PBC: Animal Models of Cholangiopathies and Possible Endogenous Viral Infections

Primary Biliary Cirrhosis (PBC) is considered an autoimmune disease characterized by immune-mediated destruction of the intrahepatic bile ducts and its characteristic serologic marker, the anti-mitochondrial antibody (AMA). Several factors were proposed to clarify the pathological and immunological mechanisms of PBC. Immunological reaction with a bacterial or a viral association was identified in the previous report, and it seems probable that PBC was thought to have such an etiology. The majority of patients with PBC was reported to have both RT-PCR and immunohistochemistry evidence of human betaretrovirus infection in lymph nodes or in 2008, the patient who developed PBC with high HIV viral load had an antiviral therapy and recovered. To understand the etiology of PBC associated with infection, several factors should be considered and especially animal models may be useful. In this paper, we introduce three typical animal models of PBC: the dominant-negative form of transforming growth factor-β receptor type II (dnTGFβRII) mouse, IL-2Rα−/− mouse and NOD.c3c4 mouse, are enumerated and described, and we discuss previous reports of viral infection associated with PBC and consider the etiology of PBC from our analysis of results in NOD.c3c4 mouse

Dysfunction of Immune Systems and Host Genetic Factors in Hepatitis C Virus Infection with Persistent Normal ALT

Patients with chronic hepatitis C (CHC) virus infection who have persistently normal alanine aminotransferase levels (PNALT) have mild inflammation and fibrosis in comparison to those with elevated ALT levels. The cellular immune responses to HCV are mainly responsible for viral clearance and the disease pathogenesis during infection. However, since the innate and adaptive immune systems are suppressed by various kinds of mechanisms in CHC patients, the immunopathogenesis of CHC patients with PNALT is still unclear. In this review, we summarize the representative reports about the immune suppression in CHC to better understand the immunopathogenesis of PNALT. Then, we summarize and speculate on the immunological aspects of PNALT including innate and adaptive immune systems and genetic polymorphisms of HLA and cytokines

Biological Significance of HCV in Various Kinds of Lymphoid Cells

It has been reported that HCV can infect not only hepatocytes but also various kinds of lymphoid cells. Although many reports have described the biological significance of lymphotropic HCV, the issue remains controversial since the target lymphoid cells might have various kinds of functions in the immune system. One of the important roles of lymphoid cells in HCV replication is being a reservoir of HCV. Several groups described the detection of HCV-RNA in lymphoid cells after HCV eradication in plasma. Another important role of lymphotropic HCV is that it acts as a carcinogenic agent and induces immune dysfunction. In this paper, we summarize the reports regarding the biological significance of lymphotropic HCV in representative lymphoid cells

A qualitative comparative survey of first cycle radiography programmes in Europe and Japan

Purpose: To qualitatively compare First Cycle Radiography programmes in Europe and Japan. Methods: This qualitative survey was conducted via a series of case-studies of university-based radiography curricula in Europe and Japan. Findings and conclusions: The main themes arising from the survey were that: (a) in Europe the freedom that most universities have in setting their own curricula and examinations means that in practice there is still a wide variability in curricula between and within states. On the other hand in Japan curricula are more uniform owing to central government guidelines regarding radiography education and a centrally administered national radiography examina- tion. This means that student and worker mobility is much easier for Japanese radiographers. (b) in some countries in Europe principles of reporting and healthcare management are being expanded at the expense of the more technological aspects of radiography. Physical science competences on the other hand are considered highly in Japanese culture and form a major part of the curriculum. This may indicate that Japanese students would be in a much better position to cope with role developments linked to changes in imaging technology. Pragmati- cally oriented studies need to be carried out to determine ways in which radiographers can enhance their role without sacrificing their technological competences. The profession cannot afford to lose its technological expertise e it is neither in the interest of the profession itself and even less of the patient.peer-reviewe

