Screening for mutations at codon 717 of the amyloid precursor protein gene in Alzheimer's disease

Abstract Three kinds of missense mutation at codon 717 of amyloid precursor protein (APP) gene (Val→Ile; Val→Gly; Val→Phe) were screened in 114 patients with familial and sporadic Alzheimer's disease (AD), using a rapid testing method for each Val→Gly and Val→Phe mutation and Goate's method for Val→Ile mutation based on the polymerase chain reaction. Mutations were not found in the subjects, confirming earlier suggestions that these three mutations at codon 717 of APP gene account for only a small proportion of cases of not only familial AD but also sporadic AD.     

Measurement of prostate specific antigen complexed to α1-antichymotrypsin to avoid unnecessary biopsy in patients with serum prostate specific antigen levels 4–20 ng/mL

AIM: To investigate whether measuring prostate specific antigen complexed to alpha1-Antichymotrypsin (PSA-ACT) can increase sensitivity and specificity in detecting prostate cancer. METHODS: In this prospective study, we measured serum total PSA, PSA-ACT, free PSA, prostate volume and transition zone volume on 210 patients with total PSA level of 4-20 ng/mL. From fitted curves between positive predictive values for prostate cancer and age, prostate volume, transition zone volume, total PSA, PSA-ACT or F/T ratio, each function predicting prostate cancer was determined. Relative probabilities for prostate cancer (RPpca) which were defined by combined functions of age, F/T ratio, prostate volume or transition zone volume, and total PSA or PSA-ACT were calculated. Furthermore, using logistic regression, analysis was performed to determine the probability of prostate cancer. Receiver-operating characteristic analysis was performed to clarify the areas under the curve (AUC) for conventional single parameters, RPpca and logistic regression probability. RESULTS: F/T ratio showed the largest AUC among conventional parameters. The AUC of RPpca was larger than those of F/T ratio and logistic regression probability. RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio showed the largest AUC and highest specificity at sensitivity 95% level, however, specificities at sensitivity 90% and 85% were identical to those of RPpca using the functions of age, prostate volume, total PSA and F/T ratio. CONCLUSIONS: RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio was the best way to detect prostate cancer, however, the usefulness of PSA-ACT appears limited, considering the cost.     

Low job control is associated with higher diastolic blood pressure in men with mildly elevated blood pressure: the Rosai Karoshi study

Job strain is a risk factor for hypertension, but it is not fully understood if components of job strain, or job demand or job control per se could be related to blood pressure (BP), and if so, whether the relationship differs between normotension and mildly elevated BP. We examined resting BP, and job stress components in 113 Japanese male hospital clerks (38.1 ± 4.4 yr). Subjects were classified into normotensive (NT) (<130/85 mmHg, n=83) and mildly elevated BP (ME) (≥130/85 mmHg) groups. Diastolic BP (DBP) showed a significant interaction between group and job control level (p=0.013). Subjects with low job control demonstrated higher DBP than those with high job control (89.1 ± 2.1 vs. 82.3 ± 2.3 mmHg, p=0.042) in ME group even after adjustments for covariates while DBP did not differ between low and high job control subjects in NT group. Systolic BP (SBP) did not differ between high and low job control subjects in both groups. Neither SBP nor DBP differed between high and low demand groups in either group. Among job strain components, job control may be independently related to BP in Japanese male workers with mildly elevated BP.     

Mortality Among Alcoholics Discharged From a Japanese Hospital

A study of mortality among alcoholics was carried out involving patients discharged from the alcoholic ward of a Hamamatsu University-affiliated hospital from 1972 to 1984 (1021 patients). The average age at death was 48,4 years. The causes of death were divided into three groups; ‘diseases, accidents’, ‘suicide and homicide’, accounting for 73.5%, 10.5% and 7.3% of 257 deaths, respectively. Death rates per 1000 persons for the years at risk were compared with the expected rates for the general population. Briefly, the death rates for patients were more than 10 times as large as those in the general population. Our results showed that liver cirrhosis and heart failure ranked high among the causes of death in alcoholics. Among patients who died, only 3.1% were total abstainers after discharge from hospital, which was an extremely low proportion in comparison with the average cross-total abstinence rate of 25.8% among patients after discharge.     

Peptic Ulcer in Infants: Three Case Reports and a Review of the Japanese Literature

Abstract: Three cases of peptic ulcer in children under two years of age are reported, and 33 cases of infants with peptic ulcer reported in Japan between 1955 and March, 1989 are reviewed. Case 1 was an 8-month-old male complaining of melena, and endoscopic examination showed a gastric ulcer on the lesser curvature of the antrum. Cases 2 and 3 were a 15-month-old mule and an 18-month-old male, respectively, with complaints of melena and hematemesis. Endoscopic examination revealed an active duodenal ulcer in both cases. All 3 infants were successfully treated with H₂ blocker and/or antacid. In these 3 cases, infection or drugs were speculated to be predisposing factors, and the fathers of these three infants all had histories of duodenal ulcer. Among 33 cases of infants under 2 years old with peptic ulcer in Japan, 9 had a gastric ulcer and 24 had a duodenal ulcer. Seventeen were treated with conservative therapy and 16 were operated on because of perforation or bleeding. We should always keep in mind that peptic ulcer does occur in infancy, and that endoscopic examination should be promptly performed when peptic ulcer is suspected.     

Pedunculated Submucosal Ectopic Mucosa of the Stomach Treated by Endoscopic Polypectomy: Report of Two Cases

We report here two cases of submucosal ectopic gastric mucosa which grew with pedunculation. A lesion 23 mm in size was located in the posterior wall of the upper gastric body in a 61-year-old female. A 58-year-old female had a lesion 12 mm in size in the anterior wall of the upper gastric body. Both were elevated lesions expressed as Yamada's type IV and were endoscopically diagnosed as submucosal tumors. For the purpose of total biopsy, endoscopic polypectomy was performed in both cases. Histological examination of the polypectomized specimens showed gastric mucosa in the submucosal layer. These two cases were unique in that ectopic gastric mucosa was pedunculated and diagnosed after endoscopic polypectomy, not by postoperative pathological examination.     

Usefulness of Mechanical Lithotripters in Endoscopic Sphincterotomy

We have been performing bile duct lithotripsy by EST at Kumamoto Regional Medical Center since January 1982. A balloon catheter is the method of choice for performing lithotripsy. For stone removal, a conventional FG-22Q basket catheter was used from January 1982 to June 1984 (extraction rate: 88.5%), and a prototype EML BML-1Q basket catheter was used with a FG-22Q basket catheter from July 1984 to April 1990 (extraction rate: 91.5%). Since May 1990, lithotripsy has been performed in the following sequence with excellent results (extraction rate: 97.0%): EST-balloon catheter, slide-type EML BML-3Q-balloon catheter. Although the difference between the extraction rates for BML-1Q and BML-3Q basket catheters were only marginally significant, the difference between the conventional basket FG-22Q and BML-3Q was clearly significant. Lithotomy using the procedure employed since May 1990 is therefore recommended as a highly effective means of extracting gallstones and is considered to be superior to conventional methods.     

Inactivation of Vesicular Stomatitis Virus by Serum from Patients with Hepatocellular Carcinoma

Vesicular stomatitis virus was inactivated by serum from tenpatients with hepatocellular carcinoma more strongly than bythe serum of ten healthy adults. This action of human serumwas also observed in an infant, a child, a patient with agammaglobulinemia(Bruton type) and the cord blood of three babies (lacking IgM).Serum samples treated with zymosan and by heating at 56°Cfor 30 min lost this ability only partially, although complementaction in the same samples was completely inactivated.