bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of complement regulatory proteins on erythrocytes from patients with idiopathic focal segmental glomerulosclerosis
Authors: Arora Meenakshi , Arora Reetakshi , Tiwari S C , DAS1 Nibhriti , SRIVASTAVA1 L M
Published: March 2003

Focal segmental glomerulosclerosis (FSGS) is a heterogeneous group of disorders with respect to aetiology, morphology, clinical course and response to treatment. The present study assessed the expression of complement receptor 1 (CR1), decay accelerating factor (DAF) and membrane inhibitor of reactive lysis (CD59) on the erythrocytes of FSGS patients using flow cytometry compared with their expression on the erythrocytes of minimal change nephrotic syndrome (MCNS) patients. Significantly reduced expression of CR1, DAF and CD59 was observed on the erythrocytes of FSGS patients compared with the reduced expression of CR1 and enhanced expression of DAF on the erythrocytes of MCNS patients. A significant inverse relationship was demonstrated between CR1 expression and proteinuria levels in FSGS patients (r = 0.55, P < 0.01). A follow‐up study of 12 patients with FSGS after immunosuppressive therapy showed that the levels of complement regulatory proteins are significantly increased when the disease goes into remission. However, in patients not responding to immunosuppressive therapy, levels of these proteins remained low. MCNS patients showed significant increases in CR1 and decreases in DAF expression during remission of the disease.
Renal haemodynamic characteristics and their correlation with renal pathology in patients with systemic lupus erythematosus
Authors: Nakano Masaaki , Ueno Mitsuhiro , Hasegawa Hisashi , Kuroda Takeshi , Ito Satoshi , Arakawa Masaaki , Gejyo Fumitake
Published: March 2003

To clarify the characteristics of renal haemodynamics and their correlation with renal pathology in patients with systemic lupus erythematosus (SLE), renal function and renal biopsy findings from 101 SLE patients were analysed retrospectively. Glomerular filtration rate (GFR) and renal plasma flow (RPF) were examined simultaneously. Filtration fraction (FF) was calculated from the values obtained for GFR and RPF (GFR/RPF). The GFR was low in one‐third and within normal limits in two‐thirds of class IV patients with lupus nephritis (LN). In contrast, high RPF was observed in half of class IV patients. As a result, over 70% of class IV patients possessed a very low FF (less than 15%). The sensitivity of very low FF for class IV LN was significantly higher than that of low GFR. In conclusion, low FF was frequently recognized, especially in patients with diffuse proliferative LN. Decreased FF was a highly sensitive indicator of diffuse proliferative LN. Thus, determination of renal haemodynamics, including FF, may be a useful clinical parameter for evaluating renal involvement in patients with SLE.
Cerivastatin inhibits fetal calf serunvinduced DNA synthesis in cultured rat mesangial cells
Authors: HE JIN‐SONG , HORIKOSHI SATOSHI , FUNABIKI KAZUHIKO , SHIRATO ISAO , TOMINO YASUHIKO
Published: March 2003

SUMMARY: Inhibition of mevalonate synthesis by several statins has been shown to suppress DNA synthesis in glomerular mesangial cells. In the present study, we investigated the effect of a new statin, cerivastatin, on fetal calf serum (FCS)‐induced DNA synthesis of cultured rat mesangial cells. Cultured rat mesangial cells were stimulated by 10% FCS in the presence or absence of cerivastatin and mevalonate. 5‐bromo‐2‐deoxyuridine (BrdU) incorporation was used to assess DNA synthesis. the present study showed that 10% FCS caused marked stimulation of DNA synthesis in the mesangial cells. Cerivastatin inhibited FCS‐stimulated BrdU incorporation in a dose‐dependent manner. IC50 was approximately 1 umol/L. Exogenous mevalonate, farnesyl pyrophosphate and geranylgeranyl pyrophosphate significantly prevented the inhibitory effect of cerivastatin on DNA replication. It appears that cerivastatin, by inhibiting the synthesis of mevalonate, may suppress DNA synthesis in the mesangial cells.
Effects of aging and potassium depletion on renal collecting tubule K+‐controlling ATPases
Authors: EIAM‐ONG SOMCHAI , EIAM‐ONG SOMCHIT , SABATINI SANDRA
Published: March 2003

SUMMARY: The effects of aging and potassium depletion (KD) on renal cortical and medullary collecting tubule (CCT and MCT) K+‐controlling ATPase activities, Na+,K+‐ATPase and H+,K+‐ATPase, were performed in 4 and 30 month‐old male Fischer 344 x Brown‐Norway F1 (F344xBNF1) rate. Following KD, which was induced by a K+‐deficient diet for 7 days, both animal age groups had comparable levels of hypokalaemia, but the decreased fractional excretion of K+ (FEK+) was more prominent in the old‐age group. the aged animals had a 37% lower basal Na+,K+‐ATPase activity in MCT (P < 0.05), but marked increases in basal H+,K+‐ATPase activity in both CCT and MCT (P<0.001) were noted. Potassium depletion resulted in 28% (P<0.05) and 66% (P<0.01) increases in CCT and MCT Na+,K+‐ATPase activities, respectively, in the young‐age group. In the old‐age group, KD caused a 125% (P< 0.001) increase in MCT Na+,K+‐ATPase activity, but had no effect on CCT Na+,K+‐ATPase activity. the collecting tubule H+,+‐ATPase activity was increased in both the young and old‐age KD groups. the increase of magnitude in the latter was much higher than in the former. In response to KD, the more prominent rises in CCT and MCT H+,K+‐ATPase activities (with an increased percentage in MCT Na+,K+‐ATPase activity) was observed in the old‐age animals when compared with the younger ones. This could result in an increased K+ reabsorption, leading to the lower value of FEk+. Thus, the K+‐controlling mechanisms in the renal collecting tubule of aging rats are still intact and effective in coping with KD.
Attenuating effect of soy protein as compared with casein on glomerular injury in spontaneous hypercholesterolemic male Imai rats
Authors: SAKEMI Takanobu , IKEDA Yuji , MINE Makoto , TOMIYOSHI Yoshiyuki
Published: March 2003

