that alertness reduced significantly before bedtime. Ophthalmological abnormalities were not found after exposure. These findings suggest that short duration morning bright light exposure reduces night-time vigilance.     

SECONDARY AMYLOIDOSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS: DIAGNOSTIC AND PROGNOSTIC VALUE OF GASTRODUODENAL BIOPSY

Upper gastrointestinal endoscopy was performed in patients withrheumatoid arthritis (RA) during the period 1989–1991,and biopsy specimens were obtained from the stomach and fromthe duodenum for examining amyloid deposits. Among 407 patients,gastrointestinal amyloidosis was confirmed in 54 (13.3%). Twenty-twopatients were regarded as having slight amyloid deposits, while32 patients were categorized as having marked amyloid deposits.The incidence of clinical manifestations suggestive of systemicamyloidosis was more frequent in the marked deposits group thanin the slight deposits group (47% vs 14%, P < 0.05). Amongthe patients who died of manifestations associated with amyloidosis,the survival period following endoscopy was shorter in the markeddeposits group than in the slight deposits group. These findingssuggest that gastroduodenal biopsies may be useful for diagnosingsecondary amyloidosis and that the degree of amyloid depositsseems to be correlated with the clinical manifestations of RA. KEY WORDS: Rheumatoid arthritis, Complications, Secondary amyloidosis, Diagnosis, Endoscopy, Biopsy, Prognosis     

Expulsion of Hymenolepis nana from mice with congenital deficiencies of IgE production or of mast cell development

The roles of IgE and mast cells on expulsion of adult Hymenolepis nana from the intestine were examined in mice. IgE-dependency was determined by comparing congenitally IgE-deficient SJA/9 and IgE-producing SJL/J mice infected with 50 H. nana eggs. Anti-H. nana IgE antibody was detected at three weeks post infection (p.i.) in SJL but not in SJA mice. The number of adult worms in the intestines of SJA and of SJL mice were similar at two weeks, but significantly more were found in SJA mice at three weeks p.i. Treatment of mice with anti-ɛ antibody also resulted in an increased worm burden at three weeks, suggesting participation of IgE in expulsion of H. nana. Intestinal mastocytosis was induced by infection regardless of the IgE status of the mice. Mast cell-dependency was tested in mast cell-deficient W/W^u and in normal littermate +/+ mice infected with 100 H. nana eggs. Anti-H. nana antibody was detected in both groups of mice at three weeks p.i. Worm expulsion seemed to be mast cell dependent because expulsion was less complete in W/W^u mice at three weeks p.i. Peripheral blood eosinophilia was comparable at three weeks p.i. in both IgE and mast cell sufficient and deficient mice. These results suggest that IgE and mast cells participate in the expulsion of H. nana adults from intestine in mice.     

GLOMERULAR TISSUE INJURY IN IgA NEPHRITIS

The glomerular lesions In 129 cases of IgA nephritis were analyzed. The development of glomerular injury occurred in two ways, one being a chronic mesangial depositive and sclerosing lesion commonly found in most glomeruli, and the other an acute but local injury initiating from the local peripheral glomerular basement membrane abnormality, i.e., thinning and/or splitting, which was seen at least in one third of all cases. The activation of the local coagulatory process could add segmental glomerular changes including small crescents, adhesion, and local tuft necrosis to the mesangial lesion. ACTA PATHOL. JPN. 33; 367–380, 1983.     

Prediction of Optimal Atrioventricular Delay in Patients with Implanted DDD Pacemakers

In patients with an implanted DDD pacemaker (PM), the atrial contribution may be interrupted by too short an atrioventricular (AV) delay, and filling time may be shortened by too long an AV delay. The AV delay at which the end of the A wave on transmitral flow coincides with complete closure of the mitral valve may be optimal. The subjects were 15 patients [70.3+/-12.3 (SD) years old] with an implanted DDD PM. Cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) were measured by Swan-Ganz catheter. Transmitral flow was recorded by pulsed Doppler echocardiography. AV delay was prolonged stepwise by 25 msc. When the AV delay was set at 155+/-26 ms, the end of the A wave coincided with complete closure of the mitral valve. When the AV delay was prolonged 25, 50, 75, and 100 ms from this AV delay, the interval between the end of the A wave and complete closure of mitral the valve was prolonged 16+/-5, 39+/-6, 65+/-4 and 88+/-5 ms, respectively (r = 0.97, P<0.0001) and diastolic mitral regurgitation was observed during this period. Thus, the optimal AV delay may be predicted as follows: the slightly prolonged AV delay minus the interval between the end of the A wave and complete closure of the mitral valve. When the AV delay was set at 215 ms, there was a significant positive correlation between the predicted optimal AV delay (166+/-23 ms) and the optimal AV delay (CO: 161+/-26 msec, r = 0.93, P<0.0001, PCWP: 161+/-28 msec, r = 0.95, P<0.0001). In conclusion, optimal AV delay can be predicted by this simple formula: slightly prolonged AV delay minus the interval between end of A wave and complete closure of mitral valve at the AV delay setting.     

不安全注射——扩大免疫规划面临的挑战

不安全注射正日渐成为扩大免疫规划(EPI)中不容忽视的问题.甚至在指出不安全注射有传播血源性疾病的危险之后,在发展中国家不安全注射仍被普遍实施.18个国家中有14个国家超过50%的注射是不安全的.在日本丙型肝炎的病因被认为是医源性传播.在中国只换针头的多针一管注射很普遍,一次性注射器的普及仍不能解决这一问题.提供足够的器材、培训、监督和正确的处理使用过的一次性注射器,对于保证安全注射是很关键的.