Alterations of Contralateral Thalamic Perfusion in Neuropathic Pain

Contralateral thalamus, the place of termination of spinothalamic tract, is affected in patients with pain. We employed single photon emission computed tomography (SPECT) to evaluate the thalamic perfusion in patients with spontaneous neuropathic pain. Ten patients with complex regional pain syndrome (CRPS) and eleven radiculopathiy patients were enrolled in this study. Regional cerebral blood flow of thalamus was assessed bilaterally by iodine-123-labelled iodoamphetamine SPECT. To standardize the inter-patient data, we set a contralateral thalamic uptake index (CTUI) for assessing thalamic asymmetry. In one study, we found elevation of CTUI in patients with symptoms of neuropathic pain for less than 12 month, whereas no change was observed in the case of a longer lasting disease. An another study demonstrated decrease of CTUI after pain treatment, even though it was unrelated to the pain intensity prior to treatment. Our SPECT study revealed that neuropathic pain altered thalamic neuronal activity. CTUIs were increased in early stage of the disease but decreased as the disease progressed to the chronic stage. These results suggest that CTUI can be used to improve management of neuropathic pain for proper evaluation of spontaneous pain

高齢夜間頻尿患者における夜間尿産生に対する閉塞性睡眠時無呼吸症候群の影響

OBJECTIVE: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on night-time secretion of brain natriuretic peptide (BNP) and antidiuretic hormone (ADH) in older men with nocturia accompanied by nocturnal polyuria. MATERIALS AND METHODS: One hundred six men with nocturia aged ≥ 60 years underwent full-night polysomnography to determine whether they had OSAS. Blood count, standard chemistry panel, BNP, urinary ADH, urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 AM, and a frequency volume chart was recorded on the same day that polysomnography was performed. RESULTS: We evaluated 83 patients after excluding 18 with mild OSAS and 5 with nocturnal polyuria index <0.35. Participants with OSAS had higher apnea-hypopnea index (P < .0001) than those without OSAS. Body mass index and systolic blood pressure were higher in OSAS patients than those in the control group. BNP was higher in the OSAS patients than in the control patients (48.6 ± 41.4 vs 30.7 ± 31.5; P = .0006). On urinalysis, OSAS patients showed higher urinary sodium and u-Cre secretion than controls (24.7 ± 11.3 vs 16.2 ± 5.1; P <.0001). Urine osmolarity was also higher in OSAS patients than in the control patients (616 ± 172 vs 516 ± 174; P = .0285). There was no significant difference in urinary ADH and u-Cre (6.7 ± 10.4 vs 6.8 ± 7.8; P = .3617) between the 2 groups. CONCLUSION: Our results indicated that older men with nocturnal polyuria and OSAS did not compensate their fluid imbalance presented with decreased secretion of ADH but increased BNP level.博士（医学）・乙第1349号・平成26年12月3日Copyright © 2014 Elsevier Inc. All rights reserved

