An Outbreak of Echovirus 11 Meningitis in a Newborn Nursery

In the summer of 1981 an outbreak of echovirus 11 meningitis in a newborn nursery occurred in a general hospital near Tokyo. Ten newborn infants developed febrile illness in a period of 20 days. Nine babies out of ten were diagnosed as aseptic meningitis according to the CSF findings. Virus isolation was successful in 50% (3/6 cases) in the CSF, 80% (4/5 cases) in the stool and 20% (1/5 cases) in the throat swab. Echovirus 11 was proven to be the responsible agent. Clinical manifestations of aseptic meningitis were mild and nonspecific, except in one premature baby which had apnea and exanthema. Mean febrile period was 4.1 days. Pleocytosis of the CSF, dominant in polymorphonuclear cells, was observed in 6/9 cases. EEG about one month after onset revealed abnormal or borderline findings in 6/9 cases. In a community outbreak of echovirus. infection, newborn babies in nurseries are threatened with both horizontol and vertical transmission of virus.     

Computational consideration of cisplatin hydrolysis and acid dissociation in aqueous media: effect of total drug concentrations

Cisplatin (cis-DDP) is subject to nucleophilic displacement of chloride in water, forming aquated species, subsequently liberating hydrogen ion(s) with increasing pH. This study intends to theoretically analyze the hydrolysis and polyprotic dissociation behavior of cis-DDP in various aqueous media. A mathematical model was expressed by nonlinear simultaneous equations in terms of the total drug concentration, pH and pCl based on the hydrolysis and acid dissociation constants already published. Some of the interesting simulation results include that (1) in water, cis-DDP behaves in a very complicated manner, highly depending on the total drug concentration, pH and pCl, (2) in normal saline, about 3% of the total concentration is a positively charged chloro-aqua that may be very reactive, (3) in assumed blood (pH 7.4, [Cl(-)]=0.11 mol/l, mu=0.15), the drug is stabilized at the level of 85% and the remnants are the chloro-hydroxo (11%) and the chloro-aqua (4%), (4) in assumed intracellular conditions (pH 7.1, [Cl(-)]=0.01 mol/l, mu=0.15), the drug is converted to a large extent to various species including the parent species (44%), the chloro-hydroxo (30%), hydroxo-aqua (2%), chloro-aqua (24%) diaqua (less than 1%) and dihydroxo (null). The results of this analysis may provide a useful preliminary knowledge of existing species in a system concerned and a rationale for re-evaluating the reactions between cis-DDP and various nucleophilic substances already reported while there are somewhat conflicting interpretations of some cis-DDP reactions.     

Twenty-six week carcinogenicity study of ampicillin in CB6F1-TgrasH2 mice

As a part of the ILSI-HESI Alternative to Carcinogenicity Testing (ACT) program, we performed a 26-week carcinogenetic study of nonmutagenic drug, ampicillin (ABPC) in Tg-rasH2 mice. ABPC was given to Tg-rasH2 mice (0, 350, 1000, 3000 mg/kg, p.o.) and Non-Tg mice (0, 3000 mg/kg, p.o.) daily for 26 weeks. As a positive control, a single dose of MNU was administered once to Tg-rasH2 mice (75 mg/kg, i.p.). In this study, Tg-rasH2 mice did not demonstrate any increases in tumor development in response to ABPC. Thus, ABPC had no carcinogenicity in the 26-week carcinogenesis study in Tg-rasH2 mice or in a 2-year carcinogenesis study in B6C3F1 mice.     

Acute effects of methyl bromide gas in rats and mice--studies on survival time

Wistar male rats and ddY male mice were exposed to 500-10,000 ppm of methyl bromide gas up to 8 hours, and the survival time and weights of brain, lung, liver, kidneys, spleen and tests were measured. The survival time decreased with the gas concentration almost exponentially. In general, rats had a longer survival time than mice under the same exposure concentration. Difference of survival time between rats and mice was remarkable at low concentrations but small at high concentrations. Spleen weight decreased significantly and kidney weights tended to increase at 2000 ppm or greater exposure concentrations. Difference between wet and dry lung weight in the exposure group was significantly greater than that in the control group, especially for high concentrations, which suggested pulmonary edema or bronchopneumonia.     

