The prevalence of primary neck and shoulder pain, and its related factors in Japanese postpartum women.

PURPOSE: This study investigated the prevalence, location, and severity of neck and shoulder pain (NSP), its disturbance of quality of life (QOL), and the factors related to NSP in Japanese postpartum women. MATERIALS AND METHODS: The study involved 308 postpartum women who had a medical examination one month after delivery. The questionnaire consisted of the background and details of NSP. Mood states were evaluated using the Profile of Mood States-Brief (POMS-B), Japanese Version. RESULTS: The prevalence of NSP was 73.1%, one-fourth of which occurred after birth. The most common area was the superior part of the trapezium muscles. Prevalence was associated with past history of premenstrual syndrome (PMS), anemia during pregnancy, time per breastfeeding, and the mean POMS-B Fatigue score. Total breastfeeding time a day, the mean POMS-B score for Fatigue, Confusion, Anger-Hostility, and Depression were significantly higher for "worse" after birth than those for "no-change/relief". The disturbance of daily life due to NSP in postpartum women with past history of PMS and Hiesho were significant higher than that for women without those. CONCLUSIONS: The prevalence of NSP in postpartum women was very high. The factors which affect NSP were the mental states, breastfeeding, past history of PMS, and anemia during pregnancy.

Ileal adenomyoma accompanied by primary peritonitis: report of a case.

We report herein the case of a 52-year-old woman who presented with severe abdominal pain and a 2-week history of a yellow vaginal discharge. An emergency operation was performed for localized peritonitis attributed to acute perforated appendicitis. There were no findings to indicate the cause of peritonitis, but by chance, a submucosal tumor was found in the ileum 2m from Bauhin's valve. Appendectomy and wedge resection of the ileum with the submucosal tumor were carried out. The peritonitis was considered to have been idiopathic from bacterial and molecular biological examination of the ascites. Pathological, immunohistochemical, and flow cytometrical findings of the resected ileal submocosal tumor indicated a diagnosis of ileal adenomyoma with no malignancy, which suggested metaplasia of the pancreaticobiliary to gastric epithelium.

Oxidative modification of tryptophan 43 in the heme vicinity of the F43W/H64L myoglobin mutant.

The F43W/H64L myoglobin mutant was previously constructed to investigate the effects of electron-rich tryptophan residue in the heme vicinity on the catalysis, where we found that Trp-43 in the mutant was oxidatively modified in the reaction with m-chloroperbenzoic acid (mCPBA). To identify the exact structure of the modified tryptophan in this study, the mCPBA-treated F43W/H64L mutant has been digested stepwise with Lys-C achromobacter and trypsin to isolate two oxidation products by preparative fast protein liquid chromatography. The close examinations of the (1)H NMR spectra of peptide fragments reveal that two forms of the modified tryptophan must have 2,6-disubstituted indole substructures. The (13)C NMR analysis suggests that one of the modified tryptophan bears a unique hydroxyl group in stead of the NH(2) group at the amino-terminal. The results together with mass spectrometry (MS)/MS analysis (30 Da increase in mass of Trp-43) indicate that oxidation products of Trp-43 are 2,6-dihydro-2,6-dioxoindole and 2,6-dihydro-2-imino-6-oxoindole derivatives. Our finding is the first example of the oxidation of aromatic carbons by the myoglobin mutant system.

Self-assembly of frameworks with specific topologies: construction and anion exchange properties of M3L2 architectures by tripodal ligands and silver(I) salts.

Three five-component architectures, compounds 3, 4, and 5 were obtained by self-assembly of tripodal 1,3,5-tris(imidazol-1-ylmethyl )-2,4,6-trimethylbenzene (6) and 1,3,5-tris(benzimidazol-2-ylmethyl)benzene (7) ligands with silver(I) salts. The structures of these novel complexes have been determined by X-ray crystallography. The results of structural analysis indicate that these frameworks have same M3L2 components, but different structures. Compounds 3 and 4 are both M3L2 type cage-like complexes, while the 5 is an open trinuclear complex. The complex 3 is a cylindrical cage with simultaneous inclusion of a perchlorate anion inside of the cage as a guest molecule. Such guests can be exchanged for other anions through the open edge of the cage as evidenced by crystal structure of 4. The results demonstrate that the molecular M3L2 type cage can act as a host for anions and provide a nice example of supramolecular architectures with interesting properties and possible applications.

