Identification of a novel polymorphism of estrogen receptor-α gene that is associated with calcium excretion in urine

A novel variation of the estrogen receptor-α (ERα) gene was identified by polymerase chain reaction–single-strand conformational polymorphism (PCR-SSCP). It is one base substitution in codon 325 (CCC [allele M] to CCG [allele m]) in exon 4 of the human ERα gene. This substitution did not cause an amino acid change. We categorized 306 unrelated Japanese postmenopausal women into three genotypes: MM, Mm, and mm; the frequency of each genotype was 26.5%, 43.1%, and 30.4%, respectively. Then, the association of this polymorphism with bone mineral density (BMD) of lumbar spine and bone–calcium metabolic markers was studied. There was no significant difference in BMD of the lumbar spine or most of the bone metabolic markers. However, the urinary calcium (Ca) excretion ratio (u-Ca/Cre) corrected by creatinine was significantly lower in the genotype mm group compared with the genotype MM group (MM vs mm, 0.247 ± 0.158 vs 0.200 ± 0.105; P < 0.05). We examined the relationship of restriction fragment length polymorphisms (RFLPs) (PvuII, XbaI) in intron 1 and the polymorphism in exon 4. The frequency of genotype MM was higher in the genotype PPxx, which was reported to be associated with lower BMD in the same population of Japanese postmenopausal women. The ER polymorphism identified in this study might be related to some biological mechanisms that regulate calcium metabolism. Received: Oct. 6, 1997 / Accepted: Sept. 28, 1999     

An epidemic of a pertussis-like illness caused by Chlamydia pneumoniae

BACKGROUND: Between June and July, 1994, we encountered an epidemic of a pertussis-like illness in adolescents in a junior high school located in a rural area of Japan. The purposes of this study were to record the clinical manifestations and to identify an etiology. PATIENTS AND METHODS: We interviewed patients and parents and we performed physical examinations on patients with cough during the epidemic. The chest radiographs were also reviewed by us. To identify an etiology we performed culture and serologic studies for a variety of bacteria, Mycoplasma, chlamydiae and viruses. Polymerase chain reaction (PCR) for Chlamydia pneumoniae was carried out on throat swab specimens. RESULTS: Of a total of 230 students 136 (59%) had severe cough illnesses. One developed pneumonia, 9 had bronchitis and the remaining 126 (93%) presented upper respiratory tract infections (URI). The mean duration of cough in cases with URI was 17.4 days and that in cases with bronchitis and pneumonia was 30.4 days. Serology and/or cultures for Bordetella pertussis, Bordetella parapertussis, Mycoplasma pneumoniae, Chlamydia trachomatis, Chlamydia psittaci or viruses were negative. Detection of C. pneumoniae infection was carried out in 46 patients with pneumonia, bronchitis or URI by serology and PCR. The patient with pneumonia, 7 of 7 patients with bronchitis and 32 (84%) of 38 patients with URI were documented to be infected by C. pneumoniae either by serology, PCR or both tests. CONCLUSION: An epidemic of a pertussis-like illness in a junior high school population was caused by C. pneumoniae.     

Effect of nifedipine on the progression of coronary atherosclerosis in humans. Analysis of coronary angiogram by videodensitometry.

This study was conducted retrospectively to elucidate whether the long-term use of nifedipine is effective against the progression of coronary atherosclerosis in humans. Twenty-nine subjects with ischemic heart disease, on whom repeated coronary angiographic examinations (CAG) were performed, were randomly selected. Sixteen subjects were on nifedipine therapy (40 mg/day; NIF group, age 53 +/- 2) and 13 subjects not on nifedipine therapy served as the control group (C group, age 58 +/- 3). No significant differences were observed in clinical backgrounds, including the interval between CAG, between the 2 groups. The lesions with 25 to 75% stenosis on the first CAG were defined as the regions of interest (ROI), and the magnitude of stenosis was quantitatively measured by videodensitometry for each ROI on the first and the second CAG. The magnitude of stenosis showed a small increase (54.1 +/- 2.6 to 58.6 +/- 3.3%: N.S.) for 37 ROIs in the C group. In contrast, it showed a significant decrease (52.5 +/- 3.8 to 46.2 +/- 4.3%: p less than 0.05) for 33 ROIs in the NIF group. The trend was more apparent in the left coronary artery. The change in the mean value for ROIs in each subject produced similar results. These results suggest that the long-term use of nifedipine might be effective in retarding the progression of coronary atherosclerosis in humans. However, a prospective study should be performed to confirm this.     

Clinico-pathological studies on multiple colorectal cancer

Of 743 patients with colorectal cancer operated during the past 21 years, 52 with double cancer, excepting patients in whom the disease was associated with familial polyposis, were examined. A higher association of adenomas was noted in multiple carcinomas of the large intestine than in a single carcinoma. As most of the multiple carcinomas were located close to each portion, it is possible to resect the multiple tumors concomitantly during a single operative procedure. No recurrence or mortality was seen in patients with synchronous multiple carcinomas that coexisted with advanced and early cancers. However, all patients with two or more advanced cancers died a short time after the operation. In 66.7% of the cases the other organ involved in the double cancer was the stomach. When the cancers were in the early stage, long-term survival could be achieved even in the presence of synchronous double cancers. Despite the early detection of the primary cancer in metachronous double cancer, patients whose second cancer was in the advanced stage died shortly after the second operation.     

Clinicopathological study of a malignant lesion in the remnant stomach

Thirty-six cases of malignant lesion in the remnant stomach were studied clinicopathologically. Ten had been surgically managed as benign lesions and eight were suspected of being metachronous multiple gastric cancer. The pathological characteristics of the malignant lesions and the operation interval (mostly more than 10 years) were similar in these two groups. Although malignant lesion in the remnant stomach is difficult to differentiate clearly when there is no sufficient histological evidence, the operation interval of more than 10 years can be one of the criteria for differential diagnosis.