Silent cerebral infarction predicts vascular events in hemodialysis patients

Silent cerebral infarction predicts vascular events in hemodialysis patients.BackgroundCardiovascular disease is the leading cause of death in hemodialysis (HD) patients. We have previously reported a higher incidence of silent cerebral infarction (SCI) in HD patients compared with the control group using MRI studies. In the present study, we examined whether or not SCI could predict vascular events in HD patients.MethodsCranial magnetic resonance imaging (MRI) was performed on 119 HD patients without symptomatic cerebrovascular disease. SCI was detected by MRI, and the patients were prospectively followed up. The end points of the study were the incidence of major events related to vascular events (cerebral events, cardiac events, and sudden deaths). We investigated the prognostic role of SCI in cerebral, cardiac, and vascular events by using the Kaplan-Meier method and Cox proportional hazards analysis.ResultsThe prevalence of SCI was 49.6% in HD patients. During a follow-up period of maximum 60 months, vascular events, which included 13 cerebral events, 5 cardiac events, and 3 sudden deaths, occurred in 21 patients. The presence of SCI was predictive for a higher cerebral and vascular morbidity compared to the absence of SCI [18.6% (N = 11) vs. 3.3% (N = 2), P = 0.0169, and 30.5% (N = 18) vs. 5.0% (N = 3), P = 0.0006, respectively]. By multivariate Cox proportional hazards analysis, SCI remained a powerful independent predictor of cerebral and vascular events (hazard ratio for cerebral events 7.33, 95% CI 1.27–42.25: for vascular events 4.48, 95% CI 1.09–18.41).ConclusionThe findings of the present study indicate that the presence of SCI is a new risk factor for vascular events in HD patients

膀胱Nephrogenic adenomaの2例(本邦報告例の文献的考察)

症例1は72歳女.尿管腫瘍に対する腎尿管全摘術8ヵ月後の膀胱鏡時に膀胱腫瘍を認めた.症例2は57歳女.5回のTUR-Btの後に計6回のBCG膀胱内注入療法を行い, その後の膀胱鏡で2個の膀胱腫瘍を認めた.2例ともTUR-Btを施行.組織学的診断では2例ともnephrogenic adenoma.今回の2例を含めて, これまで計39例の本症が我が国で報告されている.男21例, 女18例で平均年齢は56.5歳.おもな症状は血尿が16例と最多で, ついで頻尿が6例である.本症の誘因としては尿路の外科的手術が16例で, 尿路感染症が9例, BCG膀胱内注入療法が6例である.特にBCGが保険認可された1996年12月以降はBCG膀胱内注入療法に引き続いて起こる症例の比率が高くなっており, 将来的な膀胱nephrogenic adenomaの増加が予想されるIn the two cases we report here, tumors were diagnosed as nephrogenic adenoma by pathohistological examination. Case 1 was a 72-year-old female presenting with a bladder tumor 8 months after receiving ureteral tumor surgery. Transurethral resection of bladder tumor (TUR-Bt) was performed. Case 2 was a 57-year-old female who had received intravesical bacillus Calmette-Guerin (BCG) treatment 6 times after her fifth TUR-Bt. Two tumors were found by cystoscopy, and TUR-Bt was performed. There have been 39 cases of nephrogenic adenoma of the bladder reported in Japan; 21 were male and 18 female with a mean age of 56.5 years. The main complaint was hematuria, which was seen in 16 cases followed by pollakisuria in 6 cases. Nephrogenic adenoma occurred after surgery of the urinary tract in 16 cases, followed by urinary tract infection in 9 cases and intravesical BCG treatment in 6 cases. The ratio of cases occurring after intravesical BCG treatment has increased since BCG approval for bladder carcinoma treatment in December 1996 in Japan, and an increase in the number of cases is expected in the future

A novel steroid receptor co-activator protein (SRAP) as an alternative form of steroid receptor RNA-activator gene: expression in prostate cancer cells and enhancement of androgen receptor activity.

We have cloned a cDNA coding for a novel steroid receptor co-activator protein termed SRAP from a rat prostate library. Although the nucleotide sequence of the SRAP has 78.2% identity to that of the human steroid receptor RNA activator (SRA), a novel RNA molecule which was reported to act as an RNA transcript without being translated into protein [Lanz, McKenna, Onate, Albrecht, Wong, Tsai, Tsai and O'Malley (1999) Cell 97, 17-27], the cDNA of SRAP is capable of generating a functional protein. Glutathione S-transferase pull-down assays showed that SRAP associates with the partial androgen receptor (AR) protein composed of a DNA-binding domain and an activation function 2. Luciferase assays demonstrated that SRAP enhances the transactivation activity of the AR, the glucocorticoid receptor and the peroxisome proliferator-activated receptor gamma(1) in a ligand-dependent manner. Using a green fluorescent protein (GFP) fusion-protein construct, we demonstrated in vivo translation of the GFP-SRAP fusion protein in HeLa cells co-transfected with pSG5AR and reporter gene in the presence of 5 alpha-dihydrotestosterone (DHT). Co-transfection of the GFP-SRAP fusion protein expression plasmid enhanced the transactivation activity of AR whereas incorporation of mutations in SRAP of the fusion protein resulted in loss of enhancement of the transactivation activity. Northern blot analysis and reverse transcriptase PCR assays showed that SRAP and SRA are expressed in rat and human prostate cancer cell lines respectively. In HeLa cells and the human prostate cancer cells line DU-145, co-transfected with SRAP, the DHT-dependent transactivation activities of AR were not completely inhibited by the anti-androgen flutamide, but the transactivation activities still remained high even in the presence of 5 microM flutamide, suggesting that SRAP may play an important role in enhancing AR activity in prostate cancer

Direct Thioamination of Arynes via Reaction with Sulfilimines and Migratory <i>N</i>‑Arylation

A novel method for preparing a diverse range of <i>o</i>-sulfanylanilines is described. Direct thioamination of arynes with sulfilimines gives <i>o</i>-sulfanylanilines, involving C–N and C–S bond formations and migratory <i>N</i>-arylation