Effect of drinking on the outcome of cirrhosis in patients with hepatitis B or C

Survival rates were calculated for 251 patients with cirrhosis of the liver but without hepatocellular carcinoma, primary biliary cirrhosis, or autoimmune cirrhosis who underwent laparoscopy during the past 21 years at the authors' hospital. The survival rates were calculated by the Kaplan-Meier method. Stored serum was assayed for hepatitis B surface antigen (HBsAg) and antibodies to the hepatitis C virus (HCV). Patients with alcoholic cirrhosis had significantly better survival rates than patients with HBsAg, HCV, or both. Differences in survival rates between patients with hepatitis B and C were insignificant. In both groups, habitual drinkers had a significantly lower survival rate. The results suggested that alcohol accelerates liver damage in subjects with viral hepatitis.     

Learning model and curriculum designs for international health in nursing

Aim: Nursing's domain of inquiry for international health is unclear. A learning model to frame this specialty is unavailable. The goal of this analysis was to open debate worldwide on the nature of concepts, relationships, and analytic constructs that can serve as a foundational blueprint for international nursing curriculums. The aim was to define and operationalize international health in nursing by constructing a learning model. Methods: The exercise was exploratory using content analysis to distinguish key concepts in disciplinary and multidisciplinary documents through relevancy sampling. Sources of certainty were expert knowledge and experience and the embodied practices in international health. Procedures to ensure interrater reliability were used to strengthen confidence in formulating the bases for robust curriculum designs. Results: The five main concepts discerned were environment, demography, culture, technology, and research. Nursing goals framed as analytic constructs with amplification serve as the basis for statements of student outcome competencies. The resulting concepts, constructs, and competencies taken together provide a beginning operationalization of international health in nursing for a variety of progressive curriculum designs. Conclusions: In Japan, higher education is increasingly international and, for this, clear, agreed‐on academic goals are warranted. Nursing's higher education is obligated to prepare students for a future in environments highly globalised and technological with a culture of tolerance. The model facilitates scholarly debate for a progressive view of international health characterized by emphasis on theory and practical application.     

Controlled Study of Therapeutic Granulocyte Transfusions in Granulocytopenic Patients with Severe Infections

The effectiveness of therapeutic granulocyte transfusions wasstudied in a controlled trial involving 75 granulocytopenicpatients with severe infections. Patients who had granulocytecounts of less than 200/mm³ and no response to antibiotic therapywere assigned to receive antibiotic therapy alone or granulocytetransfusions plus antibiotic therapy. Granulocytes were collectedby filtration leukapheresis (FL), intermittent flow centrifugeleukapheresis (IFCL) or continuous flow centrifuge leukapheresis(CFCL). Therapeutic effects of granulocyte transfusions wereevaluated on the basis of 20-day survival after entry into thestudy. The patients were divided into three groups: 1) 22 patientsreceived antibiotic therapy alone for 29 infectious episodes(control group); 2) 27 patients received 131 transfusions ofgranulocytes collected by FL for 31 infectious episodes (FLgroup); 3) 26 patients received 139 transfusions of granulocytescollected by IFCL and CFCL for 27 infectious episodes (IFCL& CFCL group). The overall survival of the transfused patientswas not significantly different from that of the untransfusedpatients. Similarly, there was no significant difference insurvival between the transfused and untransfused patients whenthe data concerning septicemia were analyzed. When patientsshowed bone-marrow recovery, which was indicated by recoveryof granulocytes to 500/mm³ or more during the study, 20-daysurvival was observed in 13 of 14 untransfused patients andin all of 26 transfused patients. In contrast, the survivalrate for the patients without bone-marrow recovery was 13% (2/15)in the control group, 39% (7/18) in the FL group and 57% (8/14)in the IFCL & CFCL group respectively. Thus, the survivalrate was significantly higher for the transfused than for theuntransfused patients. These observations suggest that therapeutic granulocyte transfusionsmay be of limited value in improving the outcome of severe infectionsin persistently granulocytopenic patients. Since bone-marrowrecovery is a critical factor for the prognosis of severe infections,therapeutic granulocyte transfusions do not provide any beneficialeffects in granulocytopenic patients whose bone-marrow functionwill recover.     

