Early use of donepezil against psychosis and cognitive decline in Parkinson's disease: a randomised controlled trial for 2 years.

Objectives: Brain acetylcholine is decreased even in patients with cognitively preserved Parkinson's disease (PD). We investigated whether early and long-term use of donepezil prevents psychosis in non-demented PD patients.

Methods: A double-blinded, placebo-controlled trial was conducted.

Neutrophil extracellular traps in neuropathy with anti-neutrophil cytoplasmic autoantibody-associated microscopic polyangiitis.

To clarify the roles of neutrophils in anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitic neuropathy, we studied neutrophil extracellular traps (NETs) in peripheral nerve vasculitis. Stored nerve samples from 17 patients with microscopic polyangiitis (MPA) were immunohistochemically analyzed using antibodies for citrullinated histone H3 (citH3) and various neutrophil enzymes. We defined merged citH3 and extracellularly released myeloperoxidase (MPO) as NET formation.

Impact of glucocerebrosidase mutations on motor and nonmotor complications in Parkinson's disease.

Homozygous mutations of the glucocerebrosidase gene (GBA) cause Gaucher disease (GD), and heterozygous mutations of GBA are a major risk factor for Parkinson's disease (PD). This study examined the impact of GBA mutations on the longitudinal clinical course of PD patients by retrospective cohort design. GBA-coding regions were fully sequenced in 215 PD patients and GD-associated GBA mutations were identified in 19 (8.

[Pneumonitis induced by rifampicin].

An 86-year-old male with pulmonary tuberculosis developed fever, rash, and interstitial pneumonia 3 weeks after the beginning of treatment with isoniazid (INH), rifampicin (RFP), and ethambutol (EB). Chest CT showed new infiltration shadows that were diffuse bilateral ground-glass opacities mixed with dense consolidation and septal thickening, accompanied by a small amount of pleural effusion. Drug-induced pneumonitis was suspected, and therefore the antituberculous regimen was discontinued.

Two subtypes of Churg-Strauss syndrome with neuropathy: the roles of eosinophils and ANCA.

The aim of this study was to clarify the differences in the pathogenesis of neuropathy between myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-positive and -negative patients with Churg-Strauss syndrome (CSS). Eight MPO-ANCA-positive and 14 MPO-ANCA-negative patients were included. In addition to the standard histology, nerve biopsies were examined, employing immunohistochemistry for eosinophil major basic protein and electron microscopy.

Hypoxia-inducible factor 1alpha may be a marker for vasculitic neuropathy.

Neuromuscular biopsy is still an essential method for diagnosing vasculitic neuropathy, although its diagnostic sensitivity is at most 60%. Our objective was to examine the expression of hypoxia-inducible factor 1alpha (HIF-1alpha) in peripheral nerves and to evaluate its usefulness in diagnosing vasculitic neuropathy, especially for discrimination from other axonal neuropathies. Forty-one patients with vasculitic neuropathy consisting of 20 definite, 14 probable and seven possible diagnoses, 15 patients with metabolic neuropathy, five with motor neuron disease and six with chronic inflammatory demyelinating polyneuropathy were included.

Novel intramedullary plug with sliding mechanism used in revision total knee arthroplasty.

A novel intramedullary plug with sliding mechanism has been developed and evaluated clinically in the settings of revision total knee arthroplasty (TKA). The new plug consists of a pair of specially designed components. Each component is shaped like an obliquely cut cylinder.

[Falls in peripheral neuropathy].

Falling accidents are predisposing factors in worsening the quality of life. Causes of falls included gait and balance problems, visual disorder, cognitive impairment and drugs. However, falls in neuropathic patients are not often investigated.

Therapeutic potential of growth factors for aging voice.

Objectives/hypothesis: It has been reported that in aged vocal folds, dense collagen deposition takes place and hyaluronic acid decreases in the lamina propria, which are thought to contribute to the vocal problems occurring with age (presbyphonia). To restore aged vocal folds to their younger state, it seems crucial to address these age-related lamina propria changes. Intervention that might increase hyaluronic acid and decrease collagen would appear to be a potentially useful approach.

Olfactory groove schwannoma--case report.

A 30-year-old man presented with a 2-year history of intermittent headache. No neurological deficit was detected. Computed tomography (CT) and magnetic resonance imaging showed a tumor with a diameter of 2.

Prevention of vocal fold scarring by topical injection of hepatocyte growth factor in a rabbit model.

Objectives/hypothesis: Vocal fold scarring disrupts the layer structure of the vocal fold lamina propria that is essential for optimal mucosal vibration. Prevention of vocal fold scarring remains challenging. Hepatocyte growth factor (HGF) has strong antifibrotic activity.

Adiponectin in anorexia nervosa and bulimia nervosa.

To study the role of adiponectin, a novel adipocyte-specific secreted protein, on the pathophysiology of eating disorders, circulating levels of fasting adiponectin, leptin, insulin, and glucose were measured in 31 female patients with anorexia nervosa (AN) and in 11 with bulimia nervosa. Hormone levels were compared with 16 age-matched, normal body weight controls, six healthy constitutionally thin subjects, and nine obese subjects. Moreover, changes in levels were reevaluated after nutritional treatment and weight gain in 13 patients with AN.