Dinuclear calcium complex with weakly NH...O hydrogen-bonded sulfonate ligands.

The novel intramolecularly NH...O hydrogen-bonded Ca(II)-aryl sulfonate complex, [Ca2(SO3-2-t-BuCONHC6H4)2(H2O)4]n(2-t-BuCONHC6H4SO3)2n (1), sulfonate anion, (HNEt3)(SO3-2-t-BuCONHC6H4) (2a), (PPh4)(SO3-2-t-BuCONHC6H4) (2b), (n-Bu4N)(SO3-2-t-BuCONHC6H4) (2c), and sulfonic acid, 2-t-BuCONHC6H4SO3H (3), were synthesized. The structures of 1, 2a, and 2b depict the presence of the formation of NH...O hydrogen bonds between the amide NH and S-O oxygen for a series of compounds as determined by IR and 1H NMR analyses both in the solid state and in the solution state. Thus, the NH...O hydrogen bonds with neutral amide groups are available for investigation of the electronic state of the O- anion. The combined data from the IR and 1H NMR spectra indicate that the sulfonic acid, sulfonate anion, and Ca(II) complex have a substantially weak intramolecular NH...O hydrogen bond between the SO3 oxygen and amide NH. In the detailed comparison with the intense NH...O hydrogen bonds for the carboxylate, weak NH...O hydrogen bonds for sulfonate is due to the strong conjugation of the SO3- group with the lower nucleophilicity.

Regional cerebral blood flow after status epilepticus.

Two patients with status epilepticus due to specific conditions were examined using MRI and stable Xe/CT CBF. [Case 1] A 30-year-old woman developed a grand mal seizure during delivery. She was comatose, and MRI revealed abnormal high intensity areas bilateral basal ganglia, compatible with eclampsia. Regional CBF was decreased in bilateral occipital lobes and right basal ganglia. Six days after onset. Regional gray matter flow was increased, especially in the thalami and basal ganglia. [Case 2] The patient is a 31-year-old male diagnosed with temporal lobe epilepsy since 10 years. At the onset, he had a prolonged right hemiconvulsion followed by generalized tonic-clonic convulsion. MRI 13 days after onset showed left hemispheric edematous swelling of gray matter. Stable Xe/CT 3 weeks after onset demonstrated increased cortical CBF corresponding to edematous area. The results suggested that regional CBF decreased immediately after status epilepticus and then increased for 1-3 weeks in the interictal period. We speculate that the energy debt incurred during prolonged seizure causes relative ischemic condition in the neurons, with the increase in CBF resulting from accelerated energy production for a long period.

Long-term effect of growth hormone (GH) treatment on body composition in children with GH deficiency.

OBJECTIVE: It is important for GH-deficient children to treat abnormal body composition associated with a metabolic consequence, not only short stature. In this study we evaluated long-term effects of GH therapy on body composition in GH-deficient boys and girls. SUBJECTS AND METHODS: Forty-nine subjects with GH deficiency, 35 boys and 14 girls, 6 to 14 years of age, were studied. All the subjects were treated for three years with recombinant human GH at a weekly dosage of 0.5 IU/kg by subcutaneous daily injection. Body composition was measured by bioelectrical impedance analysis (BIA 101, Spectrum II 287, RJL Systems, Detroit, Mich). RESULTS: Body fat (%) decreased significantly during the first three months of GH treatment. These values were maintained low thereafter in boys, in contrast to those which continued to tend upward in girls from the second year of the treatment. Lean body mass (kg) increased significantly with increasing extracellular water (kg) and body cell mass (kg) in both sexes during GH treatment. CONCLUSION: Our data demonstrate that GH can reduce body fat mass in GH-deficient boys and girls. The gender difference in changes in body fat with age during the course of this study is compatible with that observed in normal children. The rapid increase in extracellular water and the gradual increase in body cell mass both contributed to the steady increase in LBM during GH treatment.

Unfavourable impact of growth hormone (GH) discontinuation on body composition and cholesterol profiles after the completion of height growth in GH-deficient young adults.

