The Absence of Prion-Like Infectivity in Mice expressing Prion Protein-Like Protein

Cellular prion protein, PrP^C, undergoes pathogenic structural conversion into the proteinase K (PK)-resistant isoform, PrP^Sc, to constitute a nucleic acid-free infectious agent, so called a prion. To determine whether a recently identified PrP-like protein, named PrPLP/Dpl, could also be transformed to a prion-like protein, we intracerebrally inoculated a mouse-adapted Fukuoka-1 prion into Ngsk and Zrch I mice either homozygously (Prnp^0/0) or heterozygously (Prnp^0/+) devoid of PrP^C. Only the former expressed PrPLP/Dpl ectopically in the brains, particularly in neurons. Ngsk Prnp^0/+ and Zrch I Prnp^0/+ mice similarly developed the disease. The diseased Ngsk Prnp0/+ mice transmitted the disease to the mice expressing PrP^C but not to the mice expressing PrPLP/Dpl, showing abundant accumulation of PrP^Sc but not PK-resistant PrPLP/Dpl in the brains. Moreover, the inoculated Ngsk Prnp^0/0 mice neither developed the disease nor produced any infectivity transmissible to PrPLP/Dpl-expressing mice. These results indicate that PrPLP/Dpl have no potential to undergo pathogenic conversion to form a prion-like infectious particle

Toward understanding transcriptional regulatory networks in abiotic stress responses and tolerance in rice

長崎大学学位論文 [学位記番号]博（医歯薬）甲第1168号 [学位授与年月日]令和元年6月5

Chemical Pleurodesis Could Exacerbate Lymphedema of Yellow Nail Syndrome

Chemical pleurodesis is sometimes performed for the management of intractable pleural effusion. We describe a woman with yellow nail syndrome (YNS), which is characterized by yellow discoloration of the nails, lymphedema, and pleural effusion. At the age of 43, she was hospitalized with edema of the lower limbs. Despite a number of medical treatments, massive lymphedema of lower limbs developed over a period of three years, resulting in skin cracks and subsequent infection, septicemia and multiple organ failure. At autopsy, abnormally dilated lymph and blood vessels were evident in soft tissue throughout the whole body. She had undergone chemical pleurodesis at 36 years of age for reduction of pleural effusion associated with YNS. Our case illustrates possible complication of chemical pleurodesis to YNS, which resulted in accumulation of lymph flow into the lower half of the body

Receptor Autoradiographic Analysis of Muscarinic Receptors in the Rat Atrioventricular Node

We carried out investigations on muscarinic acetylcholine receptors (m-AChR) in the rat heart, including the atrioventricular (AV) node. The related tissue sections were incubated with 3H-quinuclidinyl benzilate (3H-QNB), then autoradiography and an image analysis coupled with computer-assisted microdensitometry were done. A single type of specific and high affinity binding sites of 3H-QNB was found to be highly concentrated in the AV node, the maximum binding capacity (Bmax) being 1.4 pmol/mg protein and with a dissociation constant (Kd) of 0.5 nM. The density and affinity of the binding to the AV node were the highest, when compared with findings in the atrium (interatrial septum) and ventricle (interventricular septum). The binding was competitively displaced by AF-DX 116, a selective antagonist for the M2 AChR subtype, with a high affinity, whereas pirenzepine, an antagonist for the M1 AChR subtype was much less potent in displacing the binding. Therefore, vagal-cholinergic stimulation presumably plays a significant role in functions of the rat AV node, probably by interacting with the specific, high affinity M2 AChR subtype

Development of eosinophilic granulomatosis with polyangiitis during the clinical course of microscopic polyangiitis: A case report

Rationale: Eosinophilic granulomatosis with polyangiitis (EGPA) is belongs to the antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) subgroups. EGPA, unlike other subgroups of AAV, including microscopic polyangiitis (MPA) and granulomatosis with polyangiitis, has the unique feature that both ANCA and eosinophilic inflammation are involved in its pathogenesis. Although AAV often relapses, there are currently no reports of EGPA developing during other subgroups of AAV. Herein, we document a case of EGPA that developed during the clinical course of MPA.Patient concerns: A 61-year-old Japanese woman was diagnosed with MPA based on interstitial lung disease and myeloperoxidase-ANCA positivity. After starting immunosuppression therapy, including prednisolone and tacrolimus, she was expected to achieve clinical remission. Nonetheless, she occasionally experienced MPA relapse, which required an increased prednisolone dose, rituximab, intravenous cyclophosphamide, and plasma exchange. Three years after MPA onset, she developed renal amyloidosis; thus, subcutaneous tocilizumab was added to her regimen. Following clinical remission, the administration interval of her subcutaneous tocilizumab therapy was extended and immunosuppressants were discontinued. She then developed bronchial asthma and mild eosinophilia (eosinophilic count: ~1000/μL). Further, a year later, she underwent total hip replacement using a titanium implant. Subsequently, she developed abnormal sensation in both hands, numbness, and muscle weakness, as well as palpable purpura and massive eosinophilia (eosinophilic count: ~8500/μL).Diagnosis: We diagnosed the patient with EGPA based on 5 items (asthma, multiple mononeuropathies, sinus abnormality, and extravascular eosinophils) of the 1990 American College of Rheumatology classification criteria.Interventions: We administered 400 mg/kg intravenous immunoglobulin for 5 consecutive days, 300 mg mepolizumab subcutaneously every 4 weeks, and 40 mg/day prednisolone following pulsed methylprednisolone therapy (1000 mg/day for 3 consecutive days).Outcomes: After these treatments, the patient’s symptoms improved, and eosinophilic count and inflammatory markers declined.Lessons: The present case suggests that EGPA can be induced by the development of eosinophilic inflammation in other subgroups of AAV.Abbreviations: AAV = ANCA-associated vasculitis, ANCA = antineutrophil cytoplasmic autoantibody, CCL = chemokine (C–C motif) ligands, CRP = C-reactive protein, EGPA = eosinophilic granulomatosis with polyangiitis, IL = interleukin, ILC2 = group 2 innate lymphoid cells, ILD = interstitial lung disease, MPA = microscopic polyangiitis, MPO = myeloperoxidase, mPSL = methylprednisolone, PSL = prednisolone, TAC = tacrolimus, TCZ = tocilizumab, Th2 = T helper 2

