A case of migrainous infarction accompanying idiopathic thrombocytopenic purpura]

We reported a 31 year-old man with repeated episodes of migraine at a frequency of about once a week on and after January, 2000. In January 2001, scintillating scotoma and pulsating headache appeared followed by left hemianopsia. His platelet count decreased to 80,000/microliter and high intensity areas were observed in the right occipital lobe and hippocampal gyrus on the FLAIR image of brain MRI. Subsequently performed brain MRA and vertebral angiography revealed segmental stenosis and obstruction in the right posterior cerebral artery. Under the diagnosis of migrainous infarction, sodium ozagrel and lomerizine hydrochloride were administered. Idiopathic thrombocytopenic purpura was additionally diagnosed based on the decreased platelet count which was then treated with predonisolone. After these treatment, his migraine attack disappeared. In this patient, platelet destruction due to idiopathic thrombocytopinic purpura and subsequent release of serotonin seemed to have involved in the occurrence of migrainous infarction.     

Objective definition and measurement method of ground-glass opacity for planning limited resection in patients with clinical stage IA adenocarcinoma of the lung

Objective: The standard operation for patients with stage IA lung adenocarcinoma is considered to be a lobectomy. Recently, some researchers have reported that patients with tumors showing greater proportions of ground-glass opacity (GGO) at computed tomography (CT) could be candidates for limited resection, because of its less aggressive nature. However, the lack of a precise definition or standard measuring method of GGO prevents its general use as an index for planning limited resection. Therefore, we attempted to define GGO based on CT number and measured it more objectively. Methods: Between 1998 and 2001, 90 patients with clinical stage IA adenocarcinoma, who underwent standard or intentional limited resection and whose images of chest high-resolution CT were preserved in Digital Imaging and Communications in Medicine (DICOM) format, constituted the study population. The tumor shadow seen on the solid window (WL, −160 HU; WW, 2 HU) was regarded as the central solid area of the tumor seen on the lung window, and GGO was defined as the whole tumor area with the exception of the central solid area. Each area was measured using Scion Image (Scion Corp., Frederick, MD). We analyzed the relationship between the proportion of GGO and both of pathologic findings and recurrence. Results: Among the 90 tumors, 31 (34.4%) were calculated to have a GGO area greater than or equal to 50%. Of these, 27 (87%) tumors were bronchioloalveolar carcinoma. Lymphatic and vascular invasions, or nodal involvement were found only in patients with a smaller proportion of GGO (<50%) (P<0.05). During the follow-up period (median 36 months), recurrences occurred in eight patients who were diagnosed as having tumors showing smaller proportion of GGO (<50%). Conclusions: Tumors with a greater proportion of GGO measured by our method are thought to have a less invasive nature. Our objective measuring method of GGO could be useful for future multicenter trials to elucidate the value of limited resection for clinical stage IA adenocarcinoma based on the proportion of GGO.     

Clinicopathological Significance of Nuclear Accumulation of Tumor Suppressor Gene p53 Product in Primary Lung Cancer

Since the nuclear accumulation of p53 protein is known to correspond well with mutation of the p53 tumor suppressor gene, the authors examined 88 primary lung cancer specimens immunohistochemically using anti-p53 mouse monoclonal antibody, pAb1801, and analyzed the relationship between the immunohistochemical results and clinicopathological features. Nuclear localization of p53 protein was found in 43/88 (49%) tumor specimens, but not in the corresponding normal lung tissues. The percentage of cases showing nuclear p53 localization varied according to the histological type. In squamous cell carcinoma, nuclear p53 localization was found in 15/26 (57%), appearing more frequently than in other histologic types. However, no obvious correlation was observed between nuclear p53 localization and patients' age, sex, history of smoking, TNM factor, degree of differentiation, or any other clinicopathological features analyzed. In adenocarcinoma, nuclear p53 localization was found in 20/46 (43%). Incidence of positive cases was significantly correlated with regional lymph node metastasis, distant metastasis, and pathological stage ( P < 0.05). These results indicate that mutation of the p53 tumor suppressor gene plays an important role in the development of primary lung cancer, and that nuclear accumulation of p53 protein is a potential prognostic factor in adenocarcinoma of the lung.     

