Attitudes toward Tuberculosis in Vietnamese Immigrants

OBJECTIVES: To explore Vietnamese immigrants' knowledge, attitudes, beliefs, and practices concerning tuberculosis (TB). METHODS: Three focus groups were conducted at community health centers in California as part of a nationwide research project on attitudes toward TB in Asians and Pacific Islanders. Vietnamese health workers mediated group discussions by asking 11 openended questions on the causes of TB, medical consequences of TB, TB treatment, and the impact of the disease on social relationships. The results of these groups were reviewed by a panel of Vietnamese health workers in Hawaii. RESULTS: The focus group participants attributed TB to malnutrition, stress, smoking, alcohol consumption, and hard labor. They expressed a belief in the extreme contagiousness of TB, that it can be spread through eating utensils or towels. Lung diseases and other organ complications were cited to be the chief problems of TB. The participants expressed belief that the use of Western medicine is more effective in treating TB than other form of treatment such as acupuncture or herbal medicines. A consequence of the extreme contagiousness of TB is social isolation, leading to mental anguish. CONCLUSIONS: An understanding of shared attitudes toward TB in Vietnamese may contribute to the treatment of patients with TB. Community education to rectify some common misconceptions may be of utility.     

Meningo-encephalitis associated with HHV-6 related exanthem subitum

We report a 10-month-old boy with acute meningo-encephalitis associated with exanthem subitum. It has recently been reported that human herpesvirus-6 is the causative agent of exanthem subitum, and to our knowledge our case is the first report of meningo-encephalitis associated with HHV-6 infection.     

Different Roles of 8-Hydroxyguanine Formation and 2-Thiobarbituric Acid-reacting Substance Generation in the Early Phase of Liver Carcinogenesis Induced by a Choline-deficient, l-Amino Acid-defined Diet in Rats

The present study was performed to assess the roles of hepatocellular oxidative damage to DNA and constituents other than DNA in rat liver carcinogenesis caused by a choline-deficient, l -amino acid-defined (CDAA) diet by examining the effects of the antioxidant N, N' -diphenyl- p -phenylenediamine (DPPD). The parameters used for cellular oxidative damage were the level of 8-hydroxyguanine (8-OHGua) for DNA and that of 2-thiobarbituric acid-reacting substance (TBARS) for constituents other than DNA. A total of 40 male Fischer 344 rats, 6 weeks old, were fed the CDAA diet for 12 weeks with or without DPPD (0.05, 0.10 or 0.20%) or butylated hydroxytoluene (BHT, 0.25%). In the livers of the rats, the numbers and sizes of glutathione S -transferasc (EC 2.5.1.18) placental form (GSTP)- and/or γ-glutamyltransferase (GGT, EC 2.3.2.2)-positive lesions and levels of 8-OHGua and TBARS were determined. The GSTP-positive lesions of 0.08 mm² or larger were all stained positively for GGT as well in cross-sectional area, whereas the smaller lesions were generally negative for GGT. DPPD and BHT reduced the size of the GSTP-positive lesions without affecting their total numbers. At the same time, they reduced TBARS generation without affecting 8-OHGua formation in DNA. The present results indicate that oxidative DNA damage (represented by 8-OHGua formation) and damage to constituents other than DNA (represented by TBARS generation) may play different roles in rat liver carcinogenesis caused by the CDAA diet; the former appears to be involved in the induction of phenotypically altered hepatocyte populations while the latter may be related to the growth of such populations.     

Immunotherapy with paternal lymphocytes preceding in vitro fertilization-embryo transfer for patients with repeated failure of embryo transfer.

Immunotherapy with paternal lymphocytes for unexplained recurrent aborters was applied, preceding IVF-ET, for infertile women with repeated failure of ET. In one patient showing close histocompatibility with the husband, the subsequent new IVF-ET was successful under positive MLR-blocking antibody induced by immunotherapy.     

Characterization of human placental activity for transport of L-alanine, using brush border (microvillous) membrane vesicles.

To characterize the placental activity for the transport of amino acids, the uptake of L-alanine was investigated by rapid membrane filtration using brush border membrane vesicles separated from the human placenta of early pregnant (12-13 gestational weeks) and late pregnant (37-38 gestational weeks) women. The uptake of L-alanine into the brush border membrane vesicles at early and late stage of gestation showed a pattern of transport dependent on the intra- and extravesicular Na+ concentration gradient (extravesicular Na+ greater than intravesicular Na+). The Na+ concentration gradient-dependent uptake of L-alanine into the brush border membrane vesicles at early and late stage of gestation also showed a dependency on the potential difference of the internal and external membrane. The transport of L-alanine into the brush border membrane vesicles was markedly augmented at late stage of gestation. On the basis of the double reciprocal plotting of the L-alanine concentration and the Na(+)-dependent uptake of L-alanine into the vesicles, Km and Vmax were calculated as parameters of the Na(+)-dependent uptake of L-alanine into the vesicles. In the early stage of gestation Km was 0.78 mM, and in the late stage of gestation was 0.80 mM. In the early stage of gestation Vmax (nmol/mg protein/20 sec) was 0.62, and in the late stage of gestation was 3.53. From the results, it was considered that the placental active transport mechanism of L-alanine is the same in the early and late stages of gestation, and it was shown that its transport activity increases greatly in late stages compared to the early stages of gestation.     

