Amyloid deposits in the aged tongue: a postmortem study of 107 individuals over 60 years of age

The incidence and distribution of amyloid deposits in aged tongues obtained from 107 necropsies over 60 years of age were examined. Thirty-nine tongues were affected with amyloid deposits and the overall incidence was 36.4%. The incidence increased with each advancing decade, and the group over 90 years old showed the higest incidence of 59.6%. Although the amount of amyloid deposits differed in each case, severely affected cases were most frequently found in the advanced decades. Amyloid deposits were almost always confined to blood vessels, especially arterioles and arteries. They occasionally occupied the entire wall and occluded the lumen. Blood vessels affected with amyloid were usually located in the muscle layers of the tongue. Vessels in the subepithelial layer and lingual glands were, however, sometimes affected. Amyloid deposits were resistant to Congo red staining with the potassium permangante method, and stained positively with DMAS. The present study suggested that the tongue is an important organ as to the appearance of amyloid deposits in elderly persons.     

Co-existence of malignant squamous cells and herpes simplex virus type 2-infected cells

A case is presented in which malignant squamous cells and herpes virus infected cells were recognized concomitantly at routine cytologic examination for detection of cervical cancer. Further examinations on admission revealed Stage 1b carcinoma of the cervix and characteristic pathologic changes of herpetic infection in the tumor cell nests. Virus was isolated from the cancerous tissues in the ectocervix following radical hysterectomy, and was identified as herpes simplex virus type 2 (HSV-2). The typical HSV-2 particles were detected by electron microscopic observation on the infected FL monolayer cells with isolation. Neutralizing antibody levels against HSV-2 declined and remained low after hysterectomy. The HSV-2, isolated and identified, might be considered as “passenger” virus. The role of this isolated virus as an etiologic agent of the cervical cancer was not clear.     

Interventonal radiology in the splanchnic arteries

We present a review of interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges. Embolization is currently the treatment of choice for hemorrhagic events due to anastomotic leakage after intestinal anastomosis, although occasional association with liver necrosis poses a hazardous problem yet to be overcome. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. The indications for the embolization of aneurysms is limited depending on the morphology of the aneurysm and surrounding vessels. Rotational angiography and other recently developed imaging techniques can help analyze the vascular anatomy of every lesion in decision making on the appropriate treatment for each patient when choosing between embolization and surgical obliteration. Partial splenic artery embolization for hypersplenism has been highly evaluated since the 1980s, although treatment indication should be carefully studied for patients with severe liver dysfunction. For acute mesenteric artery occlusion, local fibrinolysis should always be backed up by or combined with surgical treatment, and the treatment outcome is still sometimes dismal, suggesting one of the boundaries of modern medicine.     

Effects of combined sensory and muscular training on balance in Japanese older adults

BACKGROUND: Adequate levels of physical balance and muscular strength are necessary to live independently in old age. The effects of an exercise training program targeting the sensory and muscle systems on balance and strength in a group of older adults were determined in this study. METHODS: Static balance (one-leg balance with eyes closed), dynamic balance (limits of stability [endpoint excursion [EPE], maximum excursion [MXE]]), and strength (chair stand) were assessed before and after the intervention. Volunteers were divided randomly into a training group (TR, n = 15, 76 +/- 4 years) and a control group (CN, n = 14, 76 +/- 7 years). TR performed 12-week (2 days/week, 60 min/day) supervised training while standing on the floor (first 4 weeks) and progressing to standing on foam pads of different compliances. Exercises included movements that challenged the sensory and muscle systems. RESULTS: After 12 weeks of training, the TR demonstrated significant improvements in static balance (82%); EPE backward (72%), right (32%), and left (33%); MXE backward (74%), right (31%), and left (18%); and lower body muscle strength (20%) with no significant changes in CN. CONCLUSION: These results indicate that this training program is very effective in improving balance and lower body strength in older adults.     

