Wire-loop lesion is associated with serological immune abnormality, but not renal prognosis, in lupus nephritis.

BACKGROUND: Wire-loop lesion (WL) is one of the active lesions of lupus nephritis (LN). However, few reports have focused on the clinicopathological relationships of WL to serological immune abnormality and renal prognosis. METHODS: We enrolled 126 Japanese LN patients subjected to renal biopsy in 11 hospitals from 2000 to 2018. In patients with class III or IV of the International Society of Nephrology/Renal Pathology Society classification, we retrospectively compared clinicopathological findings between those with WL (WL+ group) and without WL (WL- group) to detect factors associated with WL. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate of <60 mL/min/1.73m2 for more than three months. We also compared these findings between those with CKD (CKD+ group) and without CKD (CKD- group) at the last visit to investigate factors associated with renal prognosis. RESULTS: Of 126 patients, 100 (79.4%) were classified as class III or IV. WL was found in 36 (36.0%) of them. Although the renal function did not differ, the WL+ group had a higher titre of serum anti-dsDNA antibodies and lower serum complement 3 levels than the WL- group. Linear regression analysis revealed a significant association only between anti-dsDNA antibodies and WL (ß = 0.27, 95% confidence interval (CI) 0.001-0.100, p = 0.01). Of these patients, 69 were tracked for 59.6 ± 55.1 months. Kaplan-Meier analysis showed no difference in renal prognosis between these groups. Next, the CKD+ group included 15 (22.1%) patients. They were older and had higher frequencies of hypertension and hyperuricaemia, serum creatinine (Cr) level, glomerulosclerosis, interstitial inflammation, interstitial fibrosis and tubular atrophy than the CKD- group at the time of renal biopsy. The frequency of WL was not significantly different. Cox regression analysis revealed significant associations of CKD with hypertension, hyperuricaemia, serum Cr level at the time of renal biopsy clinically and with tubular atrophy histologically. CONCLUSIONS: WL was associated with serum anti-dsDNA antibodies but not with renal prognosis, suggesting that WL reflects immune abnormality but is not an independent factor predictive of renal prognosis in LN.

Digital Image Correlation and Finite Element Analysis of Bone Strain Generated by Implant-Retained Cantilever Fixed Prosthesis.

PURPOSE: The present study evaluated the displacement and strain generated in an implant- supported fixed prosthesis under axial and non-axial loads using two methods. MATERIALS AND METHODS: Three implants were inserted in a resin block. The Digital Image Correlation (DIC) was used to measure displacement and strain generated on the surface of the resin blocks for the different load applications (500N, 1 image/second). A 3-dimensional model was constructed and a load of 500 N was applied at an axial point and a non-axial point through finite element analysis (FEA). RESULTS: Both methods gave similar trends for the strains, and both gave slightly higher strains with non-axial loading. FEA predicted higher strain magnitude (±11%) in comparison with DIC, but with the same mechanical behavior. According to ANOVA, the loading influenced the strain concentration. Higher strain was generated for non-axial loading around the implant nearest to the loading. CONCLUSIONS: For implant-retained cantilever fixed prosthesis, the same load applied in the lever arm induces higher strain in the cervical area of the last implant, which suggests more damaging potential than a load applied at the center of the prosthesis.

Durability of feldspathic veneering ceramic on glass-infiltrated alumina ceramics after long-term thermocycling.

