Discontinuation of leisure time impact-loading exercise is related to reduction of a calcaneus quantitative ultrasound parameter in young adult Japanese females: a 3-year follow-up study.

UNLABELLED: A 3-year follow-up study on 334 young Japanese females enrolled in a university at the age of 18 years revealed that discontinuation of leisure time impact-loading exercises performed in junior high and/or high school was associated with increased risk of reduction in calcaneus osteo-sono assessment index (OSI). INTRODUCTION: Bone strength rapidly increases during puberty and reaches its peak by the end of adolescence. The aim of this study was to determine the lifestyle factors that influence the maintenance of calcaneus OSI in young adult females around the time when peak bone mass is attained. METHODS: Annual health checkups including OSI measurements, anthropometrics, lifestyle analysis, and blood examination were performed 4 times on 334 Japanese females enrolled in a university at the age of 18 years. According to the slope of OSI change during the 3-year follow-up, the subjects were grouped into two categories: OSI loss (the lowest tertile) and OSI gain/stable (the second and third tertiles). RESULTS: At the baseline assessment, the OSI loss group had higher OSI and height and an earlier menarche age than the OSI gain/stable group. Performing leisure time impact-loading exercise in junior high and/or high school but discontinuing it at university was associated with increased risk of OSI loss, independent of OSI, height and weight at the age of 18 years, weight change during follow-up, age of menarche, energy-adjusted nutrient intake, and alcohol drinking; the odds ratios were 4.1-4.9 compared with those performing impact-loading exercise at university. In particular, duration, frequency, and subjective intensity of impact-loading exercise during high school were positively associated with OSI loss. CONCLUSION: Discontinuation of leisure time impact-loading exercises performed during late adolescence is associated with an increased risk of OSI loss in young adult females during the 3-year follow-up period.

Calciphylaxis in a patient with end-stage renal disease secondary to systemic lupus erythematosus associated with acral gangrene and mesenteric ischemia.

A patient with end stage renal disease secondary to systemic lupus erythematosus (SLE) ultimately required amputation of the four extremities and developed mesenteric ischemia. The patient presented with widespread medial calcification involving various small to medium sized arteries, although no noticeable secondary hyperparathyroidism was observed. We speculated that SLE associated with systemic vasculitis and uremic milieu over a number of years may represent the perfect preexisting condition for calcific arteriolopathy to occur following which several factors including chronic administration of corticosteroids, photosensitivity in lupus, and significant weight loss may have contributed to acral gangrene and mesenteric ischemia.

[A case of hepatitis B virus carrier complicated with nephrotic syndrome].

We report a patient, a 23-year-old man, who was a hepatitis B virus(HBV) carrier complicated with nephrotic syndrome. He was admitted to our hospital because of generalized edema and massive ascites. Laboratory data on admission were as follows: proteinuria 9,850 mg/day, Cr 2.7 mg/dl, BUN 73 mg/dl, albumin 1.9 g/dl, cholesterol 501 mg/dl, GOT 23 IU/l, GPT 19 IU/l, HBsAg(+), and HBeAg(222.7). Since his nephrotic symptoms were seriously complicated with renal failure, we selected steroid therapy for nephrosis preference. His renal function was improved and the urinary protein decreased immediately, but his liver function deteriorated. The renal biopsy revealed focal mesangial proliferative glomerulonephritis. Immunofluorescent examination revealed slight deposits of IgG, IgM, and C3 along the glomerular basement membrane and mesangial matrix. He was not compliant and often stopped taking the steroid therapy, thereby causing nephrosis to recur each time. After all, nephrotic symptoms have been well-controlled with cyclosporin and steroid. In spite of the seroconversion of HB virus by formation of HBe antibody, mutant HBV infection continued. The fact that liver biopsy revealed severe lymphoid infiltration at the portal area suggested chronic active hepatitis. His clinicopathologic course suggests that HBV-associated nephropathy does not always remit as there are some cases in whom hepatitis remains in an active state even after seroconversion, due to its mutant status. In these cases, the long-term prognosis of HBV nephropathy has not been defined. Further study is necessary to establish the optimal treatment for HB nephropathy in adults.

[A case of hepatitis C virus-associated glomerulonephropathy presenting with MPO-ANCA-positive rapidly progressive glomerulonephritis].

