Increased Protein-Conjugated Acrolein and Amyloid-β40/42 Ratio in Plasma of Patients with Mild Cognitive Impairment and Alzheimer's Disease

The objective of this study was to determine whether plasma levels of acrolein, a compound that causes cell damage, and amyloid-β (Aβ) are useful biochemical markers for Alzheimer's disease (AD). The study included 221 elderly subjects divided into 101 non-demented [33 healthy control and 68 non-demented subjects with white matter hyperintensity (nd-WMH)], 50 mild cognitive impairment (MCI), and 70 AD. Increases in both protein-conjugated acrolein (PC-Acro) and Aβ40/42 ratio were observed in MCI and AD patients compared with values in control subjects. When the combined measurements of PC-Acro and Aβ40/42 ratio were evaluated using the median value of the relative risk value for dementia, they were in the order AD (0.98) ≥ MCI (0.97) > nd-WMH (0.83) > control (0.35). The results indicate that measurements of PC-Acro and Aβ40/42 ratio not only detect MCI and AD patients but also nd-WMH subjects. Furthermore, both PC-Acro and Aβ40/42 ratio in plasma for 120 MCI and AD patients were significantly higher than those for 101 control and nd-WMH subjects, indicating that both values become useful biochemical markers for MCI and AD subjects.     

Comparison of the analgesic effects of bisphosphonates: etidronate,alendronate and risedronate by electroalgometry utilizing the fall of skin impedance

Analgesic effects of etidronate, alendronate and risedronate were compared in patients with osteoporosis and/or osteoarthritis by measuring the fall of skin impedance along with conventional subjective pain-estimation by visual rating scale (VRS). One hundred ninety-nine postmenopausal women consulting the Osteoporosis and Osteoarthritis Clinic of Katsuragi Hospital complaining of back and/or knee pain were randomly divided into four groups; Group A (49 subjects) given 5 mg/day alendronate, Group E (50 subjects) 200 mg/day etidronate, Group R (50 subjects) 2.5 mg/day risedronate and Group P no bisphosphonate. None of the four groups showed significant deviation from others as to age and parameters of bone metabolism. Proportions of subjects with osteoporosis was 18–40%. Those with osteoarthritis of the spine and knee, higher than Grade II according to the Nathan and Lawrence-Kellgren scale, respectively, was 45 and 61%, respectively, without a significant difference among the four groups. Significant positive correlation was found between the fall of skin impedance and pain expressed in VRS. Attenuation of exercise-induced fall of skin impedance and also subjective pain expressed in VRS was greatest in Group E with a highly significant difference from Groups A (P = 0.0002 and P < 0.0001), R (P < 0.0001 and P = 0.0014) and P (P < 0.0001 and P < 0.0001). Neither A nor R showed significant difference from P as to the fall of skin impedance. Among the three bisphosphonates tested, etidronate appeared to be outstanding in analgesic effects.     

Screening for Proteinuria and Hematuria in School Children—Methods and Results—

In Japan, a urinalysis method in which the first morning urine sample is examined twice (Tokyo method) is currently widespread in the urine screening of school children Mass screening of elementary school and junior high school children for urinary abnormalities using this method yielded a positive prevalence of proteinuria, hematuria and both abnormalities of approximately 0.08%, 0.5% and 0.03%, respectively, for elementary school children and corresponding values of approximately 0.4%, 0.9% and 0.08%, respectively, for junior high school students. These prevalence values may vary depending upon conditions of urine collection, conditions of preservation and transport of urine samples, time interval between collection and testing, testing facility, reagent strips and criteria for evaluation of test results. Since attempts at detection of renal disease through examination of urine tend to yield excess positive rates with an abundance of false-positives and false-negatives, the reliability of such testing is reduced unless it is performed correctly under strictly controlled conditions. In order to overcome these difficulties it is mandatory that the entire urinalysis system has a high degree of accuracy.     