SUMMARY: Soy protein has hypocholesterolemic and oestrogenic properties. Because the reno‐protective effect of both lipid‐lowering agents and oestrogen has been reported, we investigated whether soy protein has an ability to attenuate glomerular injury in male Imai rats in which hyperc‐holesterolemia, focal and segmental glomerulosclerosis (FSGS) and renal insufficiency occur spontaneously. Twenty male Imai rats were randomly divided into two groups and fed diets containing 20.0 g/100 g of either casein or soy protein. Each group was fed freely one of the respective test diets from when they were 8–26 weeks of age. Bodyweight, urinary protein, serum constituents and systolic blood pressure was investigated every 4 or 8 weeks from when rats were 10 weeks through to 26 weeks of age. At 26 weeks of age, rats were studied morphologically. Soy protein‐fed animals consumed larger amounts of diet and showed higher urinary urea excretion and a more rapid weight gain than the control casein diet‐fed animals. No significant differences were seen in blood pressure between the two groups. the soy protein diet did not influence absolute kidney or heart weight, but significantly reduced those organs to bodyweight ratios. Soy protein diet resulted in less proteinuria, less hyperlipidemia, less hypoalbuminemia, less renal functional impairment, less glomerular hypertrophy, and less renal histological damage as compared with the control casein diet. the soy protein diet tended to affect serum sex‐hormone levels with a trend toward lower levels of both testosterone and estradiol. the present study showed a beneficial effect of soy protein diet on glomerular disease in a spontaneous FSGS model, although the mechanisms remain to be determined.
Nephrogenesis accompanied by vascularisation in the mouse embryonic metanephros transplanted into the adult kidney for the creation of additional nephrons
Authors: JOHKURA KOHEI , LIANG YAN , TENG RUIFENG , OGIWARA NAOKO , SASAKI KAKUNORI
Published: March 2003

SUMMARY: Metanephric kidneys of nude mice were transplanted on embryonic day 12 into an adult kidney of the same strain, and the growth of the implants was analysed histochemically to investigate the ontogenesis, structure and function of the newly developed additional nephrons. By using a light microscope, developing nephrons at various stages were observed in the implants growing in the host kidney 7 days after transplantation. Immature nephrons, comprising the nephrogenic zone, were intensely positive for proliferating cell nuclear antigen (PCNA) immunostaining, but were no longer present 14 days after transplantation. Vascular integration was observed between the host and implant tissues. Electron microscopic observation 14 days after transplantation showed that the afferent arterioles together with juxtaglomerular cells had entered the gtomeruli. All of the cell types were identified in the vascularised glomeruli with erythrocytes. the visceral epithelial cells had differentiated foot processes, whereas the endothelium of the glomerular tufts was rather thick in parts, and most of the epithelial and endothelial basement membranes were not fused. Several parts of the uriniferous tubules, including proximal and distal tubules, could be identified, and it was found that many of them had remained immature. Some proximal tubules with well‐developed brush‐border microvilli reabsorbed the horseradish peroxidase (HRP) injected into the host inferior vena cava, thus providing evidence of glomerular ultrafiltration in the vascularised implants perfused by the host. These findings indicate that the nephrogenesis in the implants followed a nearly normal developmental route and showed marked vascularisation, which promoted the organogenesis of the implanted metanephros and nephron function.
IgA nephropathy and mesangial cell proliferation: shared global gene expression profiles
Authors: Sakai Hideto , Yano Naohiro , Fadden‐Paiva Kimberly J , Endoh Masayuki , Kurokawa Kiyoshi , Abboud Hanna E , Rifai Abdalla
Published: March 2003

SUMMARY:
It is well established that mesangial cell proliferation plays a major role in glomerular injury and progressive renal injury. The expression of a number of different genes has been reported in proliferative mesangial cells in culture. However, the relevance of these genes to renal injury in general and IgA nephropathy (IgAN) remains to be established. Assessment of gene activity on a global genome‐wide scale is a fundamental and newly developed molecular strategy to expand the scope of clinical investigation from a single gene to studying all genes at once in a systematic pattern. Capitalizing on the recently developed methodology of high cDNA array hybridization, the simultaneous expression of thousands of genes in primary human proliferating mesangial cells was monitored and compared with renal tissue of IgAN. Complex [α‐33P]‐labelled cDNA targets were prepared from cultured mesangial cells, remnant tissue from five IgAN renal biopsies and four nephrectomies (controls). Each target was hybridized to a high‐density array of 18 326 paired target genes. The radioactive hybridization signals were analysed by phosphorimager. Approximately 8212 ± 530 different gene transcripts were detected per target. Close to 5% (386 ± 90 genes) were full‐length mRNA human transcripts (HT) and the remainder were expressed sequence tags (EST). Using a relational database, electronic subtraction was performed and matching was carried out to allow identification of 203 HT with shared expression in proliferative mesangial cells and IgAN renal biopsies. In addition hierarchical clustering analysis was performed on the HT of IgAN and controls to establish differential expression profiles of mesangial HT in IgAN and controls. Collectively the presented data constitutes a preliminary renal bioinformatics database of the transcriptional profiles in IgAN. More importantly, the information may help to speed up the discovery of genes underlying human IgAN.
Midwifery work and the making of narrative
Authors: Maher Jane‐Maree , Torney Souter Kay
Published: March 2003

