初診時に膀胱刺激症状のみを訴えたループス膀胱炎の1例

37歳女性.患者は重度の膀胱刺激症状のみを主訴とし受診, 膀胱生検で粘膜下の炎症と血管炎の所見を認めた.血液データより自己免疫疾患が疑われたため, 更に検査を追加したところSLE(全身性エリテマトーデス)およびループス膀胱炎と診断された.治療として早期のステロイド投与を行なったところ重度の膀胱刺激症状は軽快したCystitis related with systemic lupus erythematosis (SLE) is termed as lupus cystitis. It is a subtype of SLE in which gastrointestinal and bladder symptoms are prominent and it usually manifests with other symptoms of SLE. We present a case in a 37-year-old woman whose sole complaint was the severe urinary symptoms. A biopsy of the bladder showed inflammation in the submucosa and the finding of vasculitis. An autoimmune disease was suspected from the blood serum sample. A further laboratory study was performed and she was diagnosed with SLE and lupus cystitis. Prompt therapy with corticosteroids resulted in the improvement of the severe bladder symptoms

Roti sääreluu posttraumaatilise reparatsiooni võrdlev elektronmikroskoopiline uurimine kinnise murru, osteotoomia ja perforatsiooni korral

Artiklis on tutvustatud tööd, mille eesmärgiks oli uurida elektronmikroskoopiliselt trauma järgset luu paranemist roti sääreluu kinnise murru, osteotoomia ja perforatsiooni esimestel operatsioonijärgsetel nädalatel. Leiti, et kuigi luu paranemise staadiumid on üldjoontes sarnased, sõltub luu reparatsiooni iseloom trauma tüübist (kinnise murru järel indirektne, osteotoomia puhul primaarselt periosteaalne, sekundaarselt endosteaalne ja perforatsiooni järel primaarselt endosteaalne, sekundaarselt periosteaalne ossifikatsioon) ning kahjustuse ulatusest, samuti on treeningul luu reparatsiooni stimuleeriv, immobilisatsioonil aga inhibeeriv mõju. Tulemused andsid olulist informatsiooni rakusiseste muutuste ja intratsellulaarse substantsi sünteesi kohta erinevate traumade korral. Eesti Arst 2007; 86 (1): 1–

Clinical response in Japanese metastatic melanoma patients treated with peptide cocktail-pulsed dendritic cells

BACKGROUND: Metastatic, chemotherapy-resistant melanoma is an intractable cancer with a very poor prognosis. As to immunotherapy targeting metastatic melanoma, HLA-A2(+ )patients were mainly enrolled in the study in Western countries. However, HLA-A24(+ )melanoma patients-oriented immunotherapy has not been fully investigated. In the present study, we investigated the effect of dendritic cell (DC)-based immunotherapy on metastatic melanoma patients with HLA-A2 or A24 genotype. METHODS: Nine cases of metastatic melanoma were enrolled into a phase I study of monocyte-derived dendritic cell (DC)-based immunotherapy. HLA-genotype analysis revealed 4 cases of HLA-A*0201, 1 of A*0206 and 4 of A*2402. Enriched monocytes were obtained using OptiPrep™ from leukapheresis products, and then incubated with GM-CSF and IL-4 in a closed serum-free system. After pulsing with a cocktail of 5 melanoma-associated synthetic peptides (gp100, tyrosinase, MAGE-2, MAGE-3 and MART-1 or MAGE-1) restricted to HLA-A2 or A24 and KLH, cells were cryopreserved until used. Finally, thawed DCs were washed and injected subcutaneously (s.c.) into the inguinal region in a dose-escalation manner. RESULTS: The mean percentage of DCs rated as lin(-)HLA-DR(+ )in melanoma patients was 46.4 ± 15.6 %. Most of DCs expressed high level of co-stimulatory molecules and type1 phenotype (CD11c(+)HLA-DR(+)), while a moderate number of mature DCs with CD83 and CCR7 positive were contained in DC products. DC injections were well tolerated except for transient liver dysfunction (elevation of transaminases, Grade I-II). All 6 evaluable cases except for early PD showed positive immunological responses to more than 2 melanoma peptides in an ELISPOT assay. Two representative responders demonstrated strong HLA-class I protein expression in the tumor and very high scores of ELISPOT that might correlate to the regression of metastatic tumors. Clinical response through DC injections was as follows : 1CR, 1 PR, 1SD and 6 PD. All 59 DC injections in the phase I study were tolerable in terms of safety, however, the maximal tolerable dose of DCs was not determined. CONCLUSIONS: These results suggested that peptide cocktail-treated DC-based immunotherapy had the potential for utilizing as one of therapeutic tools against metastatic melanoma in Japan