Distribution of EGF receptor expressing and DNA replicating epidermal cells in psoriasis vulgaris and Bowen''s disease

We have examined the localization of DNA replicating cells and EGF receptor-expressing cells in the epidermis of psoriasis vulgaris, a benign hyperproliferative skin disease, and Bowen's disease, a pre-malignant hyperproliferative skin disease, and normal skin. DNA replicating cells were detected by anti-BrdU monoclonal antibody after incubating tissue sections with BrdU, and EGF receptors were detected by the anti-EGF receptor monoclonal antibody B4G7. In normal skin, DNA replicating cells were localized exclusively in the basal and suprabasal layers. EGF receptor expression was observed most strongly in the basal and parabasal layers, but diminished gradually towards the upper squamous layer. In psoriatic skin, DNA replicating cells were also localized in the basal and parabasal layers, but the number of these mitotic cells was about 10 times higher than in normal skin. In this case, more EGF receptors were detected in all viable layers of the epidermis. Apparently normal skin adjacent to psoriasis lesions showed persistent expression of EGF receptors in the upper squamous layer without an increased number of DNA replicating cells in the basal and parabasal layers. In Bowen's disease, DNA replicating cells and EGF receptor expressing cells were distributed in all layers of the epidermis. These findings indicate that the increased production of EGF receptors may be, in part, responsible for the hyperproliferative state of the epidermis and that cells in the upper squamous layer of psoriasis may have lost a mechanism by which EGF receptor expression is diminished thus allowing differentiation. This altered process of EGF receptor production may be involved in the onset of psoriasis vulgaris.     

Interspecies-specific Ovarian Autoantigens Involved in Neonatal Thymectomy-induced Murine Autoimmune Oophoritis

PROBLEM: Thymectomy of mice on day 3 after birth (3d-Tx) gives rise to the appearance of a particular type of ovarian lesion known as experimental autoimmune oophoritis (AIO). METHOD: In the present study, the spleen cells from BALB/c mice having undergone 3 day-Tx AIO were fused with X63-Ag8-6.5.3 myeloma cells, and a number of hybridoma clones producing autoantibodies against ovarian tissue were established. RESULTS: On the basis of immunohistochemical and protein-chemical analysis, two independent clones, designated as T2.2 and S1.6, were found to react with interstitial tissues surrounding the follicles. These monoclonal antibodies showed broad cross-species reactivity, in that they recognized similar antigenic macromolecules in the rat, pig, human, and mouse. The antigenic determinants were strongly resistant to heat and acid, especially to the treatment of periodic acid, indicating that the antigenic determinants had no relation with carbohydrate components. CONCLUSIONS: By antibody affinity chromotography, two kinds of autoantigens were identified. SDS-PAGE, under reduced or nonreduced conditions, revealed an 80/85 kDa protein for T2.2, and an 82 kDa for S1.6, respectively.     

Hematologic Findings in Children Exposed to A-Bomb Radiation In Utero in Hiroshima

1. Hematologic findings in in utero atomic bomb irradiated and nonirradiatedchildren of Hiroshima between the years 1950 to 1957 have been compared,and no changes peculiar to the irradiated group were found.

2. Despite several predisposing factors in Japan toward the development ofiron deficiency in children, overt anemia was rare and distribution of hemoglobin levels was only slightly lower than those reported in American andEuropean children.

3. Leukocyte levels, irrespective of age of the children, were found to beprogressively falling in the children of Hiroshima, whether or not exposure toirradiation had occurred. Thus, by 1957 the values were distinctly lower thanthose reported for normal children in Japan and the United States. No causefor this change was apparent.

Submitted on January 25, 1961 Accepted on February 17, 1961     

Possible involvement of β-PKC rather than that of α-PKC in differentiation of 3T3–L1 cells to adipocytes

Abstract. The change of subspecies of protein kinase C (PKC) was studied in 3T3—L1 cells in terms of their differentiation to adipocytes. 3T3—L1 cells feasible to differentiate to adipocytes by exposure to 3–isobutyl-1–methylxanthine (IBMX) and dexamethasone had both α- and β-PKC. However, 3T3–Ll cells unfurnished with such feasibility had only α-PKC. α-PKC, therefore, seems to be more deeply involved in differentiation of 3T3–LI cells to adipocytes than α-PKC.