Midwifery work and the making of narrative

This paper draws on a study of birth support conducted across three Melbourne maternity units. Midwife informants were asked to participate in semistructured interviews with two researchers and describe the activity and role of lay birth support people. In the course of the study, the activity of the midwives themselves became a research focus. The study found that one of the key tasks midwives described was assisting birthing women to develop and negotiate satisfactory birth narratives that could encompass the intense and sometimes difficult experience of birth. Midwife informants offered strategies for the development of such narratives as part of their professional and personal labour in the birth room.
`Chiyamai', a panic‐like disorder in woman divers from Hegura Island
Authors: TOCHIMOTO SHINICHI , KITAMURA TATSURU , KURATA KOICHI , NAKAMURA ICHIRO , KOSHINO YOSHIFUMI
Published: March 2003

In Hegura Island, Japan, we have recently found female divers who suffer from a disorder called `Chiyamai'. From interviews, questionnaires and temporarily proposed diagnostic criteria for Chiyamai, nine cases from 44 female divers interviewed, were diagnosed as having Chiyamai. Clinically, Chiyamai is characterized by a panic‐like attack. Ten symptoms were observed during a panic‐like attack, compared with 13 symptoms in a panic attack described in the DSM‐IV. The average age at onset was 30 years and the average duration of illness was approximately 26 years. Several cases were so severe that the patients were unable to continue diving. Additionally, we report a typical case of Chiyamai, and discussed the similarities and differences between Chiyamai and anxiety disorders in the DSM‐IV. We suggest that Chiyamai is a panic‐like disorder specific to female divers from Hegura Island and that it is a result of heavy diving.
Clinical characteristics of upper airway resistance syndrome
Authors: Watanabe Takuya , Mikami Akira , Taniguchi Mitsutaka , Motonishi Masamichi , Honda Hideharu , Kyotani Kyoko , Uruha Shigehiko , Terashima Kiyoji , Teshima Yoshio , Egawa Isao , Sugita Yoshiro , Takeda Masatoshi
Published: March 2003

Polysomnographic findings and clinical symptoms were investigated in 14 cases of upper airway resistance syndrome. The mean scores of the Epworth sleepiness scale and self‐rating depression scale in eight cases were 13.5 and 38.6, respectively. The mean sleep latency of the multiple sleep latency test in four cases was 10.2 min. Seven cases were treated with continuous positive airway pressure (CPAP), and one with hormone replacement therapy. The most common symptom was daytime sleepiness. Five cases had hypertension. CPAP reduced increasing negative esophageal pressure (Pes) and frequency of EEG arousals, and improved hypertension in one case. Hormone replacement therapy ameliorated increasing negative Pes and clinical symptoms.
The signal detection ability of patients with auditory hallucination: Analysis using the continuous performance test
Authors: Ishigaki Takuma , Tanno Yoshihiko
Published: March 2003

Signal detection theory is appropriate for analyzing the problem of whether auditory hallucination arises from a sensory or judgmental disorder. In the present study the sensory discrimination ability and decision bias of psychiatric patients with auditory hallucination was investigated by using the visual continuous performance test. Based on signal detection theory the d′ (d prime) and the lnβ value (the natural logarithm of the β value) were calculated. The d′ is indicator of discriminating ability, whereas the lnβ value is an indicator of decision bias. The psychiatric inpatients with the diagnosis of schizophrenia mainly were divided into 11 patients with auditory hallucinations (AH(+)) and 11 patients without hallucinations (AH(−)). As compared with the AH(−) group, the AH(+) group showed the same d′ value and a significantly lower ln β value. As compared with the normal control group, the AH(+) group showed a significantly lower d′ value and a nearly normal lnβ value. These results suggest that auditory hallucination is characterized by a cognitive deficit of unreasonably maintaining a relatively risk‐taking decision bias in spite of decreased discriminating ability, which opposes the interpretation of Bentall and Slade (1985). The AH(+) group was divided into subgroups with bizarre delusions (BD(+)) and without bizarre delusions (BD(−)). The BD(+) group showed a stronger tendency toward a lower d′ value and normal ln β value, which the AH(+) group had.
Estimation of generator sources of human sleep spindles by dipole tracing method
Authors: Ueda Kazutaka , Nittono Hiroshi , Hayashi Mitsuo , Hori Tadao
Published: March 2003

Equivalent dipole sources of two types of human sleep spindles (14 and 12 Hz) were investigated on five normal subjects. The present study showed that a sleep spindle can be represented by a single equivalent dipole. For both 14 and 12 Hz sleep spindles, the equivalent dipole sources were estimated near the thalamus. The orientation of the equivalent dipole of a 14 Hz sleep spindle was in the centro‐parietal direction, while that of a 12 Hz sleep spindle was in the frontal direction. These results suggest that both types of sleep spindle activities are generated in the thalamus, and cortical de‐arousal plays a modificatory role on their different topographical distributions.
Seasonal changes in human sleep–wake rhythm in Antarctica and Japan
Authors: Usui Akira , Obinata Ichio , Ishizuka Yoshikazu , Okado Tamio , Fukuzawa Hitoshi , Kanba Shigenobu
Published: March 2003

Abstract The subjects were eight men of the Japanese Antarctic Research Expedition (average age 35.8 years), and 10 healthy people living around Kofu, Japan (28.9 years). They completed a sleep log for 12 to 18 months, and the sleep–wake state was scored in 10‐min epochs. Q24 values calculated by χ2 periodgram were low in the Antarctic midwinter. This means that there was difficulty in synchronizing to a 24‐h period in the Antarctic midwinter. In Antarctica, sleep onset and offset times were delayed mostly in the midwinter. In Japan, sleep offset time was delayed mostly around the winter solstice.
Culture‐bound syndrome and a culturally sensitive approach: From a viewpoint of medical anthropology
Authors: Shimoji Akitomo , Miyakawa Taihei
Published: March 2003

