The vascular endothelial cells (ECs) express various antigens related to coagulation factors, including factor VIII-related antigen or von Willebrand factor (vWF) in the cytoplasm and thrombomodulin (TM; a thrombin receptor)along the plasma membrane. CD34 (a hematogenic stem cell marker) is also expressed along the surface membrane of the ECs. Using these EC markers and fluorescein-isothiocyanate-labeled dextran (FITC-dextran)(Sigma Co., St. Louis, MO), we attempted to demonstrate the complex network of microvessels and their EC phenotypes in tracheo-bronchial trees and lung parenchyma of the normal adult ICR male mice. Under anesthesia, saline with heparin was infused slowly through left ventricle to drain off the blood. Following brief fixation with 4% buffered paraformaldehyde solution (PFA) through the same route, one group of animals received, 1) FITC-dextran injection via left ventricle, and the large airways and lungs were further fixed in PFA, or 2) The airways and lungs of the other group were rapidly frozen, and the thin sections were stained with two antibodies of vWF and Alexa Fluor 594-labeled CD34. The vWF antibody was later labeled by FITC. The microvessels of airways and lungs were observed by a laser scanning confocal microscope (TC-SP, Leica, Heidelberg, Germany). The phenotypic characteristics of microvessel ECs appeared mostly identical with those described previously in the human lung^1,2, although CD34 was applied instead of TM in the present study. The topographical heterogeneity of immunohistochemical properties of ECs would suggest functional differences at different sites of the lung, that would provide a novel insight for understanding the pathogenesis of human lung diseases.

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The brain is an important target organ for circulating steroid hormones secreted from peripheral organs such as the adrenal cortex, testis and/or ovary. In other words, these peripheral organs control the central nervous system. Steroid hormones substantially influence brain development, reproduction, sexual differentiation, cognition, memory, behavior, and so on. These effects are mediated by steroid hormone receptors, which directly regulate gene expression. The steroid hormone receptor superfamily is an intracellular ligand-regulated transcription factor. All members, including the glucocorticoid receptors (GR), mineralocoroticoid receptors (MR), estrogen receptors (ER), progesterone receptors (PR) and androgen receptor (AR), mediate the expression of a gene by binding to hormone responsive elements (HREs) as dimmers in a ligand-dependent manner. In particular, steroid hormones have an important role for the regulating neurons and cells, which are associated with the neuroendocrine and endocrine regulation system, because many neuroendocrine neurons and cells express the steroid hormone receptors, such as estrogen receptor (ER), androgen receptor (AR) and corticosteroid receptors. In this review, first the localization of GR and MR immunoreactivities in the brain is introduced, and secondly, the effects of change of GR expression in neurons are examined by several morphological approaches. Third, the interaction of GR expression and pituitary cell function is introduced. Finally, the recent topics on the control system of feeding regulation in the central nervous system, which also closely involves steroid hormone action, are discussed.

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It is now increasingly apparent that modifier genes have a considerable role to play in phenotypic variations of single-gene disorders. Intrafamilial variations, altered penetrance, and altered severity are now common features of single gene disorders because of the involvement of several genes in the expression of the disease phenotype. Oligogenic disorders occur because of a second gene modifying the action of a dominant gene. It is now certain that cancer occurs due to the action of the environment acting in combination with several genes. Although modifier genes make it impossible to predict phenotype from the genotype and cause considerable difficulties in genetic counseling, they have their uses. In the future, it is hoped that modifier genes will allow us to understand cell and protein interactions and thus allow us to understand the pathogenesis of disease.

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Although it is now known that pituitary hormones activate the immune system, there are still numerous questions to be answered with regard to the mechanisms involved. In this study, which focuses on growth hormone (GH) and natural killer (NK) cells, the latter's antitumor effects on glioma were investigated. Using fluorescein isothiocyanate-labeled rat 9L glioma and NK-receptive YAC-1 cells as target cells and rat splenocytes as effector cells, a cytotoxicity assay was carried out with the fluorescence-activated cell sorter method, which stains dead cells with propidium iodide. The effector cells were pretreated 48 hours in advance with various concentrations of GH. A similar experiment was also carried out in the presence of anti-asialo-GM1 antibodies. When the GH concentration of 9L was 10 to 40 μg/ml, cytotoxicity was confirmed to have been enhanced 17% to 39%. This enhancement disappeared in the presence of anti-asialo-GM1 antibodies. A similar increase in cytotoxic activity was also confirmed in YAC-1 cells. In this experiment we observed GH enhancement of natural killer activity against glioma.

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We examined Helicobacter pylori infection in patients who visited the Iso Clinic (Kasama City, Ibaraki Prefecture) with abdominal complaints, and determined the prevalence of H. pylori infection by age, sex, endoscopic diagnosis, abdominal complaint, gastric mucosa, and living environment. Peptic ulcer disease was observed in 23.2% of the patients examined with endoscopy, but there was no association between abdominal complaints and the prevalence of H. pylori infection. The prevalence of H. pylori infection was high among patients with peptic ulcer disease and atrophic gastritis. The prevalence of H. pylori infection was higher in the generation born before tae start of the period of rapid economic growth (71.5%) than in the generation born afterward (64.8%). No significant difference was observed between males and females. The prevalence of H. pylori infection was high in those who drank well water during childhood and those who were raised in a house with a nonflushing of toilet (67.2% and 67.5%, respectively). There were no associations with river basin of residence, alcohol consumption, or smoking. The prevalence of H. pylori infection among patients who visited Iso Clinic was higher than that among patients seen at Tama-Nagayama Hospital, Nippon Medical School (Tama City, Tokyo). The difference is attributable to the higher prevalence of H. pylori infection in the elderly.

