Liaison psychiatry and HIV infection (I): Avoidance coping responses associated with depressive symptoms accompanying somatic complaints

Abstract We examined the relationship of somatic complaints to coping behaviors and mood states among 50 HIV-positive patients without AIDS. Although no patients fulfilled the DSM-III-R criteria for mood disorders including major depression, scores for depressive symptoms were significantly higher in the HIV-positive patients than in healthy persons. Although depressive symptoms in HIV patients may not be strong enough to warrant a psychiatric diagnosis of mood disorders, these patients may be prone to depressive symptoms. The HIV patients indicated a tendency toward somatic complaints more frequently than their healthy counterparts. The scores for depressive symptoms were significantly and positively correlated with scores for avoidance coping responses. The presence or absence of six complaints (i.e., general fatigue, abdominal distress, chest pain or discomfort, and numbness or chills) could be discriminated based on the score of avoidance coping responses. The results of this study suggest that avoidance coping responses associated with depressive symptoms accompany several somatic complaints in HIV patients without AIDS.     

Mental health of visually and hearing impaired students from the viewpoint of the University Personality Inventory

Tsukuba College of Technology is the first national university established as an institute of higher education for the visually and hearing impaired. We have been systematically conducting a University Personality Inventory (UPI) survey on our students since 1989 to understand their mental health. In this study, we compared the UPI scores of the new students of Tsukuba College of Technology in 1993 and 1994 with unimpaired students from the University of Tsukuba (control group), but found no significant difference in the UPI scores of the visually impaired and the control group. However, we noticed a significant difference in the average UPI scores between the hearing impaired and the control group. The visually impaired group were divided into four subgroups, UPI scores descended in order from degree 1 (total blindness), to degrees 2 and 3 (amblyopia), to degree 4 (visual acuity 0.3). The UPI scores of the degree 4 subgroup were significantly lower than those of the control group. An investigation of the items for which the check rate was at least 50% showed that the visually impaired students had a variety of psychological problems, most of which seemed to concern depression or anxiety as did the normal control group. The number of affirmative responses increased with low visual acuity. The only one belonging to the `lie' scale item was observed in the group of hearing impaired students. Thus, comparing these three groups from the viewpoint of mental health, we noticed the hearing impaired group was slightly different from the other two groups, but the visually impaired group was similar to the normal control group.     

Lung Hypoplasia in Developing Mice and Rats Induced by Maternal Exposure to Nitrofen

Abstract: The effects of maternal exposure to 2, 4-dichlorophenyl- p -nitrophenyl ether (nitrofen) on prenatal lung growth were examined by dietary administration (2,000 ppm in ICR mice and 500 ppm in CD rats). Embryos and/or fetuses (conceptuses) were removed from dams on days 12 to 18 of gestation in mice and on days 14 to 20 of gestation in rats. Body and lung weights of the conceptuses were measured. General growth retardation was noted especially in the later period of intrauterine life in both mice and rats. Bilateral retardation of lung development of the nitrofen exposed conceptuses was noticed throughout intrauterine life including the periods before the closure of pleuroperitoneal canals in both species indicating that nitrofen induced primary lung hypoplasia. In mice, the left lung was more hypoplastic than the right one, while it was opposite in rats. The species specificity in side prevalence of the developmental retardation of the lung was observed even before completion of the embryonic diaphragm and it was well in accord with the side on which posterolateral diaphragmatic hernia (Bochdalek's diaphragmatic hernia, BDH) took place later. We conclude that nitrofen induces primary lung hypoplasia regardless of the presence or absence of BDH.     