Abstract Some aspects of the culture‐bound syndrome are presented for discussion. From the psychiatric and medical anthropological viewpoints, kamidaari is described as an initiatory illness for seeing a shaman, and focus on clinical realities developing between different therapeutic subcultures in the same culture and the complementary practices of two epistemological ones, namely, the shamanistic and modern psychiatric system in the shamanistic climate. It is suggested that the culture‐bound syndrome that reflects cultural influences on disease patterns and renders them difficult to place in a universal classificatory system should be seen as a vernacular bricolage or as tactics used by people within the web of their own local culture of origin. Therapists who treat patients in a cross‐epistemological milieu should be aware of the subcultural‐epistemological issues that may affect the clinical process. It should be recognized that, depending on the nature of a particular psychiatric crisis, the clinical encounter is straddling the boundaries of multiple clinical realities. At every stage in the clinical field, there is an intersection, consonance, or interruption of rejoinders in the open dialog by all those engaged in the clinical time. Aspects of climatic, culturally sensitive psychotherapy will be described, and the concept of the culture‐bound syndrome will be reconsidered. Our approach could be seen as ‘situation‐ and fudo‐bound’.
Persistent effects of a structured psychiatric intervention on breast cancer patients' emotions
Authors: Hosaka Takashi , Sugiyama Yoko , Tokuda Yutaka , Okuyama Toru
Published: March 2003

Abstract The aim of the present study was to investigate persistence of the clinical effectiveness of a 5‐weekly structured group intervention program for Japanese breast cancer patients. Each program is a series of five 90‐min sessions, which include psycho‐education, problem‐solving, psychological support, relaxation training, and guided imagery. Fifty‐seven patients with breast cancer participated in the program and the 47 who completed were analyzed. The results of the Profile of Mood States (POMS) scores were compared before, just after, and 6 months after the intervention. According to the change in POMS scores, the clinical effectiveness of a structured group intervention program persisted for 6 months for the patients who had no psychiatric diagnoses at entry. By contrast, this 5‐weekly intervention program did not show persistent effects for patients who had a psychiatric diagnosis at entry. Therefore, additional intervention would be needed for patients with psychiatric diagnosis at entry.
Lithium carbonate in prophylaxis of reappearing catatonic stupor: Case report
Authors: Sugahara Yuriko , Tsukamoto Hajime , Sasaki Tsukasa
Published: March 2003

Abstract The case of a patient with reappearing stupor, accompanied by auditory hallucinations and persecutory ideas during the periods and not with alternating excitement, is reported. After 24 years of neuroleptics medication with little effect, the lithium carbonate regimen was started, which showed a remarkable prophylactic effect. The implications of lithium carbonate treatment for recurrent psychosis are discussed.
Differential diagnosis of obstructive sleep apnea syndrome patients and snorers using cephalograms
Authors: Miyao Etsuko , Miyao Masaru , Ohta Tatsuro , Okawa Masako , Inafuku Shigeru , Nakayama Meiho , Goto Shigemi
Published: March 2003

Abstract Severe snoring is thought by many to be an early stage of obstructive sleep apnea syndrome (OSAS), but the anatomical relation between snoring and OSAS, if any, has remained unclear. To compare the morphology of the airway between snorers and OSAS patients for possible similarities, we conducted a cephalometric analysis of Japanese OSAS patients (n = 10), habitual snorers (n = 10), and non‐snoring controls (n = 50). There was no significant difference in SNB (the angle formed by the sella, nasion and point B) between OSAS patients and the control subjects. Obstructive sleep apnea syndrome patients tended to have an anteriorly positioned maxilla, and an anteroposterior misalignment between the maxilla and mandible. There was also a tendency toward skeletal openbite. Both OSAS patients and snorers had large tongues and large soft palates, thus causing constriction of the airway with resultant smaller airway diameter and smaller airway surface area. Significant differences between OSAS patients and snorers were found in thickness and length of soft palate surface area, and thickness, length, and position of the hyoid bone. These results suggest that cephalographic measurements may be of considerable use in determining the seriousness of a patient's condition.
Prevalence of Alzheimer's disease, vascular dementia and dementia with Lewy bodies in a Japanese population
Authors: Yamada Tatsuo , Hattori Hiroyuki , Miura Ayako , Tanabe Mitunori , Yamori Yukio
Published: March 2003

Abstract We studied the prevalence of dementing disorders in a rural town of Japan (Amino‐cho), using a door‐to‐door two‐phase design. Of the 170 persons screened as having cognitive impairment, 142 cases were diagnosed as having dementia. The prevalence (cases/100 aged 65 years older) was 3.8 for all types of dementia, 2.1 for Alzheimer's disease (AD), 1.0 for vascular dementia (VD) and 0.7 for other types of dementia. Among other types of dementia, there were four male patients with dementia with Lewy bodies (prevalence: 0.1), but no patients with frontotemporal lobar degeneration. The overall prevalence was higher in women for AD, while that of VD was the same in both sexes. With results similar to many previous studies in Western countries and some recent surveys in Japan, the present sudy clearly showed that AD is more prevalent than VD.
Ten year progressive ventricular enlargement in schizophrenia: An MRI morphometrical study
Authors: Saijo Tomoyuki , Abe Tetsuo , Someya Yasuhiro , Sassa Takeshi , Sudo Yasuhiko , Suhara Tetsuya , Shuno Takehiko , Asai Kunihiko , Okubo Yoshiro
Published: March 2003

