An autopsy case of pulmonary capillary hemangiomatosis without evidence of pulmonary hypertension.

We report a case of pulmonary capillary hemangiomatosis (PCH) affecting a 37-year-old woman. PCH is a rare disease accompanying intrapulmonary capillary growth and pulmonary hypertension. In the present case, capillaries infiltrated the alveolar and bronchial walls but not the vascular walls. No signs or symptoms of pulmonary hypertension or right heart hypertrophy/dilatation were present. These findings suggest that vascular involvement in PCH is responsible for the induction of pulmonary hypertension.

[Three cases of malignant lymphoma accompanied by renal cell carcinoma].

Three cases of malignant lymphoma (ML) accompanied by renal cell carcinoma (RCC) are reported. From September 1997 through August 2000, we treated 85 patients with ML. Among these patients, three had accompanying RCC (clear cell type): case 1, a 57-yr-old man with gamma/delta-T cell lymphoma; case 2, a 25-yr-old man with Grade 3 follicular lymphoma; case 3, a 64-yr-old man with MALToma of the right orbit. Renal cell carcinoma is a relatively rare disease, but several reports have indicated that, for some reason, the incidence of concurrent RCC and ML is higher than expected. It is possible that the two malignancies share some common background factors, such as genetic mutation, immunological abnormality, or an immunomodulatory effect of the first tumor. The patient in case 2 was thought to have an abnormal immunological background from his medical history, which included bronchial asthma, idiopathic thrombocytopenic purpura, and mesangial proliferative glomerulonephritis (non-IgA type). Therefore the combination of ML and RCC in this patient may have been due to immunological impairment.

Postoperative ambulatory level after hip fracture in the elderly predicts survival rate.

The purpose of this study was to evaluate whether the ambulatory level premorbid or at discharge reflected the survival rate better. Ambulatory level was retrospectively evaluated as a postoperative indicator of survival rate following operative treatment in 301 consecutive patients over 65 years old. All of the patients were followed up for a mean of 62 months. The postoperative ambulatory level at discharge reliably reflected the survival rate in the elderly after hip fracture, better than the premorbid ambulatory level. It is confirmed that the planning of the operation and rehabilitation to maintain the premorbid ambulatory level after hip fracture might be critical.

Decreasing hypocomplementemia and membranoproliferative glomerulonephritis in Japan.

The number of patients with membranoproliferative glomerulonephritis(MPGN) diagnosed in our institution and the incidence of hypocomplementemia as determined by school urinary screening programs in Japan were investigated retrospectively. Fifty-seven children were diagnosed as having MPGN between 1974 and 1997. Of these, 13 patients were diagnosed during period 1 (1974-1979) and 25 during period 2 (1980-1985). A decreasing trend was observed during periods 3 (1986-1991) (12 patients) and 4 (1992-1997) (7 patients) compared with period 2 (P<0.05 and P<0.01, respectively). A significant difference was also noted when MPGN was compared between periods 1 and 2 (1974-1985) and periods 3 and 4 (1986-1997) (P<0.01). Serum C3 was measured in 1,282 school children with abnormal urinary findings between 1980 and 1997. Thirty children had hypocomplementemia. The incidence of hypocomplementemia was significantly lower in period 3 (1986-1991) (9 children) and period 4 (1992-1997) (2 children) compared with period 2 (1980-1985) (19 children) (P<0.05 and P<0.01, respectively). New cases of MPGN in our institution and the incidence of hypocomplementemia as determined by school urinary screening programs are decreasing in Japan. The reason for this trend is unknown.

Changes in bone mineral density of the proximal femur after total knee arthroplasty.

This study investigates the relationship between total knee arthroplasty (TKA) and bone mineral density (BMD) in the same and opposite hips. The study prospectively evaluated 24 consecutive patients undergoing TKA (31 knees, 47 hips). The mean follow-up was 48 months. The mean age at latest follow-up was 69 years, and all patients had the preoperative diagnosis of osteoarthritis. BMD of the hip was measured by dual-energy x-ray absorptiometry. Despite a predicted age-related loss of 4% during 2 years, 45% of the hips on the operative side and 59% of the hips on the nonoperative side had BMD higher than preoperative levels. Of hips, 81% on the operative side and 82% on the nonoperative side had BMD that was within the expected 4% age-related loss. Assuming that higher hip BMD may be protective against later hip fractures, the results infer that, by increasing hip BMD, TKA may be protective against later hip fractures. The increase with TKA in patient mobility and the increased hip loading may be a mechanism whereby the hip BMD increases.

Complete remission in three patients with acute myeloblastic leukemia by administration of G-CSF without antileukemic agents.

We describe 3 patients with acute myeloblastic leukemia (AML), who received rhG-CSF for infections such as pneumonia or for prophylaxis of infection, and who achieved complete remission. They had not received any antileukemic therapy before or during the administration of rhG-CSF. These findings suggest the possibility that complete remission can be brought about by G-CSF itself in some patients with AML.

Nephrotic syndrome in a bone marrow transplant recipient with chronic graft-versus-host disease.

A 21-year-old male developed massive proteinuria and microscopic hematuria, 1 year after allogeneic BMT for acute lymphoblastic leukemia. These symptoms occurred during an exacerbation of chronic cutaneous graft-versus-host disease (GVHD). Renal biopsy revealed granular deposits of IgG and IgM along the glomerular basement membrane, and subepithelial electron dense deposits. A diagnosis of membranous nephropathy was made. With prednisolone therapy proteinuria decreased gradually, and amelioration of cutaneous lesions was also noted. It was speculated that the disordered immune regulation of chronic GVHD resulted in the development of immune complex nephritis.

A model for self-sustained potential oscillation of lipid bilayer membranes induced by the gel-liquid crystal phase transitions.

To clarify the mechanism of self-sustained oscillation of the electric potential between the two solutions divided by a lipid bilayer membrane, a microscopic model of the membrane system is presented. It is assumed, on the basis of the observed results (Yoshikawa, K., T. Omachi, T. Ishii, Y. Kuroda, and K. liyama. 1985. Biochem. Biophys. Res. Commun. 133:740-744; Ishii, T., Y. Kuroda, T. Omochi, and K. Yoshikawa. 1986. Langmuir. 2:319-321; Toko, K., N. Nagashima, S. liyama, K. Yamafuji, and T. Kunitake. Chem. Lett. 1986:1375-1378), that the gel-liquid crystal phase transition of the membrane drives the potential oscillation. It is studied, by using the model, how and under what condition the repetitive phase transition may occur and induce the potential oscillation. The transitions are driven by the repetitive adsorption and desorption of proton by the membrane surface, actions that are induced the periodic reversal of the direction of protonic current. The essential conditions for the periodic reversal are (a) at least one kind of cations such as Na+ or K+ are included in the system except for proton, and the variation of their permeability across the membrane due to the phase transition is noticeably larger than that of proton permeability; and (b) the phase transition has a hysteresis. When these conditions are fulfilled, the self-sustained potential oscillation may be brought about by adjusting temperature, pH, and the cation concentration in the solutions on both sides of the membrane. Application of electric current across the membrane also induces or modifies the potential oscillation. Periodic, quasiperiodic, and chaotic oscillations appear especially, depending on the value of frequency of the applied alternating current.