AIM: Growth hormone (GH) plays an important role in the regulation of body composition and metabolism. GH deficiency is associated with obesity and hypercholesterolemia, which respond to GH treatment. In this study we evaluated changes in body composition and cholesterol profiles after discontinuation of GH therapy to assess atherogenic risk factors in GH-deficient patients. METHODS: We studied 18 male patients with GH deficiency 17-20 years of age at the time of discontinuing GH therapy. Body composition and cholesterol were measured 6 months before discontinuation of GH therapy with a weekly dose of 0.5 IU/kg (approximately 0.19 mg/kg), and immediately, 2 months, and 6 months after the end of GH therapy. RESULTS: Two months after termination of GH therapy the percentage of body fat and fat mass increased from 7.4% to 9.4% and from 3.8 kg to 5.0 kg, respectively, and remained high thereafter. Lean body mass decreased gradually, but the change was not significant. Lean body mass: fat mass ratio decreased from 14.7 at termination of GH therapy to 10.9 at the end of study. Total cholesterol (TC) showed a significant linear increase from 156 mg/dl immediately after discontinuation to 169 mg/dl 6 months after discontinuation of GH, whereas high-density lipoprotein cholesterol (HDLC) showed no change during the study. The TC to HDLC ratio showed a slight but insignificant trend toward an increase. There were no significant changes in any variables during the last 6 months of GH therapy. CONCLUSION: GH therapy in patients with GH deficiency can reduce risk factors for obesity-related diseases and atherosclerosis. These beneficial effects are reversed after discontinuation of GH therapy. Further long-term studies of the effects of the GH withdrawal on lipid profiles, adiposity and life expectancy must be performed.

Long-term prospective study of body composition and lipid profiles during and after growth hormone (GH) treatment in children with GH deficiency: gender-specific metabolic effects.

GH has many effects on metabolism in addition to promoting growth. We studied changes in body composition and lipid profiles during and after GH treatment in 94 children with GH deficiency. Sixty-two subjects (46 boys and 16 girls) were evaluated at the beginning and during 36 months of GH treatment. The other 32 (21 boys and 11 girls) who had already been treated with GH were examined after the discontinuation of GH for a 6-month period. The height SD scores at the beginning and the discontinuation of GH treatment were -2.81 and -1.34 in boys and -3.14 and -1.38 in girls, respectively. The percent body fat (BF) significantly decreased from 16.5% to 11.7% in boys and from 16.7% to 11.6% in girls during the first 6 months of GH treatment (P < 0.01). BF subsequently remained constant in boys, but started to increase in girls from the 18th month of treatment. Lean body mass (kilograms) increased linearly throughout the treatment in both sexes (P < 0.01). Mean total cholesterol (TC) values decreased as a result of marked declines in low density lipoprotein cholesterol in both sexes, although statistical significance was detected only in boys (P < 0.01). High density lipoprotein cholesterol (HDLC) and apolipoprotein AI (Apo-AI) rapidly increased only in boys (P < 0.01). Triglyceride, Apo-AII, Apo-B, Apo-CII, Apo-CIII, Apo-E, and lipoprotein(a) showed no significant changes compared with baseline levels. Mean TC/HDLC and Apo-B/Apo-AI ratios decreased during treatment in both sexes, but the difference from baseline was significant only in boys (P < 0.01). After discontinuation of GH treatment, BF increased, and lean body mass decreased in boys (P < 0.01), whereas these variables did not change in girls. TC and low density lipoprotein cholesterol increased in boys within 6 months of discontinuing GH (P < 0.05). Other lipoproteins did not change in either sex, except for lipoprotein(a), which decreased significantly 6 months after the cessation of GH treatment in boys (P < 0.01). The mean TC/HDLC and Apo-B/Apo-AI ratios increased in boys slightly, but insignificantly. We concluded that GH treatment has beneficial effects on body composition and lipid profiles in both boys and girls with GH deficiency, although there are considerable gender differences. These beneficial effects of GH were reversed after the discontinuation of GH treatment, suggesting an important role of GH for GH-deficient children in the maintenance of normal metabolism even after the completion of linear growth.

Change of mechanical activity to contraction from the relaxation induced by the intracellular Ca2+ antagonist KT-362; effects of alkylation of side chain, and substitution of 2,3,4,5-tetrahydro-1,5-benzothiazepine derivatives.