Long-lasting contractile action and the inhibitory action of cupric ions on ileal longitudinal muscle

Cupric ions (Cu(2+)), at concentrations above 0.03 mM, induced a progressive increase in the tonic contraction of guinea-pig ileal longitudinal muscle. Maximal contraction of 0.1 mM Cu(2+) attained a level above that of the 60-mM K(+)-induced tonic response, within 20 min of application. The tension induced by Cu(2+) persisted for more than several hours. Tetrodotoxin (3 x 10(-6) M) had no effect on the contraction induced by 0.1 mM Cu(2+). After incubation in a Ca(2+)-free medium, the ileal response to 0.1 mM Cu(2+) was lost. Nifedipine, a L-type Ca(2+) channel blocker, dose-dependently inhibited contractions induced by Cu(2+). As the duration of the first application of 0.1 mM Cu(2+) increased above 30 min, after washing with normal medium, the contractile response to a second application of 0.1 mM Cu(2+) decreased gradually. After 150 min of the first application of 0.1 mM Cu(2+), a second application of Cu(2+) could not evoke any contraction. After the application of 0.1 mM Cu(2+) for 150 min, when muscles were washed with a medium containing 1 mM EDTA, the response to 0.1 mM Cu(2+) returned to a greater extent in the normal Ca(2+) medium. In conclusion, Cu(2+) (0.1 mM) induced a maximal ileal tension above that of the K-induced tonic response within 20 min. The ileal contraction to Cu(2+) persisted for more than several hours and depended on extracellular Ca(2+) concentrations. It is possible that a part of Cu(2+), bound to a EDTA-inaccessible site, also has a tension inhibitory effect.     

Advances in the development of a reliable assay for the measurement of stool decay-accelerating factor in the detection of colorectal cancer

We have previously shown that stool concentrations of decay-accelerating factor (DAF; CD55), a membrane-bound complement-regulatory protein, are significantly elevated in patients with colorectal cancer and that the measurement of stool DAF may be a valuable test for the detection of colorectal cancer. Accordingly, we are working to develop a clinically useful immunoassay for fecal DAF. A requirement for such assay is a plentiful and reliable supply of anti-DAF antibodies. We developed a sandwich enzyme-linked immunosorbent assay (ELISA) for DAF in stool specimens, using two monoclonal anti-DAF antibodies recognizing different epitopes on the DAF molecule. When we first used a biotin-labeled antibody and enzyme-linked streptavidin method, we often observed stool interference, probably due to the presence of a substance(s) with biotin activity which non-specifically bound to the Fc portion of IgG of the first anti-DAF antibody on the ELISA wells. By the use of inorganic salts in the sample-dilution buffer and HRP-labeled anti-DAF as second antibody, we circumvented the stool interference and established that the new ELISA system could reliably measure DAF at low concentrations in stool specimens. Because the new assay system uses only monoclonal antibodies, we can now consistently supply ample amounts of antibodies for routine measurement of stool DAF.     

Quality control for antimicrobial susceptibility test using correlation between MIC results

The method of National Committee for Clinical Laboratory Standards (NCCLS) is widely used for the daily quality control of the antimicrobial susceptibility test. This method, however, cannot detect the accidental error, although it is useful to detect the systematic error in the examination. We developed a computer program using the correlation between the various antimicrobial susceptibility test results to detect an accidental error. The combinations of the MIC results determined for two antimicrobial agents which showed a high correlation coefficient (> or = 0.7), were selected from 98 bacterial species (2122 strains) isolated from January 2000 to December 2000 at Oita Medical University Hospital. Subsequently, a total of 127 combinations of antimicrobial agents for 13 species were selected on the basis of acceptable correlation ranges. Then, the method were verified with 666 strains (5753 combinations) isolated during the period of January to June, 2001. Twenty-six strains (47 combinations) were identified as an unexpected result, and the occurrence of error were confirmed in 3 strains (12 combinations). These results suggest that this method which evaluated the correlation between MICs against different antimicrobial agents is applicable for the quality control of antimicrobial susceptibility testings.     

