HLA-Bw54 (Bw22-J, J-1) Antigen in Juvenile Onset Diabetes Mellitus in Japan

HLA—B8 and/or Bw15, associated with juvenile onset insulin-dependent diabetes mellitus (JDM) in Caucasians, have a very low frequency in the Japanese population. Thus, we were interested in investigating the association between JDM and HLA antigen in a Japanese population. Eighty-nine patients with JDM and 128 unrelated random controls were HLA-typed by the micro-lymphocytotoxicity test. The data revealed a significant, positive association between this type of diabetes mellitus and HLA-Bw54 (Bw22-J, J-1) antigen (Japanese-specific split antigen of HLA—Bw22).     

Systemic origin of the sole artery to the basal segments of the left lung without pulmonary sequestration

A sixty-one year-old man with squamous cell carcinoma of the left upper lobe had an aberrant systemic artery to the left basal segments without pulmonary sequestration. Physical examination revealed neither cardiac murmur nor any sign of heart failure, which was at variance with reported cases in the literature. Chest X-ray film showed no abnormal density suggesting sequestrated lung. Bronchogram disclosed obstruction of the left upper lobar bronchus by the tumor and normal segmental bronchi of the lower lobe. Left pulmonary angiogram showed normal arterial distribution of the left upper lobe and the superior segment of the lower lobe, but the basal segmental arteries were not visualized. The aberrant pulmonary artery arising from the descending aorta was visualized by computed tomography. Following dissection of the abnormal vessel pneumonectomy was performed. Pathological examination of the left basal segments revealed prominent atheromatous changes in the aberrant systemic intrapulmonary artery and irreversible obstructive lesions in its tributaries. These arterial lesions in this patient would have precluded plastic operations such as transfer of the origin of the aberrant vessel to the left pulmonary artery even if other circumstances had been favorable for preservation of the left lower lobe.     

Metabolism of α-PHP and α-PHPP in humans and the effects of alkyl chain lengths on the metabolism of α-pyrrolidinophenone-type designer drugs

Forensic Toxicology - This study aims to investigate the urinary metabolites of two common α-pyrrolidinophenones (PPs), α-pyrrolidinohexiophenone (α-PHP) and...     

Antisense inhibition of angiotensinogen attenuates vasopressin release in the paraventricular hypothalamic nucleus of spontaneously hypertensive rats

It has been reported that intracerebroventricularly injected antisense oligonucleotide to angiotensinogen reduces arterial pressure in spontaneously hypertensive rats (SHR), but the mechanism and the sites of action remain unclear. In the present study, we examined whether injection of antisense oligonucleotide to angiotensinogen into the paraventricular hypothalamic nucleus (PVN) would influence arterial pressure and vasopressin release. For this purpose, 12-week-old male SHR were cannulated into the bilateral PVN. One week later, we injected antisense or sense oligonucleotide to angiotensinogen into the bilateral PVN (0.2 nmol/200 nl each side). After 24 h, we directly monitored arterial pressure, and then took blood samples to measure plasma vasopressin, catecholamines and renin activity. Mean arterial pressure did not change in either group (from 144+/-3 to 154+/-4 mmHg for the antisense oligonucleotide group, n=11; from 147+/-4 to 156+/-3 mmHg for the sense oligonucleotide group, n=11). Antisense oligonucleotide attenuated vasopressin release compared with sense oligonucleotide (1.30+/-0.28 vs. 3.29+/-0.60 pg/ml, respectively, P<0.01). Plasma catecholamines also decreased in the antisense oligonucleotide group compared with the sense oligonucleotide group. However, the plasma renin activity did not differ between the groups. In the additional experiment, we examined the neurohormonal and cardiovascular effects of intracerebroventricularly injected antisense oligonucleotide to angiotensinogen in SHR. Mean arterial pressure, plasma vasopressin and plasma norepinephrine were significantly lower in the antisense oligonucleotide group than in the sense oligonucleotide group. These results suggest that angiotensinogen in PVN plays important roles in vasopressin release and sympathetic nerve activity, but may not contribute to the maintenance of arterial pressure in SHR.     

