Chlamydia pneumoniae infection is not involved in carotid artery stenosis

Recent studies have suggested the existence of a close relationship between Chlamydia pneumoniae infection and atherosclerosis. However, it has been speculated that C. pneumoniae infection is not associated with early atherosclerosis but with advanced atherosclerosis. In the present study, we test this hypothesis. In 524 consecutive patients who underwent cerebral angiography were recruited for the study. From the films obtained during angiography, percent stenosis of neck internal carotid artery was calculated according to the method of the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Serum C. pneumoniae IgG and IgA antibodies were measured by a commercial ELISA enzyme immunoassay kit. Cerebrovascular risk factors such as age, gender, hypertension, diabetes mellitus, hyperlipidemis and smoking were assessed by interview. Old age above 60 years and diabetes mellitus were found to be independent risk factors for carotid artery stenosis in this study after adjustment for cerebrovascular risk factors. When we defined carotid artery stenosis as the presence of greater than 30% stenosis of one artery, there was no association after adjustment for other risk factors between C. pneumoniae IgG and IgA seropositivity and the presence of carotid artery stenosis for any cut-off value of seropositivity. When we defined carotid artery stenosis as the presence of greater than 70%, there was also no association between C. pneumoniae IgG and IgA seropositivity and the presence of carotid artery stenosis for any cut-off value of seropositivity. These results suggest that C. pneumoniae infection is not associated with carotid artery atherosclerosis.     

The current managements and controversies of the clinical practice for patients with asthma. A questionnaire survey of asthma management for doctors professing internal medicine in Saitama prefecture]

A questionnaire survey of the current medical therapy in patients with mild persistent (step 2) asthma was conducted of doctors professing internal medicine in Saitama prefecture. Responses were obtained from 933 of those surveyed (response rate: 53%). Medications frequently prescribed for asthma control were theophylline (77%), inhaled corticosteroids (ICSs: 75%), and leukotriene modifiers (64%). Usage of theophylline in exacerbation reached 87% and was given priority over inhaled beta2-agonist, suggesting too much usage of theophylline among respondents. ICSs were used in 75% of respondents. Doctors specializing in respiratory or allergic medicine used ICSs more frequently than the others. They started ICSs at large doses initially (48%), followed by small doses, and they showed a trend of continuing ICSs after the asthma was under control (75%). Eighty-three percent of respondents used leukotriene modifiers, which were evaluated as easy to administer orally, having a synergistic effect with ICSs, and having fewer side effects compared with other asthma medications.     

Evidence of Direct Recognition Subset in Xeno-reactive Helper T Cells

Abstract: There are two functional subsets of alloreactive helper T cells: one recognizes the alloantigens on self-antigen-presenting cells (APCs), and the other recognizes the alloantigens on alio-APCs. In this study, we analyzed which specific Th cells have a possible effect on concor-dant-xenograft rejection responses and how Th cells recognize xeno-antigens. In the proliferative response stimulated with spleen cells obtained from rats (r-SPC), mouse T cells (m-Tc) were not inhibited by GK1.5 (CD4) or 2.43 (CD8) antibodies. In a xeno-mixed lymphocyte reaction, m-Tc that included APC (APC(+)) proliferated when stimulated with r-SPC APC(+) or APC(-). In contrast, B6 T cell APC(-) proliferated only when stimulated with r-APC(+)SPC but not when stimulated with APC(-). The m-Tc lines responded to F344 SPC APC(+) but not to SPC APC(-); however, the m-Tc line did not respond to SPC from another rat strain. We hypothesize that both CD4⁺ Th and CD8⁺ Th are included in the concordant xeno-reactive Th; there are both xeno-APC-restricted Th and self-APC-restricted Th; and xeno-APC-restricted Th recognizes xeno-major histocompatibility complexes.     

The negative correlation between age and intraocular pressures measured nyctohemerally in elderly normal-tension glaucoma patients

PURPOSE. To evaluate the correlation between age and intraocular pressure (IOP) measured every 3 h for 24 h in older normal-tension glaucoma (NTG) patients. METHODS. Ninety consecutive patients suspected of having NTG on the basis of both visual field defect and disc appearance were hospitalized for measurement of nyctohemeral IOP every 3 h over a 24-h period with a Goldmann tonometer after a 4-week wash-out of any existing medication. Sixty-nine patients (76.7%) were diagnosed as having NTG. Sixty-nine eyes of 69 subjects were enrolled for this prospective, cross-sectional study. They were divided into two groups by age (cut-off between 59 and 60 years: group 1, under 60 years; group 2, over 60 years). The correlations between age and the mean, maximum and minimum IOP and IOP variation of the eight nyctohemeral IOP measurements nyctohemerally were evaluated for each group. The times of day at which the maximum and minimum IOPs were observed were recorded. RESULTS. Groups 1 and 2 consisted of 28 patients (age: 50.2+/-6.1 years) and 42 patients (age: 70.3+/-6.1 years) ( P<0.0001), respectively. Neither mean, maximum or minimum IOP nor the IOP variation was significantly different between the groups (all P values > or =0.115). The mean, maximum and minimum IOP in group 2 were all correlated with age ( n=41; r=-0.516, P=0.0004; r=-0.434, P=0.004; r=-0.522, P=0.0004, respectively), while none of those in group 1 was correlated with age (all P values > or =0.303). CONCLUSION. The IOPs of the elder NTG patients have a negative correlation with age while those of the younger ones have no relation to age.