Significance of normal oral flora, particularly group oral streptococci as defense mechanism against infection in healthy individuals (normal defense mechanism by oral Streptococcus group)]

The alpha-streptococci, consisted of normal oral flora mainly, with inhibitory activity against pathogenic microbes in healthy individuals was investigated by group A Streptococcus (indicator strain 6-22 nonmucoid T-12). Rate of alpha-streptococci with inhibitory activity against group A Streptococcus was increased as aging, and the rate in pre-school children was higher than that in school children. These results suggested that more than 90% of the tested alpha-streptococci with strong inhibitory activities (S. salivarius) against indicator strain had inhibitory activities against group A Streptococcus (mucoid T-6), H. influenzae, S. pneumoniae, group C Streptococcus, and from 40% to 70% of the tested strains had also inhibitory activities against other pathogens. As there were many strains of alpha-streptococci with inhibitory activities against pathogens, that usually detected in the upper respiratory infection, the problem on the strains in the future will explain significance of the defense mechanism against upper respiratory infection and this can be applied clinically.     

Neurally mediated syncope and arrhythmias: a study of syncopal patients using the head-up tilt test

Understanding the causes of syncope in patients with arrhythmia is important in determining the therapeutic interventions. Neurally mediated syncope (NMS) was evaluated in 55 patients with various arrhythmias. The head-up tilt test with or without isoproterenol infusion induced NMS in 41 (74%) patients. When these patients was categorized into 3 types, depending on the development of syncope, vasodilatation was significant in a majority of patients. In 46% of patients with tachyarrythmias, NMS was accompanied by an increase in extrasystole. It was concluded that the evaluation of vasodilatation is important for the preventive strategy of NMS in patients with arrhythmias and that NMS may induce arrhythmias.     

Atelosteogenesis Type 3: The First Patient in Japan and a Survivor for more than 1 year

We report the first patient of atelosteogenesis type 3 (AO₃) in Japan. The patient had multiple craniofacial abnormalities at birth, including ocular hypertelorism, a flat nasal bridge, micrognathia and a cleft palate. There was rhizomelic shortness of the limbs and a club-foot. The infant had short broad thumbs in the hands similar to those observed in the feet. There were no chromosomal abnormalities. Radiological examination demonstrated striking hypoplasia of the humerus with proximal rounding and distal tapering giving a 'drumstick' appearance, 'S'-shape configuration of the cervical spine, scoliosis and coronal cleft in the thoracolumbar vertebral bodies. The infant experienced recurrent apnea and persistent severe tracheomalacia, which necessitated tracheostomy at 5 months of age. Despite his multiple skeletal deformities and respiratory problems, this patient survived more than 1 year with motorneuronal developmental delay.     

Printed Health Information Materials: Evaluation of Readability and Suitability

Interdisciplinary collaboration and coordination of services are receiving new emphasis in Birth to Three Early Intervention programs under Part H of Public Law (PL) 102-119 (Individuals with Disabilities Education Act, formerly PL 99-457, the Education for All Handicapped Children Act). Public Health Nurses (PHNs) have historically provided health promotion services in the home to families of infants and children with special health and developmental needs, whereas other community programs have provided specific developmental and related services. Now, as the number of professional specialties involved with children with special needs increases, overlap also increases. Nursing is frequently questioned as to its unique contribution. The holistic health perspective of nursing, which integrates all aspects of the health and well-being of individuals and families, can provide especially valuable insight to the assessment, planning, and service delivery processes. Nurses need to not only participate in the planning process during the interdisciplinary planning meetings, but also to contribute their own assessment and recommendations from a nursing perspective. Under PL 102-119, the Individual Family Service Plan (IFSP) provides the framework for family-centered planning of services for the infant or young child with special needs. Developed in partnership with the family, this plan identifies strengths, resources, concerns, and priorities based on the family's determination of relevancy (Sokoly &; Dokecki, 1992). IFSP development includes formal and informal assessments by qualified professionals who provide their special expertise as shaped by the family's priorities. The health assessment and services called for within PL 102-119 are consistent with public health nursing's focus on prevention and early intervention. Health issues are basic to the definition of children with special health needs and often must be addressed before developmental goals can be...     

Alteration of the langerhans islets in pancreatic cancer patients

Summary An abnormal glucose metabolism occurs in up to 80% of pancreatic cancer patients shortly or a few months before the first clinical admission. Reasons for this abnormality are obscure. We investigated immunohistochemically the pattern of islets in 14 pancreatic cancer specimens and used 14 chronic pancreatitis samples and 10 normal pancreata as controls. To study the topographical relationship of these islets to the cancer, islets in four different arbitrary zones within and around the cancer were evaluated. Ten out of 14 cancer specimens showed a significant loss of β cells (p<0.005) and eight of them also showed a significant increase of α cells (p<0.005), all of them from hyperglycemic patients. Most affected islets were found within zone 1 (intratumoral) and zone 2 (peritumoral), to a lesser extent in zone 3 (acini close to tumor) and none in zone 4 (acini remote from tumor). No comparable changes were found in chronic pancreatitis patients. The incidence of 72% with alteration of islets in our material correlates with the frequency of abnormal glucose levels in human pancreatic cancer patients. Our findings support the notion that islet cell abnormalities is likely caused by substances released from cancer cells.     