The Effects of Class Origin on Dropout from Higher Education in Postwar Japan

The purpose of this article is to explore the relationship between dropout from higher education and social class origin. It focuses on the following three points; 1) to investigate the pattern of association between class origin and the risk of dropout; 2) to compare the impact of class origin on dropout among several educational transition stages; 3) to examine the trends in the effect of class origin on dropout from higher education. In order to conduct the empirical analysis, large-scale datasets which were merged from various Japanese national representative survey datasets, such as the Social Stratification and Mobility surveys (SSM), Japanese General Social Surveys (JGSS), and Japanese Life-course Panel Surveys (JLPS) are used. The risk of dropout is estimated using binary logit models, rare-event logit models, and transition models. Results show that the risk of dropout from higher education is affected by class origin. Non-manual and agricultural classes are less likely to drop out, while manual and self-employed classes are more likely to drop out from higher education. As for dropout from secondary education, the same pattern of inequality of the risk of dropout among classes is observed. The degree of impact of class origin on dropout is smaller than that on entering into next stage of education. There are no trends in the effects of class origin on dropout. This finding supports Maximum Maintained Inequality (MMI) hypothesis because educational expansion did not affect the pattern of educational inequality including dropping out stage. In conclusion, stable, huge inequality of dropout among social classes is found. Class origin is crucial factor for predicting the risk of dropout from higher education, also a long time ago even now.本研究は，科学研究費・特別推進研究（25000001）および基盤研究C（16K04029），2016年度参加者公募型共同研究（二次分析研究会テーマB）の成果の一部である

Histopathologic and Clinical Subtypes of Autoimmune Pancreatitis: The Honolulu Consensus Document

Autoimmune pancreatitis (AIP) has been extensively reported from Japan, Europe and the USA. While the descriptions of AIP from Japan have predominantly been based on the presence of a distinct clinical phenotype, reports from Europe and the USA describe at least 2 histopathologic patterns in patients diagnosed with AIP, namely lymphoplasmacytic sclerosing pancreatitis (LPSP) and idiopathic duct-centric pancreatitis (IDCP) or granulocytic epithelial lesion- positive pancreatitis. While the 2 entities share common histopathologic features (periductal lymphoplasmacytic infiltration and peculiar periductal fibrosis), expert pathologists can accurately distinguish them on the basis of other unique histopathologic features. Clinically, the 2 entities have a similar presentation (obstructive jaundice/pancreatic mass and a dramatic response to steroids), but they differ significantly in their demography, serology, involvement of other organs and disease relapse rate. While LPSP is associated with elevation of titers of nonspecific autoantibodies and serum IgG4 levels, IDCP does not have definitive serologic autoimmune markers. All experts agreed that the clinical phenotypes associated with LPSP and IDCP should be nosologically distinguished; however, their terminology was controversial. While most experts agreed that the entities should be referred to as type 1 and type 2 AIP, respectively, others had concerns regarding use of the term ‘autoimmune’ to describe IDCP

A case of Autoimmune-related Pancreatitis - Usefulness of Fluorodeoxyglucose Positron Emission Tomography for the Evaluation of the Effect of Steroid Therapy -

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Rebamipide, a Cytoprotective Drug, Increases Gastric Mucus Secretion in Human: Evaluations with Endoscopic Gastrin Test

We have previously developed a rapid, simple endoscopic method for evaluating gastrin-stimulated maximal acid output (the endoscopic gastrin test, EGT). In EGT, gastric fluid newly secreted over 10 min after gastrin stimulation is collected under direct endoscopic visualization. In this study, employing the EGT, we evaluated the effect of rebamipide, a cytoprotective anti-ulcer drug, on gastric mucus secretion. In ten Helicobacter pylori-negative healthy volunteers, gastric juice was collected by EGT prior to and after 4-week administration of rebamipide. The collected gastric juice was subjected to analysis for gastric mucus output. Total gastric mucin output was significantly increased by 53% by rebamipide administration from 3.2 ± 1.2 mg hexose/10 min to 4.9 ± 2.2 mg hexose/10 min (P < 0.01). Further analysis by ion-exchange chromatography revealed that rebamipide administration induced a specific increase in acidic mucin rich in sialic acid. Applying EGT, this study demonstrated that rebamipide administration increased gastric mucus secretion in human

A Case of Severe Esophageal Intramural Pseudodiverticulosis Whose Symptoms Were Ameliorated by Oral Administration of Anti-Fungal Medicine

Esophageal intramural pseudodiverticulosis (EIPD) is a rare disease of unknown etiology that displays multiple pseudodiverticula radiologically, leading to benign esophageal stricture. Dysphagia, which sometimes slowly progresses, is the main symptom in the majority of cases. We here report a 59-year-old male EIPD patient who suffered from severe dysphagia. Radiography and endoscopy of this patient disclosed a severe constriction in the upper thoracic esophagus. Although we tried several endoscopic procedures including frequent endoscopic balloon dilatation (EBD), the effect was very limited and his dysphagia relapsed shortly after the treatments. During the procedures, we noticed some white, thick, creamy liquid emerging from the orifices of EIPD, and PAS staining of biopsy specimens revealed infection with Candida albicans. Hence, the patient was given anti-fungal medicine in addition to EBD. The additional treatment with anti-fungal medicine dramatically improved his symptoms and the esophageal constriction. This case suggests that anti-fungal treatment is an effective first-line therapy even against a severe form of esophageal constriction in EIPD