Axillary lymph-node metabolic activity assessment on 18F-FDG-PET/CT in rheumatoid arthritis patients treated with biologic therapies.

Objective: Recent studies have provided new insights into the role of lymph nodes (LNs) in rheumatoid arthritis (RA). The aim of this study was to evaluate the metabolic activity of the axillary LNs in relation to that of the upper limb joints and the clinical assessment of disease activity in RA patients treated with biologic therapies.Method: 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) scans were acquired for 64 patients with RA at baseline and after 6 months of biologic therapy, and the patients' clinical status was evaluated. The maximum standardized uptake value (SUVmax), metabolic active volume, and total lesion glycolysis (TLG) were used to assess glucose metabolism in the LNs and 12 joints. Clinical evaluations included serum markers and the Disease Activity Score based on 28-joint count-erythrocyte sedimentation rate (DAS28-ESR).Results: Changes in the SUVmax and TLG for the axillary LNs correlated significantly with those of the ipsilateral wrist joints. There was a positive correlation between the changes in the three metabolic parameters of the axillary LNs and the changes in disease activity after treatment. After 6 months of biologic therapy, all metabolic parameters for the axillary LNs in patients with a DAS28-ESR < 3.2 were significantly lower than those of patients with a DAS28-ESR ≥ 3.2.Conclusion: A relationship between the glucose metabolism of the axillary LNs and the ipsilateral wrist joints was demonstrated by the 18F-FDG-PET/CT parameters. The metabolic activity and active volume of axillary LNs may reflect the therapeutic response to the biologic treatment of RA.

Presence of protein phosphatase type 1 and its involvement in temperature-dependent flagellar movement of fowl spermatozoa.

Even in the presence of ATP, the motility of demembranated fowl spermatozoa was negligible at the avian body temperature of 40 degrees C. Motility could be restored by the addition of calyculin A, okadaic acid, specific inhibitors of phosphatase type 1 (PP1) and PP-2A, and inhibitor 1 or inhibitor 2, which are specific inhibitors of protein phosphatase type 1 (PP1). Demembranated spermatozoa, stimulated by calyculin A or okadaic acid, lost their motility following the addition of 1 mM CaCl2, but this was restored gradually by the stepwise addition of EGTA. Immunoblotting of sperm extract using an antibody to PP1 revealed a major cross-reacting protein of 36-37 kDa, which corresponded to the molecular weight of the known catalytic subunit of PP1. These results suggest that PP1 present in the fowl sperm axoneme may be involved in the inhibition of fowl sperm motility at 40 degrees C via Ca(2+)-dependent regulatory systems.

[Analysis of urinary tract infections in hospitalized elderly patients, with particular reference to the use of diapers].

We investigated the clinical and laboratory data of 215 hospitalized patients (mean age were 76.9 +/- 12.1) to analyze both the characteristics of senile UTI and the influence of the way of urination. UTI was present in 121 of 1897 patients (6.4%), 95 of whom (78.5%) were female. Comparison of the parameters between non-infected and infected patients were as follows: body temperature was 36.57 +/- 0.64 degrees C vs. 37.49 +/- 0.77 degree C; WBC, 5410 +/- 2040/microliters vs. 7260 +/- 3230/microliters; CRP, 1.2 +/- 2.4 mg/dl vs. 3.5 +/- 3.4 mg/dl; mean class of urinary RBC, 0-1/hpf vs. 3-5/hpf; and mean class of urinary WBC, 5-10/hpf vs. 30-50/hpf. All parameters were significantly elevated (p < 0.001) in the patients with UTI. The rate of detection of causative bacteria was 88.7%; with 14.8% Escherichia coli, 12.8% Providencia species, 9.6% Enterococci, and 8.7% Pseudomonas aeruginosa. Patients with UTI were divided into three groups according to their method of urination: normal urination, use of diapers and catheterization. Body temperature (> or = 37.5 degrees C) was 2.8%, 10.1% and 34.9%; WBC (> or = 9.000), 2.7%, 6.1%, and 14.3%; CRP, 16.9%, 36.1% and 51.1%; urine RBC (> or = 6-10/hpf), 8.4%, 7.1% and 36.1%; urine WBC (> or = 15-30/hpf), 20.4%, 44.4% and 76.9%, respectively. There was a significant difference (p < 0.05-0.001) between all parameters except for urine RBC between the normal-urination patients and diaper using patients. This investigation suggested that the use of diapers was a risk factor for UTI in elderly patients.

[Detection of antibody specific to rifampicin metabolite by ELISA--mechanism of sensitization by rifampicin].

A 46-year-old male tuberculosis patient developed acute renal failure and liver dysfunction following the oral administration of rifampicin (RFP). The mechanism of the reaction was examined by means of enzyme-linked immunosorbent assay (ELISA). 3-formylrifamycin-SV (Formylrifamycin), which is one of RFP metabolites, was conjugated to human serum albumin. ELISA was performed with this conjugate (Formylrifamycin-HSA) as an antigen. We also evaluated 100 tuberculosis patients receiving oral RFP and 45 healthy volunteers in order to determine the incidence of sensitization by RFP. IgG and IgM antibodies specific to Formylrifamycin-HSA were detected in serum from the patient with RFP-induced renal failure. Among the IgG subclasses, IgG1 antibody was detected. IgG and IgG1 antibodies specific to Formylrifamycin-HSA were detected in serum from only one of the 100 tuberculosis patients. Our results indicate that sensitization to RFP can occur on oral administration, and that acute renal failure was caused by IgG, IgM, and IgG1 antibodies specific to Formylrifamycin as a hapten.