MOLECULAR EPIDEMIOLOGIC ANALYSIS OF JAPANESE PATIENTS WITH MOLLUSCUM CONTAGIOSUM

Background. Molluscum contagiosum virus (MCV) causes molluscum contagiosum (MC) in both children and adults. Recent studies have revealed that the DNA of MCV can be classified into two major types by restriction enzyme cleavage patterns; however, the relationship between MCV types and the clinical features has not been fully understood. Our study was conducted to examine whether there are geographic differences in the incidence of MCV types and whether a correlation exists between MCV types and the age, sex, and clinical status of the patients. Methods. Specimens were obtained from 171 Japanese patients. The total DNA was extracted and digested with the restriction enzymes, BamH I, Hind III, and Cla I, respectively. Specimens were then electrophoresed in agarose gels. The gels were stained with ethidium bromide and photographs were taken under transillumination. Results. Six different cleavage patterns were observed; they were classified into two major types, MCV 1 and MCV 2, consisting of two MCV 1-variants, and MCV 2 prototype, and three MCV 2-variants. The ratio of MCV 1 to MCV 2 was 13:1. Mcv 1 was commonly detected in children (98%) and adult Women (92%). MCV 2 was more frequently isolated from adult men (44%) and from patients with human Immunodeficiency virus (HIV) infection (75%). Conclusion. MCV types found in Japanese children and adult women were predominantly MCV 1 and less frequently MCV 2. This pattern is similar to that observed in European countries and Australia, suggesting a high frequency and World-wide distribution of MCV 1. The higher incidence of MCV 2 among adult men and HIV-positive patients may indicate that transmission routes of MCV 1 and MCV 2 is somewhat different of which the latter may be in part by sexual contact.     

Characterization of pigmented granules in minocycline-induced cutaneous pigmentation: observations using fluorescence microscopy and high-performance liquid chromatography

We describe a technique to facilitate histopathological detection and quantitative measurement of trace amounts of tissue minocycline. In a patient with minocycline-induced hyperpigmentation, a series of biopsies were taken from the affected skin over a period of 54 months, and examined for tissue minocyclinc deposition. Frozen sections treated with 1 m MgCl₂-ethanol yielded minocycline-specific yellowish fluorescence, the location of which corresponded to clumps of granular deposits in the dermis. A decrease in the number of fluorescent granules correlated with the clinical resolution of hyperpigmentation and a significant decrease in the tissue minocycline level. Our data also provide further support for the concept that the pigment granules contain insoluble complexes of minocycline chelated with iron. The fluorescence technique is simple, sensitive, and reproducible.     

Low-dose Pulse Methotrexate Inhibits Articular Destruction of Adjuvant Arthritis in Rats

The purpose of this study was to determine whether low-dose methotrexate pulse therapy, which had recently become important in the treatment of rheumatoid arthritis, was effective for controlling the progression of articular destruction in rats with adjuvant arthritis. Intraperitoneal methotrexate at a dose of 0.05 or 0.1 mg kg^?1 twice weekly inhibited inflammation in rats with adjuvant arthritis, as shown by reduction of the hind-paw volume. Methotrexate also inhibited articular destruction, as shown by X-ray findings. Although the mechanisms by which low-dose pulse methotrexate acts on rat adjuvant arthritis are still unclear, our results imply that it might effectively slow the progression of articular destruction in rheumatoid arthritis in man. In addition, assessment of articular destruction in this animal model might be useful when evaluating new treatments for rheumatoid arthritis.     

Modification of spontaneous renal lesion of APA hamsters by streptozotocin-induced diabetes

Syrian hamsters of the APA strain (APA hamsters) develop spontaneous mesangial thickening in the renal glomeruli from an early age. They also develop focal and segmental glomerulosclerosis (FSG) at and after 6 months of age. In this study, histopathological, immunohistochemical and lectin histochemical examinations were conducted to clarify the modification of the spontaneous renal lesions of APA hamsters by streptozotocin(SZ)-induced diabetes. Histopathological analysis revealed that the expansion of the mesangial region was more prominent and the thickening of the glomerular basement membrane (GBM) was weaker in SZ-treated animals than in non-treated ones. Immunohistochemical analysis suggested that type IV collagen and laminin were involved in the expansion of the mesangial region and thickening of the GBM. In lectin histochemical analysis, podocytes, capillary endothelial cells, GBM and a part of mesangial region of SZ-treated animals were positive for RCA₁₂₀ and GSL-I with neuraminidase-pretreatment although they were negative for these lectins in non-treated animals. These results suggest that the spontaneous glomerular lesion of APA hamsters is modified qualitatively and quantitatively by SZ-induced diabetes.     