Abstract Recent studies of the brain using magnetic resonance imaging (MRI) have suggested progressive structural changes in schizophrenics. However, those studies were conducted over periods of less than 5 years and thus lacked sufficient capacity to determine the course and nature of this process. In this study, MRI scans were obtained in 15 schizophrenics and 12 controls at baseline and after 4‐ and 10‐year follow ups. Volumes of the lateral ventricles were measured. Patients were assessed by the Brief Psychiatric Rating Scale (BPRS) at the same two time points: at baseline and at 10‐year follow up. After 10 years, a significant lateral ventricular enlargement was found in patients (mean percentage change: +22.9%) but not in controls (5.1%). Although our results are not in disagreement with the neurodevelopmental hypothesis, they do provide strong evidence that in schizophrenia progressive brain reduction occurs even in its chronic stage.
The effects of flumazenil on sleepiness, task performance and nocturnal sleep after anesthesia with midazolam
Authors: Ozone Motohiro , Itoh Hiroshi , Ohbuchi Keita , Ohyama Eisaku , Hayashida Kenichi , Sato Miki , Sasaki Mitsuo , Ushijima Sadanobu , Tanifuji Yasumasa
Published: March 2003

The purpose of the present study was to clarify the changes in psychophysiological functions after anesthesia with midazolam (intravenous (i.v.) benzodiazepine anesthetic) and to examine the ability of flumazenil (benzodiazepine antagonist) to prevent the adverse effects of anesthesia with midazolam. Clinical dose of midazolam (0.1 mg/kg i.v.) was administered to seven healthy volunteers and either flumazenil (0.3 mg i.v.) or saline was injected at the end of the anesthesia. After anesthesia with midazolam, subjective sleepiness and euphoria increased significantly, but these changes were not observed when flumazenil was administered. In addition, sleep latency was prolonged and sleep efficiency decreased significantly after midazolam anesthesia with and without flumazenil. Slow wave sleep decreased significantly only by co‐administration of flumazenil.
Effects of isoflurane and ketamine on sleep in rabbits
Authors: Takahashi Satoshi , Matsuki Akitomo , Matsuki Akitomo
Published: March 2003

The postoperative sleep disturbance (POSD) is characterized by reduction of sleep after surgical operation. However, its mechanism is not well known. Therefore, we hypothesized that anesthetics could contribute to the POSD, and studied the effects of isoflurane and ketamine on sleep in rabbits. Rabbit sleep was measured for 21 h after isoflurane exposure or intravenous injection of ketamine. Non‐rapid eye movement sleep (NREMS) was decreased after isoflurane anesthesia. In contrast, ketamine anesthesia significantly enhanced NREMS. Both anesthetics did not affect rapid eye movement sleep. These results suggest that isoflurane may contribute to the POSD, but ketamine may decrease the POSD.
Long‐term follow‐up study on patients with sleep apnea syndrome
Authors: Inoue Yuichi , Nanba Kazuyoshi , Hazama Genni , Takata Kokichi , Arai Heii
Published: March 2003

We did a 5‐year follow‐up study on sleep apnea syndrome (SAS)‐related symptoms and respiratory disorder variables on 109 patients. At follow up, SAS‐related symptoms were improved in a significantly higher percentage of the treatment success group than the treatment failure group. A significant deterioration of the respiratory disorder variables was recognized only in the patients 40–60 years of age. These results indicate that treatment effect for SAS might be maintained in the long term and that the natural evolution of the disorder might be prominent in middle‐aged patients.
A case of diffuse neurofibrillary tangles with calcification
Authors: Narita Kosuke , Murata Tetsuhito , Ito Tatsuhiko , Murata Ichiro , Fukutani Yuken , Tsuji Yukie , Wada Yuji
Published: March 2003

Abstract We report a 79‐year‐old female with atypical senile dementia with Fahr‐type calcification.
The patient started to show memory disturbance at the age of 75 years, followed by
visual hallucination, stereotypy, personality changes such as irritability, aggression
and disinhibition. Brain computed tomography (CT) demonstrated bilateral and symmetric
calcification of the basal ganglia and thalamus. Magnetic resonance imaging (MRI)
revealed diffuse cortical atrophy pronounced in the fronto‐temporal areas. On MRI
T1‐weighted images the calcified areas showed a mixture of low‐ and high‐intensity signals. Based on the overlapping clinical symptoms of Alzheimer's disease and Pick's disease, together with the brain CT and MRI findings, we clinically diagnosed the patient as having ‘diffuse neurofibrillary tangles with calcification’ (DNTC). The characteristics of psychiatric symptoms and neuroradiological findings in DNTC are discussed.
Falling asleep while driving and automobile accidents among patients with obstructive sleep apnea–hypopnea syndrome
Authors: SHIOMI TOSHIAKI , ARITA AKI TANIGUCHI , SASANABE RYUJIRO , BANNO KATSUHISA , YAMAKAWA HIROKI , HASEGAWA RIKA , OZEKI KAORI , OKADA MAKI , ITO ASAO
Published: March 2003

Abstract Among 448 patients with obstructive sleep apnea–hypopnea syndrome (OSAHS), 40 patients (8.9%) had been involved in one or more automobile accidents during the preceding 5 years. The main cause of these accidents was falling asleep while driving. Excessive sleepiness during driving was associated with an Epworth sleepiness scale (ESS) score of > 11 and/or an apnea–hypopnea index (AHI) of > 15. The automobile accident rate among 182 patients with severe OSAHS (AHI > 30) was significantly higher than the rate among 106 simple snorers (AHI < 5). Although four of the simple snorers were involved in automobile accidents, their ESS scores were all very high (15 or more).
No evidence for an association between the 5‐hydroxytryptamine 5‐HT2a receptor gene and schizophrenia in Kuwaiti Arabs
Authors: HAIDER MOHAMMAD Z. , ZAHID MOHAMMAD A.
Published: March 2003