KT-362 (5-[3-[2-(3,4-Dimethoxyphenyl)ethyl]aminopropionyl]-2,3,4, 5-tetrahydro-1,5-benzothiazepine fumarate) is an intracellular Ca2+ antagonist. The compound obtained by introducing methyl groups onto the nitrogen (R2) of the side chain of KT-362 showed vasoconstrictive activity. Therefore we synthesized various derivatives, and examined their activities. Substitution at position R2 of the side chain resulted in potent contractile activity, and the optimal alkyl length was two or three carbons. The potency was further increased by the introduction of a chloro group at the R1 position of 2,3,4,5-tetrahydro-1,5-benzothiazepines. One of the synthesized compounds, 8-chloro-5-¿N-ethyl-N-[2-(3,4-dimethoxyphenyl)ethyl]aminopropionyl¿-2,3,4, 5-tetrahydro-1,5-benzothiazepine fumarate (9b), showed an EC50 value of 3.47 x 10(-8) M for contraction of rabbit iliac artery. The action of compound 9b was antagonized competitively by an H1-histamine receptor antagonist, diphenhydramine, and the pA2 value was 7.82. The maximum constriction was inhibited by a Ca2+ entry blocker, nicardipine, but not by an alpha 1-adrenoreceptor antagonist, prazosin. In a Ca(2+)-free medium, tonic constriction induced by 9b disappeared, and only a phasic constriction was observed. Though this phasic constriction was inhibited by diphenhydramine, it was not inhibited by prazosin or nicardipine.

[Continuous infusion high-dose leucovorin with cisplatin and 5-fluorouracil for a recurrent oropharynx carcinoma].

Cisplatin and leucovorin heighten the activity of 5-fluorouracil by increasing the intracellular concentration of reduced folates. Therefore, we treated the recurrent oropharynx carcinoma case, who had received concurrent chemotherapy with low-dose cisplatin and radiotherapy, with continuous infusion high-dose leucovorin with cisplatin and 5-fluorouracil. Chemotherapy included continuous intravenous infusion of cisplatin (25 mg/m2, days 1 through 5); 5-fluorouracil (600 mg/m2, days 2 through 6); and leucovorin (200 mg/m2, days 1 through 6) administered once about every 4 weeks. Three cycles were performed, and a complete response was achieved. Grade 3 to 4 mucositis, nausea-vomiting, anemia, neutropenia, and thrombocytopenia occurred. Continuous infusion high-dose leucovorin with cisplatin and 5-fluorouracil was effective for this recurrent head and neck carcinoma. However, one must be cautious when comparing this chemotherapy in terms of toxicity.

[New intracellular calcium antagonists. I. Synthesis and pharmacological evaluation of 2,3,4,5-tetrahydro-1,5-benzothiazepine analogs].

A series of 2,3,4,5-tetrahydro-1,5-benzothiazepine and related compounds were prepared, and the intracellular Ca2+ inhibitory effects were examined using methoxamine- or caffeine-induced contraction of isolated rabbit arteries. Structure-activity relationship studies of these compounds are discussed and the results suggest that novel 5-[3-[2-(3,4-dimethoxyphenyl)ethyl]aminopropionyl]-2,3,4,5- tetrahydro-1,5-benzothiazepine fumarate (20d) showed the most potent inhibitory action on the intracellular Ca2+ release.

Beneficial effect of growth hormone on atherogenic risk in children with growth hormone deficiency.

We studied changes in the atherogenic index (total cholesterol divided by high-density lipoprotein cholesterol) in 12 prepubertal boys with growth hormone (GH) deficiency during 9 months of GH treatment. High-density lipoprotein cholesterol level increased until 5 months without significant changes in total cholesterol level; thus GH therapy may be beneficial in reducing the atherogenic index in boys with GH deficiency.

1H-, 13C-, and 113Cd-NMR study of the Cd(II) complex of a blocked peptide, Z-Cys-Ala-Pro-His-OMe, in organic solvents.

The Cd(II) complex of a peptide, Z-Cys-Ala-Pro-His-OMe was prepared and characterized by absorption, CD, 1H-, 13C-, and 113Cd-nmr, and nuclear Overhauser effect spectroscopy (NOESY) spectra to show the coordination of cysteine thiolate and histidine imizazole to Cd(II) ion. The NOESY spectra in dimethyl formamide showed that the cysteine residue was in proximity to the histidine residue. These results reveal the chelation of Z-Cys-Ala-Pro-His-OMe to Cd(II) ion in solution. Temperature-dependent dissociation equilibrium of histidine imidazole in solution was observed in this complex. Structural features of the chelating peptide are discussed.

