Circulating vascular endothelial growth factor is independently and negatively associated with trait anxiety and depressive mood in healthy Japanese university students

Objective

Anxiety and depressive mood are sometimes accompanied by modulation of neuroendocrine and immune functions. The aim of this study was to identify circulating immune mediators reflecting anxiety and depressive mood in healthy young adults.

Methods

Anxiety and depressive mood in 209 healthy medical students (125 males and 84 females, aged 20.7 ± 2.7 years (mean ± SD)) were assessed by the Spielberger state-trait anxiety inventory (STAI) and the Zung self-rating depression scale (Zung-SDS), respectively. Cortisol and chromogranin A (CgA) levels in saliva were measured using enzyme immunoassay kits, and 50 different mediators in sera were measured by a multiplex-suspension array system. The level of statistical significance was set at α = 0.05.

Results

Forty-four mediators were measurable in sera, and each mediator showed substantial individual variations. After determining Pearson correlation coefficients, we selected candidate cytokines whose levels were associated with STAI-state (2 cytokines), STAI-trait (8 cytokines), or SDS scores (8 cytokines). The candidate cytokines plus interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and macrophage migration inhibitory factor were then subjected to multiple regression analysis adjusted for gender, BMI, and salivary concentrations of cortisol and CgA. Vascular endothelial growth factor (VEGF) was independently and negatively associated with both trait anxiety (p < 0.05) and depressive mood (p < 0.01). IL-1β showed independently positive association with depressive mood (p < 0.05). Interactions between these two cytokines and gender or BMI were not observed.

Conclusion

Besides IL-1β, circulating VEGF may be a potential biomarker for negative mood states in healthy young adults.     

Detection of human papillomavirus type 16 in Bowen's carcinoma of the toe

Background Human papillomavirus (HPV) is known to cause cervical cancer. Because it has been detected in lesions of Bowenoid papulosis, Bowen’s disease, and Bowen’s carcinoma, HPV infection has been implicated in the pathogenesis of these diseases. Methods A 44‐year‐old man was diagnosed clinicopathologically with Bowen’s carcinoma of the right great toe. He developed multiple organ metastases and died. We examined HPV DNA in skin biopsy specimens from the primary and skin metastatic lesions by polymerase chain reaction (PCR) and in situ hybridization (ISH). The PCR assay was carried out using primer sets specifically designed for detecting the E6 and E7 genes of the HPV types associated with malignancy. Purified and cloned PCR products were subjected to DNA sequence analysis. The ISH studies used INFORM^® HPV III probes. Results We found HPV DNA in specimens from both the primary and the skin metastatic lesions. DNA sequencing detected HPV type 16. We compared the base sequences of viral DNA from the primary and metastatic lesions. Point mutations of the base sequences of the E6 and E7 genes were observed in viral DNA from metastases but not in that from primary lesions. The E6 gene had mutated from G to A in the 383rd base sequence, causing a Glu‐to‐Lys amino acid change. Results of ISH showed punctuate signals in the nuclei of tumor cells. Conclusions We suspect an association between HPV 16 infection and the development of this malignant occurrence.     

Selection of Pulmonary Resection Procedures to Avoid Postoperative Complications

Purpose We previously found a potential predictive value in a retrospective analysis of spirometry and an expired gas analysis during the exercise. We sought to reduce postoperative cardiopulmonary complications by selecting lung tumor resection procedures based on a combination of specific preoperative cardiopulmonary function test results. Methods Out of the 53 patients requiring a lung tumor resection, five preoperative parameters (forced expiratory volume in 1 s for intact-side, maximal oxygen uptake, ejection fraction, occluded pulmonary artery pressure, and occluded total pulmonary vascular resistant index) were used to assign patients to one of five risk categories in order to select the optimal pulmonary resection procedure. The patients were later grouped according to their postoperative course to test the value of this procedure selection method. Results No patient died or developed severe complications after surgery. Five patients had mild complications, while 46 had a good postoperative course; the 13 deaths, in the cancer cases, included 11 from primary or metastatic cancer and 2 from other causes. The overall five-year survival was 61.4%. Conclusion This method for determining a pulmonary resection procedure avoided postoperative deaths and severe cardiopulmonary complications, while achieving a good outcome.     

Symptom structure in Japanese patients with obsessive-compulsive disorder

OBJECTIVE: Obsessive-compulsive disorder (OCD) comprises a number of specific symptom dimensions. The authors factor analyzed data on the Yale-Brown Obsessive Compulsive Scale symptom checklist in a large group of Japanese OCD patients to examine whether symptom dimensions were stable across cultures. METHOD: A principal components analysis of Yale-Brown Obsessive Compulsive Scale major symptom categories was performed on Japanese OCD patients (N=343). The association between symptom dimensions and clinical variables, including 1-year outcome after combination treatment, was also examined using Pearson correlations. RESULTS: Four factors explaining 57.7% of the variance were identified: 1) contamination/washing, 2) hoarding, 3) symmetry/repeating and ordering, and 4) aggressive/checking symptoms. The symmetry dimension was associated with early age at onset, and both the symmetry and hoarding dimensions were associated with decreased functioning and treatment resistance. CONCLUSIONS: The findings in this study support transcultural stability in the symptom structure of OCD, which is consistent with the hypothesis that OCD is mediated by universal psychobiological mechanisms.     

Cyclosporine A as treatment of esophageal involvement in dermatomyositis

We report a case of a 70-year-old man with dermatomyositis complicated by esophageal involvement resistant to corticosteroid therapy. It had serious and potentially life-threatening implications, resulting in impossible oral feeding. This condition was successfully resolved by administration of cyclosporine A.