Unique Physicochemical Properties of Perfluorinated Compounds and Their Bioconcentration in Common Carp <Emphasis Type="Italic">Cyprinus carpio</Emphasis> L.

Carp (Cyprinus carpio L.) was exposed to perfluorinated compounds (PFCs)—perfluoroalkyl carboxylic acids (number of carbon atoms, C = 8, 11, 12, 14, 16, and 18) and perfluorooctane sulfonate (PFOS)—in bioconcentration tests to compare the bioconcentration factors (BCFs) and physicochemical properties of each specific compound. Despite having the same number of carbon atoms (C = 8), the BCFs of perfulorooctanoic acid (PFOA) and PFOS differed by more than two orders of magnitude (PFOA BCF = < 5.1 to 9.4; PFOS BCF = 720 to 1300). The highest BCFs were obtained from perfluorododecanoic acid (BCF = 10,000 to 16,000) and perfluorotetradecanoic acid (BCF = 16,000 to 17,000). The longest observed depuration half-lives were for perfluorohexadecanoic acid (48 to 54 days) and PFOS (45 to 52 days). The concentrations of PFCs were highest in the viscera, followed by the head, integument, and remaining parts of the test fish. PFCs concentrations in the integument, which was in direct contact with the test substances, were relatively greater than that of other lipophilic substance (hexachlorobenzene). It is likely that Clog P would be a better parameter than log K _ow for the prediction of BCFs for PFCs. Threshold values for PFCs bioaccumulation potential (molecular weight = 700, maximum diameter = 2 nm) seemed to deviate from those generally reported because of the specific steric bulk effect of molecule size.     

Uncommon electrocardiographic changes corresponding to symptoms during recurrent pulmonary embolism as documented by computed tomography scans

Electocardiographic (ECG) findings of pulmonary embolism (PE) include S₁Q₃T₃ pattern, right bundlebranch block, right-axis deviation, and T-wave inversion in medial precordial leads. We report other uncommon ECG changes associated with various symptoms during recurrent PE as documented by computed tomography (CT) scans in a single patient. An 83-year-old woman was admitted with PE secondary to deep venous thrombosis in the left leg. During episodes of chest pain, ECG showed QTc prolongation (480 ms) with new T-wave inversion in leads III, aVF, and V₁-V₃, and ST-segment depression in leads V₅-V₆. Despite adequate anticoagulant therapy, recurrent episodes of PE occurred in the hospital. When the patient experienced sudden chest tightness, ECG showed a new S-wave notch in lead V₁ and clockwise rotation with sinus tachycardia. She also experienced transient syncope with hypotension. At this time, ECG showed transient atrioventricular junctional rhythm followed by sinus arrest, and CT scan showed a new massive embolus in the main pulmonary trunk with right ventricular dilatation, as demonstrated by echocardiography. The mechanism responsible for QTc prolongation with ST-T changes, the S-wave notch in lead V₁ with clockwise rotation, or atrioventricular junctional rhythm with sinus arrest during PE may be associated with myocardial ischemia, acute right ventricular overload, or vagal reflex, respectively.     

Efficacy of calcium channel blocker in the secondary prevention of myocardial infarction--retrospective analysis of the 10-year prognosis or coronary thrombolysis-treated patients.

BACKGROUND: Calcium channel blockers (CCBs) may have a positive influence on the long-term prognosis of Japanese patients with ischemic heart disease. METHODS AND RESULTS: The effect of nifedipine-retard (NR) (n=202) compared with that of non-CCB treatment (n=92) on the secondary prevention of myocardial infarction (MI) was retrospectively investigated in patients who had survived acute MI between 1987 and 1996. The primary endpoint was the occurrence of cardiac death or non-fatal MI. The median follow-up was 6.3+/-2.4 years. The incidence of cardiac events was 8.9% in the NR group and 14.1% in the non-CCBs group (p=0.14, odds ratio (OR): 0.584, 95% confidence interval (CI): 0.286-1,193). However, subanalysis revealed that NR significantly reduced the incidence of cardiac events in patients aged less than 55 years (4.2 vs 18.2%, p=0.016, OR: 0.180, 95%CI: 0.045-0.721) and those who did not smoke (8.6 vs 16.4%, p=0.048, OR: 0.462, 95%CI: 0.203-0.999). CONCLUSION: Although this was a retrospective analysis, it showed that NR did not cause an increase in the incidence of cardiac events in post-MI patients; it even prevented cardiac events, especially in those who were less than 55 years of age and in non-smokers, suggesting the potential usefulness of CCBs in the secondary prevention of MI in Japan.     

Electron microscopic localization of periodate-reactive complex carbohydrates in acute megakaryoblastic leukemia

The localization of complex carbohydrates in 41 patients with acute megakaryoblastic leukemia (AMKL) was studied using the periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) method. Examination by the PA-TCH-SP method revealed that the megakaryoblasts from AMKL had a thick cell coat, a small amount of glycogen, granules and well-developed GERL ofNovikoff. Multivariate analysis revealed no cytochemical differences in the distribution of glycoconjugates in the cytoplasm between AMKL blasts in children and adults, but they were noted between all AMKL blasts and blasts from patients with chronic myelocytic leukemia in megakaryoblastic crisis (CML-MK). The ultrastructural distribution of complex carbohydrates in the blasts from AMKL was extremely different from the acute myelocytic leukemia (AML) blasts as demonstrated by the analysis.