We report a case of hepatitis C virus-associated glomerulonephropathy presenting with MPO-ANCA-positive, rapidly progressive glomerulonephritis(RPGN). A 60-year-old woman was admitted to our hospital for evaluation of RPGN. Laboratory evaluation revealed microhematuria, proteinuria(800 mg/day), anemia, renal failure(blood urea nitrogen 27 mg/dl, serum creatinine 2.2 mg/dl), cryoglobulinemia, hypocomplementemia, positive MPO-ANCA(232 EU), and hepatitis C virus infection(GOT 58 IU/l, GPT 38IU/l, HCV-RNA(PCR) 1,200 kcopy/ml, serotype 1). After admission, the patient's renal function and anemia deteriorated rapidly, then prednisolone(30 mg/day) was started. After treatment her renal function gradually improved, then a renal and liver biopsy was performed. The renal biopsy revealed six sclerosing fibrous crescentic glomeruli in twelve glomeruli. Immunofluorescent examination revealed granular deposits of IgG, C3, and fibrinogen along the glomerular basement membrane and mesangial matrix. The pathogenesis of RPGN in this case may relate to the deposition of immune complexes in the glomeruli because immunofluorescent examination was revealed to be the immune-complex type, but not pauci immune type nephritis. Liver histology revealed chronic active hepatitis with mild piecemeal necrosis and did not reveal vasculitis. Although her renal function was improved after treatment with prednisolone, she suffered from pulmonary manifestations(dry cough etc.) on the 120th hospital day. Suddenly she died because of pulmonary hemorrhage on the 180th hospital day. These findings suggest that various HCV-induced immunological abnormalities, such as positive MPO-ANCA, cryoglobulinemia and hypocomplementemia, play an important role in the pathogenesis of this RPGN, although we could not demonstrate deposition within glomeruli of immune complexes containing HCV. The effect of interferon therapy on such immunological abnormalities remains to be documented. Since interferon is known to have immunomodulatory effects, we selected corticosteroid therapy. Future studies need to focus on the optimal treatment strategy for hepatitis C virus-associated glomerulonephritis.

[Mucinous adenocarcinoma of the renal pelvis: a case report].

A rare case of primary mucinous adenocarcinoma of the renal pelvis is reported. A 76-year-old woman was admitted to our hospital because of right abdominal fullness. Physical examination revealed a melon-sized (22 cm in diameter) tumor located in the middle and lower right quadrant of the abdomen. Computed tomography and transabdominal sonography revealed hydronephrosis and a renal stone. Retrograde pyelography was impossible because of ureteral obstruction on the right side. A diagnosis of severe hydronephrosis was made and a right nephrectomy was performed. The kidney measured 24 x 14 cm in size and contained 1,500 ml of mucinous material. The histological diagnosis was mucinous adenocarcinoma of the renal pelvis. The patient has had neither recurrence nor metastasis for 2 years following postoperative chemotherapy.

Mode of action of the anti-influenza virus activity of plant flavonoid, 5,7,4'-trihydroxy-8-methoxyflavone, from the roots of Scutellaria baicalensis.

When mouse-adapted influenza virus A/PR/8/34 (A/PR8) (10 PFU/cell) was adsorbed to Madin-Darby canine kidney (MDCK) cells at 4 degrees C for 1 h and incubated at 37 degrees C, release of the virus from the cells was detected in the medium from 4 h after incubation and reached to plateau at 8 h. However, 5,7,4'-trihydroxy-8-methoxyflavone (F36) from the roots of Scutellaria baicalensis significantly reduced this single-cycle replication of A/PR8 from 4 h to 12 h after incubation by dose-dependent manner and the dose which decrease the virus titer one tenth was 11 microM. F36 (50 microM) did not inhibit the adsorption of A/PR8 to MDCK cells, but reduced release of the virus in the medium, when it was added at 0 or 2 h after the incubation. The cell-associated virus determined by sialidase activity was also reduced by F36 treatment at 0 or 2 h. F36 also inhibited the fusion of A/PR8 with liposomes containing bovine brain mixed gangliosides at pH 5.0. However, F36 little affected on the elongation activity of the viral RNA-dependent RNA polymerase in vitro. These results suggest that F36 reduces the replication of A/PR8 by inhibiting the fusion of the virus with endosome/lysosome membrane which occurs at early stage of virus infection cycle. Whereas, when F36 was added to the MDCK cells infected with A/PR8 at 3 or 4 h after incubation, release of the virus in the medium was reduced but the cell-associated virus was increased in comparison with control.(ABSTRACT TRUNCATED AT 250 WORDS)

The cell envelope structure of the lipopolysaccharide-lacking gram-negative bacterium Sphingomonas paucimobilis.

