A case control study of female systemic lupus erythematosus in Japan

In a multi-institutional case-control study, we investigatedrisk factors for systemic lupus erythematosus (SLE) in 151 Japanesewomen treated for SLE during the period September 1988 to August1990. We used two control groups: sisters of SLE patients andsisters of female patients with another disease. Informationwas obtained by a self-administered questionnaire. Our findingssuggest that having a history of operations and blood transfusionsand working in a cold environment may be risk factors for SLE.Viral infections, psychological stress, and pet ownership werenot risk factors for SLE in our study. In addition, smokingwas not protective for SLE. Skin sensitivity to sunlight andcold feet, which may be symptoms of SLE that occurred beforethe diagnosis, were also positively associated with SLE.     

REDUCTION OF HUMAN AND RAT TESTICULAR FOLLICLE STIMULATING HORMONE RECEPTORS BY HUMAN MENOPAUSAL GONADOTROPHIN IN VIVO AND IN VITRO

Reduction of human and rat testicular FSH receptors by hMG was studied in vivo and in vitro. After a single injection of hMG, the number of high affinity FSH receptors were significantly reduced for 5 and 3 d in human and rat testes, respectively, without affecting their affinity. FSH receptor numbers recovered to pretreatment values by 14 d after the injection. Radioactivity in rat testes found 48 h after a s.c. injection of 125I-labelled human FSH was less than 10% of the maximum found 10 h after the injection, showing that the prolonged reduction of FSH receptors after hMG injection was not due to occupancy of the binding sites. Occupied FSH receptors measured in rat testes accounted for about 15% of all receptors on the day after an injection of hMG and for less than 5% after the third day. In experiments in vitro using organ culture techniques, an exposure to hMG for 24 h induced a dose-related significant loss of the specific FSH binding sites for 7 and 5 d in human and rat testes, respectively. Thereafter, the loss was gradually recovered. These findings suggest that the reduction in FSH receptors in human and rat testes by hMG is mainly due to down-regulation of the binding sites and that the testicular organ culture method used in the present study is useful to study hormonal regulation of testicular function, especially in human testes.     

Hypoplastic left heart syndrome with a single coronary artery originating from the pulmonary artery

A newborn male infant with hypoplastic left heart syndrome due to mitral and aortic atresia died on the third day of life. Autopsy revealed a single coronary artery originating from the pulmonary artery, reversed coarctation of the aorta, a coronary sinus type atrial septal defect and stenosis of the left subclavian artery. To our knowledge, hypoplastic left heart syndrome associated with a single coronary artery originating from the pulmonary artery has never been reported in the English or Japanese literature. This may be the first such case.     

Gestational age assessment in Japanese low birthweight infants

We evaluated the validity of the Ballard scoring system for assessing gestational age in Japanese low birthweight infants. Infants included in this study were 116 neonates who were admitted to seven hospitals in Hokkaido. Gestational ages of all infants were prenatally established by ultrasonographic measurement of the crown-rump length performed between 8 and 12 weeks of gestation (clinical age). Of these, 74 infants were appropriate for gestational age (AGA) and the remaining were small for gestational age (SGA). Mean birthweight was 1703 g and 34% (39/116) were <1500 g. The correlation coefficient for the total population was 0.93 (P < 0.001). Although mean Ballard age tended to overestimate clinical age, mean differences between Ballard age and clinical age did not exceed 0.6 weeks. Agreement within 2 weeks among all infants was 86.2%. Percentages of agreement within 2 weeks did not differ to a statistically significant degree between AGA and SGA. These results indicate that the Ballard method is of value in assessing gestational age in Japanese low birthweight infants.     

Simple Technique to Place the Lateral Mass Screws in the Revision Surgery after Cervical Laminoplasty for Ossification of the Posterior Longitudinal Ligament

A lateral mass screw (LMS) is one of the standard anchor screws in posterior cervical fixation. Although the advantage of cervical LMS is that it is easier and safer to place than pedicle screw, it is sometimes difficult for surgeons to confirm the exact point for screw entry and accurate angle in cases of revision surgery. When LMS fixation is performed as revision surgery after cervical laminoplasty or laminectomy, it might be complicated to secure safe placement of the LMSs. We present a simple but practical technique involving a caliper and angle device for revision surgery after cervical laminoplasty for ossification of the posterior longitudinal ligament. In this technique, the distance between the bilateral entry points is ascertained using preoperative CT. Insertion of the screw is guided using the angle device set to 25 degrees. The technique presented here is easy and allows accurate placement of the LMSs in the posterior cervical spine, and is practical even for revision surgery.     

A study of cognitive development and behavior problems in mentally retarded children

Abstract Cognitive development in seventy-one mentally retarded children (19 autistic, 52 non-autistic; aged 7–19 years) from a school for handicapped children was studied, using Ohta's scale for evaluating cognitive development level based on language comprehension (Ohta's stage), and other developmental scales. Behavior problems were also examined. The present study reports on the utility of Ohta's stage in non-autistic children, and the relationship between cognitive development level and behavior problems in mentally retarded children. In non-autistic children, there were temporal correlations between Ohta's stage and other development scales (a standard developmental test, speech development, symbolic play development, imitation development), suggesting that in non-autistic children as well, Ohta's stage may serve well as a scale for cognitive development, and reflect symbolic representational functioning. In non-autistic children, most behavior problems in feeding, elimination and sleeping, hyperkinesis, hypokinesis, stereotyped behaviors, self-injurious behavior and licking were closely associated with cognitive development level, and were more often noted in children of lower cognitive development level rather than only in the severely mentally retarded children. Some behavior problems may often occur in the sensorimotor period and hardly occur in the symbolic representational period.     

基质金属蛋白酶-2在侵袭性垂体腺瘤中的表达

目的　探讨基质金属蛋白酶 2 (matrixmetalloproteinase 2 ,MMP 2 )的表达与侵袭性垂体腺瘤的关系。方法　用免疫组化的方法对 5 4例垂体瘤患者组织标本中MMP 2的表达进行检测。并对其中 16例患者采用逆转录 聚合酶链反应 (RT PCR)的方法检测了MMP 2mRNA的表达。免疫组化结果用半定量的方法进行分析。结果　 5 4例垂体瘤患者中 ,有 32例女性 ,2 2例男性。其中 ,12例为侵袭性垂体腺瘤 ,4 2例为非侵袭性垂体腺瘤。免疫组化显示 ,侵袭性垂体腺瘤的MMP 2的表达明显高于非侵袭性垂体腺瘤 (分别为 4 .3± 0 .5 ;2 .3± 0 .2 ;P <0 .0 1)。大型垂体腺瘤和微垂体腺瘤 ,以及功能性和非功能性垂体腺瘤的MMP 2的表达则无明显差别。MMP 2的表达与Ki 6 7的表达无明显相关性 (r =$C 0 .0 5 ,P >0 .0 5 )。侵袭性垂体腺瘤MMP 2mRNA的表达 ,明显高于非侵袭性垂体腺瘤 (6 8.3± 15 .3;2 1.8± 8.2 ;P <0 .0 5 )。结论　MMP 2的高表达与肿瘤的侵袭性密切相关。但与肿瘤的大小及分泌功能无明显关系。MMP 2可以作为肿瘤侵袭性一项有效的指标