AIM: This study compared the bond strength durability of a feldspathic veneering ceramic to glass-infiltrated reinforced ceramics in dry and aged conditions. METHODS: Disc shaped (thickness: 4 mm, diameter: 4 mm) of glass-infiltrated alumina (In-Ceram Alumina) and glass-infiltrated alumina reinforced by zirconia (In-Ceram Zirconia) core ceramic specimens (N=48, N=12 per groups) were constructed according to the manufacturers' recommendations. Veneering ceramic (VITA VM7) was fired onto the core ceramics using a mold. The core-veneering ceramic assemblies were randomly divided into two conditions and tested either immediately after specimen preparation (Dry) or following 30000 thermocycling (5-55 ºC±1; dwell time: 30 seconds). Shear bond strength test was performed in a universal testing machine (cross-head speed: 1 mm/min). Failure modes were analyzed using optical microscope (x20). The bond strength data (MPa) were analyzed using ANOVA (α=0.05). RESULTS: Thermocycling did not decrease the bond strength results for both In-Ceram Alumina (30.6±8.2 MPa; P=0.2053) and In-Ceram zirconia (32.6±9 MPa; P=0.3987) core ceramic-feldspathic veneering ceramic combinations when compared to non-aged conditions (28.1±6.4 MPa, 29.7±7.3 MPa, respectively). There were also no significant differences between adhesion of the veneering ceramic to either In-Ceram Alumina or In-Ceram Zirconia ceramics (P=0.3289). Failure types were predominantly a mixture of adhesive failure between the veneering and the core ceramic together with cohesive fracture of the veneering ceramic. CONCLUSION: Long-term thermocycling aging conditions did not impair the adhesion of the veneering ceramic to the glass-infiltrated alumina core ceramics tested.

Secretion into the cerebrospinal fluid by caudal neurosecretory neurons.

Neurons of the regenerating caudal neurosecretory system of Tilapia mossambica and of the normal system of Albula vulpes send processes into the central canal of the spinal cord. Evidence for appreciable release of secretion into the cerebrospinal fluid from these processes has been obtainied with both light and electron microscopes.

Effects of somatostatin and urotensin II on tilapia pituitary prolactin release and interactions between somatostatin, osmotic pressure Ca++, and adenosine 3',5'-monophosphate in prolactin release in vitro.

Both somatostatin (SRIF) and urotensin II, a dodecapeptide from the teleost caudal neurosecretory system, inhibit PRL release from the organ-cultured rostral pars distalis of the tilapia, Sarotherodon mossambicus, in a dose-related manner. The inhibitory action of SRIF on PRL release was completely prevented by the presence of the calcium ionophore A23187. PRL release was also blocked when Ca++ was excluded from the incubation medium, even in the presence of the ionophore. Both dibutyryl cAMP (dbcAMP) and the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine, alone or in combination, stimulated PRL release during incubation in high osmotic pressure medium. The effect of dbcAMP appeared to be dose related. Together, dbcAMP and 3-isobutyl-1-methylxanthine were also effective in preventing the inhibition of PRL release by SRIF. These results are consistent with the notion that Ca++, and possibly cAMP, may be important mediators of PRL secretion, and it is likely that SRIF may inhibit PRL release by blocking a Ca++- or cAMP-mediated mechanism.

Development-associated changes in thyroxine kinetics in juvenile salmon.

Smoltification is a transformation that occurs in some species of salmon, during which solitary fish in fresh water become schooling fish and migrate to the sea. This process is accompanied by large increases in plasma T4. T4 secretion rate and other parameters of T4 metabolism in juvenile coho salmon were estimated by applying kinetic analyses to measurements of the disappearance of injected T4 radiotracer from plasma. Studies were performed at the beginning (March) and end (May) of the increase in T4 concentration in fresh water and seawater. Early and intensive sampling permitted characterization of a very fast initial component of the T4 disappearance curve when analyses included a zero time datum derived from an independent estimate of plasma volume. The plasma volume, equal to 1.77% of body weight, was obtained by measuring the disappearance of radiolabeled albumin from the plasma in two other groups of animals in fresh water and seawater. There were 3- to 7-fold changes in T4 production, distribution, and metabolism between March and May, whereas environment (fresh water vs. seawater) had relatively minor effects on T4 kinetics. In fresh water, the T4 secretion rate was 4.48 ng/h in March and 1.50 ng/h in May. The total T4 pool size was 37.8 ng in March and 12.2 ng in May. Plasma-tissue T4 fluxes were 3- to 7-fold greater in May. Relatively less T4 was distributed in tissue in May (63% vs. 83%), and T4 spent much less time in tissue in May than in March during each pass through the tissue space (11 min vs. 3.1 h). We propose that the difference in secretion rate and a redistribution of T4 between blood and tissues contribute to both the rise and fall in the plasma T4 concentration between March and May. Changes in T4 kinetics during salmonid smoltification resemble those occurring during amphibian metamorphosis and mammalian gestation and neonatal life, and may reflect an increased requirement and an important role for thyroid hormones during periods of rapid development in vertebrates in general.

