Clinical features of Japanese children and adolescents with systemic lupus erythematosus: Results of 1980–1994 survey

Marked advances have been made in the past decade in the management of adults with systemic lupus erythematosus (SLE). Therefore, a nationwide retrospective survey was conducted between 1980 and 1994 to investigate the clinical manifestations of SLE in Japanese children and adolescents. Questionnaires were sent to 340 hospitals. Of 405 patients reported by 176 hospitals, 373 patients, diagnosed by the criteria established by the Pediatric Study Group of the Japanese Ministry of Health and Welfare in 1985, were enrolled in the study. Forty-nine of the 354 patients (13.8%) had relatives with a connective tissue disease within the third degree of consanguinity. The frequent manifestations in 373 patients were the presence of antinuclear antibody (98.9%), immunologic disorders (93.0%), hypocomplementemia (87.1%), malar rash (79.6%) and fever (74.0%). Lupus nephritis was present in 148 of the 309 patients (47.9%) at their first visit to a clinic, and 261 of the 373 patients (70.0%) developed renal involvement during the observation period. Of 370 patients, 92 patients (24.9%) exhibited central nervous system lupus. Of 368 patients, 192 patients (52.2%) were treated by methylprednisolone pulse therapy and 148 patients (40.2%) received immunosuppressants in combination with steroid therapy at some stage during the observation period. Survival rate at 5 years from onset was 95.9%. Management of infection, coagulopathies, and central nervous system involvement is essential to improve the prognosis of SLE in Japanese children and adolescents.     

Characteristics of juvenile dermatomyositis in Japan

Questionnaires were sent to 1290 hospitals in Japan asking for data on patients with juvenile dermatomyositis (JDM) diagnosed between June 1984 and May 1994. Of the 204 patients identified by these questionnaires, 102 met the criteria for JDM. JDM is categorized into three subtypes: Banker-type JDM , Brunsting-type and fulminant-type; patients with the latter exhibit markedly elevated serum levels of creatinine phosphokinase (> 10 000 U/mL) and appear to be at risk of renal failure. Cutaneous manifestations were present in 98% of patients and preceded the appearance of other symptoms. This tendency is one of the reasons for the difficulty in some cases in diagnosing the onset of JDM. Better criteria for early treatment of JDM are needed. The results of the present study suggest that itching and calcinosis are factors that indicate a poor prognosis in patients with JDM. Muscle enzyme levels do not always reflect disease activity, suggesting that methods other than measurement of muscle enzymes, such as measurement of the levels of neoprerin and von Willebrand factor antigen, as well as magnetic resonance imaging should be used to be evaluate disease severity. Patients with Brunsting-type JDM who exhibit dysphagia and antinuclear antibody positivity and patients with Banker-type JDM should be treated aggressively. Pulse therapy should be selected as the initial therapy in patients with fulminant-type JDM.     

MDR逆转活性紫杉烷类化合物的合成

目的:合成天然产物taxinine NN-3和taxinine NN-14,研究其对肿瘤细胞的多药耐药逆转活性.方法:以紫杉宁为出发原料,通过选择性水解9,10位的乙酰氧基,制成原乙酸酯后再水解.结果:以紫杉宁为原料经过3步反应,可以同时获得taxinine NN-3,taxinine NN-4两种天然产物,其中taxinine NN-3的收率为25%,taxinineNN-4的收率为68%.结论:高收率地合成了taxinine NN-3和taxinine NN-14.     

