A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multi-immunosuppressive therapy.

The prognosis of interstitial pneumonia in patients with dermatomyositis is thought to depend on the histologic type and response to therapy. We report a case of hypomyopathic dermatomyositis with rapid development of a fatal interstitial pneumonia. Although the histology of lung biopsy indicated minimal alveolitis, the patient died despite multi-immunosuppressive therapy.

Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis.

Study Design: Retrospective case series.

Objectives: To assess the efficacy of posterior spinal shortening for paraparetic patients following vertebral collapse owing to osteoporosis, especially on instrumentation loosening.

Setting: Department of orthopaedic surgery, Jichi Medical University Hospital and Omiya Medical Center in Japan.

Antisynthetase syndrome associated with sarcoidosis.

A 30-year-old man complained of polyarthralgia and fatigue. The clinical findings and laboratory data included myositis, polyarthritis, interstitial pneumonia, Raynaud's phenomenon, mechanic's hand, and anti PL-7 antibody (threonyl-tRNA synthetase antibody). All of these signs were consistent with antisynthetase syndrome.

Monocyte chemoattractant protein-1 A-2518G gene polymorphism and renal survival of Japanese patients with immunoglobulin A nephropathy.

Background: Monocyte chemoattractant protein (MCP)-1 is closely related to the pathogenesis of the progression of various chronic renal diseases, including IgA nephropathy (IgAN), through its chemoattractant effect on macrophages. However, the correlation of MCP-1 gene polymorphism with the long-term prognosis of Japanese patients with IgAN has not been clearly determined yet.

Methods: We investigated 277 Japanese patients diagnosed with IgAN based on renal biopsy to clarify the association between the progression of IgAN and MCP-1 gene polymorphism at position A-2518G, which regulates the transcription of the MCP-1 gene.

Sporotrichosis in a husband and wife.

Familial occurrence of sporotrichosis is rare. We report two patients, a husband and wife, with sporotrichosis. A 67-year-old man and a 63-year-old woman, who were farmers, had erythematous plaques and nodules on their faces and his forearm.

Alteration in risk factor accumulations of acute myocardial infarction during the last one decade: analysis of patients admitted in Coronary Care Unit.

The present study was undertaken to determine accumulation of risk factors in acute myocardial infarction during two periods of 2002 and 1990-1991. We collected 173 and 153 patients with acute myocardial infarction in 2002 and 1990-1991, respectively, and analyzed the history of multiple risk factors, including diabetes mellitus, impaired glucose tolerance, hyperlipidemia, hypertension and obesity, and laboratory findings. The numbers and their percentages of all the risk factors increased in 2002 compared with 1990-1991.

[Hormones and hemodynamics in edematous diseases].

Clinical and laboratory experiments have demonstrated that arginine vasopressin (AVP), renin-aldosterone system and catecholamines play a crucial role in water and sodium retention in edematous diseases, including congestive heart failure, nephrotic syndrome and liver cirrhosis. These hormonal secretions are all increased mediated through baroreceptor mediated afferent pathway, in which the tonic inhibition of hormonal release is attenuated by decreased effective circulatory blood volume. Increased plasma hormones augment their action in renal tubules.

Mechanical stress promotes the expression of smooth muscle-like properties in marrow stromal cells.

Objective: It is poorly understood what kind of factors are involved in lineage commitment and maturation of mesenchymal stem cells. The present study investigates whether mechanical stress promotes expression of smooth muscle cell (SMC)-specific cytoskeletal protein in marrow stromal cells.

Methods: Fibroblast-like stromal cells expressing STRO-1 antigen were isolated from rat bone marrow by density gradient separation.

Unilateral active adrenal tuberculosis featuring persistent intermittent fever.

The adrenal gland is one of the organs which tuberculosis infects. In most clinical settings bilateral adrenal tuberculosis has been clarified after adrenal insufficiency is overt. On the contrary, active adrenal tuberculosis is rarely detected during the survey of infectious disease.

Life style risks of Parkinson's disease: association between decreased water intake and constipation.

Gastrointestinal dysfunction, especially constipation, is one of the major problems in the daily life of patients with Parkinson's disease (PD). About 60 to 80% of PD patients suffer from constipation. Several studies have proven that constipation appears about 10 to 20 years prior to motor symptoms.

Ruptured vertebral artery-posterior inferior cerebellar artery aneurysm associated with pulseless disease--case report.

A 48-year-old woman with a 29-year history of pulseless disease presented with subarachnoid hemorrhage caused by a rare ruptured intracranial aneurysm of the right vertebral-posterior inferior cerebellar artery. The aneurysm was successfully clipped. Pulseless disease is a chronic and nonspecific vasculitis involving mainly the aorta and its main branches such as the carotid, subclavian, vertebral, and coronary arteries.

Pathological role of aquaporin-2 in impaired water excretion and hyponatremia.

In the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), inappropriately elevated secretion of vasopressin can result in a reduction of antidiuretic efficacy: a phenomenon known as 'vasopressin escape'. We compared experimental SIADH with 1-deamino-8-d-arginine vasopressin (dDAVP)-excess rats, where both groups received continuous subcutaneous administration of dDAVP by osmotic minipump but the SIADH rats also received a liquid diet that induced hyponatraemia. The SIADH rats, but not the dDAVP excess rats, showed a marked attenuation of urinary concentrating ability.

Full-blown Cushing's disease after an episode of pituitary apoplexy.

The present study reports a rare case of full-blown Cushing's disease several years after an episode of pituitary apoplexy. A 60 year-old woman complained of muscular weakness and generalized malaise. Ten years ago she had an episode of pituitary apoplexy.

Hyponatremia and/or hyperkalemia in patients treated with the standard dose of trimethoprim-sulfamethoxazole.

Objective: High-dose trimethoprim-sulfamethoxazole (TMP-SMX) is known to cause hyperkalemia by blocking amiloride-sensitive sodium (Na) channels in distal nephrons. The purpose of this study was to establish whether the standard dose of TMP-SMX could cause electrolyte disorders.

Methods And Patients: Serum Na, potassium (K) and creatinine (Cr) levels were examined retrospectively in 53 of 77 patients prescribed TMP-SMX, before and after taking the antibiotic combination.

A case of nonscarring subepidermal blistering disease associated with autoantibodies reactive with both type VII collagen and laminin 5.

A 35-year-old Japanese woman had recurrent, pruritic, vesicular lesions on the face, neck and upper back as well as erosive lesions of the oral cavity and genitalia. The skin and mucosal lesions healed without scarring upon the systemic administration of corticosteroid and azathioprine. Direct immunofluorescence revealed linear deposits of IgG, IgA and C3 at the cutaneous basement membrane zone.

New enzymatic assay for glycohemoglobin.

Background: Previous methods to measure glycohemoglobin (GHb) have been time-consuming or imprecise; we therefore developed a new enzymatic assay for GHb.

Methods: Blood cells were first hemolyzed, and hemoglobin was digested with protease to yield fructosyl amino acid. Fructosyl amino acid oxidase acts on the fructosyl amino acid and generates hydrogen peroxide, which reacts with chromogens in the presence of peroxidase.

[Nephrogenic diabetes insipidus associated with mutations of vasopressin V2 receptors and aquaporin-2].

Nephrogenic diabetes insipidus has two types of X-linked and autosomal recessive inheritance. The former is the mutations of arginine vasopressin (AVP) V2 receptors that have had 155 mutations in 239 families in the literature. The latter is the mutations of aquaporin-2(AQP-2) water channel, which have had 11 mutations.