EFFECT OF PORCINE BRAIN NATRIURETIC PEPTIDE (pBNP) ON HUMAN ADRENOCORTICAL STEROIDOGENESIS

Porcine brain natriuretic peptide (pBNP), purified from porcine brain, had a significant suppressive effect on aldosterone and cortisol secretions in ACTH-treated cultured human adrenal cells. Concomitantly, the intracellular cGMP formation was enhanced by pBNP treatment. A specific pBNP receptor was identified in the human adrenal tissues. Affinity labelling of 125I-pBNP showed two separate molecular weights of specific binding sites for pBNP of 140 and 67 kDa. A 125I-pBNP binding study of the human adrenal membrane fraction demonstrated the presence of high-affinity and low-capacity binding sites for pBNP. Moreover, these binding sites for 125I-pBNP were displaced by unlabelled alpha-rANP as well as pBNP. From these studies, we concluded that pBNP had suppressive effects on human adrenocortical steroidogensis, possibly via a receptor which may be shared with ANP.     

Cryptophthalmia Syndrome with Laryngeal Atresia and Bilateral Renal Agenesis: A Case Report and a Review of the Literature

Abstract An autopsy case of the unilateral cryptophthalmia syndrome was presented, showing the lack of the eyelids formation on the right and the facial skin being continuous over the right eye. Potter's face, partial cutaneous syndactyly, clitorial hypertrophy, bilateral renal agenesis and absence of uterus were associated, and further laryngeal atresia was noted, leaving a small posterior opening and allowing a survival of only 10 min at birth. Histologic analysis of the right eye revealed that the cyst in the anterior segment was formed by the destruction of the lens itself. The pathogenesis of cryptophthalmia and laryngeal atresia was discussed.     

Common clonal origin of lymphocytes and plasma cells in splenic lymphoma with villous lymphocytes

In two-thirds of patients with splenic lymphoma with villous lymphocytes (SLVL) a small amount of M-protein can be detected in association with the presence of plasma cells in the peripheral blood (PB) and/or bone marrow (BM). However, it is not known whether lymphoma cells and plasma cells originate from the same clone. In this report we describe a case of SLVL which was characterized by the presence of marked monoclonal gammopathy (IgG-κ 90 g/l) and increased plasma cells in the BM. In an attempt to elucidate the origin of lymphoma cells and plasma cells, we performed morphological, cytogenetic and molecular studies on PB mononuclear cells (PBMNC) without plasma cells and BMMNC containing 10% plasma cells from this patient.
Immunofluorescence showed that lymphoma cells and plasma cells were positive for cytoplasmic γ heavy and κ light chains. Well-developed endoplasmic reticulum was observed in the cytoplasmic organelles of PBMNC using an electron microscope. The mean IgG concentration in the 3 d supernatant cultures of PBMNC was 374±24μg/l. More than 50% PBMNC differentiated into plasmacytoid cells in 6 d of liquid culture with IL-3 and IL-6. Analysis by two-colour FISH revealed that karyotypic abnormalities of monosomy X and trisomy 17 existed simultaneously in both lymphoma cells and plasma cells. JH gene rearranged bands from PBMNC and BMMNC by Southern blot hybridization were identical, whereas DNAs from PBMNC failed to hybridize with the Cμ probe.
These observations strongly suggest that lymphoma cells and plasma cells originate from the same clone, and that plasma cells, as well as lymphoma cells, which have undergone class switch recombination, could produce IgG type M-protein in this case.     