[A case of food-dependent exercise-induced anaphylaxis].

A 15-year-old man with food-dependent exercise-induced anaphylaxis is reported. The patient had begun to run 4 hours after he had lunch on fried shrimps. When running about 2000 m, he suffered from general cutaneous erythema with itching, urticaria, angioedema of face and dyspnea. He had experienced the similar episodes associated with postprandial exercise before. Skin test and IgE-RAST were positive for shrimp. Exercise challenge test after having 20 g boiled shrimp was conducted, and the elevation of plasma histamine level was recognised. 25 cases with food-dependent exercised-induced anaphylaxis have reported in Japan. 13 of 25 cases were related with wheat, and 10 cases were related with shrimp. 14 of 25 cases had experienced the similar episodes. Exercise as part of planned health program has virtually mushroom world-wide. Therefore, the fact that anaphylaxis can be a complication of such exercise must be recognised if appropriate prevention and treatment are to be administered.

[The inhibitory effects of anti-asthmatic agents on ethanol-induced bronchoconstriction in Japanese asthmatic patients].

Asthmatic symptoms are worsened after drinking small amounts of alcoholic beverages in Japanese asthmatic patients. Our previous results showed that the ingestion of pure ethanol caused a fall in FEV1.0 in about half of the Japanese asthmatics we studied. We studied the inhibitory effects of pretreatment with three kinds of anti-asthmatic agents on ethanol-induced bronchoconstriction in six Japanese asthmatic patients. We tested oral cyproheptadine hydrochloride (8 mg), which is an anti histamine agent, inhaled disodium cromoglycate (2 mg), which has an inhibitory effect on the release of chemical mediators from mast cells, and inhaled atropine sulfate (3 mg), which is an anti-cholinergic agent. Pretreatment with cyproheptadine significantly inhibited the fall in FEV1.0 120 minutes after ethanol challenge (p less than 0.05). Inhaled DSCG had significant inhibitory effects on the fall in FEV1.0 15 and 30 minutes after ethanol challenge (p less than 0.05). Inhaled atropine had no inhibitory effect. These results suggest that histamine, released from mast cells, plays an important role in ethanol induced bronchoconstriction in Japanese asthmatic patients.

[Function of the shoulder joint after pectoralis major transfer--tracking movement and its electromyographical study].

In 11 cases of pectoralis major transfer, tracking movement was performed in the scapular and sagittal planes for both shoulder joints to compare the tracking movement ability of the operated shoulder and the unoperated shoulder. At the same time, electromyograms were taken of the upper trapezius, the middle deltoideus, the pectoralis major and the rhomboideus to compare the EMG amplitude of the operated shoulder and the unoperated shoulder. For all movement at average values, tracking movement ability was better in the operated shoulder. From these findings, it is thought that pectoralis major transfer increases shoulder stability at the time of movement. The increase in EMG amplitude of pectoralis major of the operated shoulder is considered to result from the action of the transferred pectoralis major, which serves as an effective abductor of the scapula, also taking into account the early occurrence of scapular abduction.

Regulation of flagellar motility of fowl spermatozoa: evidence for the involvement of intracellular free Ca2+ and calmodulin.

The possible role of intracellular free Ca2+ and calmodulin in the regulation of fowl sperm motility was investigated using an intracellular Ca2+ chelator, 1,2-bis (2-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid, tetraacetoxymethyl ester (BAPTA/AM) and calmodulin antagonists such as N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (W-7), N-(6-aminohexyl)-1-naphthalenesulfonamide hydrochloride (W-5) and trifluoperazine. Intact fowl spermatozoa maintained vigorous movement in a Ca(2+)-free medium at 30 degrees C. In contrast, the motility of spermatozoa loaded with BAPTA/AM was negligible at 30 degrees C, but could be instantly restored by the addition of 2 mmol CaCl2 l-1. At this time, the intracellular free Ca2+ concentrations increased from 0 to about 100 nmol l-1, as measured by the fluorescent Ca2+ indicator fura-2. At 40 degrees C, neither control nor BAPTA/AM-treated spermatozoa were motile, but the motility of both kinds of spermatozoa was restored by the subsequent addition of 2 mmol CaCl2 l-1. Even in the presence of 2 mmol CaCl2 l-1, the addition of W-7 and trifluoperazine inhibited the motility of intact spermatozoa at 30 degrees C and 40 degrees C, and induced a concomitant decrease in the rate of oxygen consumption and ATP concentration, suggesting that energy depletion might be involved in the inhibition of motility. In contrast, the motility of demembranated spermatozoa was not inhibited by the addition of W-7 and trifluoperazine at 30 degrees C. The addition of W-5, a weaker antagonist, did not appreciably affect the motility of either intact or demembranated spermatozoa.(ABSTRACT TRUNCATED AT 250 WORDS)

[Six cases of allergic bronchopulmonary aspergillosis].

Six cases of allergic bronchopulmonary aspergillosis (ABPA) were evaluated. In four cases, diagnosis and steroid therapy were delayed, which resulted in irreversible pulmonary dysfunction. The important points for early diagnosis were: (1) Differentiation from pulmonary tuberculosis, (2) the presence of bronchial asthma was not essential for diagnosis, and (3) fungi other than Aspergillus fumigatus might cause this syndrome.