Radiotherapy with concurrent docetaxel for advanced and recurrent breast cancer

BACKGROUND: Docetaxel has shown remarkable radiosensitizing properties in vitro. In this study we investigated whether the addition of docetaxel to radiotherapy enhanced tumor response in patients with advanced or recurrent breast cancer. METHODS: A total of 35 patients were enrolled in this study. Docetaxel was administered concurrently during radiotherapy. Radiation doses were 54 to 69 Gy (median 60 Gy). In those enrolled through January 2000, docetaxel 40 mg/m2 was administered biweekly (once every two weeks), with subsequent dose adjustments based on tolerance and bone marrow and liver function. Beginning in February 2000, a weekly docetaxel schedule was used instead. This new regimen was based on data suggesting reduced myelosuppression with this regimen. The weekly dose rate was 20 mg/m2, with dose reductions for impaired organ function. RESULTS: All patients were evaluated for toxicity and response and a total of 40 irradiated sites were evaluated for local response. The overall response rate of irradiated sites was 95% and the CR rate was 68%. CR and PR were achieved in 40%, 37% of patients, respectively. Acute toxicities were tolerated by most patients: 17% had Grade 3-4 neutropenia, 6% had Grade 3-4 radiation dermatitis, and 3% had Grade 3-4 pneumonitis. CONCLUSION: The combination of docetaxel with radiotherapy is an active and safe regimen in patients with inoperable advanced or recurrent breast cancer. We determined the recommended dose of docetaxel with concomitant radiotherapy to be 20 mg/m2 weekly for a Phase II study. Further study is necessary to assess the impact of this treatment on long-term outcome.     

Red blood cell deformability in relation to gender,age, blood pressure,obesity, serum lipids,alcohol consumption and smoking

OBJECTIVES: To determine the effects of environmental factors on abnormalities in red blood cell deformability (RBCD), which may play an important role in the development of cardiovascular diseases, a cross-sectional epidemiological study was conducted in healthy subjects. METHOD: The subjects were 350 males (mean age 52.7 +/- 10.3 SD) and 364 females (52.6 +/- 10.4) who participated in a health check program in the town of Akabane, Japan, in 1995-1998. Blood and serum were obtained to determine the values of RBCD and TP, TG, TCHOL, and HDLC. The inverse of RBCD (RBCDI, ms-1) was used as an indicator of RBCD. The subjects were also investigated for drinking and smoking habits, BMI, and SBP. Males and females were stratified into tertiles for each variable except drinking and smoking. For those exceptions, male subjects were stratified into three groups according to alcohol consumption (non-drinkers, moderate drinkers (up to 27 ml pure ethanol per day), and habitual drinkers (28 ml or more per day)) and according to tobacco use (non-smokers, mild smokers (equal or fewer than 20 cigarettes per day), and heavy smokers, (more than 20)). Each stratum was further divided into two groups according to age (younger, < 50 years; older, > or = 50 years). RESULTS: The mean value of RBCDI was significantly higher in males (1.041 +/- 0.135 SD) than in females (1.013 +/- 0.113). RBCDI declined with age in both genders. In analyses of variance, the averages of RBCDI decreased as TP increased in all ages and in both genders and as TCHOL increased in older males. With regard to alcohol consumption, the averages of RBCDI were the highest in moderate drinkers in younger males. Multiple linear regression analyses showed negative correlations between RBCDI values and age, TP or TCHOL values, and showed positive correlations between RBCDI values and BMI in males as well as negative correlations between RBCDI values and age and TP in females. When alcohol drinking was entered into the model, the statistical significance between TCHOL and RBCDI disappeared in males. No apparent relations between smoking habit and levels of SBP and TG to RBCDI were found. CONCLUSIONS: RBCDI was higher in males than in females and higher in the younger group than in the older group. This study suggested that TCHOL may lower RBCDI and moderate drinking may improve it. Further epidemiological study is required to clarify these relationships.