High concentration of glucose causes impairment of the function of the glutathione redox cycle in human vascular smooth muscle cells

AbstractWe demonstrated that high glucose reduced H2O2 scavenge activity in human vascular smooth muscle cells. In the cells exposed to high glucose, the intracellular glutathione content decreased, although the NADPH content was unchanged. The rate of uptake of cystine, which is a rate-limiting precursor of the glutathione synthesis, decreased in the high glucose group compared with the control group. These decreases were shown to be dependent on glucose concentration. It was suggested that high glucose causes impairment of the function of the glutathione redox cycle in human vascular smooth muscle cells, resulting in reduced H2O2 scavenge activity

Tubulointerstitial Nephritis and Uveitis Syndrome Associated with Renal Tryptaseand Chymase-positive Mast Cell Infiltration

We report the clinical course and immunohistochemical analysis of a patient who presented with tubulointerstitial nephritis and uveitis syndrome (TINU syndrome). The patient, a 40-year-old woman, was referred to our hospital with general fatigue and a slight fever from another hospital. Mast cells are closely related to the development of renal interstitial fibrosis in patients with glomerulonephritis. To determine the role of mast cells in renal interstitial injury in TINU patients, we performed immunohistochemical studies on renal biopsy specimens using anti-human tryptase and anti-human chymase antibodies specific for mast cells. Double immunostaining of tryptase and chymase was also performed in renal tissues. In double immunofluorescence, cells with both chymase and tryptase (MCtc) were marked in the regions of interstitial fibrosis in this patient. It appears that mast cells are one of the constitutive cells of interstitial fibrosis in patients with TINU syndrome

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In pursuing the objective on construction of long sleeves, variations of sleeve cap points for fitness to dropped arms form, from the point of motion convenience and external appearance were attempted, through sensory tests. The results in light of long sleeve constructions were as follows : 1. Importance is evident for appearance. For dressy-wear, fitness is shown where sleeve cap point is identical to shoulder point, or approximately 1.0-1.5cm variance toward the back from the shoulder point. 2. Stress is evident for motion fitness and function. For sporty-wear and working clothes, slant form corresponds to the mean value. Fitness is shown where sleeve cap point is identical to shoulder point with front slant of 5°-6° variance. By assessment from the mean value, front slant of 7°-12° variance shows fitness of sleeve cap point with back slant of 1.5cm variance from shoulder point. Moreover, front slant of 4° to back slant of 3° shows fitness of sleeve cap point with front slant of 1.0 cm variance from shoulder point. The above findings indicate the need for sleeve cap point variations according to clothing needs for various purposes although the sleeve design itself may not differ

トウニョウビョウ セイ ジンショウ カンジャ ヲ タイショウ トシタ タシセツ キョウドウ キョウイク サポート システム コウチク ニ カンスル ゲンジョウ ト カダイ

糖尿病性腎症患者を対象とした多施設共同教育サポートシステムを構築するため研究を開始するに当たり、腎症の診療実態を把握し、本プロジェクトの可能性を明らかにすることを目的に、2つの地域の医師会の会員で内科を標榜している165の医療機関を対象に、糖尿病患者数、アルブミン尿測定、腎症教育プログラムの有無と関心などに関するアンケート調査を行った。回収率は16.4%(27施設)、81.5%(22施設)が無床診療所で、専門医は1名であった。アルブミン尿を定期的に測定している施設は25.9%(7施設)、92.6%(25施設)は腎症教育プログラムに関心があり、85.2%(23施設)画地域での多施設共同教育サポートシステムを構築するための研究への参加を前向きに考えると回答があった。しかし、研究に参加するためには、患者の選定、説明、検査データの開示など医療現場の負担が増加すること、会場まで遠い、高齢者が多く学習効果が期待できないという患者側の事情があり、医療現場の負担の軽減と教育方法の工夫の必要性が明らかになった。To clarify the actual state of diabetic nephropathy treatment and education as well as to recognize gaps in the process, a questionnaire survey was conducted targeting 165 medical institutions registered with medical associations. The response rate was 16.4% (27facilities) for medical association, 81.5% (22 facilities) were no floor medical offices, and the specialist was one person. The majority (92.6% 25facilities) indicated an interest in participating in diabetic nephropathy training programs, and 85.2% (23facilities) responded that thei would either participate in or consider participating in a collaborative diabetic rephropathy training program offered by several medical institutions. However, the selection of patients, explanation of the disease to them, and choice of investigations are the responsibilities of the doctors. Although most doctors understood this situation, circumstances make compliance difficult because there are target groups that include patients who cannot tarvel to the clinics and older patients. The necessity of decreasing the burden on doctors and the strategy for devising training methods became quite clear

A case of surgical resection for well-differentiated squamous cell carcinoma arising in a ciliated hepatic foregut cyst

Ciliated hepatic foregut cysts (CHFC) are extremely rare, and most are benign cysts of the liver arising from remnants of the embryonic foregut. CHFC is usually found incidentally and as mostly asymptomatic cysts. We report squamous cell carcinoma (SCC) arising in a CHFC in a 50-year-old Japanese woman. She consulted our hospital for upper abdominal pain.A computed tomography and an ultrasound showed a cystic region including calcification and a solid mass in segment 4 of the liver. Left hepatectomy, B6 bile duct resection, and biliary-jejunal anastomosis were performed. Microscopic examination revealed that part of the cyst was lined by a characteristic ciliated pseudostratified columnar epithelium surrounding a connective tissue, a slightly thick fibrotic smooth muscle stromal layer, and an outer fibrous capsule. The cyst wall contained a low-papillary mural nodule showing atypical squamous hyperplasia with high-grade dysplasia. Stromal invasion was identified at the base of the nodule, leading to the diagnosis of well-differentiated SCC arising from a CHFC. We recommend careful clinical follow-up for patients with relatively large CHFCs as potentially malignant lesions and excision if they show any clinical manifestation

Molecular Pathological Characteristics of Thyroid Follicular-Patterned Tumors Showing Nodule-in-Nodule Appearance with Poorly Differentiated Component

Thyroid follicular-patterned tumors (TFTs) showing nodule-in-nodule (NN) appearance with poorly differentiated component (PDc) but neither invasion nor metastasis are diagnosed as benign nodules. Although PDc exhibits histologically aggressive features relative to the outer nodule (Out-N), its pathological significance remains unclear. TP53 binding protein-1 (53BP1) is a DNA damage response (DDR) molecule that rapidly localizes at DNA double-strand breaks. Using dualcolor immunofluorescence with Ki-67, the profile of 53BP1 expression is shown to be significantly altered during diverse tumorigenesis. In this study, we aimed to elucidate the malignant potential of PDc at the molecular level. We analyzed the profile of 53BP1 expression and NRAS codon 61 and TERT-promoter (TERT-p) mutations in 16 cases of TFTs showing NN with PDc compared to 30 adenomatous goiters, 31 follicular adenomas, 15 minimally invasive follicular carcinomas (FCs), and 11 widely invasive FC cases. Our results revealed that the expression level of abnormal type 53BP1 and incidence of NRAS and TERT-p mutations in PDc were comparable to FCs, suggesting a malignant potential. Because co-expression of 53BP1 and Ki-67 can be an indicator of altered DDR, the development of PDc in NN may be associated with DDR impairments after harboring NRAS and TERT-p mutations