Is the primitive regulation of pituitary prolactin (tPRL177 and tPRL188) secretion and gene expression in the euryhaline tilapia (Oreochromis mossambicus) hypothalamic or environmental?

We examined the effects of environmental salinity on circulating levels of the two prolactins (tPRL177 and tPRL188) and levels of pituitary tPRL177 and tPRL188 mRNA in the euryhaline tilapia, Oreochromis mossambicus. Fish were sham-operated or hypophysectomized and the rostral pars distalis (RPD) autotransplanted onto the optic nerve. Following post-operative recovery in (1/4) seawater, tilapia were transferred to fresh water (FW), (1/4) seawater (SW) or SW. Serum tPRL177 and tPRL188 levels in sham-operated and RPD-autotransplanted fish were highest in FW and decreased as salinity was increased. tPRL177 and tPRL188 mRNA levels in RPD implants as well as in pituitaries from the sham-operated fish were also highest in FW and decreased with increasing salinity. Serum osmolality increased with salinity, with the highest levels occurring in the seawater groups. We conclude that some plasma factor (probably plasma osmolality), in the absence of hypothalamic innervation, exerts a direct regulatory action on prolactin release and gene expression in the pituitary of O. mossambicus. This regulation is in accord with the actions of the two prolactins in the freshwater osmoregulation of the tilapia.

T-cell acute lymphoblastic leukemia with transient pure red cell aplasia associated with myasthenia gravis and invasive thymoma.

A 43-year-old male developed rapidly progressing anemia and a bone marrow examination revealed pure red cell aplasia (PRCA). He was diagnosed as having myasthenia gravis (MG) and invasive thymoma, and achieved complete remission by radiation and chemotherapy six years ago. Despite increased doses of oral prednisolone from 7.5 mg/day to 60 mg/day, a diagnosis of T-cell acute lymphoblastic leukemia (T-ALL) was made one month later based on findings of 37.2% abnormal lymphoblasts and positive surface markers for CD2, CD3 and CD7 T-cells. Cases of PRCA associated with MG and thymoma have been reported in the literature, however such a case followed by T-ALL is very rare.

[Basilar artery migraine with transient MRI and EEG abnormalities].

We report a case of basilar artery migraine with transient MRI and EEG abnormalities. A 25-year-old male medical student developed a right occipital throbbing headache one hour after the abrupt onset of vertigo, nausea, left-sided homonymous hemianopsia and nystagmus. All of his complaints subsided the following day. He had suffered from attacks of headache accompanied by the same type of aural symptoms almost every ten days. He was therefore diagnosed as having basilar artery migraine. CT scans during the period of recurrent migraine demonstrated no abnormalities, while T2-weighted MR images revealed a high signal intensity region in the right occipital cortex and adjacent white matter perfused by rami temporales of the right posterior cerebral artery. Cerebral hypoperfusion was detected by a SPECT scanner in the right posterior region, where EEG recorded during the migraine attack demonstrated paroxysmal-localized sharp waves. MRI and EEG performed two months after the last attack showed no obvious abnormalities along with clinical disappearance of the migraine attacks. We found few reports of transient MRI changes associated with migraine. This case suggests that transient changes in MR images reflect vasogenic edema caused by migraine.