睡眠時無呼吸症候群患者の睡眠に関連した生活習慣の調査

SAS患者は日中の眠気や倦怠感などの疾患に起因する症状を紛らわすために睡眠にとって悪い習慣を取ってしまっている可能性が指摘されている。しかしSAS患者の生活実態は明らかになっていない。そこで本研究はSAS患者の生活習慣の実態を明らかにし、Apnea Hypopnea Index (AHI)、Epworth Sleepiness Scale (ESS)、Pittsburgh Sleep Quality Index (PSQI)、Body Mass Index(BMI)との関連を検討することを目的として行った。方法は質問紙およびAHIのデータをカルテより転載し、分析を行った。対象者は睡眠時無呼吸症候群と診断され治療前の方、56名を対象として行い、回収率は86%であった。AHI、ESS、PSQI、BMIと喫煙、飲酒、カフェインの摂取、睡眠時間などとの関連をみたところ、飲酒とBMIとの間に有意な関連がみられた。また喫煙とPSQIに有意な関連がみられ、睡眠の質が低いと評価している人ほど喫煙本数が多かった。睡眠時間とESSおよび希望睡眠時間と睡眠時間の差とESSの間に相関がみられ、SASによる睡眠障害だけでなく、睡眠時間の不足も問題である可能性があると考えられた。ベッドパートナーの有無が睡眠を阻害する因子になりうる可能性が示唆された。今回の対象者では治療開始前であったが、SASの治療の第一選択であるCPAP療法には家族のサポートも重要である。そのため今後ベッドパートナーの有無がCPAP療法にどのような影響を及ぼすのかについても検討していくことが重要であると考える。It has been pointed out that Sleep Apnea Syndrome (SAS) patients may have adopted life-styles which are poor for their sleep in order to alleviate symptoms that originate in disorders such as sleepiness and fatigue during the day. However, there is no clear evidence of what kind of maladaptive life-styles have been adopted by SAS patients. This research was therefore conducted with the aim of revealing the life-styles of SAS patients, and exploring the relationships between those life-styles and their correlation with the Apnea Hypopnea Index (AHI) data, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and the Body Mass Index (BMI). It was conducted on 56 pre-treated patients diagnosed with SAS via analysis of questionnaires and AHI data from their medical records. The response-rate was 86%. An analysis of the relationships between the data derived from AHI, ESS, PSQI, and BMI to smoking, alcohol consumption, caffeine intake and sleeping hours showed a significant relationship between alcohol consumption and BMI data. Furthermore, a significant relationship was evident between smoking and PSQI data, with those who evaluated their sleep quality as poor smoking the most. A correlation could also be seen between sleeping time and the ESS data, and the difference between desired hours of sleep and actual sleeping time and the ESS data, indicating that not only sleep disturbance was caused by SAS, but also the lack of sleep time could be a problem. In addition, it was also suggested that the existence of a bed partner could be one factor disturbing sleep. While the subjects of this research had not yet been treated, family support is important to CPAP treatment. For this reason, it will also be essential to study the effect of a bed partner on CPAP treatment in the future

Strictness of the Centrifugal Location of Bundle Sheath Chloroplasts in Different NADP-ME Type C4 Grasses

C4 plants have many attractive traits for crops, but their structural and functional relationships are complicated. C4 plants are different in bundle sheath cell (BSC) chloroplast location (centrifugal or centripetal) among species. The effects of light intensity on the centrifugal location of BSC chloroplasts were investigated in four grass species of NADP malic enzyme (NADP-ME) type (Zea mays, Echinochloa utilis, Sorghum bicolorand Eriachne aristidea)by light and electron microscopy. Furthermore, the degree of granal development was examined to investigate the relation between BSC chloroplast location and dependence of BSC chloroplasts on the reducing power of mesophyll cells. We investigated BSC chloroplast location grown under high intensity light (HL) (600 μ mol m-2s-1), low intensity light (LL) (2.5 μ mol m-2s-1) and dark conditions and counted the number of granal thylakoids per granum. Although BSC chloroplasts of maize maintained the centrifugal position under all light conditions, the centrifugal location of other species was disturbed under LL and in the dark. Granal development in BSC chloroplasts in the plants grown under HL was suppressed, although the suppression in Z maysand S. bicolorwas more prominent than in other two species. These findings indicate that there is a difference in the strictness of centrifugal location of BSC chloroplasts among NADP-ME type C4 grass species and the strictness had no relation to the degree of granal development in BSC chloroplasts

Effects of Salinity Stress on the Structure of Bundle Sheath and Mesophyll Chloroplasts in NAD-Malic Enzyme and PCK Type C4 Plants

The effect of NaCl stress on the structure of leaf chloroplasts was investigated in several NAD-Malic enzyme (NAD-ME) and phosphoenolpyruvate carboxykinase (PCK) type C4 plant species. Seedlings of the monocot species, except Zoysia japonica, grown in 300 mL pots were subjected to salt stress by adding 50 mL of 3% NaCl solution per day to the soil for 5 d after the fourth leaf blades were fully developed. Z. japonica and the dicot species, Amaranthus tricolor, were also treated with 3% NaCl in a similar manner from 5 wk after germination. Salt stress negatively affected the growth, chlorophyll content and chloroplast structure in all the species. At the ultrastructure level, swelling of thylakoids and disruption of envelopes were more or less observed in mesophyll cell (MC) chloroplasts after salt treatment. The structure of bundle sheath cell (BSC) chloroplasts, on the other hand, was hardly damaged under salt condition although stromal and starch areas were considerably decreased. Furthermore, salinity induced granal development in BSC chloroplasts in most species; the number of thylakoids per granum, granal indices and appressed thylakoid density in salt-treated plants were generally higher than those in control. Since the similar responses have also been reported in all NADP-ME type C4 species investigated in our previous study, the high sensitivity to salt stress in MC chloroplasts and the granal development in BSC chloroplasts by salinity were considered to be common phenomena in all three C4 subtypes

