Delirium tremens frequently ends with behaviorally deep sleep after which the patient has usually recovered from the withdrawal state. This sleep has been called "terminal sleep" or "critical sleep". In the present study terminal sleep was investigated in 14 chronic alcoholics. Polysomnographic recordings were undertaken during terminal sleep and the patients' behavior was observed after the patients awoke from terminal sleep. A marked decrease in stages 3 and 4 sleep was found in all the patients. Sleep cycles were regularly observed in 10 patients, while in the remaining four patients sleep cycles were not observed in terminal sleep. The patients who exhibited regular sleep cycles had fully recovered from delirium tremens after they awoke from terminal sleep, and they never relapsed into delirium tremens afterwards. In contrast, the patients who demonstrated terminal sleep in which sleep cycles were not observed revealed inactive and sometimes disoriented behavior suggesting slight disturbances of consciousness. These patients developed delirium tremens repeatedly thereafter. Therefore, terminal sleep can be divided into two different types. One is recovery sleep from sleep deprivation induced by delirium tremens, in which sleep cycles are observed. The other is not sleep, but a state which is indicative of disturbances of consciousness.

Adult↗

PubMedDate not supplied

Immunohistochemical localization of pregnancy-associated plasma protein A (PAPP-A) in placentae from normal and pre-eclamptic pregnancies.

An immunohistochemical method was used to locate pregnancy-associated plasma protein A (PAPP-A) in the placenta and uterus. In addition to 10 placentae and basal plates from normal pregnancies, ranging in gestational age from 37 to 40 weeks, the following specimens were studied: three uteri obtained by hysterectomy during early pregnancy; and three placentae from patients with severe hypertensive pre-eclampsia. In early gestation, PAPP-A was localized in the villous cytotrophoblastic cell layer and the endometrial glands but was not found in the villous syncytiotrophoblast, the cytotrophoblastic cell columns or the decidual cells. On histochemical examination of placentae from cases of pre-eclampsia with hypertension, an increased number of villous cytotrophoblastic cells and so-called X-cells was observed. The monospecific antiserum to PAPP-A reacted strongly and evenly with the cytoplasm of these cells. The present study strongly suggests that the active production sites of PAPP-A are the villous cytotrophoblastic cells and the X-cells.

Female↗

PubMedDate not supplied

Cream fur: a new mouse mutation that may cause unusual lipid metabolism.

In 1986 an albino mouse with cream yellow coat color was discovered in a breeding colony of strain CAL20, which is an IgH-C congenic strain of BALB/c mice, supported by the Institute for Experimental Animals, Faculty of Medicine, Kanazawa University. Genetic analysis revealed that the cream yellow coat color phenotype was controlled by a single recessive mutant gene on chromosome 13. A preliminary study with biochemical and histologic examinations showed that cream yellow hair contained more fatty acid than unaffected normal hair and a large number of lipid droplets accumulated in parenchyma cells of the liver in mutant mice, as early as the age of 32 days old, suggesting that the cream yellow coat color was due to unusual lipid metabolism. The locus was designated cream fur locus and was given the gene symbol crf. In addition, it was found that recombination frequencies in the vicinity of the region of the crf locus were markedly different between male and female meiosis.

Animals↗

PubMedDate not supplied

MRI of multicentric reticulohistiocytosis.

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Adult↗

PubMedDate not supplied

A case control study on risk factors involved in inflammatory breast recurrence after breast-conserving surgery.

Recurrence that poses the biggest problem after breast-conserving surgery is local recurrence. Particularly, in the case of inflammatory breast recurrence which is rare but has a specific pathologic nature, it is important to elucidate the pathology and risk factors and to consider appropriate countermeasures. In the present study, we classified 133 cases of recurrence following breast-conserving surgery, collected from 18 key hospitals/institutes in Japan. Recurrence types were divided into three groups, namely, inflammatory breast recurrence, noninflammatory breast recurrence and distant metastasis only, and the risk factors involved in recurrence were investigated by the case control study allotting 2 controls to each case. The study population consisted of 9 cases of the inflammatory type, 64 cases of the noninflammatory type and 60 cases of distant metastasis. The significant risk factor for inflammatory breast recurrence was positive lymph node metastasis, which was significantly more frequent in lymphatic invasion-positive cases unlike in the distant metastasis group. The positive surgical margin and nonradiation therapy which have been shown to be significant risk factors for noninflammatory breast recurrence were entirely unrelated with inflammatory breast recurrence. In addition, the inflammatory-type recurrence time was as short as about 12 months irrespective of whether radiation therapy was performed or not. The inflammatory type was accompanied with local wide extension (cancerous embolus of the dermal lymphatic vessels), and distant metastasis (lymphangitis carcinomatosa) at the time of recurrence, and further surgery was impossible in most cases, with a significantly poorer prognosis than the other recurrence types. These findings suggest that this recurrence corresponds to the so-called 'occult' case of primary inflammatory breast carcinoma. We think it important to predict this recurrence by close pathological examination, particularly in patients with lymph node metastasis, and to consider appropriate measures.

Adenocarcinoma↗