Tissue-type plasminogen activator and its inhibitor in human glomerulonephritis.

We carried out an immunohistochemical study of tissue-type plasminogen activator (PA) and urokinase-type PA, and their inhibitors, PA inhibitor-1 and PA inhibitor-2, using renal biopsy specimens obtained from 86 patients with various forms of glomerulonephritis. The controls were four normal renal tissue specimens. On immunofluorescent observation, granular staining for tissue-type PA was found to be distributed along the glomerular capillary walls. The fluorescence was weak in the normal renal tissue and occasionally intense in the tissues of patients with IgA nephritis, minimal change nephrotic syndrome, and lupus nephritis. PA inhibitor-1 was abundant in the glomerular epithelial cells and scarce in the mesangial area and glomerular capillary lumens of the normal renal tissues. This was confirmed by immunoelectron microscopy using gold staining. The fluorescence of PA inhibitor-1 was weaker in some specimens of nephritic tissues than in the normal renal tissues. Urokinase-type PA and PA inhibitor-2 were negative within the glomeruli in all the specimens. In the glomerulonephritic tissues which were fibrin deposition-positive, tissue-type PA expression in the glomeruli tended to be strong. An association between fibrin deposition and PA inhibitor-1 staining was not clear. These data suggest that expression of tissue-type PA in the glomeruli increases in association with fibrin deposition.     

Lack of association between DNA base excision repair gene XRCC1 Gln399Arg polymorphism and risk of malignant lymphoma in Japan

Growing evidence suggests that the polymorphism of DNA base excision repair gene XRCC1 Arg399Gln is associated with altered DNA repair proficiency and subsequent cancer susceptibility; however, no evidence is available for malignant lymphoma. We therefore conducted a case-control study (372 cases, 500 controls) to evaluate links with malignant lymphoma risk in Japan. The risk was evaluated in terms of odds ratio (OR) and 95% confidence interval (CI) adjusted for age and sex in an unconditional logistic regression model. There was no statistical risk change with the Arg/Gln (adjusted OR 0.89; 0.65-1.23, P = 0.492) or the Gln/Gln (0.57; 0.27-1.17, P = 0.127) compared with the Arg/Arg of the XRCC1 Arg399Gln polymorphism. The results were unchanged in analyses according to histological subtype (diffuse large lymphoma, follicular lymphoma, low-grade lymphoma of mucosa-associated lymphoid tissue, and others). These data suggest that XRCC1 Gln399Arg polymorphism plays a limited role in lymphomagenesis. Further study on the interaction between the polymorphism and environmental exposure is required.     

Considering what clinical laboratories should become in the future--POCT, mail testing and OTC test

Medical staff working in laboratories have shown little or no interest in POCT, mail testing and OTC test. POCT and mail testing are laboratory systems that respectively involve a series of laboratory processes (advice on sampling, interpretation of data, referral to a doctor, etc.). However, the usefulness of data in the two systems differs. Data in POCT are directly used for medical treatment and those in mail testing are used as screening for health control or self-medication. OTC test is different from POCT and mail testing. People buy materials for OTC test at a drug store, then perform it and interpret the data by themselves. There are several factors in the development of POCT, mail testing and OTC test, for example the awareness of people about participation and responsibility for their own medical care, control of lifestyle-related diseases, relaxation of governmental regulation and development of technologies. These laboratories will grow gradually and influence clinical laboratories in medical facilities as well as commercial laboratories. Medical technologists and laboratory physicians should contribute to the sound development of these laboratories. As things are being changing so rapidly, medical technologists and laboratory physicians are forced to realign.     

Sotos syndrome associated with a de novo balanced reciprocal translocation t(5;8)(q35;q24.1).

We describe a de novo balanced reciprocal translocation between the long arms of chromosomes 5 and 8 [46,XX,t(5;8)(q35;q24.1)] in a 15-month-old girl with a typical Sotos syndrome phenotype. Involvement of the 5q35 region was previously reported (Maroun et al. [1994: Am J Med Genet 50:291-293]) as one of translocation breakpoints in the present patient. We suggest that the gene responsible for Sotos syndrome is located to a distal long-arm region of chromosome 5.     