Dynamics of Amyloplast Sedimentation in Growing Yam Tubers and Its Possible Role in Graviperception

The mechanism of gravitropism in yam tubers was investigated using two cultivars of Chinese yam, cv. Nagaimo which elongates to form a long tuber, and cv. Genkotsujirou which elongates in the initial stage and then spherically thickens. In both cultivars, many amyloplasts were locally formed and settled down vertically in each cell at the part beneath the stele of the elongating tuber. In contrast, amyloplasts in the stele in the apical part of the elongating tuber in these cultivars were smaller in number and size than those in the part beneath the stele and did not settle down vertically. In the thickening tuber of Genkotsujirou, the number of amyloplasts decreased and they did not settled down vertically in the part beneath the stele. In Nagaimo tuber tilted on an inclined plate, amyloplasts in the part beneath the stele in apical part of tuber also settled in the direction of gravity. Tubers elongated vertically as soon as they passed through the inclined plate. In such tubers, amyloplasts in the part beneath the stele were vertically settled down. These results indicated that amyloplasts in the part beneath the stele would play a role as statoliths for the perception of gravity. Crystal cells and tannin cells dispersed in the part beneath the stele of tuber as in the cortex surrounding the stele. The result indicated that the part beneath the stele is a part of cortex. Therefore, the cortex in the apical part of tuber was presumably important as the site of gravity perception

Structural Changes and Fate of Crystalloplastids during Growth of Calcium Oxalate Crystal Idioblasts in Japanese Yam (Dioscorea japonica Thunb.) Tubers

The structural changes of crystalloplastids during calcium oxalate crystal idioblasts growth in Japanese yam tubers were examined by transmission electron microscopy. Idioblasts developed in the cortex of tubers during the tubers developmentwere large and elliptic and contained many crystalloplastids. The crystalloplastids were shown to have novel morphological characterizations. The single or multiple obvious electron-translucent parts without membrane structures were formed in the crystalloplastids during the crystal formation. Coincidentally, the electron-dense parts containing plastid ribosomes and tubular membranes were formed at the periphery of crystalloplastids. During further progress of crystal formation, obvious electron-translucent parts enlarged and finally electron-dense parts disappeared, forming the crystalloplastids similar to small vacuoles and/or vesicles. The majority of such crystalloplastids entered and was incorporated into the central vacuoles of idioblasts during crystal formation. The plastids remaining in the cytoplasm of mature idioblasts were proplastid-like organelle. Thus, the fate of crystalloplastids with growth of idioblasts was shown in Japanese yam tubers. It was suggested that the incorporation of crystalloplastids into central vacuoles of the idioblasts was one of the processes of material transportation involved in calcium oxalate crystal formation

Expression of Photosynthesis-Related Genes during the Leaf Development of a C3 Plant Rice as Visualized by In Situ Hybridization

The expression of photosynthesis-related genes, rbcS (small subunit of ribulose 1,5-bisphosphate carboxylase/oxygenase) and cab (light-harvesting chlorophyll a/b-binding protein), in emerging rice leaves was examined. We performed in situ hybridization to visualize the spatial expression pattern of the photosynthesis-related genes. In the basal region of the leaf blade, which is the youngest region in a leaf blade of monocotyledonous plants, the expression of the genes was observed in both bundle sheath and mesophyll cells, while in the older middle and the oldest tip regions, the expression was only observed in mesophyll cells and not in bundle sheath cells. These results indicate that the expression of these photosynthesis-related genes is developmentally regulated and becomes mesophyll-specific in mature leaves. The expression of the photosynthesis-related genes in the lamina joint was also examined. These genes were not expressed in the lamina joint of immature leaves nor in the mature leaves. Therefore, the lamina joint was considered to be a photosynthetically inactive region