基于报告基因的雌激素受体β亚型激动剂细胞筛选模型的建立

目的建立基于报告基因和雌激素受体β(estrogen receptor β，ERβ)亚型信号通路的药物筛选模型，以期发现ERβ亚型激动剂。方法构建带有雌激素应答序列(estrogen responsive element，ERE)靶序列和报告基因的诱导性表达载体pTAL-ERE-SEAP，并将其转入人胚肾(HEK293)细胞中，筛选报告基因分泌型碱性磷酸酶(secreted alkaline phosphatase，SEAP)表达受雌二醇(17β-estradiol，E₂)诱导的阳性克隆。选取相关核受体配体进行模型的特异性考察，同时考察模型的稳定性及时效量效关系，以及免疫细胞化学染色鉴定转染后ERβ的表达情况。利用此模型对本实验室样品库中的2 622个化合物进行筛选。结果转染pTAL-ERE-SEAP的HEK293细胞中，SEAP报告基因的表达受E₂的诱导并呈剂量与时间依赖关系，E₂对阳性克隆细胞无增殖作用，本模型的Z′因子值为0.7，免疫细胞化学染色结果表明，转染后ERβ表达、地塞米松以及其他配体的诱导表达率低。结论利用此模型通过测定SEAP报告基因的诱导表达水平可筛选ERβ亚型激动剂。     

Transcapillary ultrafiltration and peritoneal equilibration test in pediatric patients

The usefulness of the peritoneal equilibration test (PET) in children is unknown. The relationship between transcapillary ultrafiltration and PET was investigated in order to evaluate the usefulness of PET in children. PET was performed on 14 patients undergoing peritoneal dialysis. Their age and bodyweight ranged from 3.8 to 23.6 years and 10.2 to 55.8 kg, respectively. The patients were divided into two groups according to bodyweight; group A patients weighed ≤ 40 kg (n = 7) and group B patients weighed > 40 kg (n = 7). There was no significant difference in the mean infusion volume per bodyweight between the two groups, but the mean infusion volume per body surface area was smaller in group A than in group B. Group A showed a more rapid equilibration of dialysate glucose and creatinine than group B. Higher normalized mass transfer area coefficients were evident in group A. In spite of the lower effective glucose gradient in group A, the transcapillary ultrafiltration capacity (TUFC) showed no difference between the two groups. When the slope indices of the regression equations between the two groups were compared, the slopes of the regression in the relationship between TUFC and dialysate (D) ratios D/D₀ glucose or D/P creatinine in group A were steeper than those in group B. Results of the present study indicate that the larger peritoneal area to infusion volume in patients with smaller body size results in both a rapid equilibration of solutes and sufficient transcapillary ultrafiltration.     

Personality differences in the Munich Personality Test between patients with major depression and panic disorder

This study attempted to determine whether patients with major depression and panic disorder could be differentiated by personality features, measured by the Munich Personality Test (MPT). One of the six MPT personality dimensions, `rigidity', was developed in relation to the `melancholic type of personality', which may be a specific personality feature of depressive subjects. We therefore hypothesized that the MPT might be sensitive to possible personality differences between patients with major depression and panic disorder. Sixty-six patients with major depression and 27 patients with panic disorder, taken from consecutive intakes at an outpatient unit, were compared in terms of six personality dimensions of the MPT. The results demonstrated that rigidity could significantly differentiate the two patient groups, even after the possible confounding effects on the personality assessments were statistically partialled out. The MPT was suggested to be powerful for describing distinctive personality features of depressive subjects from anxiety subjects.     

Eye Movements during Perception of Pictures in Chronic Schizophrenia

Using a device of our own built eye movements during the perception of some pictures were examined in 24 chronic schizophrenic and 20 normal subjects. While they were shown each of 4 pictures for 30 seconds, we plotted the points on which the subject's eyes fixed for a short time and observed their traces. We also recorded EOG during the eye closure for 17 cases of these schizophrenic subjects. Additional observations and comparison of eye movements during the perception with EOG findings led to the following conclusions: 1. Concerning the degree of diffusion of the eye's fixation points, the moving range of the gaze in chronic schizophrenics was much more limited than in normal subjects. 2. There was observed rather large number appearance of the small rapid eye movements with closed eyes in the schizophrenic subjects who showed limited moving range of eye's fixation points. Chronic schizophrenic patients probably look at a certain part vaguely. This may be due to their decreased motivation and lack of interest in trying to get information about the pictures and to cognize them.