Lean body mass and bone mineral density in physically exercising postmenopausal women

OBJECTIVES: To investigate whether the relative contribution of body composition (lean and fat mass component) to postmenopausal bone mineral density (BMD) differs between women participating in physical exercise and sedentary women. METHODS: Subjects were 45 postmenopausal women participating in regular physical exercise and 89 sedentary controls aged 50-60 years. Baseline characteristics included age, height, weight, body mass index (BMI, Wt/Ht(2)), age at menopause, and years since menopause (YSM). Body fat mass, percentage of body fat, lean body mass, and lumbar spine BMD (L2-4) were measured by dual-energy X-ray absorptiometry. RESULTS: Although age, height, weight, BMI, and YSM did not differ between the two groups, lean body mass and lumbar spine BMD were significantly higher (P<0.05 and <0.001, respectively), while body fat mass and percentage of body fat mass were significantly lower in exercising women than in sedentary controls (P<0.05 and <0.05, respectively). In exercising women, BMD was positively correlated with lean body mass (r=0.415, P<0.01) but not with body fat mass (r=0.155, NS). Conversely, in sedentary controls, BMD was correlated with body fat mass (r=0.251, P<0.05) and lean body mass (r=0.228, P<0.05). CONCLUSIONS: Lean body mass is a more significant determinant of postmenopausal BMD in physically exercising women than in sedentary women.     

Production of collagen fibrils in adrenocortical adenoma with Cushing's syndrome

The production of collagen fibrils, especially collagen type III, was studied with regard to eight adrenocortical adenomas with Cushing's syndrome. Anti-type III procollagen amino-terminal peptide serum (procollagen III) was employed for the PAP method. In areas of clear-type cells, the parenchymal cells were negative for procollagen III, but the stroma exhibited an intense reactivity and were arranged in an alveolar fashion. On the other hand, it was obvious that not only interstitial cells or spindle-shaped cells but also the parenchymal cells synthesized procollagen III in areas of compact-type cells, and the stroma showed a strongly positive reaction to it.     

Adrenocortical adenoma with Cushing's syndrome in culture

Two adrenocortical adenomata with Cushing's syndrome were examined employing cell culture methods. The results revealed that the clear-type cells changed into compact-type cells, and that the compact cells played a role in the production and secretion of steroid hormones. Furthermore, it is likely that they underwent fragmentation and produced collagen fibrils.     

Cardio-facio-cutaneous (CFC) syndrome: report of two patients without hyperkeratotic skin lesions.

We report on two boys with the cardio-faciocutaneous (CFC) syndrome, but without hyperkeratotic skin involvement. They showed most of the manifestations of the CFC syndrome: growth and developmental retardation, relative macrocephaly, distinct facial appearance, sparse hair, and heart defects. Their skin was not hyperkeratotic, but patient 1 had mild atopic dermatitis and keloid-like depigmented spots.     

High Frequency of Antibiotic-Associated Diarrhea due to Toxin A-Negative, Toxin B-Positive Clostridium difficile in a Hospital in Japan and Risk Factors for Infection

Patients hospitalized in a hospital with a high incidence of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive (A–/B+) Clostridium difficile were retrospectively investigated to determine the clinical manifestations and risk factors for infection. Of 77 Clostridium difficile isolates obtained from 77 patients during the 1-year investigation period, 30 were A–/B+ and 47 were toxin A-positive, toxin B-positive (A+/B+). By pulsed-field gel electrophoresis analysis, 23 of the 30 A–/B+ strains were outbreak-related, suggesting nosocomial spread of a single type of bacterium, which mainly affected patients in the wards of respiratory medicine, hematology and neurology. Using regression analysis, three factors were found to be associated with infection by A–/B+ isolates: (i) exposure to antineoplastic agents (P=0.01, odds ratio [OR]=5.1), (ii) the use of nasal feeding tubes (P=0.008, OR=5.2), and (iii) assignment to a certain internal medicine ward (P=0.05, OR=3.0). Between patients with Clostridium difficile-associated diarrhea caused by A–/B+ strains and those with A+/B+ strains, no statistically significant difference was found in body temperature, serum concentration of C-reactive protein, leukocyte count in whole blood, frequency of diarrhea, or type of underlying disease. These results indicate that A–/B+ strains of Clostridium difficile can cause intestinal infection in humans and they spread nosocomially in the same manner as A+/B+ strains.