Effect of protocatechualdehyde,a metabolite of the novel antirheumatic agent ACP,on chondrocyte metabolism

We investigated PAL (protocatechualdehyde), one of the metabolites of ACP (3,4-diacetoxy benzylidene diacetate) which is a candidate novel antirheumatic agent. Specifically, we studied the effect and mechanism of action of PAL on chondrocyte metabolism using a primary culture of chondrocytes from rabbit articular cartilage. Proteoglycan (PG) depletion in the chondrocyte matrix was induced by the addition of human recombinant interleukin-1α (hrlL-1α) or phorbol myristate acetate (PMA). PAL (10–100 μM) significantly reduced the induced PG depletion and [³⁵S]-PG release in the chondrocyte matrix. The matrix metalloproteinase (MMPs) inhibitor, 1,10-phenanthroline, and protein kinase C (PKC) inhibitor, H-7, also blocked PG depletion and [³⁵S]-PG release. Furthermore, H-7 reduced the production of MMPs induced by hrlL-1α in the culture media of chondrocytes. These results indicate that hrlL-1α causes MMPs production by the activation of PKC, which is followed by [³⁵S]-PG release in the chondrocyte matrix. While PAL also resulted in significant inhibition of MMPs production, which might be mediated by PKC activation, it had no direct influence on PKC activity. These results suggest that PAL affects chondrocyte metabolism by the inhibition of MMPs production. ©1993 Wiley-Liss, Inc.     

Exploration of a new type of antimalarial compounds based on febrifugine

Febrifugine (1), a quinazoline alkaloid, isolated from Dichroa febrifuga roots, shows powerful antimalarial activity against Plasmodium falciparum. The use of 1 as an antimalarial drug has been precluded because of side effects, such as diarrhea, vomiting, and liver toxicity. However, the potent antimalarial activity of 1 has stimulated medicinal chemists to pursue compounds derived from 1, which may be valuable leads for novel drugs. In this study, we synthesized a new series of febrifugine derivatives formed by structural modifications at (i) the quinazoline ring, (ii) the linker, or (iii) the piperidine ring. Then, we evaluated their antimalarial activities. Thienopyrimidine analogue 15 exhibited a potent antimalarial activity and a high therapeutic selectivity both in vitro and in vivo, suggesting that 15 is a good antimalarial candidate.     

Effect of oral health care program on the oral function of the elderly

In order to prepare a new prevention program under the long term care insurance from the fiscal year 2006, we have organized an oral health care program for the elderly in a town of Kagoshima prefecture. We conducted a series of oral health education, i.e., instruction on brushing and flossing, and oral function exercises. Before and after the three months program, we evaluated the unstimulated and stimulated salivary flow rate, the counts of S. mutans, the counts of repetitive saliva swallowing test (RSST), bilateral bite force and the number of permanent teeth and artificial teeth. According to the results, a statistically significant improvement was observed in RSST and the unstimulated and stimulated salivary flow rate, but not in the S. mutans level and bite force. The present research suggests the effectiveness of the oral health care program for the aged. A larger sized and longer period intervention will be necessary in order to validate our findings.     

Clinical characterization of adults with Asperger's syndrome assessed by self-report questionnaires based on depression,anxiety, and personality

Diagnosing Asperger's syndrome (AS) in adults is difficult and efficient indicators for a precise diagnosis are important in the clinical setting. We examined the clinical characteristics of AS in 129 adults (median age, 32.0 years [range, 19–57]; 102 men and 27 women; AS group (n = 64; median age, 32.0 years [range, 19–50]; 50 men and 14 women), control group (n = 65; median age, 32.0 years [range, 19–57]; 52 men and 13 women) through administration of the Japanese version of the Autism-Spectrum Quotient (AQ) and the Japanese version of the Hospital Anxiety and Depression Scale (HADS), the Liebowitz Social Anxiety Scale (L-SAS), and the NEO Five-Factor Inventory (NEO-FFI). AQ, HADS, and L-SAS scores, and the ‘Neuroticism’ scores of the NEO-FFI were significantly higher in adults with AS than in controls. The ‘Extraversion’, ‘Agreeableness’, and ‘Conscientiousness’ scores of the NEO-FFI were significantly lower in adults with AS than in controls. Total score of the AQ correlated with the ‘Anxiety’ subscale score of the HADS and the ‘Extraversion’, ‘Openness’, and ‘Conscientiousness’ subscale scores of the NEO-FFI in adults with AS, but not in controls. The findings demonstrated that the AQ and other scales could be used to elucidate the clinical characteristics of AS in adults.