[Hypertrophic cranial pachymeningitis with propionibacterium acnes detected by dural biopsy].

A 30-year-old woman experienced recurrent dull headache and frequent partial motor seizure (Jacksonian type) that marched from right fingers. This motor seizure was uncontrollable with ordinary anticonvulsant therapy. Cerebrospinal fluid showed mild pleocytosis. Cranial CT examination was unremarkable, but MRI revealed thickened dural lesion on the left fronto-parietal site, giving diagnosis of hypertrophic cranial pachymeningitis. Dural biopsy showed nonspecific chronic granulomatous state without specific granuloma such as tuberculosis nor sarcoidosis. Anaerobic culture revealed Propionibacterium acnes, a rare causative agent of meningitis. We conclude that it is important to follow a case of unknown cause pachymeningitis carefully with MRI, and in some cases, is required a dural biopsy to make a diagnosis before steroid therapy.

Expression of aquaporins and vasopressin type 2 receptor in the stria vascularis of the cochlea.

Recently, considerable evidence has been accumulated to support the novel view that water homeostasis in the inner ear is regulated via the vasopressin-aquaporin 2 (VP-AQP2) system in the same fashion as in the kidney. Indeed, multiple subtypes of AQPs including AQP-2 are reported to be expressed in the cochlea. However, the mechanism that underlies VP-AQP-2 mediated water homeostasis remains to be elucidated. In the present study, the localizations of AQP-1, -2, -3, -4, -5, -7, -8, -9, and vasopressin type 2 receptor (V2-R) in the stria vascularis (SV) were molecular biologically and immunohistochemically examined to evaluate the role of the AQP water channel system in water homeostasis of the SV. A RT-PCR study revealed that AQPs and V2-R mRNA are expressed in the cochlea. As for their immunohistochemical localization, the AQP-2 protein is expressed on the basal side of the basal cells of the SV, and proteins of AQP-3 and V2-R are expressed on the apical side of the basal cells. AQP-7 and -9 proteins are expressed on the apical side of marginal cells. AQP-4, -5, and -8 protein expressions could not be detected in the lateral wall of the cochlea. From the present results, water flux in the SV is thought to be regulated at the level of the basal cells by vasopressin. Furthermore, such a distribution of AQP-2, -3, and V2-R suggests that VP-AQP-2 mediated water transport might work actively in the basal cells from perilymph towards endolymph containing AQP-1, -7 and -9.

EXpression of ErbB proteins in human prostate.

ErbB proteins are widely expressed in human and animal tissues, notably in cells of epithelial or neuroendocrine origin. Protein expression and interactions of ErbBs were examined in prostate cancer specimens. Expression of ErbB1-4 proteins was determined with immunohistochemical methods using each monoclonal antibody in 20 prostatic adenocarcinomas. The 4 ErbB proteins were widely expressed in normal, hyperplastic and cancerous tissues of the prostate. ErbBs may contribute to normal development or tumor growth and progression in human prostate.

Effects of lithium on endolymph homeostasis and experimentally induced endolymphatic hydrops.

There is evidence to suggest that water homeostasis in the inner ear is regulated via the vasopressin (VP)-aquaporin 2 (AQP2) system in the same fashion as in the kidney. The VP-AQP2 system in the kidney is well known to be inhibited by lithium, resulting in polyuria due to a decrease in reabsorption of water in the collecting duct of the kidney. Therefore, lithium is also likely to inhibit the VP-AQP2 system in the inner ear, and consequently exert some influence on inner ear fluid homeostasis. In this study, we investigated the effects of lithium on AQP2 expression in the rat inner ear, and on the cochlear fluid volume in hydropic ears of guinea pigs. A quantitative PCR study revealed that lithium reduced AQP2 mRNA expression in the cochlea and endolymphatic sac. Lithium application also decreased the immunoreactivity of AQP2 in the cochlea and endolymphatic sac. In a morphological study, lithium intake significantly reduced endolymphatic hydrops dose-dependently. These results indicate that lithium acts on the VP-AQP2 system in the inner ear, consequently producing a dehydratic effect on the endolymphatic compartment.