Extensive white matter involvement in hemorrhagic shock and encephalopathy syndrome

Reported is a case of hemorrhagic shock and encephalopathy syndrome (HSE) with extensive white matter involvement. A three year old, previously healthy boy was presented with an acute onset of fever, loss of consciousness and convulsions. He had disseminated intravascular coagulation, metabolic acidosis, non-ketotic hypoglycemia and hepatorenal dysfunction. The computed tomography (CT) scan of his head on the second day of illness demonstrated symmetric, extensive low-density areas in the cerebral and cerebellar white matter. The child died on the 13th hospital day. A post-mortem histopathological examination of the liver revealed centrilobular necrosis and infiltration of fatty acid droplets. The concentrations of serum 2′,5′-oligoadenylate synthetase and urinary neopterin were markedly elevated, indicating excessively activated cell-mediated immunity. This overproduction of inflammatory cytokines might play an important role in the pathogenesis of the brain lesion as well as in other clinical and laboratory manifestations. The patient had a decreased serum level of α1-antitrypsin, which may have been associated with the development of uncontrolled inflammation and coagulation disorder.     

ULTRASTRUCTURE OF MICROCIRCULATION IN RENAL GRAFTS IN PATIENTS WITH ACUTE OR CHRONIC REJECTIONS

Using electron microscopy, we studied the renal microcirculation in 31 biopsied specimens from 24 transplants in patients with acute or chronic rejection. Endothelial damage was followed by extensive denudation and platelet attachment, fibrin deposition, focal or whole cytoplasmolysis, rarefaction necrosis of the medial smooth muscle cells, with or without the attachment of inflammatory cells. Medial smooth muscle cells modified by hyperplasia of ergastoplasm, appeared to migrate into the intima and to proliferate there. The endothelium was regenerated with time. Chronic rejection was characterized by "moth-eaten-like" atrophic changes of the medial smooth muscle cells in interlobular arteries with an increase in intercellular spaces with necrotic debris and basement membrane densities. Larger interlobular arteries showed additional mucoid lamellar thickening of the intima, with stenosis. Acute changes in glomerular capillaries included endothelial injury and denudation, thrombotic occlusion and enlargement of subendothelial spaces, apparently due to an increase in permeability. Extensive circumferential mesangial interposition was present in one case of a repeated rejection. Thus, chronicity with various rejections leads to severe luminal narrowing and obstruction in both interlobular arteries and the glomerulus of the grafts.     

Plasminogen is essential for granulation tissue formation during the recovery process after liver injury in mice

Summary. Background: The involvement of plasminogen in liver repair has been reported, but its exact role in promoting this process is unknown. Objective: To elucidate the underlying mechanism, we examined the dynamics of liver repair by using a reproducible liver injury model in plasminogen gene‐deficient mice and their wild‐type littermates. Methods: Liver injury was induced by photochemical reaction and the subsequent responses were histologically analyzed. Results: In wild‐type animals, the area of the damage successively decreased, and the repair process was associated with macrophage accumulation at its border. Neutrophils were also attracted to the damaged region on day 1 and were evident only at its border by day 4, which spatially and temporally coincided with the expression of macrophage chemoattractant protein‐1 (MCP‐1). Neutrophil depletion suppressed recruitment of macrophages at the border between the damaged and the normal tissues. These changes were followed by activated hepatic stellate cell accumulation, collagen fiber deposition and angiogenesis at the boundaries of the injured zone. In contrast, in plasminogen gene‐deficient mice, the decrease in the area of damage, macrophage accumulation, late‐phase neutrophil recruitment, hepatic stellate cell accumulation, collagen fiber deposition and angiogenesis were all impaired. Conclusion: Our data suggest that accumulated neutrophils at the border of the damaged area may contribute to macrophage accumulation at granulation tissue via the production of MCP‐1 after liver injury. The plasminogen system is critical for liver repair by facilitating macrophage accumulation and triggering a cascade of subsequent repair events.     

Impact of health literacy on health practices in the working life of young Japanese nurses and care workers

To continue to work healthily, health practices are necessary. This study assessed the impact of health literacy (HL) on health practices in the working life of young Japanese nurses and care workers, occupations with heavy physical and psychological burdens. A web-based survey was conducted with 500 women (330 nurses and 170 care workers) under the age of 30 in 2019. Data regarding their demographic characteristics, HL and health practices in their working life were collected. A significant association was found between high HL and better health practices, such as being likely to rest when tired, working at their own pace maintaining a good work-life balance and regularly performing self-check-ups, which were common to nurses and care workers. In addition, sub-analysis among the high-HL group revealed that the attendance of lectures regarding working life and health for new employees was effective for taking rest when needed, working when not overtired and a good work-life balance. The results of this study suggest that high HL relates to healthy practices in the working life of young Japanese nurses and care workers. Increasing HL or fundamentally enhancing attitudes towards their own health or both may, therefore, have some benefits for healthy working practices.     

