Bullous pemphigoid (BP) is an autoimmune blistering skin disease characterized by subepidermal bullae and circulating autoantibodies that bind to components of the hemidesmosome adhesion complex. The diagnosis of BP is based on clinical criteria and laboratory examinations, including direct and indirect immunofluorescence and the enzyme-linked immunosorbent assay (ELISA). Direct immunofluorescence and serological classic indirect immunofluorescence by using human salt-split skin sections and/or monkey esophagus sections have been mainly tested for BP. Antibodies targeting the structural hemidesmosomal proteins BP180 and BP230 have been shown to play a crucial role in the development of BP, and the detection of anti-BP180 antibodies by using an immunoassay ELISA or a chemiluminescent enzyme immunoassay (CLEIA) is routinely performed in Japan. We report on an 82-year-old man who was diagnosed with BP and followed up by testing anti-BP180 antibody. The patient responded well to the treatment, exhibiting a decreased anti-BP180 antibody that fluctuates in parallel with disease activity until a negative result, whereas the IIF test result was still positive. This discrepancy may be related to the fact that the IIF test detects the reaction of antibodies not only anti-BP180 but also anti-BP230. This study demonstrated that the enzyme immunoassay of anti-BP180 is useful as a part of routine examination for follow-up of disease activity and initial diagnosis of BP.
Objectives: To examine the effects of (1) trunk constraint and (2) the entry angle on the cervical spine in response to a head-first impact.
Materials: The AM50 Total HUman Model for Safety (THUMS®) v4.02, pedestrian finite element model, was subjected to head-first impacts.
Methods: The impact speed was 3.2 m/s. The following patterns were simulated: entry angle (0°, 15° to the sagittal plane) and trunk constraint (constraint, unconstraint).
Results: As a result of head-first impact, the upper cervical spine was extended and the lower cervical spine was markedly flexed when the trunk was constrained. The mean stress applied to the cervical spine was significantly increased when the trunk was constrained, as indicated by the Mann-Whitney U test.
Conclusions: In a head-first impact, the mean stress on the cervical spine increases significantly when the trunk is constrained. In order to reduce the risk of cervical spine injuries, it is desirable not to bind with teammates before a head-first impact.
Objective: The clinical significance of Arcobacter species has not been established due to a lack of suitable detection methods.
Material and Methods: A total of 1,650 stool samples submitted to the Clinical Laboratory of Heidelberg University Hospital were inoculated onto agar plates selective for Campylobacter species isolation and incubated at 37℃.
Results: Four (0.24%) of the samples were positive for Arcobacter butzleri isolates. Genus-specific primers for real-time PCR were designed to identify Arcobacter species. Of the 1,650 stool samples tested, twelve (0.73%), including the four culture-positive samples, were positive for Arcobacter species by real-time PCR. The sensitivity of real-time PCR was 10 4 CFU g -1 stool, 50 CFU reaction -1 using a stool sample.
Conclusions: Although the sensitivity of real-time PCR was relatively low compared with other PCR methods, the present method detected a broad range of Arcobacter species. The combination of the stool culture using agar selective for Campylobacter species and real-time PCR for Arcobacter species may be clinically useful for the diagnosis and epidemiology of Arcobacter species infections.
Levels of serum brain derived neurotrophic factor (BDNF) are lower in patients with major depressive disorder (MDD). The adrenal cortex secretes the corticosteroids cortisol and dehydroepiandrosterone (DHEA) under stress condition, and serum levels of DHEA are gender-dependent. Although BDNF expression is associated with these corticosteroids, the effect of gender on this association is not clear. To examine gender differences in the relationship between BDNF and corticosteroids in patients with MDD, we measured serum levels of cortisol, DHEA-sulfate (DHEA-S) and BDNF in men and women with depression. We recruited 189 inpatients with MDD (76 men and 113 women) from Juntendo Koshigaya Hospital. Serum cortisol, DHEA-S and BDNF levels were measured on the morning after admission. Multiple regression analyses were conducted to assess the effects of cortisol and DHEA-S on BDNF. After controlling for age, we found that serum BDNF levels were significantly influenced by the DHEA-S/cortisol ratio (p=0.010) in female participants. However, this association was absent in male participants. These results suggest gender differences exist in the effects of corticosteroids on BDNF. In female participants, the balance between neurotoxicity induced by cortisol and neuroprotection associated with DHEA-S may influence the pathology and symptoms of depression via BDNF.
Objective: This study examined the prevalence of and factors affecting normal weight obesity (NWO) among women aged under 40 years old. NWO was having a normal BMI but a high body-fat percentage (BFP).
Materials and Methods: We recruited 399 participants aged 18-39 during a health checkup and surveyed them about lifestyle patterns, height, weight, body composition, and girth and visceral fat area. Participants were divided into three. Those with a BMI of <25 and a BFP of <30 were classified as non-obese, a BMI of <25 and a BFP of ≥30 as NWO, a BMI of ≥25 and a BFP of ≥30 as obese. The analysis was conducted on NWO (97) and non-obese (262) groups.
Results: NWO prevalence ranged from 20% to 30% across the three age groups. NWO participants had lower values for segmental lean body mass, particularly in lower limb, and higher values for abdominal girth and visceral fat area. Among participants aged 30-39, those with NWO had higher values for triglycerides and LDL cholesterol and lower values for HDL cholesterol. Regarding lifestyle factors, among those aged 30-39, NWO was associated with past weight fluctuation, respectively. In the latter age group, a gain of more than 10 kg since the age of 20 was associated with a 13-fold increase in the odds for NWO.
Conclusions: Results suggest that for women under 40 years, detecting NWO early and guidance on effective lifestyle and exercise are necessary.
Objective: Recently, there has been a worldwide increase in non-B and non-C hepatocellular carcinoma (NBNC-HCC), which are negative for both markers of hepatitis B and C virus infection. Here, we investigated the role of phosphatase and tensin homolog (PTEN), a negative regulator of the phosphatidylinositol-3 kinase pathway in the development of NBNC-HCC.
Materials: A total of 14 patients who received hepatectomy because of NBNC-HCC (NBNC group) were analyzed retrospectively. Nine patients who underwent hepatectomy for liver metastasis of colorectal cancer, were analyzed as the control.
Methods: Expression of PTEN and p62, which is a marker of autophagic degradation, was evaluated in background liver, peritumoral region, and tumor by immunohistochemical analysis. Recurrence rate up to 7 years post-surgery was evaluated.
Results: The expression of PTEN in the NBNC group was significantly decreased in all regions compared to the control, and it was notably reduced in the tumor. In contrast, the expression of P62 in the tumor of patients of the NBNC group was significantly increased. Recurrence rate at 7 years in NBNC group reached 85%, and recurrence time post-surgery was significantly longer in survivors with strong expression of PTEN in the peritumoral region.
Conclusions: These findings indicate that the expression of PTEN decreases in NBNC chronic liver injury, which is possibly related to inhibition of autophagy as a trigger of carcinogenesis and the intrahepatic recurrence of NBNC-HCC.