Abstract The prevalence of T102C polymorphism of the 5‐hydroxytryptamine 5‐HT2a receptor gene has been investigated using a polymerase chain reaction–restriction fragment length polymorphism (PCR‐RFLP) method in 80 Kuwaiti Arabs with schizophrenia and in 109 normal healthy controls with a similar ethnic background. There was no significant difference in the frequency of T102 polymorphism in the Kuwaiti cohort of schizophrenia patients and the controls (P = 0.23). The data from Kuwaiti Arabs (although our sample size is relatively small) support the findings from some other populations (Caucasians, Japanese), in which a lack of association has been found between T102C polymorphism and the onset of schizophrenia.
Tumor necrosis factor‐β gene polymorphism may not be associated with major depressive disorder in the Korean population
Authors: Jun Tae‐Youn , Pae Chi‐Un , Chae Jeong‐Ho , Bahk Won‐Myong , Kim Kwang‐Soo , Pyo Chul‐Woo , Han Hoon
Published: March 2003

Abstract Tumor necrosis factor (TNF)‐β has been implicated in the regulation of immune system. Alterations of the immune system in patients with major depressive disorder (MDD) have been also proposed to date. The present study was undertaken to investigate whether TNF‐β gene polymorphism is associated with MDD in the Korean population. Ninety‐five patients with MDD who met the criteria of DSM‐IV and 202 gender‐ and age‐matched unrelated volunteers participated in the study. Genotyping for TNF‐β gene was performed by a polymerase chain reaction‐restriction fragment length polymorphism method. The genotype and allele distribution in patients with MDD was similar to that of the controls. This study suggests that the TNF‐β gene polymorphism does not confer a susceptibility to MDD in the Korean population. A larger scaled study to examine different races is necessary to determine a role in the pathogenesis of MDD.
K‐ras gene point mutation in neogenetic lesions of subpleural fibrotic lesions: Either an early genetic event in lung cancer development or a non‐specific genetic change during the inflammatory reparative process
Authors: Maeshima Akiko Miyagi , Maeshima Arafumi , Kawashima Osamu , Nakajima Takashi
Published: March 2003

In the present study, K‐ras mutation was investigated in 156 neogenetic epithelia that appeared in the lesion of subpleural fibrosis in order to elucidate the close relationship of lung cancer development with pulmonary interstitial pneumonia. The neogenetic epithelia were histologically subclassified into six types: (i) ciliated bronchial epithelium (CBE); (ii) squamous metaplastic epithelium (SME); (iii) cuboidal immature epithelium (CIE); (iv) stratified immature epithelium (SIE); (v) mucus cell epithelium (MCE); and (vi) intestinal metaplastic epithelium (IME). K‐ras mutation was detected in 9.6% of neogenetic epithelia overall; 21% of CIE, 12% of SIE, 16% of SME, but not in other types of neogenetic epithelia. Immunohistochemically, CIE and SIE frequently expressed surfactant apoprotein and SME was characteristic to carcinoembryonic antigen expression. According to Ki‐67 immunostain, CIE, SIE and SME are likely to grow faster than other histological types of epithelia. K‐ras mutation was seen exclusively in codon 12 with predominant G to A and G to C substitutions without any G to T transversions, results which are somewhat different to previous studies in lung cancers. The present study clearly demonstrated that K‐ras mutation appeared in certain histological types of neogenetic epithelia, but raised the question of whether K‐ras mutation in neogenetic epithelia during the inflammatory reparative process might be an early genetic event in lung carcinogenesis.
Expression of Bcl‐2, but not Bax, correlates with estrogen receptor status and tumor proliferation in invasive breast carcinoma
Authors: Yang Qifeng , Sakurai Takeo , Jing Xuefeng , Utsunomiya Hirotoshi , Shan Liang , Nakamura Yasushi , Nakamura Misa , Oura Shoji , Suzuma Takaomi , Yoshimura Goro , Umemura Teiji , Kokawa Yozo , Kakudo Kennichi
Published: March 2003

Bcl‐2 and Bax have been demonstrated to be associated with apoptosis in breast carcinoma, and the ratio between Bax and Bcl‐2 seems to be an important determinant of cellular sensitivity to induction of apoptosis. However, little information is available on the relationship between Bcl‐2, Bax and the proliferative activity of breast carcinoma. The purpose of this study was to investigate the significance of apoptosis‐related genes bcl‐2 and Bax and their correlation with expression of p53, tumor proliferation defined by MIB‐1 expression and estrogen receptor status. Immunohistochemistry was performed to determine Bcl‐2, Bax, p53, estrogen receptor (ER) and MIB‐1 expression in paraffin‐embedded tissues of 177 invasive breast cancers. Expression of the anti‐apoptotic protein Bcl‐2 was not correlated with the pro‐apoptotic Bax. Bcl‐2 immunostaining displayed a negative correlation with increasing histologic grade, p53 and MIB‐1 (P< 0.0001, P< 0.05 and P< 0.0001, respectively) and a positive correlation with rising ER immunostaining (r = 0.305, P< 0.0001). Conversely, expression of the apoptosis‐promoting protein Bax did not correlate with increasing histologic grade, p53, MIB‐1 or ER status. Neither Bcl‐2 expression nor Bax expression correlated with age, menopausal status, tumor size, histologic type or axillary lymph node status. These results imply that Bcl‐2 is associated with good prognostic markers and the regulation of Bax is complex and does not necessarily correlate with mutant p53 status in breast cancers.
Fusion of intussusceptum and intussuscipiens in intrauterine intussusception: A rare type of intestinal atresia
Authors: Imai Yukihiro , Nishijima Eiji , Muraji Toshihiro , Hashimoto Kimio , Hayashi Yoshitake , Itoh Hiroshi
Published: March 2003

