Concepts of drugs: differences in conceptual structure across groups with different levels of drug experience

Seventy-seven college students varying in degree of drug use experience rated the perceived similarities of all possible combinations of 16 drug classes (cigarettes, other tobacco, alcohol, marijuana, barbiturates, minor and major tranquilizers, amphetamines, amphetamine derivatives, cocaine, heroin, opiates, hallucinogens, inhalants, PCP, anti-depressants). Multi-dimensional scaling (INDSCAL) and network models (PFNET) indicated that abstainers had only one pharmacological category involving sedatives/depressants, and that they attached more importance to whether drugs were licit vs. illicit than to whether they were depressants vs. stimulants. Conceptions became more coherent, differentiated and based on pharmacological properties for more experienced drug users. In line with previous work, groups with greater experience with drugs had more sophisticated conceptions not only about the drugs they had used, but also about drugs they had not used. These findings suggest that early on in drug behavior sophisticated and interrelated concepts are developing that should be taken into account when designing interventions and information campaigns.     

Relationship of feeding modality to clinical features in Japanese infants with idiopathic neonatal hepatitis of the non-familial form

To clarify the relationship between idiopathic neonatal hepatitis and feeding type, that is, formula-milk feeding and breast-milk feeding, the medical records of 100 patients (68 male and 32 female babies) with idiopathic neonatal hepatitis of non-familial form referred to the medical centers of Akita University and Tohoku University during the past 18 years were reviewed. The patients were divided into two 9 year periods (1975–83 and 1984–92), and their clinical features were analyzed in terms of feeding type and sex. The number of patients enrolled decreased from 69 in the first half to 31 in the second half. The number of male patients dropped from 53 to 15, although the number of female patients (n = 16) remained the same in both 9 year periods. The frequency of formula-milk feeding significantly decreased in the second half (42/69 to 6/31, P < 0.01). Compared with the expected numbers of patients in the second half, calculated on the changes in the live birth population and feeding modality between the two halves, the actually enrolled numbers of patients in the second half were less in both the male and the formula-milk fed groups (× 0.35 and × 0.22), whereas the numbers of female and breast-milk feeding groups were close to the expected values (× 1.26 and × 1.08). When sex and feeding modality were combined, the formula-milk fed male group showed the lowest value (× 0.10), and the breast-milk fed female group showed the highest value (× 2.85). In conclusion, feeding type, especially in combination with gender, might be one causative factor in the occurrence of idiopathic neonatal hepatitis.     

Successful bladder management for a pure urogenital sinus anomaly

We report on a case of a pure urogenital sinus anomaly presented with bladder distention. A seven-day-old girl with an abdominal distension was referred to the Division of Urology, Hakodate Central Hospital, Hakodate, Japan. A common urogenital sinus without abnormalities in the labium, clitoris or anus was found. A computed tomography (CT) scan documented a distended bladder without hydrometrocolpos or hydroureteronephrosis. Cystography performed at 44 days revealed a large flaccid bladder without ureteral reflux. Urinary management by an indwelling urethral catheter was maintained until 3 months, when an endoscopic examination was performed and a stenotic urethral-type urogenital sinus with low confluence was diagnosed. Parents successfully instituted clean intermittent catheterization as a temporary urinary management, and postvoid residual urine gradually decreased. At 2 years of age, flap vaginoplasty was performed. In an urodynamic study performed postoperatively, the detrusor pressure during voiding was 40-50 cmH(2)O. The patient maintained spontaneous voiding without consequences. Appropriate urinary care is essential to prevent urological complications in cases with a pure urogenital sinus anomaly.     

Septic pulmonary embolism due to periodontal disease

Background and objective: Septic pulmonary embolism due to periodontal disease (SPE‐PD) is rarely reported and little is known about its clinical features. The purpose of this study was to evaluate the clinical and radiological features, as well as outcome, in SPE‐PD. Methods: Patients' records were retrospectively reviewed and 12 patients with SPE‐PD were identified (10 men, mean age 60.5 years). The patients' demographic features, laboratory data, physical and radiological findings, and clinical outcomes were evaluated. Results: All but one patient were smokers. Eight of the 12 patients had comorbidities including hypertension (58%) and/or diabetes mellitus (17%). Prevalent symptoms were fever (67%) and chest pain (58%). Only two patients fulfilled the criteria of systemic inflammatory response syndrome; most of the subjects were not clinically severely ill. Blood cultures were negative in all cases. Contrast‐enhanced chest computed tomography (CT) showed multiple peripheral nodules in all 12 patients, wedge‐shaped peripheral lesions abutting on the pleura in 10 (83%) and a feeding‐vessel sign in 9 (75%). All patients recovered from their illness after antimicrobial therapy concomitant with tooth extraction or periodontal care. The median duration of antibiotic administration was 51 days. Conclusions: Most patients with SPE‐PD were not seriously ill. Contrast‐enhanced chest CT appeared to be useful to diagnose SPE‐PD.     