A study of infiltrated cells in the maxillary mucosa in nasal allergy and chronic sinusitis

The cloudiness of the maxillary sinus in Waters-view is 37% in patients with nasal allergy. The pathogenesis of this cloudiness has not fully understood yet; is it due to the type- I allergic reaction, or secondary maxillary sinusitis? To clarify the pathology, we studied the infiltrated cells in 37 mucosae of the maxillary sinus in which X-ray revealed an abnormal shadow. Samples were also taken from 9 antrums with chronic sinusitis, and 18 and 4 nasal mucosae form the inferior turbinate with nasal allergy and sinusitis, respectively. Each specimen were fixed with Carnoy solution and formalin, and were stained with Hematoxylin & Eosin, and with Alcian blue & Safranin. Numbers of formalin sensitive and resistant mast cells and eosinophils were determined in the epithelium, and superficial and deep layers of the lamina propria, respectively. The population of both mast cells in each compartment was not different between nasal allergy and maxillary sinusitis both in the nasal and maxillary mucosae. The number of eosinophils in the maxillary and nasal epithelial significantly increased in nasal allergy compared with sinusitis. These results suggested that type-I allergic reaction might occur in the maxillary mucosa as well as nasal mucosa in patients with nasal allergy.     

Fatal encephalitis/encephalopathy in primary human herpesvirus-6 infection.

An encephalitic illness with a fatal outcome occurred in a 9 month old girl with virologically confirmed exanthem subitum. Human herpes-virus-6 (HHV-6) DNA was found in the cerebrospinal fluid at the acute stage of the disease by the polymerase chain reaction, but the virus antigen was not detected in her brain tissue. This suggests that HHV-6-induced encephalitis/encephalopathy may be due to a non-infectious process.     

Testicular mast cell heterogeneity in idiopathic male infertility.

OBJECTIVE: To determine if the mast cell subclass changes in diseased testes. DESIGN: Retrospective. SETTING: University hospital urology clinic and anatomy laboratory. PATIENTS, PARTICIPANTS: Fourteen normal men and 50 patients with idiopathic male infertility. INTERVENTIONS: Histochemical techniques to identify proteoglycans of mast cells were applied to the obtained testicular biopsy specimens. MAIN OUTCOME MEASURES: The numbers of the heparin containing mast cell and the chondroitin sulfate containing mast cell were measured with light microscopy. RESULTS: The total number of mast cells and the ratio of chondoroitin sulfate containing mast cells were significantly increased in the testes from patients with idiopathic male infertility. CONCLUSION: These results suggest that mast cells may play a certain role in the etiology of idiopathic male infertility.     

Basic study on the effect of nasally administered salmon calcitonin preparation on the nasal ciliary epithelium.

Nasal administration of drugs is an administration method which is worthy of attention. In such therapy, local administration should not damage the nasal mucous membranes. In the present study, we conducted an investigation by the tissue culture test method of the functional and morphological effects of new nasal calcitonin preparation, which is being developed as a nasal spray agent for osteoporosis, on the nasal ciliary epithelium. The nasal septal mucous membranes of C3H-strain mice were used, and 5 types of nasal calcitonin preparations with a microcrystalline cellulose base and additives added were used. The various drugs were added to nasal mucous membrane slices in RPMI-1640 culture medium; ciliary activity before addition and 0.5, 2, and 4 hr after was electrophotometrically measured; and morphological observation was then carried out by SEM. In the various additive groups, virtually no effect on ciliary activity was observed, and the same results were obtained when 3 and 9 times the estimated clinical spray dosage was added. Moreover, in morphological observation by SEM, in the various additive groups, no morphological changes in samples of nasal ciliary specimens were observed after 4 hr of culturing at the maximum administered dosage (9 times the estimated clinical spray dosage). Based on these findings, it was concluded that the series of calcitonin preparations with various additives had no hazardous effect on the nasal ciliary epithelium.     

Enema reduction of intussusception with a small dose of iopamidol may have advantages over barium

Barium enema (B-enema) has been the standard method for hydrostatic reduction of intussusception, although recently air enema has been used due to the lower risk when perforation occurs. Recently, we have administered a small dose of iopamidol during enema reduction (I-enema) in children with intussusception. From November 1989 to December 1993, we treated 50 children with intussusception at Kiyama Hospital. Barium was used in the first half of the period, and iopamidol in the second half. Reduction was successful in 22 of 24 patients with barium (92%) and 23 of 26 with iopamidol (88%); 25 children had the ileocolic type and 25 the ileoileocolic (-cecal) type of intussusception. Operations were carried out in 3 patients from each group. I-enema avoids some of the drawbacks of barium and air enemas. It is a new method of enema reduction, as a contrast medium is injected first. It is possible to obtain a good image of the advanced portion with a small dose of contrast medium, which is important for treatment. For institutions performing B-enemas, I-enemas can be performed easily with the same equipment and technique. It causes less contamination upon leakage than a B-enema, and also has less influence on the intestinal membrane with very few risks if perforation occurs. Better images are obtained than with air. A large dose of contrast medium is not needed, thereby reducing medical expenses to a minimum. Iopamidol can be used safely for enema reduction of intussusception with an expected high success rate.