Changes in lumbar lordosis in young patients with low back pain during a 10-year period

 Height and muscle strength have reportedly changed among Japanese youth during the past 10 years. Height has increased, and the back muscles have become weaker than 10 years ago. We compared the lumbar lordosis of youth today (113 men and 76 women) and of 10 years ago (85 men and 62 women). Lumbar lordosis and sacral inclination were measured on lateral standing radiographs of the lumbar spine. We also measured the same parameters among adults today (63 men and 63 women) and 10 years ago (56 men and 73 women) to study postural changes in another generation. In both men and women, the lumbar lordosis and the sacral inclination of youth today were approximately 10° larger than they were 10 years ago (P < 0.0001). However, there was no significant difference between the values among adults today and those of the same generation 10 years ago. Received: March 25, 2002 / Accepted: June 12, 2002 Offprint requests to: Y. Murata, Linnégatan 45, Apartment nr: 107 SE-413 08 Gothenburg, Sweden     

Osteochondroma in the lumbar spinal canal causing sciatic pain: report of two cases

 A search of the English-language medical literature found only two cases in which expansion of an osteochondroma into the lumbar spinal canal caused sciatica. We report another two cases of spinal nerve root compression by solitary lumbar spinal canal osteochondromas: in a 56-year-old man and a 55-year-old woman with no history of hereditary multiple exostoses. Osteochondromas compressing the spinal nerve root were seen at the inferior articular processes of the lumbar vertebrae by computed tomography (CT), three-dimensional reconstruction of CT scans, myelography, and magnetic resonance imaging. The symptoms disappeared after surgical removal of the lesions. Histopathologic examination confirmed the diagnosis of benign osteochondroma. Received: June 4, 2002 / Accepted: September 1, 2002 Offprint requests to: S. Ohtori     

A case of serous endometrial intraepithelial carcinoma with p53 positivity for six years

A 69-year-old postmenopausal woman was referred because she had been taking tamoxifen for four years. Tissues obtained by endometrial curettage were immunopositive for p53, but there was no definite malignancy. At age 73, cytology again showed abnormalities, so we repeated complete endometrial curettage. Again, there was no malignancy, but p53 immunostaining was widely positive. At age 75, hysterectomy was performed because cytological examination showed increasingly abnormal findings and the patient opted for surgery. In the resected uterus, endometrial glands were replaced by malignant cells resembling papillary serous carcinoma cells with high-grade nuclei, but there was no stromal or myometrial invasion. The pathological diagnosis was intraepithelial serous endometrial carcinoma. This is a rare case because we could follow the patient for 6 years by endometrial cytology or endometrial curettage and we observed gradual transformation into endometrial intraepithelial carcinoma.     

A case of drug-induced interstitial pneumonia caused by S-1 and CPT-11 combination therapy for advanced colon cancer

The patient was a 77-year-old woman admitted for nausea and abdominal pain. Computed tomography (CT) revealed advanced ascending colon cancer with liver metastasis. After operation, we started combination chemotherapy of S-1 and irinotecan (CPT-11); S-1(80 mg/m2) administered orally for consecutive days followed by 14 days rest.CPT -11 (100 mg/m2) was given as a 2-hour infusion on day 1 and 15. The patient complained of high fever and subsequent dyspnea with severe hypoxemia after the first course of combination chemotherapy of S-1 and CPT-11.CT scan showed diffuse interstitial lesions with ground glass opacity on both lungs. Steroid pulse therapy with oxygen therapy remarkably improved her symptoms, and abnormal findings on CT scan also resolved. Drug lymphocyte stimulation test was positive against S-1 and negative against CPT-11. These findings were consistent with S-1-induced lung injury. Drug -induced pneumonia needs to be considered in the differential diagnosis when patients treated with S-1 and CPT-11 combination therapy present high fever and dyspnea.     

Dopamine D(1) receptors participate in cocaine-induced place preference via regulation of ryanodine receptor expression

Ryanodine receptors (RyRs) with three different isoforms in the brain play a role to facilitate Ca(2+) release from the intracellular Ca(2+) pool. Although cocaine is a strongly addictive psychostimulant that dramatically affects the central nervous system function, the role of RyRs and regulation of their expression by cocaine-induced place preference have not yet been defined well. The present study investigated the regulation of RyR expression in mice under intermittent cocaine treatment using the place preference procedure. The cocaine-induced place preference was inhibited by intracerebroventricular pretreatment with dantrolene, a RyRs antagonist, in a dose-dependent manner. The levels of RyR-1 and -2 in the limbic forebrain and frontal cortex significantly increased in the cocaine-conditioned mice, whereas that of RyR-3 in these two brain regions showed no changes. Although the up-regulation of RyRs was not affected by blockade of L-type voltage-gated calcium channels, the increase of RyR-1 and -2 in the limbic forebrain and frontal cortex was completely abolished by SCH23390, a selective antagonist of dopamine D(1) receptors, but not by sulpiride, a selective antagonist of dopamine D(2) receptors. These findings indicate that RyRs play a critical role in the development of cocaine-induced place preference and that the up-regulation of RyRs in the brain of a mouse showing cocaine-induced place preference is regulated by dopamine D(1) receptors.     

Critical role for the immunoproteasome subunit LMP7 in the resistance of mice to Toxoplasma gondii infection

Proteasome‐mediated proteolysis is responsible for the generation of immunogenic epitopes presented by MHC class I molecules, which activate antigen‐specific CD8⁺ T cells. Immunoproteasomes, defined by the presence of the three catalytic subunits LMP2, MECL‐1, and LMP7, have been hypothesized to optimize MHC class I antigen processing. In this study, we demonstrate that the infection of mice with a protozoan parasite, Toxoplasma gondii, induced the expression of LMP7 mRNA in APC and increased the capacity of APC to induce the production of IFN‐γ by antigen‐specific CD8⁺ T cells. In vitro infection of a DC cell line with T. gondii also induced the expression of LMP7 and resulted in enhanced proteasome proteolytic activity. Finally, mice lacking LMP7 were highly susceptible to infection with T. gondii and showed a reduced number of functional CD8⁺ T cells. These results demonstrate that proteasomes containing LMP7 play an indispensable role in the survival of mice infected with T. gondii, presumably due to the efficient generation of CTL epitopes required for the functional development of CD8⁺ T cells.