Autoantibodies against a 210kDa glycoprotein of the nuclear pore complex as a prognostic marker in patients with primary biliary cirrhosis

It has been reported that the presence of anti-nuclear antibody against a 210kDa glycoprotein of nuclear pore complex (anti-gp210) is highly speci?c for primary biliary cirrhosis (PBC). The aim of the present study was to investigate the signi?cance of anti-gp210, especially as a prognostic marker. The presence of anti-gp210 was ascertained in 113 patients with PBC and 162 controls by indirect immuno?uorescence assay using HepG2 cells and immunoblotting analysis using nuclear extracts from HeLa cells. Anti-gp210 was detected in 25 of the 113 (22.1%) patients. None of the 162 controls was positive for anti-gp210. The appearance and titre of anti-gp210 in the patients with PBC did not vary from the time of diagnosis and through their clinical course. Anti-mitochondrial antibodies (AMA), including antibodies against pyruvate dehydrogenase complex, branched chain α-ketoacid dehydrogenase complex and α-ketoglutarate dehydrogenase complex, were not detected by enzyme-linked immunosorbent assay in ?ve of the 113 (4.4%) patients with PBC. However, anti-gp210 alone was positive in one of these ?ve patients. The difference in prognosis was statistically signi?cant; patients with PBC positive for anti-gp210 died from hepatic failure more frequently than those who were negative (P < 0.01), although there were no statistically signi?cant differences in the frequency of jaundice and the histological stage at the time of diagnosis between the two groups. We suggest that the presence of anti-gp210 is one of the independent prognostic markers able to predict, at the time of diagnosis, a poor outcome in patients with PBC.     

In vitro suppression of parathyroid hormone secretion by 22-oxa-calcitriol in human parathyroid hyperplasia due to uraermia

SUMMARY: 22-oxa-calcitriol (OCT), a vitamin D analogue, suppresses parathyroid hormone (PTH) secretion and has less calcaemic activity than 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃] in vivo. In this study, we evaluated the effect of OCT on PTH secretion in vitro using human hyperplastic parathyroid tissue obtained during surgery for advanced renal hyperparathyroidism and normal bovine parathyroid glands to compare the effects of 1,25(OH)₂D₃. 22-oxa-calcitriol suppressed PTH secretion by nodular hyperplastic parathyroid tissue and normal bovine tissue in a dose dependent manner, the same as 1,25(OH)₂D₃. We showed the additive effect of extracellular calcium level on suppression of PTH secretion by OCT and 1,25(OH)₂D₃. These results suggest that OCT suppresses PTH secretion, the same as 1,25(OH)₂D₃ not only in normal parathyroid cells but also on hyperplastic parathyroid cells.     

Entrainment of Ventricular Tachycardia in Arrhythmogenic Right Ventricular Tachycardia

In two patients with arrhythrnogenic right ventricular dysplasia (ARVDJ, sustained ventricular tachycardia (VT) was induced by programmed stimulations during serial drug testings. One patient had five and the other had two VT morphologies, and the sites of origin were determined by endocardial catheter mappings. When overdrive pacing was performed, constant fusion in the QflS complex was observed in the two patients. Constant fusion of a different degree was also observed at different paced cycle lengths. Both patients had dilated right ventricles and wall-motion abnormality, and the diagnosis of ARVD was further confirmed by the specimen resected at the site of origin of VT. Therefore, VT in ARVD can be entrained and reentry is the most likely mechanism of such VT.     

Prediction of interferon-alpha-induced thyroid dysfunction in patients with chronic hepatitis C

To predict interferon-alpha (IFN-α)-induced thyroid dysfunction, anti-thyroglobulin (anti-TgAb) and anti-thyroid peroxidase antibodies (anti-TPOAb) were determined by radio-immunoassay (RIA) before IFN-α treatment in 30 patients with chronic hepatitis C in whom the conventional haemagglutination test had failed to detect anti-thyroid auto-antibodies. Seven patients developed thyroid dysfunction during IFN-α treatment (transient thyrotoxicosis in four patients, transient hypothyroidism in two, and Graves’ disease in one). Anti-TgAb and/or anti-TPOAb were detectable before IFN-α treatment in six of these seven patients, while these antibodies were detected before treatment in only four of 23 patients who did not develop any thyroid dysfunction. The prevalence of these antibodies was significantly higher (P= 0.002) in the former group of patients than in the latter. In four patients with detectable anti-TgAb before treatment but no subsequent thyroid dysfunction, the antibody disappeared during IFN-α treatment. Haemagglutination tests for anti-thyroid microsomal antibodies have previously been reported to be a useful predictive marker of IFN-α-induced thyroid dysfunction. In conclusion, sensitive detection of anti-thyroid auto-antibodies using RIA may also be useful for the prediction of IFN-α-induced thyroid dysfunction in patients with a negative haemagglutination test.     