Intrauterine intussusception is well known as one of the rare causes of intestinal atresia. Although the polypoid intussusceptum is usually observed at the obstructed end on the distal side, a few cases with the polypoid lesion located apart from the blind end have been reported. To elucidate the etiology of separated polypoid intussusceptum, we reviewed 42 surgical cases of jejunal or ileal atresia over the last 12 years at Kobe Children’s Hospital, Kobe, Japan. Of the 42 cases, 11 were intrauterine intussusception. Two of the 11 cases were associated with polypoid intussusceptums separated from the obstructed ends; the intestinal portion between the polypoid intussusceptum and the obstructed end showed a partial two‐fold proper muscle wall and a mesenteric structure invaginated between the two walls. Another case showed linear ulcers facing each other on both the intussusceptum and intussuscipiens. Linear ulceration and subsequent fusion of the intussusceptum and intussuscipiens are suggested to be the pathogenesis of the first two cases.
Fibroma of tendon sheath arising from the radio‐ulnar joint
Authors: Misawa Akiko , Okada Kyoji , Hirano Yoshinori , Sageshima Masato
Published: March 2003

A report of a 65‐year‐old male with a tumor arising from synovial tissue of the radio‐ulnar joint. On magnetic resonance imaging, the tumor was demonstrated as a heterogeneous and lobulated mass with a low signal intensity both in T1‐ and T2‐weighted images. Histological findings of the tumor were identical to those of fibroma of the tendon sheath. In the peripheral villous synovial tissue, several small and fibrous nodules were observed, and their histological features were identical to those of the main tumor. Immunohistochemically, the tumor cells showed diffuse and intense reactivity to vimentin, muscle actin and S‐100. These results indicated that the tumor might be a fibromatous analog of synovial chondromatosis.
Autoimmune forms of chronic hepatitis associated with hepatitis C virus (HCV) infection with and without HCV‐RNA: Histological differences from pure autoimmune hepatitis and chronic hepatitis C
Authors: Hano Hiroshi , Takasaki Satoshi , Nakayama Junkon
Published: March 2003

Liver biopsy specimens of pure autoimmune hepatitis (pAIH), autoimmune forms of chronic hepatitis with positivity for anti‐hepatitis C virus (anti‐HCV) and negativity for HCV‐RNA (cAIH‐RNA(–)), autoimmune forms of chronic hepatitis with positivity for anti‐HCV and HCV‐RNA (cAIH‐RNA(+)), and chronic hepatitis C (CHC) were compared histologically and statistically to clarify the histological character of the autoimmune form of chronic hepatitis with HCV infection. The following representative histological features were used to investigate: inflammation, fibrosis, plasma cell infiltration, lymphoid aggregates/follicles, non‐suppurative destructive cholangitis, and the shape of the enlarged portal tracts. While a considerable overlap in histological features between the pAIH and cAIH‐RNA(–) groups and between the CHC and cAIH‐RNA(+) groups was recognized, the overlap between the pAIH and CHC groups was small. Significant differences were found between cAIH‐RNA(–) and cAIH‐RAN(+) groups, especially in necroinflammatory findings. In conclusion, most cases of cAIH‐RNA(–) with histological features similar to those of pAIH were shown to be AIH. The remaining cases might be CHC with subsidence of viral duplication. Conversely, many cases of cAIH‐RNA(+) with histological findings similar to those of CHC were shown to be CHC clinically mimicking pAIH. The remaining cases might represent coexistence of pAIH and HCV infection.
Parosteal fasciitis of the clavicle
Authors: Yamamoto Tetsuji , Marui Takashi , Mizuno Kosaku , Obayashi Chiho , Minami Rieko , Inaba Mayumi , Hayashi Yoshitake
Published: March 2003

A rare case of parosteal fasciitis arising from the periosteum of the left clavicle in a 27‐year‐old woman is reported. Magnetic resonance imaging demonstrated the lesion surrounding the periosteum of the clavicle. The lesion was iso‐intense with muscle on T1‐weighted images and hyperintense on T2‐weighted images. At surgery, the lesion was discovered to be densely adherent with the periosteum, and excised along with the periosteum. Histopathological examination revealed the proliferation of myofibroblasts in a vague storiform or short fascicular pattern. A large amount of extravasated erythrocytes, and a few lymphocytes were present in the matrix. There were some foci of abundant myxoid materials. Immunohistochemical study showed the cells to be positive for vimentin, α‐smooth muscle actin and HHF35, but negative for desmin. There was no local recurrence at a 6 months postoperative follow up.
Intrarenal mature cystic teratoma associated with renal dysplasia: Case report and literature review
Authors: Otani Masako , Tsujimoto Shiro , Miura Myota , Nagashima Yoji
Published: March 2003

We report a case of intrarenal teratoma in a 6‐year‐old boy. Two years before his operation, multicystic masses had been found in the left side of his abdomen. In the operation, three main cystic masses were located in the upper and lower poles of the left kidney, which were removed in pieces. Histologically, the cyst wall was lined mainly with keratinizing squamous epithelium with hair follicles, shafts and sebaceous glands. The adjacent renal parenchyma showed atrophy, with partially dysplastic and angiomyolipoma‐like lesions. Based on these findings, the lesion was diagnosed as mature cystic teratoma of dermoid cyst type. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from teratoid Wilms' tumor and other renal cystic lesions.
Expression of chromogranin/secretogranin mRNA in spontaneous mammary tumors in aging Fischer‐344 rats
Authors: Umemura Shinobu , Iwasaka Toshiki , Osamura R. Yoshiyuki
Published: March 2003