Nonpeptide angiotensin II receptor antagonists. I. Synthesis and biological activity of pyridine derivatives.

Substituted pyridines were synthesized as potential angiotensin II (AII) receptor antagonists. Substitution at the position 2 in the pyridine resulted in potent activity, and the optimal alkyl length was four carbons. The potency further increased with the introduction of a hydroxymethyl group at the position 4. One of the compounds, 2-butyl-6-chloro-4-hydroxymethyl-5-methyl-3-[[2'-(1H-tetrazol-5-yl )biphenyl-4-yl]methyl]pyridine 9 h (KT3-579) is a competitive AII antagonist with a pA2 value of 9.31, and is about 10 times more potent than Du Pont 753. It was found to be an AT1 specific antagonist with an IC50 of 3.09 nM.

A synthetic analogue for the active site of plant-type ferredoxin: two different coordination isomers by a four-cys-containing [20]-peptide.

The (Fe2S2)2+ complex of an artificial 20-peptide ligand, Ac-Pro-Tyr-Ser-Cys-Arg-Ala-Gly-Ala-Cys-Ser-Thr-Cys-Ala-Gly-Pro-Leu-Leu-T hr-Cys- Val-NH2, containing an invariant Cys-A-B-C-D-Cys-X-Y-Cys (A, B, C, D, X, Y = amino acid residues) fragment of plant-type ferredoxins was synthesized by a ligand exchange method with [Fe2S2(S-t-Bu)4]2-. 1H-nmr spectroscopic and electrochemical data of the complex indicate the presence of two coordination isomers. One of them having a Cys-X-Y-Cys bridging coordination to the two Fe(III) ions, has the (Fe2S2)2+ core environment similar to those of the denatured plant-type ferredoxins and exhibits a positive shifted redox potential at -0.64 V vs saturated colonel electrode (SCE) in N,N-dimethylformamide (DMF). Another isomer with the Cys-A-B-C-D-Cys bridging coordination shows a negative redox potential at -0.96 V vs SCE in DMF.

Cloning and developmental expression of the alpha 3 chain of chicken type IX collagen.

Fibrous and nonfibrous collagens comprise two major groups within the collagen family and both groups are found in a diverse variety of tissue fabrics. Type IX collagen is in the nonfibrous group; three different subunits of type IX collagen have been identified and the alpha 1 and alpha 2 subunits have been cloned. Using molecular cloning methods we have isolated, from an embryonic chicken cartilage library, cDNA clones which code for the entire alpha 3 chain of chicken type IX collagen. The cDNA clones encompass 2416 base pairs which have a conceptual open reading frame for a protein containing 675 amino acids including 193 Gly-X-Y repeats. These collagen repeats are in three separate domains which are interspersed with four major noncollagen domains. The collagen repeats also have four minor interruptions. This chain organization directly aligns with both the alpha 1 and alpha 2 chains of chicken type IX collagen. Comparison of the deduced amino acid sequence with peptide sequences of type IX collagens shows identity with 95 of the 96 known residues of the chicken alpha 3 chain and 81 of the 98 known residues of the bovine alpha 3 chain. The identical residues match those in five peptide fragments, two from the bovine protein and three from the chicken protein. The chicken and bovine alpha 3 chains have conserved cross-linking sites, separated by 137 residues which span 40 nm, the length of the hole zone in a collagen fibril. The NC3 domain of the chicken alpha 3 chain contains a repeat Cys-Pro motif which is present in both vertebrate and invertebrate nonfibrillar collagens. Northern blot hybridization exhibits a major mRNA of about 3.3 kilobases; this transcript is found in cartilaginous tissues in the embryo, including the developing limb and is not detected in other tissues or in the precondensation stage of limb development. The composite data delineate the primary structure of the alpha 3 chain of chicken type IX collagen, show its close relationship to the alpha 1 and alpha 2 chains, demonstrate its mRNA transcript, and show the appearance of that transcript in tissues of the developing chick embryo.