Studies on the site of renal tubular defect in Bartter's syndrome

Renal tubular function was studied in an 8-month-old male infant with Bartter's syndrome, which is characterized by hypokalemic metabolic alkalosis, normotensive hyperreninemic hyperaldosteronism, and reduced pressor response to angiotensin II. Chloride transport along the diluting segment (C_H2O/C_H2O + C_Cl) was impaired. Furthermore, furosemide did not elicit normal natriuresis, which suggested impaired chloride reabsorptive capacity at the furosemide-sensitive ascending limb of Henle's loop. Loss of antidiuretic hormone-mediated urinary concentration was in support of this. These findings pointed to the thick ascending limb of Henle's loop as the site of the primary defect in this child.     

Event-related changes of background electroencephalogram during contingent negative variation paradigm

Abstract The autoregressive model was applied to the background electroencephalogram during the tone(S1)-tone(S2)-respond contingent negative variation paradigm under eyes-open condition. The EEG data were obtained at the scalp sites of Fz, Cz, and Pz in seven normal males. During the first half of the interstimulus interval (ISI) of 2.5 s, Fz-dominant excitatory process was suggested in concordance with an orienting response to stimulus 1. In the second half of the ISI, Pz-dominant inhibitory process was considered. The stimulus 2 presentation and the required motor response promoted the Pz-dominant process.     

Regression speed of cardiac myosin heavy-chain isozyme V3 in loaded right or left ventricle after relief of the load

The authors examined whether there is any correlation between the regression speed of cardiac β (V3)-myosin heavy-chain (MHC) isozyme and duration of overload. The results showed that in the right ventricle of a 1-week overloaded group, the loaded ventricular MHC isozyme V3 (29.0 ± 5.0%, P  < 0.05) returned to the control level within 1 week after relief of overload (20.4 ± 4.2%, P  = NS), whereas in a 3 week overloaded group (32.8 ± 5.3%, P  < 0.05) it took 10 weeks (36.6 ± 8.6%, P  = NS). The left ventricle showed the same tendency as the right ventricle. In sham-operated rats, however, the changes in MHC isozyme V3 in the left ventricle were greater than those in the right ventricle. These results suggest that regression speed of the cardiac MHC isoform, changed by pressure overload, is accompanied by the duration of overload. Furthermore, the right and left ventricles may have different responsiveness to MHC isoform transitions in heart stresses.     

Differences in symptom structure between panic attack and limited symptom panic attack: A study using cluster analysis

Abstract We had investigated the clinical characteristics of panic disorder (PD) in a Japanese outpatient population comprised of more than 250 patients diagnosed as having PD during a 13-year study period and observed that some PD patients had both panic attacks (PA) and limited symptom panic attacks (LPA). In the criteria for PD based on the Diagnostic and Statistics Manual of Mental Disorders , third edition-revised ( DSM-III-R ), episodes involving four or more symptoms are classified as PA, while those involving fewer than four symptoms are described as LPA. Therefore, LPA is identified as part of an episode of PA, since the difference between the two episodes is only in the number of symptoms. However, some recent research suggests that there is a distinct subgroup of individuals who suffer LPA. Using cluster analysis, we investigated the differences between PA and LPA groups in terms of the structures of several panic symptoms, which included anticipatory anxiety, agoraphobia and 13 clinical symptoms based on the DSM-III-R at the time of panic attacks, in 247 patients with PD. Cluster analysis revealed clusters of three and four panic symptoms in the PA group and LPA group, respectively, and there were also differences in symptom structure between the two groups. These results suggest that there may be a subgroup of individuals who show LPA among PD patients.     

Screening for depression among first-visit psychiatric patients: Comparison of different scoring methods for the Center for Epidemiologic Studies Depression Scale using receiver operating characteristic analyses

Abstract The present paper aims to compare the ability of eight scoring methods for the Center for Epidemiologic Studies Depression Scale (CES-D), one of the most widely used self-report inventories for depression, to screen for a major depressive episode. The subjects were 591 patients who constituted representative samples of the first-visit patients to 23 psychiatric hospitals and clinics all over Japan. The criterion diagnoses were given by a semi-structured interview with established inter-rater reliability. The eight alternative scoring methods included the conventional Likert method, which gives the weights 0,1,2 and 3 to the four anchor points of the CES-D; the presence method, which gives the weights 0, 1, 1 and 1, respectively; the GHQ method, which gives the weights 0, 0, 1 and 1, respectively; the persistence method, which gives the weights 0, 0, 0 and 1, respectively; 10-item version, 5-item version, single-item version and the algorithmic method. On the basis of the receiver operating characteristic (ROC) analyses, it was found that the traditional Likert scoring method of the full CES-D performed best in detecting major depressive episodes among first-visit psychiatric patients. The presence method, the GHQ method and the 10-item version appeared to have a similar ability. The persistence method, the 5-item version and the single-item version resulted in significantly worse performance.     