Anaphylaxis following administration of intravenous methylprednisolone sodium succinate in a renal transplant recipient.

Methylprednisolone sodium succinate (MPS) is widely used in the management of renal transplantation. Of interest is the rare occurrence of anaphylaxis and anaphylactoid reaction to MPS. We report on a patient who developed anaphylaxis following the intravenous administration of MPS during a renal transplant operation.

Three novel mutations in Japanese patients with 21-hydroxylase deficiency.

Objective: This study analyzed the mutation of 21-hydroxylase deficiency (21-OHD) in 36 unrelated Japanese patients with congenital adrenal hyperplasia (CAH).

Methods: All the exons of the functional CYP21 gene (CYP21A2) were analyzed by polymerase chain reaction (PCR) and PCR direct sequencing.

Results: Apparent gene deletions and conversions were present in 23.

Antiatherogenic effect of pioglitazone in type 2 diabetic patients irrespective of the responsiveness to its antidiabetic effect.

Objective: Thiazolidinediones (TZDs), a class of insulin-sensitizing agents used clinically to treat type 2 diabetes, are also antiatherogenic. This study was designed to elucidate the relationship between the antiatherogenic and antidiabetic effects of pioglitazone, a TZD, in type 2 diabetic patients.

Research Design And Methods: A total of 136 Japanese type 2 diabetic patients were included and divided into two groups: the pioglitazone-treated group (30 mg daily for 3 months) (n = 70) and the untreated control group (n = 66).

Acceleration of aneurysm healing by controlled release of basic fibroblast growth factor with the use of polyethylene terephthalate fiber coils coated with gelatin hydrogel.

Objective: The aims of this study were to develop an endovascular delivery system containing gelatin hydrogels for the controlled release of basic fibroblast growth factor (bFGF) with the use of polyethylene terephthalate fiber coils and to analyze whether such a system would promote healing in an experimental aneurysm.

Methods: Carotid aneurysms were constructed in 66 rabbits with venous pouches. The polyethylene terephthalate fiber coils coated with and without gelatin hydrogels with different water volumes containing 0, 10, 50, and 100 microg bFGF were implanted into the aneurysms.

A novel femoral intramedullary plug with sliding mechanism.

A novel femoral intramedullary plug with a sliding mechanism has been developed and evaluated clinically. The new plug consists of a pair of specially designed components, each shaped like an obliquely cut cylinder. Postoperative plain radiographs of 30 arthroplasties using the plug were examined for cement leakage, plug migration, and radiolucent line formation between the cement and the femoral cortex.

[Clinical importance of serum anti-p53 antibodies as tumor markers].

Anti-p53 antibodies are autoantibodies induced by mutation of p53 cancer-suppressor gene, and are considered to be indirect markers for p53 gene mutations and abnormally high p53 gene levels. We evaluated the usefulness of the measurement of anti-p53 antibodies by enzymed-linked immunosorbent assay using serum samples from patients with various disorders and normal subjects. The anti-p53 antibody concentration was high in patients with lung, esophageal, gastric, hepatocellular, colonic, rectal or ovarian cancer and significantly differed between the group with neoplasms and those with non-neoplastic disorders.

Adult-onset idiopathic hypogonadotropic hypogonadism presented with erectile and ejaculatory disorder.

A 37-year-old man who had fathered a child five years previously presented with erectile and ejaculatory disorder. Endocrinological examinations revealed isolated luteinizing hormone-releasing hormone (LHRH) deficiency of hypothalamus, resulting in hypogonadotropic hypogonadism, and no causative abnormality was detected in imaging studies, including magnetic resonance imaging (MRI). Having a diagnosis of adult-onset hypogonadotropic hypogonadism, the patient received pulsatile subcutaneous administration of gonadotropin-releasing hormone (GnRH).

The phytochemical lindleyin, isolated from Rhei rhizoma, mediates hormonal effects through estrogen receptors.

Some plant compounds or herb mixtures are popular alternatives to conventional therapies and contain organic compounds that bind to some nuclear receptors, such as the estrogen receptor (ER), to exert various biological effects. We studied the effect of various herbal extracts on ERalpha and ERbeta isoforms. One herbal extract, Rhei rhizoma (rhubarb), acts as an agonist to both ERalpha and ERbeta.

Radiation-induced cerebral aneurysm successfully treated with endovascular coil embolization.

In a 30-year-old male, multiple cerebral aneurysms developed 19 years after receiving 60 Gy of irradiation for craniophariginoma. Angiogram revealed right IC-PC and upper basilar trunk aneurysms in addition to atherosclerotic change. The right IC-PC aneurysm was wrapped and the basilar trunk aneurysm located between the origins of SCA and AICA was treated by endovascular coil embolization.

Treatment of unruptured cerebral aneurysms--a multi-center study of Japanese national hospitals.

The treatment and natural course of unruptured cerebral aneurysms were analyzed in 427 cases of unruptured cerebral aneurysm registered at five Japanese national hospitals. Of these cerebral aneurysms 295 were treated by craniotomy, and 22 with endovascular coil embolization. Neurological deterioration after treatment occurred in 31 (9.