Solid phase peptide synthesis of human endothelin precursor peptide using two-step hard acid deprotection/cleavage methods

Syntheses are described for the putative human and porcine biosynthetic precursors (hET-38 and pET-39) of endothelin, with the sequence previously deduced from human- and porcine-cDNA coding for prepro-endothelin. The Boc based solid phase synthetic method was applied, followed by weak hard acid, trimethylsilyl bromide, cleavage. The peptide removal from the resin was optimally accomplished with hydrogen fluoride. Disulfide bridges were formed by air-oxidation, and the linkage modes determined by enzymic (Endoproteinase Asp-N) digestion and HPLC. Five additional C-terminally elongated endothelin homologs were also synthesized. For alternative synthesis of pET-39, the use of trimethylsilyl tri-fluoromethanesulfonate for the removal of peptide from the resin generated a major side product, which was characterized. hET-38 was found to be less effective in vitro, when compared to endothelin. The vasoconstrictor activity in vitro of other related peptides was comparable to that of hET-38.     

3,4-Dichioropropionanilide-Induced Atrophy of the Thymus: Mechanisms of Toxicity and Recovery

The herbicide 3,4-dichioropropionanilide (propanil) has severalwell-documented neurotoxic and immunotoxic effects on mice.We report here a detailed characterization of the effects ofpropanil exposure on the thymus. We found that at doses of 100–200mg/kg, propanil induces significant thymic atrophy between 2and 7 days postexposure. This atrophy is characterized by adecrease in thymus/body ratio and a decrease in cellularity.Flow cytometric analyses of thymuses from propanil- and vehicle-treatedmice indicate that the CD4⁺ CD8⁺ population of immature cells,is most significantly decreased in propanil-exposed mice. Weperformed cell cycle analysis of thymocyte populations usingtwo-color surface staining and the DNA binding dye 7-aminoactinomycinD to determine whether thymic atrophy was associated with changesin the percentages of cells in the S, G₂ and M phases of thecell cycle. We found a high percentage of proliferating CD4⁺CD8⁺thymocytes 4 days after exposure. Thus, recovery of the thymusoccurs following increases in thymocyte proliferation, mostnotably the immature CD4⁺ CD8⁺ thymocytes. We tested the hypothesisthat glucocorticoids play a role in the observed atrophy byexamining thymuses in adrenalectomized, propanil-treated mice.No atrophy was observed in those animals. These results suggestthat propanil has an immunotoxic effect on the thymus that appearsto be mediated, in part, by endogenous glucocorticoids.     

Results of clinical surveillance during the Japanese first palivizumab season in 2002–2003

BACKGROUND: In Japan, palivizumab was approved in 2002 for prophylaxis of severe respiratory syncytial virus disease in high-risk infants. In order to evaluate the efficacy and safety of this drug, a questionnaire survey was conducted. METHODS: A questionnaire was sent to member institutions of the Japan Neonatologist Association. The subjects were premature infants who were considered possible candidates for treatment with palivizumab. RESULTS: A total of 6302 case reports, including those of 2806 infants receiving palivizumab (group P) and 3496 infants not receiving palivizumab (group NP), respectively, were retrieved. Background characteristics revealed significant lower gestational age (GA) and birthweight for group P (P < 0.0001). Sex ratio did not differ significantly, while use of oxygen and mechanical ventilation in the neonatal intensive care unit, and presence of chronic lung disease were significantly higher for infants in group P (P < 0.0001). When comparison of hospitalization rate for respiratory symptoms was performed with stratification by eligibility criteria, in the group of infants born at 29-35 weeks GA the hospitalization rate was 4.0% and 5.7% in groups P and NP, respectively (P < 0.05). Multivariate analysis also showed that prophylaxis with palivizumab was the only variable that significantly decreased rate of hospitalization (odds ratio 0.630, P= 0.0053). The incidence of adverse events associated with the administration of palivizumab was low. CONCLUSION: In this non-randomized questionnaire survey, multivariate analysis showed that palivizumab significantly decreased the rate of hospitalization due to respiratory symptoms for infants born prematurely at 29-35 weeks GA. These data confirmed the efficacy and safety of palivizumab.