From the cell envelope preparation of Sphingomonas paucimobilis two membrane fractions with different densities were separated by sucrose density gradient ultracentrifugation. The high-density fraction contained several major proteins, phospholipids, and glycosphingolipids, which are the only glycolipids of this lipopolysaccharide-lacking gram-negative bacterium. The low-density fraction showed many minor bands of proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and NADH oxidase activity was localized in this fraction. Combined with morphological data of vesicles formed by these membrane fractions, the high-density and low-density fractions were proposed to be an outer membrane and a cytoplasmic membrane, respectively. The localization of the glycosphingolipid was investigated also by means of immunoelectron microscopic analysis using a glycosphingolipid-specific antibody. The glycosphingolipid was shown to localize at the cell envelope, and the antigenic sugar portion was exposed to the bacterial cell surface. From these results the glycosphingolipid was assumed to have a function similar to that of the lipopolysaccharide of other gram-negative bacteria.

Role of polymorphonuclear leucocytes and oxygen-derived free radicals in the formation of gastric lesions induced by HCl/ethanol, and a possible mechanism of protection by anti-ulcer polysaccharide.

This study examined the role of oxygen-derived free radicals in the pathogenesis of gastric mucosal lesions induced by HCl/ethanol. Superoxide dismutase, and catalase, and their combination reduced gastric lesion formation in mice. Gastric lesions were also reduced in mice treated with cyclophosphamide or anti-neutrophils, but not in mice treated with allopurinol or desulphated-carrageenan. Cobra venom factor did not reduce lesion formation. These results suggested that oxygen-free radicals may contribute to the formation of gastric mucosal lesions induced by HCl/ethanol, and that oxygen radicals were generated from neutrophils but not from xanthine oxidase. Anti-ulcer pectic polysaccharide, bupleuran 2IIc, which was recently isolated from the roots of Bupleurum falcatum L., showed potent inhibition of HCl/ethanol-induced gastric lesions in mice. Bupleuran 2IIc seemed to scavenge hydroxyl radical effectively. It was suggested that this anti-ulcer polysaccharide may provide protection to the gastric mucosa by scavenging oxygen-free radicals.

Effect of 50 kilobase-plasmid, pKDSC50, of Salmonella choleraesuis RF-1 strain on pig septicemia.

Salmonella choleraesuis strains with and without 50-kilobase plasmid (pKDSC50) were intravenously inoculated into Yorkshire pigs. By the inoculation of 7.2 x 10(5) - 3.5 x 10(7) cells, RF-1 strain with pKDSC50, but not 31N-1 strain without the plasmid, caused a septicemia. The inoculation of 8.7 x 10(9) RF-1 cells killed pigs at 2-4 day postinfection with severe hemorrhage on the whole body. Pigs with a similar number of 31N-1 cells (8.3 x 10(9) cells), showed milder hemorrhage, and they died at 6 day postinfection. These results indicated that pKDSC50 is required for RF-1 strain to express the full virulence causing a heavy cutaneous pig septicemia.

A pathological study on the virulence of Salmonella choleraesuis associated with 50-kilobase plasmid in mice.

The virulence of Salmonella choleraesuis associated with 50-kilobase plasmid was assessed by the pathology produced in mice. The strains used in this study were plasmid-contained RF-1, plasmid-cured 31N-1 and plasmid-reintroduced 31N-1-T. Mice were intraperitoneally inoculated with sublethal doses of these bacteria and chronologically necropsied. Pathologically, the plasmid-positive (P+) cases were distinctly different from the plasmid-negative (P-) ones, especially in the peritoneal fluids and peritoneum. The P+ cases were characterized by extensive, granulomatous peritoneal lesions composed of abundant macrophages frequently with neutrophils, sero-fibrinous exudates and vasculitis and the bacterial antigens were detected in such sites. By contrast, the peritonea in the P- cases were mildly involved and had scattered granulomas. The bacterial antigens were hardly visible in all tissues examined. It is suggested that spread preparations of the mesentery may be a useful tool for observing the distribution of peritoneal lesions.

[Guideline of surgical treatment of prostatic adenocarcinoma].

Based on study of 274 cases of prostate cancer treated in our clinic, selection of patient for radical surgical treatment and choice of procedures were discussed. The radical surgical procedures experienced in our clinic were classified as 31 cases of radical prostatectomy, 4 cases of radical cystoprostatectomy and 7 cases of pelvic exenteration. The endocrine therapy was added to non curative cases postoperatively. In the radical prostatectomy group, the 5-year survival rate of patients with stage A and stage B prostatic adenocarcinoma were 100 and 93 per cent, respectively, and 5-year survival rate of patients who had stage C prostatic adenocarcinoma was 75 per cent. The 5-year survival rates of patients with stage C prostatic adenocarcinoma treated by radical cystoprostatectomy and pelvic exenteration were 50 per cent and 66 per cent, respectively. Cancer recurrence has not seen in the bladder in the patients with stage C prostatic adenocarcinoma treated by radical prostatectomy. Operation of urinary diversion had improved the quality of life. From this data, radical prostatectomy would be indicated for the treatment of patients with stage A, stage B and stage C prostatic adenocarcinoma.