Hepatocyte apoptosis and hepatic expression of transforming growth factor-β1 mRNA during involution of hyperplastic rat liver induced by hepatocyte growth factor

Hepatocyte apoptosis occurs during involution of hyperplastic liver induced by administration of xenobiotic compounds in rats. With this hyperplasia and involution, hepatic transforming growth factor (TGF)-β₁ is reported to be expressed to stimulate hepatocyte apoptosis. In regenerating liver after partial resection showing no hyperplasia, such expression of TGF-β₁ is also seen. However, no hepatocyte apoptosis develops despite the high levels of TGF-β₁. When rats received an intravenous injection of human hepatocyte growth factor at 12 h intervals for 14 days, the hepatic DNA content was increased 12 h after the last injection to 140% of control. This DNA content was significantly decreased at 108 and 180 h after discontinuation of treatment. At 60 h after the last injection, the number of apoptotic bodies positive for nick end-labelling of DNA in hepatocytes was significantly greater in treated rats than in control rats. Hepatocyte apoptosis was also identified electron micrographically. Hepatic TGF-β₁ mRNA levels in treated rats were significantly lower than in control rats at 12 h and then gradually increased towards control levels. We conclude that hyperplastic liver induced in normal rats by hepatocyte growth factor regresses with hepatocyte apoptosis and suppressed hepatic TGF-β₁ mRNA levels.     

Intracellular Transcobalamins in Various Cultured Cell Lines Established from Hematological Malignancies

Intracellular transcobalamins (TCs) in 17 cultured cells establishedfrom hematological malignancies were measured to solve the cellularorigin of TCs. The cultured cell lines used in this study areas follows: myeloid cell lines K-562, HL-60, NALM-1; T-celllines P12/lchikawa, MOLT-4B, CCRF-CEM, RPMI-8402, MT-1; B-celllines P3HR-1, Daudi, BALL-1; nonT, nonB cell lines NALM-16,KOPN-1, Reh, P30/Ohkubo, NALL-1; and, as control cells, P13/Koyamaderived from normal B-cells, normal human lymphocytes and granulocytes.The homogenized cytoplasmic fraction was incubated with ⁵⁷CoB₁₂ and subjected to DE₅₂ cellulose column chromatography andpolyacryla mide gel electrophoresis (PAGE) to separate TC₁₁from R-binders. In myeloid cell lines established from blasticcrises of chronic myeloid leukemia, K-562 had the highest TC₁₁/R-bindersratio, while NALM-1 had the lowest, suggesting that the myeloidand lymphoid crises of chronic myeloid leukemia may have differentTC₁₁/R-binders ratio. T and B cell lines showed no differencein intracellular TC levels. NonT, nonB cell lines had the lowestlevel of intracellular TC. ^*Present address: Department of Internal Medicine, JikeikaiUniversity Auto Hospital, Tokyo.     

A case of primary hyperparathyroidism that had been treated under a diagnosis of depression for 10 years

Abstract A 66 year old man who had been treated under a diagnosis of depression for 10 years was referred to the Kyoto Prefectural University of Medicine, Kyoto because of general fatigue and appetite loss. The patient was diagnosed as having primary hyperparathyroidism (PHPT) based on the increased parathyroid hormone (PTH) and serum calcium levels. Computed tomography revealed solitary adenoma of parathyroid gland. The resection of this solitary adenoma improved the PTH and serum calcium concentrations to normal ranges, which resulted in an improvement in his depressive state. This case suggests that ionic calcium levels contribute to the mental symptoms associated with PHPT. As PHPT is curable, the possibility of PHPT should be taken into account when patients have depressive symptoms.     

Epidemic enterocolitis possibly as a result of Norwalk virus infection presenting as ischemic colitis

Ischemic colitis usually presents as an isolated event, and clustering seldom occurs. Although a majority of instances of colonic ischemia have no clearly identifiable cause, many kinds of predisposing factors for the occurrence of ischemic colitis are pointed out. These include high age, generalized atherosclerosis, impaired cardiac function, hypovolemia, hypotension, colonoscopy, obstructing colonic cancer, coagulopathies and use of vasoconstrictors or contraceptives. However, infectious viral enterocolitis has not been regarded as a predisposing factor for colonic ischemia. We present here two cases of epidemic enterocolitis presenting as ischemic colitis that occurred almost simultaneously in two compromized long‐term patients in Noda Hospital, Chiba Prefecture. At the time, viral enterocolitis due to Norwalk virus infection was epidemic in Japan, including in the region of the hospital. It is likely that epidemic enterocolitis induced strong gut peristalsis and caused colonic spasm that mediated colonic ischemia. Indeed, both patients were elderly and had prominent signs of atherosclerosis, and one patient suffered from diabetes mellitus. Notably, the physician who performed the rectosigmoidoscopy in the two patients presented with enterocolitis 1 day after the procedure. This indicates that occupational transmission of epidemic enterocolitis can occur in medical staff during endoscopy procedures.