Involvement of the raphé pallidus in the suppressive effect of preoptic warming on non-shivering thermogenesis in rats

Thermogenesis in the brown adipose tissue (BAT) is activated by the stimulation of the ventromedial hypothalamic nucleus (VMH). Local warming of the preoptic area (PO) suppresses this response. Injection of the GABA(A) receptor antagonist bicuculline into the caudal periaqueductal gray (cPAG), where excitatory neurons for BAT thermogenesis are located, did not influence the suppressive effect of PO warming. On the other hand, after bicuculline injection into the raphé pallidus, where excitatory neurons for BAT thermogenesis are also located, VMH stimulation produced BAT thermogenesis even during PO warming. The present results suggest that the inhibitory signal from the PO reaches the raphé pallidus and not the cPAG for the control of BAT thermogenesis.     

Sarcomatoid carcinoma of the urinary bladder with a spontaneous perforation: a case report

A 65-year-old woman was referred to our clinic with gross hematuria. Cystoscopy revealed a non-papillary and non-pedunculated tumor on the left lateral wall of the bladder. A piece of necrotic tissue obtained from the bladder irrigation was histologically squamous cell carcinoma. A perforation at the left lateral wall of the bladder was found on the cystogram. Bone scintigraphy showed multiple metastases and computed tomography scans showed multiple lymph node metastases in the pelvic cavity. The clinical diagnosis was bladder carcinoma of T4N2M1 stage with an abscess due to a spontaneous perforation. Total cystectomy with bilateral ureterocutaneostomy was performed. She died due to sepsis 13 days after the operation. Histologically, the tumor was composed of carcinomatous and sarcomatous elements. The carcinomatous element was compatible with squamous cell carcinoma and the sarcomatous element was composed of undifferentiated malignant spindle cells. Immunohistochemical examination showed that the carcinomatous component was positive for keratin and human chorionic gonadotropin (HCG) and the spindle cell component positive for vimentin, desmin and HCG. Therefore, we diagnosed the tumor as sarcomatoid carcinoma. We reviewed 56 cases of carcinosarcoma of the bladder in Japan and discussed the clinicopathology of the disease.     

A case of spindle cell type hepatocellular carcinoma responding to hepatic intra-arterial infusion chemotherapy

We report herein a case of spindle cell type hepatocellular carcinoma responding to hepatic intra-arterial infusion chemotherapy. A 50-year-old woman was hospitalized for right epigastralgia. A computed tomography scan demonstrated cloudy liver tumor with a diameter of 12 cm in S5 and S8. Surgery was performed based on the diagnosis of liver tumor. However, because the tumor was also present in the left lobe, we did only a biopsy for a part of tumor. From the pathological findings, this was diagnosed as a spindle cell type hepatocellular carcinoma. After the operation, hepatic intra-arterial injection therapy of continuous infusion with 5-FU was conducted for two weeks. A small reduction in the tumor was seen with computed tomography after the completion of two courses.     

Development and evaluation of a photo-rhinometer for clinical use

We developed a photo-rhinometer (PRM) which is a modification of the Glatzel nasal mirror, and which can promptly evaluate nasal patency under natural respiration without any facial apparatus. We also investigated the clinical applications of the PRM. In PRM operation, moisture deposits resulting from expiratory nasal flow onto a glass plate are visualized for the right and left nostrils separately with an image analyzing computer at a television scan rate of 1/30 of a second. These visualized moisture deposits are averaged over the initial 1 second and differentiated for the initial 90 milliseconds to obtain an average moisture deposit area (AMDA) and the velocity of the moisture deposit (VMD), respectively. The resulting PRM chart, a graphic presentation of the moisture deposit area versus time was expected to be useful for the visual evaluation of nasal patency. PRM measurements were performed on 100 adult volunteers who were selected without knowing whether they had any nasal symptoms or disorders. Results showed that statistical distributions of both AMDA and VMD were equivalent to the normal distribution. A significant correlation was observed between nasal conductance as determined by a rhinomanometer and AMDA as determined by the PRM, and also between the nasal conductance and the VMD, which is r = 0.66 and r = 0.78 respectively. In addition to the 100 cases, five cases of chronic sinusitis and ten cases of acute sinusitis, which had been conservatively treated, were investigated by using the PRM. In some of these cases where improvements in the nasal conditions and reduction of subjective nasal obstruction were recognized, increases in the AMDA and VMD showed a good correlation with improvements in the nasal disorder.