Feather-pulp lesions in chickens with naturally occurring Marek's disease lymphomas.

Feather pulps of 15-to-35-week-old chickens with Marek's disease (MD) lymphomas were examined histopathologically. Of the 64 chickens, 59 (92.2%) had lymphoproliferative (T-type) lesions in the feather pulp. The T-type feather-pulp lesion (FPL) occurred in all regions, but more frequently in the upper column of the pulp. Severe lesions were distributed throughout the feather pulp. Some of the T-type FPLs regressed to inflammatory lesions consisting of necrosis or loss of constituent cells, edema, and infiltration by small lymphocytes, heterophils, and plasma cells. The regressive T-type FPL was usually diffuse throughout the tumorous lesions, but proliferative foci were often seen concomitantly with regressive lesions. The grade and histologic picture of T-type FPLs in chickens correlated well with those of the visceral lymphomas. These findings suggest that the severity of MD lymphoma is predictable without autopsy by examining feather-pulp samples.

[Pharmacokinetics of astromicin intravenous drip infusion in patients with renal disorders].

Astromicin (ASTM), a new aminoglycoside antibiotic, was administered to 7 patients with renal disorders. Concentrations of ASTM in blood were determined for pharmacokinetic analysis. ASTM was administered by intravenous drip infusion over 1 hour at a dose of 200 mg to each of 6 patients and at a dose of 100 mg to 1 patient. Renal function was observed by the clearance of intrinsic creatinine (Ccr) as the indicator. Concentrations of ASTM in blood became higher and retention times longer as degrees of the loss of renal function were larger. Although ASTM is proved to be one of drugs with the highest degree of safety compared with other existing aminoglycoside antibiotics, it should be administered with care to patients with renal disorders.

Chronological observations of Marek's disease-associated feather-pulp lesions in field chickens.

Fourteen test groups consisting of a total of 541 field chickens in six rearing farms, all of which were vaccinated with turkey herpesvirus at one day old, were investigated for chronological changes in Marek's disease (MD)-associated feather-pulp lesions (FPL) and their association with nuclear-inclusion (NI) formation in the feather-follicle epithelium (FFE) and with incidence of MD. The FPL observed were categorized into R1-type (non-tumorous lymphoid lesion), R2-type (inflammatory lesion consisting of plasma cellular infiltration, edema or collagenosis of the pulp, and germinal-center formation) and T-type (tumorous lymphoproliferative lesion). In every test group, the incidence of R1-type lesions was highest at 2-4 weeks of age, in spite of the low incidence of NI formation in the FFE. The initial R1-type lesions were generally transitory and were followed occasionally by R2-type lesions. In each test group, incidence of NI formation in the FFE peaked between 9 and 16 weeks of age. The second peak of incidence of R1-type lesions coincided with the period of peak NI formation. Subsequent skin samples revealed that the incidences of R1-, R2-, and T-type lesions in individual chickens or test groups were closely related to the incidence of NI in the FFE and to the incidence of MD.

[Clinical evaluation of aztreonam for complicated urinary tract infection].

Efficacy and safety of Aztreonam, a monobactam antibiotic developed by E.R. Squibb & Sons, Inc. U.S.A., in complicated urinary tract infections (UTI) were studied. Aztreonam was administered to 15 patients with complicated UTI admitted to our Hospitals between July, 1984 and January, 1985. A two-gram dose of Aztreonam was administered twice a day intravenously or intraductally for 5 days consecutively. There were 11 evaluable cases in accordance with the UTI Drug Efficacy Evaluation Standard (the second issue). Overall clinical effect of these cases were "excellent" in 6 cases, "good" in 2 cases and "poor" in 3 cases. All the effective cases ("excellent" and "good") were of single infections and all the non-effective cases ("poor") were of complicated infections. All of the gram-negative pathogens and 4 of the 8 gram-positive pathogens were eliminated. In no cases were side effects or significantly abnormal laboratory findings reported. Therefore, Aztreonam is very effective and safe for complicated UTI, especially gram-negative infections.