Three types of proteoglycans (PG-I, II and III) present in the human yellow ligament extracellular matrix were separated using a combination of CsCl isopycnic density gradient centrifugation, DEAE-Sephacel ion-exchange chromatography, gel-filtration on Sepharose CL-4B and CL-2B, and Octyl-Sepharose CL-4B chromatography. Proteoglycan-I was a high-molecular-weight proteoglycan, which was excluded by Sepharose CL-4B, and its molecular weight, estimated using sodium dedecyl sulfate-polyacrylamide gel electrophoresis, was over 350,000. The glycosaminoglycan chain of PG-I was composed of chondroitin 6-sulfate, and PG-I appeared to be an aggrecan-type proteoglycan. Proteoglycan-II and III were low-molecular-weight proteoglycans with molecular weights of 190,000 and 105,000, respectively. The core protein sizes of PG-II and III were similar, 44,000, but anti-human decorin antibody reacted with PG-III, not with PG-II. The glycosaminoglycan chain of PG-II contained dermatan sulfate and chondroitin 6-sulfate, whereas that of PG-III contained the former only. In the light of these results, PG-II and III were suggested to be biglycan- and decorin-type proteoglycans, respectively. The major proteoglycan in the human yellow ligament extracellular matrix was PG-III.

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Purpose: To study of contribution of plasma endothelin-1 (ET-1) concentration to pathogenesis of glaucomatous optic neuropathy.
Subjects and Methods: We examined plasma ET-1 concentrations in 102 patients with normal tension glaucoma (NTG), 90 patients with primary open-angle glaucoma (POAG) and 78 age-matched non-glaucomatous subjects (CONT). In addition, the relationship between the plasma ET-1 concentrations and glaucoma stages were also studied.
Results: Plasma ET-1 concentrations of patients with NTG (3.34 ± 1.27 pg/ml, P<0.01) and POAG (3.80 ± 1.40 pg/ ml, P<0.05) were significantly lower than those of CONT (4.39 ± 1.34 pg/ml). No relation was observed between these plasma ET-1 concentrations and glaucoma stages in NTG and POAG.
Conclusions: These results indicate that plasma ET-1 may be involved in the pathogenesis of glaucomatous optic neuropathy.

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Purpose: To report the clinical significance of ankle-brachial index (ABI) and pulse wave velocity (PWV) in retinal vascular occlusion.
Method: We measured the ABI and PWV, which are used as clinical indicators of arteriosclerosis, of 106 patients with retinal vascular occlusion (RVO) as well as hypertensive retinopathy (HR) and diabetic retinopathy (DR), and 100 age-matched healthy control subjects.
Results: ABI decreased with advancing age in patients with RVO, whereas no age-related changes were observed in non-RVO patients and control subjects. Furthermore, ABI was significantly lower in patients having combined presence of HR, DR and RVO than it was in patients with either HR, DR, RVO, HR+DR, HR+RVO or DR+RVO. Five out of six patients with abnormally low ABI values (less than 0.9) had associated central retinal artery occlusion (CRAO). In contrast, no such associations were observed in PWV among the groups.
Conclusion: Our present data provide the first evidence that measurement of ABI may be a clinical marker for management for retinal vascular occlusion, especially for CRAO.

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    We investigated the recognition on the discharge, the employment and the marital status of schizophrenic inpatients who had been treated with occupational therapy. The present study included 84 patients. Twenty-four (29%) patients answered that they did not hope for discharge from hospital, and most of them answered that they were satisfied with life in hospital. There was a significant difference in the age, the term of hospitalization and the duration of disease between the patients who hoped for discharge and the patients who did not hope for discharge. A close relationship existed between their anxieties about discharge and the social factors such as family, economy and job. As to marital status, 22 (26%) patients had been married. Eighteen (82%) of the married patients had experienced divorce. This high divorce rate showed that schizophrenia has negative effects on the patient's married life. In patients who hoped for employment, the proportion of patients who hoped for discharge was significantly higher than that in patients who did not hope for employment. We should deepen our understanding of sociomedical aspects of each individual schizophrenic inpatient to develop a more effective and aggressive occupational therapy.

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Background: Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass were described as severe postoperative complication. Although the incidence of ARDS after cardiopulmonary bypass (CPB) is about 1%, the mortality of ARDS is extremely high. It has been well recognized that CPB is associated with systemic inflammation. This pulmonary dysfunction after CPB is one of those inflammatory responses, activated neutrophil and neurophil elastase play an important role in this injury.
Method: ELASPOL (Sivelestat sodium hydrate: Ono Pharmaceutical Co., in Japan) is neutrophil elastase inhibitor that was introduced in 2002 for acute lung injury with SIRS. We hypothesized that this drug would reduce lung dysfunction after CPB especially in the patient who had total arch replacement or cardiac surgery with severe preoperative condition. We compared control group and group treated with ELASPOL^® group retrospectively. The control group were cases of total arch replacement with severe lung dysfunction before 2002, therapeutic group were cases of total arch replacement with ELASPOL that included a case without operation. Arterial PO₂/FiO₂ as indication of lung injury (The P/F ratio is an index of acute lung injury and ARDS, it is defined as acute lung injury when the P/F ratio is under 300, and the P/F ratio of ARDS is under 200.), platelet count, WBC count, CRP, duration of intubation and ICU stay were evaluated.
Results: As compared with the control group that had almost same operative procedure with ELASPOL, P/F ratio (arterial PO₂/FiO₂) was increased over 200 at four postoperative days and well maintained after all in therapeutic group. On the other hand it dropped to below 150, and it did not recovered to 200 until 10 days after the operation in the control group (p<0.05). Platelet count in ELASPOL group was relatively higher than control, but there is no significance of differences between groups. The other factors such as WBC count, CRP level, duration of intubation and ICU stay were almost equal.
Conclusions: We conclude that ELASPOL is expected to reduce lung injury after CPB in the case of total arch replacement or cardiac surgery with severe preoperative condition.

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