Optical Identification of the ASCA Large Sky Survey

We present results of optical identification of the X-ray sources detected in the ASCA Large Sky Survey. Optical spectroscopic observations were done for 34 X-ray sources which were detected with the SIS in the 2-7 keV band above 3.5 sigma. The sources are identified with 30 AGNs, 2 clusters of galaxies, and 1 galactic star. Only 1 source is still unidentified. The flux limit of the sample corresponds to 1 x 10^{-13} erg s^{-1} cm^{-2} in the 2-10 keV band. Based on the sample, the paper discusses optical and X-ray spectral properties of the AGNs, contribution of the sources to the Cosmic X-ray Background, and redshift and luminosity distributions of the AGNs. An interesting result is that the redshift distribution of the AGNs suggests a deficiency of high-redshift (0.5 10^{44} erg s^{-1}) absorbed narrow-line AGNs (so called type 2 QSOs).Comment: Accepted for publication in ApJ. 57 pages with 13 figures, 9 JPG plates, 5 additional PS tables. Original EPS plates (gzipped format ~1Mbyte/plate) and TeX tables are available from ftp://ftp.kusastro.kyoto-u.ac.jp/pub/akiyama/0001289

Log N - Log S Relations and Spectral Properties of Sources from the ASCA Large Sky Survey --- their Implications for the Origin of the Cosmic X-ray Background (CXB)

We carried out the first wide-area unbiased survey with the ASCA satellite in the 0.7-10 keV band around a north Galactic-pole region covering a continuous area of 7 square degrees (Large Sky Survey; LSS). To make the best use of ASCA capability, we developed a new source-detection method where the complicated detector responses are fully taken into account. Applying this method to the entire LSS data independently in the total (0.7-7 keV), hard (2-10 keV), and soft (0.7-2 keV) band, we detected 107 sources altogether with sensitivity limits of 6 x 10E-14 (0.7-7 keV), 1 x 10E-13 (2-10 keV), and 2 x 10E-14 erg sE-1 cmE-2 (0.7-2 keV), respectively. A complete list of the detected sources is presented. Based on detailed studies by Monte Carlo simulations, we evaluated effects of the source confusion and accurately derived Log N - Log S relation in each survey band. The Log N - Log S relation in the hard band is located on the extrapolation from the GINGA and HEAO1 results with the Euclidean slope of -3/2, while that in the soft band is consistent with the results by ROSAT. At these flux limits, 30 (+/- 3) percent of the CXB in the 0.7-7 keV band and 23 (+/- 3) percent in the 2-10 keV band have been resolved into discrete sources. The average spectrum of faint sources detected in the total band shows a photon index of 1.63 +/- 0.07 in the 0.7-10 keV range, consistent with the comparison of source counts between the hard and the soft energy band. Those detected in the hard band show a photon index of 1.49 +/- 0.10 in the 2-10 keV range. These spectral properties suggest that contribution of sources with hard energy spectra become significant at a flux of 10E-13 erg sE-1 cmE-2 (2-10 keV). The most plausible candidates are type-II AGNs, as indicated by on-going optical identifications.Comment: 28 pages, 11 figures, to appear in ApJ 518, 1999; figure 1 replaced, minor errors in text correcte

Levels and Concentration Ratios of Polychlorinated Biphenyls and Polybrominated Diphenyl Ethers in Serum and Breast Milk in Japanese Mothers

Blood and/or breast milk have been used to assess human exposure to various environmental contaminants. Few studies have been available to compare the concentrations in one matrix with those in another. The goals of this study were to determine the current levels of polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) in Japanese women, with analysis of the effects of lifestyle and dietary habits on these levels, and to develop a quantitative structure–activity relationship (QSAR) with which to predict the ratio of serum concentration to breast milk concentration. We measured PBDEs and PCBs in 89 paired samples of serum and breast milk collected in four regions of Japan in 2005. The geometric means of the total concentrations of PBDE (13 congeners) in milk and serum were 1.56 and 2.89 ng/g lipid, respectively, whereas those of total PCBs (15 congeners) were 63.9 and 37.5 ng/g lipid, respectively. The major determinant of total PBDE concentration in serum and milk was the geographic area within Japan, whereas nursing duration was the major determinant of PCB concentration. BDE-209 was the most predominant PBDE congener in serum but not in milk. The excretion of BDE 209 in milk was lower than that of BDE 47 and BDE 153. QSAR analysis revealed that two parameters, calculated octanol/water partition and number of hydrogen-bond acceptors, were significant descriptors. During the first weeks of lactation, the predicted partitioning of PBDE and PCB congeners from serum to milk agreed with the observed values. However, the prediction became weaker after 10 weeks of nursing