Impact of Pharmacological Autonomic Blockade on Complex Fractionated Atrial Electrograms

Autonomic Blockade During Atrial Fibrillation . Introduction: The influence of the autonomic nervous system on the pathogenesis of complex fractionated atrial electrograms (CFAE) during atrial fibrillation (AF) is incompletely understood. This study evaluated the impact of pharmacological autonomic blockade on CFAE characteristics. Methods and Results: Autonomic blockade was achieved with propanolol and atropine in 29 patients during AF. Three‐dimensional maps of the fractionation degree were made before and after autonomic blockade using the Ensite Navx^® system. In 2 patients, AF terminated following autonomic blockade. In the remaining 27 patients, 20,113 electrogram samples of 5 seconds duration were collected randomly throughout the left atrium (10,054 at baseline and 10,059 after autonomic blockade). The impact of autonomic blockade on fractionation was assessed by blinded investigators and related to the type of AF and AF cycle length. Globally, CFAE as a proportion of all atrial electrogram samples were reduced after autonomic blockade: 61.6 ± 20.3% versus 57.9 ± 23.7%, P = 0.027. This was true/significant for paroxysmal AF (47 ± 23% vs 40 ± 22%, P = 0.003), but not for persistent AF (65 ± 22% vs 62 ± 25%, respectively, P = 0.166). Left atrial AF cycle length prolonged with autonomic blockade from 170 ± 33 ms to 180 ± 40 ms (P = 0.001). Fractionation decreases only in the 14 of 27 patients with a significant (>6 ms) prolongation of the AF cycle length (64 ± 20% vs 59 ± 24%, P = 0.027), whereas fractionation did not reduce when autonomic blockade did not affect the AF cycle length (58 ± 21% vs 56 ± 25%, P = 0.419). Conclusions: Pharmacological autonomic blockade reduces CFAE in paroxysmal AF, but not persistent AF. This effect appears to be mediated by prolongation of the AF cycle length. (J Cardiovasc Electrophysiol, Vol. pp. 766‐772, July 2010)     

Analysis of psoriatic patients registered in Asahikawa Medical College Hospital from 1983 to 2007

Psoriasis is a chronic inflammatory skin disease, which has been increasing during the last 50 years in Japan. The aim of the present study is to analyze psoriatic patients registered from 1983–2007 in Asahikawa Medical College Hospital, which is located in the northern part of Japan. A total of 607 cases were registered at the first inspection in the Department of Dermatology, Asahikawa Medical College. Men (403 cases, 66.4%) were predominant over women (204 cases, 33.6%). The clinical types of psoriasis were psoriasis vulgaris (91.5%), guttate psoriasis (4.2%), psoriasis arthropathica (2.8%), psoriatic erythroderma (0.6%), generalized pustular psoriasis (0.6%), localized pustular psoriasis (0.15%) and infantile psoriasis (0.15%). Topical corticosteroids (78.1%) and vitamin D3 (18.1%) products were the main previous topical agents. Previous systemic treatments included etretinate (7.7%), cyclosporine (1.5%) and methotrexate (0.3%). Use of topical vitamin D3 and cyclosporine therapies have been gradually increasing during the past 25 years. Regarding the previous phototherapy, topical psoralen and ultraviolet A therapy (PUVA) (4.9%) was predominant over ultraviolet B (0.9%), and systemic PUVA (0.7%). Use of ultraviolet B phototherapy has been increasing during the past 5 years. The results are essentially similar to those of a survey of psoriasis in Japan from 1982–2001. Although the incidence of psoriasis might be higher in Hokkaido Prefecture, there is essentially no variation in the disease profile of psoriatic patients.