Expression of CD44v6 in advanced gastric cancer and its relationship to hematogenous metastasis and long-term prognosis

BACKGROUND AND OBJECTIVES: Variants of CD44 have been proposed to be important in promoting tumor progression and metastasis. We attempted to determine the expression of CD44v6 product in advanced gastric cancer and to evaluate its prognostic value. METHODS: The expression of CD44v6 was analyzed immunohistochemically in advanced gastric cancers using monoclonal antibody, 44-2V. We investigated the relationship between CD44v6 expression and prognosis in 201 gastric cancer patients. RESULTS: Ninety-five (47.3%) of 201 cancer tissues expressed CD44v6. The expression of CD44v6 protein was significantly higher in differentiated, adenocarcinoma than in diffuse type carcinoma. The CD44v6-positive cancers were more frequently associated with hematogenous metastasis. There was no significant correlation between CD44v6 immunoreactivity, and prognosis among the combined cases. Among patients with differentiated adenocarcinoma, however, the prognosis was significantly poorer in patients with CD44v6-positive tumors than in those with CD44v6-negative tumors. CONCLUSIONS: CD44v6 protein may have an important role in hematogenous metastasis, and may be a biologic marker of prognostic significance in differentiated type gastric cancers.     

Bronchial Artery Embolization for Hemoptysis Due to Benign Diseases: Immediate and Long-Term Results

Purpose: To clarify the immediate effect and long-term results of bronchial artery embolization (BAE) for hemoptysis due to benign diseases and the factors influencing the outcomes. Methods: One hundred and one patients (aged 34–89 years) received bronchial artery embolization with polyvinyl alcohol particles and gelatin sponge for massive or continuing moderate hemoptysis caused by benign pulmonary diseases and resistant to medical treatment. Results: After BAE, bleeding stopped in 94 patients (94%). The immediate effect was unfavorable in cases where feeder vessels were overlooked or the embolization of the intercostal arteries was insufficient. Long-term cumulative hemoptysis nonrecurrence rates after the initial embolization were 77.7% for 1 year and 62.5% for 5 years. In bronchitis (n = 9) and active tuberculosis (n = 4) groups, an excellent (100%) 5-year cumulative nonrecurrence rate was obtained. The rate was lower in groups with pneumonia/abscess/pyothorax (n = 8) or with pulmonary aspergillosis (n = 9) (53.3%, 1-year cumulative nonrecurrence). There were higher incidences of early recurrence among patients with massive hemorrhage or more marked vascularity and systemic artery–pulmonary artery shunt in angiography: however, these trends were not statistically significant Conclusions: BAE can yield long-term benefit in patients with hemoptysis due to benign diseases. Technical problems in the procedure had an impact on the short-term effect. The degree of hemorrhage or the severity of angiographical findings were not significant factors affecting the outcome. The most significant factor affecting long-term results was whether the inflammation caused by the underlying disease was medically well controlled.     

Abnormal vestibular evoked myogenic potentials in the presence of normal caloric responses.

OBJECTIVE: Combined use of vestibular evoked myogenic potential (VEMP) and caloric response testing has enabled us to examine the function of the inferior and superior vestibular nerves separately. Although results of VEMP testing and caloric response testing have been reported for many diseases, a clinical entity showing abnormal VEMP responses but normal caloric test responses has rarely been reported. The aim of the study was to investigate clinical features of diseases showing abnormal VEMP responses with normal caloric test responses. STUDY DESIGN: Retrospective. SETTING: University hospital. PATIENTS: Eight hundred eleven patients with balance problems who had undergone both caloric response and VEMP testing were included in the study. MAIN OUTCOME MEASURES: The amplitudes and latencies of the first positive-negative peak of the VEMP (p13-n23) were measured. RESULTS: Forty of the 811 patients (5%) were found to have abnormal VEMP responses with normal caloric test responses. Clinical diagnoses of these patients were Ménière's disease (n = 12), acoustic neuroma (n = 8), sudden deafness with vertigo (n = 6), and other diseases (n = 6). Eight patients could not be diagnosed as having a disease already recognized. Clinical manifestations of these eight patients were rotatory vertigo in six patients and non-rotatory dizziness in two. None of these patients showed abnormalities other than VEMP responses on neurologic or neurotologic examinations. CONCLUSION: Apart from Ménière's disease, acoustic neuroma, and sudden deafness with vertigo, which are already known as diseases with abnormal VEMP responses but normal caloric test responses, some patients might be diagnosed as having a disease that involves only the inferior vestibular nerve region.