There is a type of human breast cancer showing a neuroendocrine differentiation. Little is known, however, about the cell origin of this cancer or the process by which it expresses neuroendocrine features. Rat mammary tumors, either spontaneous or induced, have not been subjects for the investigation of aspects regarding the neuroendocrine differentiation of mammary epithelial cells. The aim of the present study was to show the potential of rat mammary tumors for expressing chromogranin (Cg)/secretogranin (Sg) mRNA. We examined CgA, SgI and SgII mRNA expression by reverse transcription–polymerase chain reaction in rat mammary adenocarcinoma and fibroadenoma which had arisen spontaneously in aging Fischer‐344 rats. CgA and SgII mRNA were expressed in both mammary tumors, but SgI mRNA was not detected in either. The results of the present study show that rat mammary tumors can express chromogranin genes.
Expression of parathyroid hormone‐related protein (PTHrP) in multiple myeloma
Authors: Kitazawa Riko , Kitazawa Sohei , Kajimoto Kazuyoshi , Sowa Hideaki , Sugimoto Toshitsugu , Matsui Tosimitsu , Chihara Kazuo , Maeda Sakan
Published: March 2003

Multiple myeloma is a plasma cell neoplasia often associated with multiple skeletal lesions and hypercalcemia. Several cytokines, including interleukin (IL)‐1, IL‐6 and tumor necrosis factor‐β (TNF‐β), derived from myeloma cells are thought to accelerate osteoclastic bone resorption and cause hypercalcemia through a paracrine mechanism. We report on a case of a 69‐year‐old man with multiple myeloma associated with hypercalcemia and advanced osteolytic lesions. After bisphosphonate treatment and MP (melphalan and prednisolone) therapy, the patient’s serum calcium level was successfully but transiently recovered to the normal range. Biochemical analysis showed a remarkable increase in serum parathyroid hormone‐related protein (PTHrP; 3.7 pmol/L) and IL‐6 (22.0 pg/mL). On the other hand, parathyroid hormone and 1α,25(OH)2 vitamin D3 were suppressed. By immunohistochemistry and in situ hybridization on aspiration‐biopsied bone marrow clot sections, PTHrP mRNA and protein were detected in the cytoplasm of myeloma cells. The rate of PTHrP‐positive myeloma cells was estimated to be at least one‐third. Since PTHrP can, as an endocrine factor, systemically act on bone and kidney, hypercalcemia in this case might have been caused through both local osteolytic hypercalcemia and humoral hypercalcemia of malignancy mechanisms.
Differential distribution of basement membrane type IV collagen α1(IV), α2(IV), α5(IV) and α6(IV) chains in colorectal epithelial tumors
Authors: Hiki Yutaka , Iyama Ken‐ichi , Tsuruta Junji , Egami Hiroshi , Kamio Takihiro , Suko Shuji , Naito Ichiro , Sado Yoshikazu , Ninomiya Yoshifumi , Ogawa Michio
Published: March 2003

In this study, we examined the relationship between the histopathological grade and immunohistochemical localization of six genetically distinct type IV collagen α chains, the major component of basement membrane (BM), in normal and neoplastic colorectal tissues. In the normal colorectal mucosa, α1/α2(IV) and α5/α6(IV) chains were stained in all epithelial BM. However, α3/α4(IV) chains were restrictively immunostained in the BM of the apical surface epithelium. Similar immunostaining profiles for α1/α2(IV) and α5/α6(IV) chains were observed in tubular adenomas with mild/moderate atypia. However, in intramucosal carcinomas, both α1/α2(IV) chains were linearly stained in the BM of cancer cell nests, while the assembly of α5/α6(IV) chains into the BM was inhibited in a discontinuous or negatively stained pattern. The normal colorectal mucosa forms a second network of BM composed of α5/α6(IV), partly α3/α4(IV) chains, in addition to the classic network of α1/α2(IV) chains. The differential immunohistochemical localization of the type IV collagen α5/α6 chains could be one diagnostic marker for the invasiveness of colorectal cancer.
Smad expression of hepatic stellate cells in liver cirrhosis in vivo and hepatic stellate cell line in vitro
Authors: Kitamura Yukisato , Ninomiya Haruaki
Published: March 2003

Smad expressions, signaling mediators of transforming growth factor‐β (TGF‐β) superfamily of cytokines, were investigated in paraffin‐embedded tissue sections of liver cirrhosis due to the hepatitis C virus infection and in the hepatic stellate cell (HSC) line in vitro. Smad 2/3, 4 and 7 was expressed in the nucleus of the HSC in the cirrhotic liver, while the expression was weak in the non‐cirrhotic liver. TGF‐β1 expression in the HSC of the cirrhotic liver was strong, while the expression was weak in the non‐cirrhotic liver. In situ hybridization also demonstrated the Smad signalings in the HSC of the cirrhotic liver, which confirmed the results of the Smad expressions by immunohistochemistry. The HSC line showed a cytoplasmic and a weak nuclear expression of Smads without TGF‐β1 stimulation, while these cells showed a strong Smad expression in the nucleus by TGF‐β1 stimulation. Immunocytochemical assay demonstrated that the TGF‐β1 stimulation induced the increase of the Smad expressions and the decrease of the autocrine TGF‐β1 in the HSC line. In situ hybridization assay also demonstrated an increase of the Smad mRNA signalings by TGF‐β1 stimulation in vitro. These observations suggest that the Smad expressions increase in the nucleus of the HSC in the cirrhotic liver and that the TGF‐β1 stimulation induces the Smad expression.