Cytodifferentiation to Serous and Myoepithelial Cells in Salivary Gland and Salivary Gland Type Tumors

Three-hundred-and-three cases of salivary gland and salivarygland type tumors in the head and neck and lower respiratorytract, treated in our institution, were reviewed histologically.Some of these cases were analyzed; 51 arbitrarily selected casesby conventional stainings, 15 cases by immunostainings for amylaseand actomyosin, and 22 cases by electron microscopy for cellulardifferentiation to serous and myoepithelial cells For morphologicaland biochemical comparison, six cases of ectopic amylase-producingtumor were also studied Serous acmar cells contained amylaseand basaly located cells of acini and ducts contained actomyosinin non-neoplastic salivary glands Although zymogen type granuleswere barely observed except in a case of acinic cell carcinomaof the palate and in a case of adenocarcinoma of the lung bylight and electron microscopy, some tumor cells contained amylasewhich seemed to be specific of salivary gland tumor in threecases and of ectopic amylase-producing tumor in three cases,confirmed by immunofluorescent microscopy, enzyme assay andelectrophoresis of the tumor tissues In cases of mixed tumor, adenoid cystic carcinoma, and mucoepidermoidcarcinoma, cells reactive to anti-actomyosin were often encounteredin the outer layer of duct-like structures By electron microscopy, location of myoepithelium-like cellswas in accord-ance with that of actomyosin-positive cells insome instances Coexistence of tonofibrils and myofilaments inone and the same cell was occasionally seen ^* Present address: Department of Pathology, Tokai UniversitySchool of Medicine, Kana gawa, Japan.     

A CASE OF FAHR'S DISEASE WITH AN UNUSUAL PERIVASCULAR PAS-POSITIVE MATRIX IN THE MOLECULAR LAYER OF THE CEREBELLAR CORTEX

In a case of Fahr's disease an unusual PAS-positive perivascular matrix with amorphous background substances and fine trabeculae developed in the molecular layer of the cerebellar cortex. The significance of this matrix is remained as obscure.     

Outcomes of infants whose mothers are positive for human herpesvirus-6 DNA within the genital tract in early gestation

It has been reported that HHV-6 (human herpesvirus-6) DNA has been identified within the female genital tract. However, the clinical significance of this finding has been unclear. The clinical outcome of the presence of HHV-6 DNA in the genital tract of pregnant women on their infants was evaluated in the present study. One hundred and ten pregnant women were enrolled. Vaginal swabs were collected between 4 and 8 weeks of gestation and the presence or absence of HHV-6 DNA was evaluated by nested polymerase chain reaction (nPCR). The swabs were cultured to isolate the virus. The women were divided into two groups: HHV-6 DNA-positive, and negative. The outcome variables of the infants of these two groups were statistically estimated at birth and at 1 month of age. Saliva and blood cells were collected from the infants at birth and at 1 month of age and were also evaluated by nPCR. HHV-6 DNA was detected in the vaginal swabs of 28 pregnant women (25.5%), but was not detected in any other samples, including saliva and blood cells from their infants. Virus could not be isolated from any vaginal samples. Any outcome variables were not significantly different between the two groups. The presence of HHV-6 DNA within the genital tract of pregnant women did not affect the health of their infants. It is suggested that HHV-6 transmission to infants through the genital tract of their mothers during pregnancy does not occur, or only very rarely.     

Fatty acid compositions of colostrum,cord blood,maternal blood and major infant formulas in Japan

Lipid profiles in colostrum, cord blood, maternal blood and major infant formulas in Japan were analyzed. In the first part of the study, colostrum obtained from 36 normal delivery women and six kinds of infant formulas provided by three major milk companies were analyzed for their fatty acid composition using capillary gas-lipid chromatography. Although enriched with docosahexaenoic acid (DHA), the percent composition of DHA in the six infant formulas (0.15–0.21%) was significantly lower than that in the colostrum (1.1 ± 0.54). Arachidonic acid (AA) and eicosapentaenoic acid (EPA) were present in the colostrum but not detectable in the infant formulas. It is recommended that although the exact amount of specific fatty acids needed in the infant diet was not completely known, to be as close as possible to natural breast milk, the level of DHA, EPA and AA should be raised in the infant formulas. In the second part of the study, 19 pairs of maternal and cord blood were analyzed for their lipid profile. All samples were from normal vaginal delivery. The measurement of cholesterol, triglycerides, phospholipids and free fatty acids was performed with commercially available enzymatic methods on an automated discrete random access analyzer. Total fatty acid was determined as described in the first part of the study. The results were analyzed with Spearman's rank correlation coefficient. No correlation could be found between maternal and fetal concentrations of cholesterol, triglycerides, phospholipids or total fatty acids. Correlation could be found in non-esterified fatty acids, in palmitic acids, and oleic acid levels. It was concluded that the lipid transport and metabolism in the fetal-placenta unit is complex and further delicate investigation is required.