A stone developed within the dilated intravesical ureter following ureteroscopy

A 58-year-old man presented with a stone within the dilated intravesical ureter, which was probably attributable to a previous ureteroscopy. Transurethral incision of the right intravesical ureter and lithotripsy were carried out without subsequent urinary tract impairment. Although some complications resulting from ureteroscopy, such as ureteral stricture, ureteral perforation and vesicoureteral reflux, have been reported, this complication is considered to be very rare.     

ARGYROPHILIC NUCLEOLAR ORGANIZER REGION IN PROLIFERATING CELL HAS A PREDICTIVE VALUE FOR LOCAL RECURRENCE IN SUPERFICIAL BLADDER TUMOR

PURPOSE: It has been shown in many carcinomas that the proliferation rate and number of argyrophilic nucleolar organizer regions (AgNOR) are associated with tumor aggressiveness. However, in bladder tumor the significance of the correlation between the number of AgNOR and tumor behavior remains controversial. Therefore, it would be helpful if a new technique could be developed that would allow for more accurate AgNOR counting in association with tumor behavior. We established the simultaneous staining technique of AgNOR with Ki-67 labeling to reveal the significance of AgNOR count in superficial bladder tumor. MATERIALS AND METHODS: A total of 50 paraffin sections of superficial bladder tumor were stained with AgNOR and Ki-67 (MIB-1). The numbers of AgNORs in proliferating (MIB-1 positive) or resting (MIB-1 negative) cells were counted from a total of 100 nuclei. Correlations between MIB-1 associated AgNOR count and clinicopathological parameters were statistically analyzed. RESULTS: The AgNOR count in proliferating cells was significantly higher than that in resting cells (p<0.01), and the count significantly increased with tumor grade (p<0.01). Based on recurrence-free survival analyses the local recurrence rate was significantly higher in patients with high proliferating cell NOR but not for those with resting or whole cells. However, no AgNOR score helped to select patients at high risk for disease progression. CONCLUSIONS: Proliferating cell NOR had a predictive value for local recurrence in patients with superficial bladder tumor.     

A Nodule-aggregating Lesion of the Rectum Associated with Gastric Adenoma —A Case Report—

Abstract: A 81-year-old female was admitted to our hospital to undergo endoscopical treatment for a gastric adenoma and received YAG-laser therapy. The gastric adenoma was completely removed by laser therapy. However, following treatment, she complained of having mucous feces. Although she had undergone a colonoscopy twice during the previous six month, we examined her large intestine using colonoscopy and barium enema. A colonoscopy revealed a large-flat elevated lesion of the same color as the surrounding mucosa and no transmucosal vascularity of the rectum. A well demarcated flat lesion 4 cm in size with conglomerated nodules on its surface was confirmed using the dye-spraying contrast method with 0.2% indigo carmine solution. A lower anterior resection of the rectal lesion was performed and the patient is now living and well 16 month following surgery. We believe that, if we encounter gastric adenomas, more careful observation and use of the dye-spraying contrast method are necessary for the detection of adenomas or cancers in the colon.     

Activation of Cellular Immunity and Complement System in Immune-Deficient Aged Subjects by Streptococcal Preparation OK-432 (Picibanil)

In a study of 290 patients without malignancy, 10 aged subjectswere found to have impaired cellular immunity. They were givenlong-term therapy with a streptococcal preparation OK-432, andit was found that OK-432 potentiated cellular immunity in agedindividuals if 1KE of the preparation is given daily. The decreasein the third component of complement C3 in these patients duringtherapy indicates that the complement system was activated viathe alternate pathway.     

Effect of Long-Term Administration of OK-432 (Picibanil), PS-K (Krestin) and Levamisole on Immune Responses in Aged Subjects Without Malignancy

So-called immunomodulators, streptococcal preparation OK-432(Pici-banil), protein polysaccharide PS-K (Krestin) and anthelminthiccompound Levamisole, were investigated for their ability torestore the decreased immune responses in aged patients withoutmalignancy. These immunomodulators exerted their effect on host-immuneresponses during six months of therapy, as determined by theMantoux skin test, the phytohemagglutinin skin test, the endotoxinskin test and in vitro blastoid transformation of lymphocytes.