Determination of triazolam in serum by deactivated metal capillary gas chromatography with electron-capture detection.

A method for the determination of trace amounts of triazolam in serum by deactivated metal capillary gas chromatography with electron-capture detection was established. The column used exhibits excellent thermostability in high-temperature analysis and easy handling and a long lifetime of the column and well shaped peaks on the chromatograms are obtained. With the metal capillary column, it was found to be easier to maintain suitable analytical conditions for the routine assay of triazolam than with a fused-silica column. With this method, 0.5 ng/ml of triazolam in serum can be determined. The method is useful for pharmacokinetic and therapeutic purposes.

Relation of mitochondria-rich chloride cells to active chloride transport in the skin of a marine teleost.

Mitochondria-rich cells in the skin of the marine teleost, Gillichthys mirabilis, were found to be ultrastructurally similar to typical chloride-secreting cells of marine fish gill, but had a tall, spindlelike shape due to the thickness of the stratified epithelium. The fluorophore, dimethylaminostyrylethyl-pyridiniumiodide (DASPEI), was used to visualize and count skin chloride cells so that cell density could be regressed against the in vitro short-circuit current (ISC) measured on the same tissue. The regression (r2 = 0.76; n = 72) demonstrated that chloride cells are responsible for anion transport across Grillichthys skin.

Novel effect of vasoactive intestinal polypeptide and peptide histidine isoleucine: inhibition of in vitro secretion of prolactin in the tilapia, Oreochromis mossambicus.

The effects of vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine (PHI) on the in vitro secretion of two prolactins (PRL) from the rostral pars distalis (RPD) and of growth hormone (GH) from the proximal pars distalis (PPD) of the pituitary of the tilapia (Oreochromis mossambicus) were studied. RPDs were incubated for 20 hr in hypoosmotic (280-300 mOsm) or hyperosmotic (340-350 mOsm) Krebs-Ringer bicarbonate medium with added peptide concentrations of 0 (control), 0.3, 3.0, 30, and 300 nM; similarly, PPDs were incubated with the same peptide concentrations in isoosmotic (325 mOsm) medium supplemented with cortisol. PRL and GH in the tissue and secreted into the medium were measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by soft laser densitometry of the protein band(s). Neither VIP nor PHI has a detectable effect on the secretion of GH. Secretion of the two PRLs is significantly inhibited by VIP and PHI in both hyperosmotic and hypoosmotic medium. In hyperosmotic medium, 300 nM VIP inhibits secretion of both PRLs by 47%, whereas in hypoosmotic medium, 300 nM VIP inhibits their secretion by 27%. PHI inhibits their secretion by ca. 65% in hyperosmotic medium and by 40% in hypoosmotic medium. There is preliminary immunocytochemical evidence for some VIP-like immunoreactivity (IR), but no conclusive indication of PHI-like IR, in the hypothalamo-hypophysial area. The inhibitory actions of VIP and PHI on PRL secretion in tilapia are in contrast to the known stimulatory actions of VIP and PHI on PRL secretion in tetrapods.

In vitro release of growth hormone from the pituitary gland of tilapia, Oreochromis mossambicus.

The release of growth hormone from the proximal pars distalis of the tilapia, Oreochromis mossambicus, was significantly stimulated by cortisol (1 microgram/ml) in an in vitro system. Growth hormone released into the medium and remaining in the tissue was measured by densitometry after gel electrophoresis. Neither triiodothyronine (6.7 ng/ml) nor equimolar concentrations of thyroxin altered the release of growth hormone. In combination with cortisol, triiodothyronine did not alter the effect of cortisol alone.