Clinicopathological characteristics of the focal and segmental form of idiopathic membranous nephropathy: Comparison with the typical form of this disease

Although idiopathic membranous nephropathy (IMN) is thought to represent a diffuse glomerulopathy, it was found that three of 31 children histologically diagnosed as IMN showed focal and segmental deposition of immunoglobulin G (IgG) and C3 on the glomerular capillary walls. The present study attempted to comparatively investigate clinical and pathological features of the diffuse group and the focal segmental group in 31 IMN children. Immunofluorescence study revealed that 28 of 31 IMN exhibited diffuse granular deposition of IgG along glomerular capillary walls. In contrast, focal and segmental deposition of IgG and C3 was noted in three children with IMN. In addition, focal and segmental electron-dense deposits were identified in these cases. In two children of the focal segmental group, immunofluorescent patterns of IgG deposition were unchanged even at the second biopsy. The focal segmental form of IMN tended to occur in younger children than diffuse IMN. However, other clinical parameters such as the range of proteinuria, hematuria, serum albumin and prognosis did not show any significant differences between both groups. Electrophoretic profiles of urinary proteins on sodium dodecylsulfate-polyacrylamide gel electrophoresis were not different between both groups. It is proposed that the focal segmental form of IMN may have a distinctive glomerulopathy from the typical form of IMN.     

Relationship between psychosocial factors and objective physical function in special needs school staff members suffering from low back pain

Physical function impairment in patients with low back pain (LBP) occurs due to the influence of psychosocial factors. Only a few studies have objectively evaluated physical function. We aimed to objectively assess the physical functions of individuals subjects with LBP, and clarify the association between physical function and psychosocial factors. We enrolled 411 individuals with LBP working in special needs schools. We examined their degree of pain, and the psychosocial factors strength through the STarT Back Tool, which categorized them into the low-risk, medium-risk, and high-risk groups. We assessed their abdominal muscle endurance, lower limb muscle strength, and hip joint flexibility. The relationships between these physical functions and psychosocial factors were analyzed by logistic regression models. Those in the high-risk group had significantly lower abdominal muscle and lower limb muscle strength (p<0.001). After adjusting for confounding factors, the odds ratios of the high-risk compared to the low-risk group for low abdominal muscle endurance, lower limb muscle strength, and restricted right and left Straight Leg Raising were 5.47, 3.14, 2.65, and 3.12, respectively (95% CIs: 2.35–12.74, 1.43–6.89, 1.08–6.55, and 1.20–8.11, respectively). Therefore, the low physical function observed in the high-risk group was associated with their psychosocial factors.     

INVOLVEMENT OF PRESYNAPTIC α2-ADRENORECEPTORS IN THE DEPRESSOR RESPONSE PRODUCED BY REPEATED ADMINISTRATION OF DEXTROMETHAMPHETAMINE

• 1 The mechanism for the depressor response produced by the repeated administration of dextro-methamphetamine was studied in rats and rabbits.
• 2 In the urethane anaesthetized and atropinized rat, the methamphetamine-induced depressor response was markedly inhibited by α-adrenoreceptor antagonists or by chronic reserpinization in combination with α-methyl-p-tyrosine, while it was not affected by propranolol. Yohimbine reversed the methamphetamine-induced depressor response to a pressor one when it was administered during the course of the depressor phase whilst prazosin or phentolamine caused only a further depressor response.
• 3 In the pithed rat with electrical stimulation of the spinal cord, the first administration of methamphetamine elicited a marked pressor response whereas, following treatment with cocaine, the first administration of methamphetamine produced only a depressor response which was abolished by yohimbine.
• 4 In the rabbit isolated aorta prelabeled with ³H-noradrenaline, methamphetamine enhanced the stimulationevoked ³H-overflow and caused an enhanced contraction. However, in the presence of cocaine, methamphetamine reduced both stimulation-evoked ³H-overflow and neurogenic contractions.
• 5 These findings suggest that the methamphetamine-induced depressor response results from the inhibition of catecholamine release from noradrenergic nerve terminals probably mediated by the activation of peripheral presynaptic α2-adrenoreceptors.