To examine the usefulness of Dorsiflexion Assist Controlled by Spring Ankle-Foot Orthoses (DACS-AFO), 5 hemiplegic patients in Brunnstrom's recovery stage IV were prescribed the DACS-AFO, after which their gait with the DACS-AFO was clinically evaluated. Clinical observation did not reveal that their gait with the DACS-AFO was better than that with an AFO which the patients usually used, except when one patient walked on a slope. No significant difference in 10 m walking time was found between when the DACS-AFO and shoehorn type AFO were used. Subjective evaluations by the patients indicated that the DACS-AFO was as good as a shoehorn type AFO in walking on flat and sloped surfaces, though its weight, noise, and appearance caused by the cylinder of the DACS-AFO were regarded as poor. In spite of the excellent biomechanical characteristics of the DACS-AFO, the patients did not adopt it. The subjects in this study had already walked well with their own shoehorn type AFO, and their selection may have been biased toward poor results. However, we did not conclude that the DACS-AFO is superior to the shoehorn type AFO for hemiplegic patients in the stage IV.

View full abstract

Splenomegaly was observed both in male and female Sprague-Dawley rats after 1 week of exposure to CdCl₂ (0.6 mg Cd/kg/day). Spleen weight reached about double that in controls by 8 weeks of Cd exposure. Histopathological examination of the enlarged spleen revealed that iron- and lipid-laden histiocytes were clustered in the periarterial lymphatic sheath, and the red pulp appeared to be expanded. It is noteworthy that electron microscopy revealed marked poikilocytosis and Heinz body formation in red blood cells (RBCs) in both the sinus and cord. Histiocytes were swollen by a granular substance in the cytoplasm and also many secondary lysosomes. These morphological findings indicate that degradation of damaged RBCs induced by exposure to Cd might be promoted in the spleen and possibly cause splenomegaly. This RBC damage-hemolysis-splenomegaly sequence is also considered to be associated with the etiology of Cd-induced anemia. In addition to the abnormal RBC degradation, nuclei of lymphocytes in the Cd-exposed spleen exhibited high electron density, consistent with a preapoptotic state suggesting the immunosuppressive effect of Cd.

View full abstract

The usefulness of two-phase helical computed tomography (CT) of the liver was evaluated in clinical cases. First, an optimal scanning protocol was determined using time-attenuation analysis. Monophasic dynamic CT was performed with 100 ml of contrast media (iodine 300 mg/ml) injected either at 3 ml/s or at 2 ml/s. Aortic, hepatic and portal time-attenuation curves were made for each protocol. The results showed that these two different injection protocols produce equivalent enhancements and that the injection rate of 2 ml/s is satisfactorily applicable to clinical cases. The first scanning (arterial phase) must be started 40-45 s after the beginning of the injection of contrast media and the second scanning (delayed phase) 80-120 s after the beginning of injection. Using these CT protocols, 327 cases were examined. In this study 83 hepatic lesions (hepatocellular carcinoma; HCC, n=29; suspected HCC, n=30; hemangioma, n=24) were evaluated. There were 15 HCCs smaller than 30 mm in diameter (71.4%) detected by either arterial phase or delayed phase alone. This result indicates that two-phase helical hepatic CT is very useful in the detection of small HCC. Particularly, four of 5 HCCs of less than 10 mm in size (80%) showed a hyperattenuation area in the arterial phase alone. HCCs which have sufficient vascularity were also easily demonstrated. However, this two-phase helical hepatic CT could not demonstrate 11 lesions (13.3%) with almost normal blood supply. In such cases the complementary role of ultrasound (US) seems to be important. Hence as a screening of hepatic mass lesions both CT and US are necessary. Most HCC could be differentiated from hemangioma by an enhancement pattern using this protocol. But the small liver lesions of less than 15 mm in size with homogeneous hyperattenuation in the arterial phase and isoattenuation in the delayed phase included HCC, hemangioma and metastatic tumors.

View full abstract

The British educational system of occupational medicine was compared to the Japanese system. Furthermore, a comparison was carried out between the certified occupational physician (COP) recognized by the Japan Society for Occupational Health in Japan and the Associateship of the Faculty of Occupational Medicine (AFOM) by the Faculty of Occupational Medicine (FOM) which is a part of the Royal College of Physicians in the United Kingdom. Judging from the comparison of the minimum total training period, the clinical training period, the occupational health training period, the method of examination and the success rate between COP and AFOM, it is suggested that the British system of occupational physicians may be better as a training system for occupational medicine and may regard occupational clinical training as more important than the Japanese system does. A comparison of a Diploma in Occupational Medicine (Dip Occ Med) approved by the FOM and the certification of occupational physicians by the Japan Medical Association has shown that the former has an examination but there is no test system in the latter. It should be discussed whether an examination system for the certification of occupational physicians should be introduced into the Japanese system in the near future.

View full abstract

Pathogenicity of urinary tract infection (UTI) has been reviewed mainly focussing on the bacterial adherence in uropathogens and the inflammatory responses of urinary mucosa. Bacterial fimbriae or pili, which are encoded by chromosomal gene clusters played a major role in the adherence mechanisms of uropathogenic bacteria, including Escherichia coli. Furthermore, inflammatory responses in urinary mucosa including cytokine release was also investigated. The latest information concerning pathogenicity of UTI is described and discussed here.

View full abstract

As industries' structures have evolved and diversified recently, the framework of occupational health nursing has been expanded on multidisciplinary bases. On the occasion of the opening of the School of Health Sciences, Universitiy of Occupational and Environmental Health, Japan (UOEH), the author was given an opportunity to visit US administrations, academic institutions and some industries to investigate cccupational medicine and health nursing in that country. And as the author took part in programming the 17th UOEH International Symposium on Occupational Health Nursing Expertise that took place at the campus of the Universitiy in October, 1997, these two events are reported in this paper. The first part of the report is on the visit to the US occupational health professionals including occupational health doctors, nurses, industrial hygienists and other staffs. They have perceived that there has never been more emphasis placed on the significance of occupational health services than in recent years, and that young students have become more interested in occupational health. The second report will be on the 17th UOEH Internatioal Symposium - Occupational Health Nursing Expertise - the next time.

View full abstract

Cytochrome P 450s (P450s) are a gene superfamily of heme enzymes involved in xeno-or endo-biotic metabolisms. They have approximately 500 isozymes via evolution, immense diversity in their functions and a broad range of substrate specificities. Thus, they are called diversozymes and their versatility is understood as a mechanism for living via detoxification of toxicants. However, some of the huge human-made chemicals are bioactivated by P 450s. To explain diversity of P 450s, further studies regarding relations between crystal structures and functions of P 450s are required. P 450s can be applied for exposure-biomarkers of environmental pollution, screening of drug metabolism and remedy for pollutants.

View full abstract