Season and activity of rheumatoid arthritis in Japan

Aim: To investigate the relationship between rheumatoid arthritis (RA) activity and season. Methods: Two hundred and eighty RA patients were asked whether they experienced any deterioration at different times of year. Each patient's RA activity was also recorded on medical charts. Results: Sixty‐two percent of patients recognized seasonal deterioration. Spring and winter were common seasons of deterioration. From medical charts, there were two peaks of high deterioration. One peak was from April to June, and the other was from November to January. Conclusion: Two‐thirds of RA patients felt deterioration related to season. Evaluation and notes of the deterioration pattern could support early appropriate therapy for RA patients.     

Permeability of NS-3, a Thyrotropin-releasing Hormone Analogue,into the Brain After Its Systemic Administration in Rats: A Microdialysis Study

The concentration of NS-3 (montirelin hydrate, CG 3703), a thyrotropin-releasing hormone (TRH) analogue, in the cerebral cortex of urethane-anaesthetized rats was measured after its systemic administration (1 mgkg^?1, i.v.), using in-vivo microdialysis coupled with a radioimmunoassay. The concentration in microdialysates was highest (24nM) during the first 20 min after injection, and it fell below the detection limit (3.5 nM) 100 min after treatment. The maximal interstitial concentration was estimated to be 0.51 μM. From these results, it is suggested that NS-3 can readily penetrate into the brain.     

Pedunculated gastric carcinoma demonstrating a gastric foveolar phenotype

We report a case of gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells. An endoscopic examination revealed a pedunculated polyp in the fornix of the stomach. A surgical operation was performed and the pathological findings showed very well differentiated adenocarcinoma mimicking gastric foveolae with a poorly differentiated component containing signet ring cells. This is the first case of pedunculated gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells and also demonstrating a gastric foveolar phenotype.     

Measurement of prostate specific antigen complexed to α1-antichymotrypsin to avoid unnecessary biopsy in patients with serum prostate specific antigen levels 4–20 ng/mL

AIM: To investigate whether measuring prostate specific antigen complexed to alpha1-Antichymotrypsin (PSA-ACT) can increase sensitivity and specificity in detecting prostate cancer. METHODS: In this prospective study, we measured serum total PSA, PSA-ACT, free PSA, prostate volume and transition zone volume on 210 patients with total PSA level of 4-20 ng/mL. From fitted curves between positive predictive values for prostate cancer and age, prostate volume, transition zone volume, total PSA, PSA-ACT or F/T ratio, each function predicting prostate cancer was determined. Relative probabilities for prostate cancer (RPpca) which were defined by combined functions of age, F/T ratio, prostate volume or transition zone volume, and total PSA or PSA-ACT were calculated. Furthermore, using logistic regression, analysis was performed to determine the probability of prostate cancer. Receiver-operating characteristic analysis was performed to clarify the areas under the curve (AUC) for conventional single parameters, RPpca and logistic regression probability. RESULTS: F/T ratio showed the largest AUC among conventional parameters. The AUC of RPpca was larger than those of F/T ratio and logistic regression probability. RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio showed the largest AUC and highest specificity at sensitivity 95% level, however, specificities at sensitivity 90% and 85% were identical to those of RPpca using the functions of age, prostate volume, total PSA and F/T ratio. CONCLUSIONS: RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio was the best way to detect prostate cancer, however, the usefulness of PSA-ACT appears limited, considering the cost.     

Laparoscopic Findings of the Liver of Adult T cell Leukemia with Hepatic Injury— A Case Report

Abstract: A 54 year- old man was admitted to our hospital because of general fatigue and marked hepato -splenomegaly. Laboratory findings revealed marked leukocytosis including atypical lymphocytosis and abnormalities in the hepatic function tests. A diagnosis of acute stage of adult T-cell leukemia (ATL) was made from his positive serum anti-ATL (HTLV-1). Since the complication of alcoholic liver disease could not be ruled out because of his heavy consumption of alcohol, hepato - splenomegaly and abnormal liver function tests, a laparoscopic examination was performed. The laparoscopic findings of the liver revealed it was yellow / brown in color, and showed swelling of both lobes, granular unevenness and diffuse white markings on the surface. Histological findings of the liver biopsy specimen revealed an enlargement of the portal areas with diffuse infiltration of ATL cells but no evidence of alcoholic liver diseases. It is suggested that the white markings on the liver surface, which showed slight elevation unlike those seen in chronic hepatitis, might reflect an infiltration of ATL cells.     

STEROIDOGENESIS IN VITRO BY HUMAN OVARIAN FOLLICLES DURING THE PROCESS OF ATRESIA

Slices of each of the six antral follicles at different stages of atresia isolated from ovaries of six patients with or without pretreatment with HCG before laparotomy, were incubated with [1–¹⁴C] acetate. Incorporation into progestins, androgens and oestrogens was assessed by the reverse dilution technique with recrystallization to constant specific activity. The greatest incorporation into androstenedione without any incorporation into progesterone was commonly observed throughout the morphologically denned three stages of atresia. In the first stage atretic follicles, characterized by coexistence of normally developed thecal cells with degenerating granulosa cells, a minute incorporation into oestradiol was identified. In the second stage atretic follicles, showing hyperplasia and hypertrophy of thecal cells without granulosa cells, an increased incorporation into androgens was shown. Treatment with HCG induced similar but much pronounced changes in function and morphology. In the third stage atretic follicles, with subsiding thecal cells, a diminished incorporation into androstenedione was observed with 17-hydroxyprogesterone being the only other steroid formed in this stage. The observed qualitative and quantitative changes of steroidogenesis in vitro may be functional reflections of structural changes during the atretic process.