Relationship between the characteristics of lower extremity function and activities of daily living in hospitalized middle-aged and older adults with subacute cardiovascular disease

[Purpose] To clarify the relationship between lower extremity function and activities of daily living and characterize lower extremity function in hospitalized middle-aged and older adults with subacute cardiovascular disease. [Participants and Methods] The Short Physical Performance Battery, 6-minute walk distance, and functional independence measure tests were conducted in 79 inpatients with subacute cardiovascular disease (mean age, 76.7 ± 11.9 years; 34 females). Multiple regression analysis used the functional independence measure score as the dependent variable and the Short Physical Performance Battery and 6-minute walk distance scores as independent variables. Cross-tabulations were performed for each age group, and patients who performed the Short Physical Performance Battery and 6-minute walk distance tests were divided into two groups by their respective cutoff values. [Results] Only the Short Physical Performance Battery (β=0.568) and 6-minute walk distance (β=0.479) scores were adopted as significant independent variables in each multiple regression model. The age <75 years group had the most patients with both good lower extremity function and aerobic capacity, whereas the age ≥75 years group had the most patients with both functions impaired. [Conclusion] Although cardiovascular disease is generally associated with decreased aerobic capacity, many older patients with cardiovascular disease in this study had decreased lower extremity function, too.     

The correlation between unemployment and suicide rates in Japan between 1978 and 2004

The number of suicides in Japan has increased from approximately 22,000 per year from 1988 to 1997 to over 30,000 per year since then; this increase is among the most important problems facing Japan. Moreover, the unemployment rate in Japan has increased rapidly since 1998. In this study, we examined the total number of suicides and both the suicide and unemployment rates in Japan from 1978 to 2004. We also focused on the correlation between annual suicide rates in Japan and the annual unemployment rates during the study period. During that period, 455,357 males and 225,012 females committed suicide in Japan, and the suicide rates by sex were 27.8 males and 13.3 females per 100,000 population (P<0.05). The annual suicide rates among males correlated significantly with the annual unemployment rates: r(27)=0.94, P<0.001, while the female suicide rates did not correlate with the unemployment rates: r(27)=0.39, P=0.05. Thus, when unemployed men are observed to be depressed, it is important for those close to them, as well as their health care professionals, to pay careful attention to their behavior to detect suicidal tendencies or intentions.     

Efficacy and Safety of Endoscopic Papillary Large Balloon Dilation for Large Bile Duct Stones in Elderly Patients

Background

Minimally invasive interventions for choledocholithiasis are preferable in elderly patients because they tend to have multiple underlying disorders or a decreased activity of daily living. Endoscopic sphincterotomy and endoscopic papillary balloon dilation have been recognized as first-line treatments for choledocholithiasis excluding difficult cases such as large stones or multiple stones. Recently, the safety and efficacy of endoscopic papillary large balloon dilation (EPLBD) for difficult choledocholithiasis cases have been reported, although scarcely in elderly patients.

Aims

To investigate whether EPLBD can be safety and effectively performed in patients aged 75 years or older.

Methods

The medical records of 165 patients who underwent EPLBD from November 2006 to August 2013 were analyzed retrospectively. The patients were divided into 2 groups: Group A (≥75 years); Group B (<75 years).

Results

Some underlying diseases were significantly more common in Group A than in Group B (P < 0.05). However, there was no significant difference in the success rates in the first session (96.2 vs 95.0 %, P = 0.970) and in the final success rates (100 % in both groups) between Group A and Group B. The adverse event rates (2.9 vs 5.0 %, P = 0.783) and recurrence rates of choledocholithiasis (6.7 vs 10.0 %, P = 0.444) were not significantly different. Regarding patients with an altered anatomy, the EPLBD outcome was not significantly different.

Conclusion

EPLBD can be safely performed for elderly patients similarly to younger patients.