Histochemical Nature of Eosinophilic Globules in Pheochromocytoma of Adrenal Medulla

Eosinophilic globules were observed in 7 out of 11 cases of pheochromocytoma of the adrenal medulla. All of these globules were present in the cytoplasm, and were round and eosinophilic, measuring 3 μm to 30 μm in diameter. These globules were periodic acid Schiff (PAS) -positive with and without diastase predigestion, phosphotungstic acid hematoxylin (PTAH) positive, acid fuchsin positive, and autofluorescent under ultraviolet illumination. These findings were very similar to the eosinophilic globules of yolk sac tumor, hepatocellular carcinoma, Kaposi\u27s sarcoma, and alpha-l-antitrypsin deficiency in light microscopy and histochemistry. They were not stained with Grimelius\u27s method for argyrophil reaction, and Fontana-Masson\u27s method for argentaffin reaction. It might be suggested that eosinophilic globules in pheochromocytoma of the adrenal medulla were not related to the chromaffin secretory granules and these globules were glycoprotein

Analysis of mRNA expression for steroidogenic enzymes in the remaining adrenal cortices attached to adrenocortical adenomas.

DESIGN AND METHODS: We have recently demonstrated that the adrenal cortices attached to aldosterone-producing adenoma (APA) contained microscopic subcapsular micronodules suggestive of active aldosterone production. In this study, we used in situ hybridization to investigate the mRNA expression of steroidogenic enzymes in the adrenal cortices attached to cortisol-producing adenoma (CPA) and clinically silent adenoma (non-functioning adenoma; NFA), in addition to APA. RESULTS: Microscopic subcapsular micronodules, which were several hundreds of micrometers in size and spheroid in shape, were observed in the cortices attached to CPA and NFA, as well as APA, at high frequency. Most of the cortical nodules in zona fasciculata to zona reticularis showed a suppressed steroidogenesis in the cortices attached to adenoma, but some expressed intensely all necessary steroidogenic enzyme mRNAs for cortisol synthesis. CONCLUSIONS: It is thus necessary to keep in mind, on the occasion of subtotal adrenalectomy, that lesions with the potential to later develop into functional adrenocortical nodules may be present in other parts of the ipsilateral or contralateral adrenal cortices

The Japanese Clinical Practice Guideline for acute kidney injury 2016

Acute kidney injury (AKI) is a syndrome which has a broad range of etiologic factors depending on different clinical settings. Because AKI has significant impacts on prognosis in any clinical settings, early detection and intervention are necessary to improve the outcomes of AKI patients. This clinical guideline for AKI was developed by a multidisciplinary approach with nephrology, intensive care medicine, blood purification, and pediatrics. Of note, clinical practice for AKI management which was widely performed in Japan was also evaluated with comprehensive literature search

The Common Genetic Variant rs944289 on Chromosome 14q13.3 Associates with Risk of Both Malignant and Benign Thyroid Tumors in the Japanese Population

Background: Several single nucleotide polymorphisms (SNP) have been identified to be associated with the risk for differentiated thyroid cancer in populations of distinct ethnic background. The relationship of these genetic markers to a benign tumor of the thyroid, follicular adenoma (FA), is not well established. Methods: In a multicenter retrospective case-control study, five thyroid cancer-related SNPs - rs966513 (9q22.33, FOXE1), rs944289 (14q13.3, PTCSC3), rs2439302 (8p12, NRG1), rs1867277 (9q22.23, FOXE1), and rs6983267 (8q24, POU5F1B) - were genotyped in 959 cases of histologically verified FA, 535 papillary thyroid carcinomas (PTC), and 2766 population controls. Results: A significant association was found between FA and rs944289 (p=0.002; OR 1.176 [CI 1.064-1.316]), and suggestively with rs2439302 (p=0.033; OR 1.149 [CI 1.010-1.315]). In PTC, significant associations were confirmed for rs965513 (p=4.21E-04; OR 1.587 [CI 1.235-2.000]) and rs944289 (p=0.003; OR 1.234 [CI 1.075-1.408]), newly found for rs2439302 (p=0.003; OR 1.266 [CI 1.087-1.493]) and rs1867277 (p=1.17E-04; OR 1.492 [CI 1.235-1.818]), and was not replicated for rs6983267 (p=0.082; OR 1.136 [CI 0.980-1.316]) in this series. A significant correlation between rs2439302 genotype and relative expression of NRG1 was detected in normal and tumor counterparts of PTC (about 10% decrease per each risk allele). NRG1 expression also significantly correlated with that of PTCSC3. Conclusions: Association of rs944289, which was previously known to confer risk for thyroid cancer, with FA, and the correlation between PTCSC3 and NRG1 expression demonstrates that predisposing genetic factors are partly common for benign and malignant thyroid tumors, and imply broader roles of the pathways they underlie in thyroid tumorigenesis, not limited to carcinogenesis