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The prognosis and clinical and biological characteristics of infant leukemia differ from those of leukemia in children 1 year or older. We reviewed the charts of patients younger than 1 year in whom leukemia was diagnosed from January 1981 through December 2003 at our institution. Fourteen infants had leukemia, 6 had acute lymphoblastic leukemia (ALL), and 8 had acute myeloid leukemia (AML). The age of patients at diagnosis ranged from 2 to 11 months. Five of 8 AML patients presented with cutaneous manifestations, such as erythema and nodules, at diagnosis. Central nervous system (CNS) involvement was seen in 1 AML patient at diagnosis. Hyperleukocytosis of more than 50×10⁹/L was seen in 4 of 6 ALL patients and in 4 of 8 AML patients at diagnosis. All ALL patients showed a morphological diagnosis of L1 using the French-America-British classification system. For patients with AML, the morphological diagnoses were M0 for 1 patient, M2 for 1 patient, M4 for 2 patients (1 with eosinophilia), M5b for 2 patients, and M7 for 2 patients. One patient showing M7 morphology had Down syndrome. Surface markers were examined in 5 of 6 ALL patients and all AML patients. Five ALL patients showed a B-cell precursor immunophenotype. Two of 5 patients with ALL had CD10-positive leukemic cells and 3 of 5 patients with ALL had CD10-negative leukemic cells. All AML patients were positive for CD13 or CD33 or both. Three of 5 patients with ALL showed abnormal chromosomes related to 11q. Six of 7 patients with AML showed abnormal karyotypes. MLL gene rearrangements were seen in 3 (2 ALL, 1 AML) of 5 (2 ALL, 3 AML) patients. Serum immunoglobulin M levels were increased in 9 of 14 patients. Complete remission (CR) was achieved in all infants with ALL. Three patients relapsed and then died of the original disease. One of these 3 patients died after cord blood transplantation. Three ALL patients are alive without leukemia. CR was achieved in 6 of 8 AML patients. Four of 6 patients are alive without leukemia. Infant leukemia patients in our institution had some special features. CNS involvement at diagnosis was seen in only 1 patient and serum IgM levels were higher than those in children whose leukemia was diagnosed at 1 to 10 years of age.

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Aim: The present study was designed to assess whether prophylactic use of bicarbonated Ringer's solution ameliorates metabolic acidosis in patients undergoing aortic surgery. Methods: Twenty patients undergoing elective infrarenal aortic aneurysm repair were randomly assigned to receive either bicarbonated Ringer's solution or acetated Ringer's solution. The pH, PaCO₂, and base excess (BE) were measured before surgical incision (T0), 5 min before reperfusion (T1), 5 min after reperfusion (T2), and 30 min after reperfusion (T3). Data were compared between the two groups. Results: Both pH and BE initially showed a slight decrease in both groups during clamping. After unclamping of the aorta, an additional decrease in pH was observed in both groups (T0 to T2, and T3). There were no significant differences in pH between the groups throughout the study period. Conclusions: Aortic cross-clamping leads to the development of metabolic acidosis, with a decrease in pH and BE. The effect of administration of bicarbonated infusion fluid during elective abdominal aortic surgery had not significant compared with that of acetated Ringer's solution with respect to acid-base homeostasis.

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Three abnormal shadows were detected in the right lung on chest X-ray films and computed tomography in a 75-year-old woman during follow-up for idiopathic thrombocytopenic purpura. Because a definitive diagnosis was not obtained through general examinations, exploratory thoracotomy was performed for diagnosis and treatment. The main lesion in the right middle lobe was diagnosed as mucosa-associated lymphoid tissue (MALT) lymphoma according to histopathological findings, cytogenic studies and reverse transcriptase-polymerase chain reaction analysis, and nodular lesions in S³ and S⁷ were diagnosed with Congo-red staining as local deposition of amyloid. The patient had no recurrence of the MALT lymphoma of the lung or other organs for 4 years after surgery. To our knowledge, this is the first reported case of primary pulmonary MALT lymphoma combined with idiopathic thrombocytopenic purpura/lung amyloidoma.

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We have experienced three cases of retroesophageal right subclavian artery. Two cases were cadavers, and one case was a live human. In the two cadavers of a 68-year-old and a 76-year-old, respectively Japanese and European males, the right subclavian artery originated from the aorta after the aorta branched the right carotid artery, the left carotid artery and the left subclavian artery. The right carotid artery immerged solely from the aorta. Where the right subclavian artery originated from the aorta, the artery took a dorsal direction. It passed between the esophagus and the vertebral column. The esophagus was compressed from the dorsal side by the right subclavian artery. The structural anomaly of the right subclavian artery accompanied the cephalad recurrence of the branch from the right vagal nerve toward the larynx. In the live human case, we obtained CT views. The patient was a 41-year-old Japanese, who complained of dysphagia lusoria. We found that the right subclavian artery was anomalous and originated from the aorta as the last cardinal branch in the thorax.

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A case of Henoch-Schönlein purpura (HSP) with necrosis of the small intestine, neurological symptoms, and pericardial tamponade after frequent recurrence is described. Neurological symptoms were controlled well with steroid pulse therapy, and pericardial tamponade was treated successfully with pericardiocentesis and steroid pulse therapy. To treat necrosis of the small intestine, the necrotic tissue was excised and artificial anuses were constructed. Five months later, the small intestine was anastomosed in a curative operation. Periodic administration of coagulation factor XIII was required from the onset of symptoms until curative surgery, but the activity of this factor returned to normal levels after surgery operation. We report a case of Henoch-Schönlein purpura with extremely rare complications: necrosis of the small intestine, neurological symptoms, and pericardial tamponade.

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We report an asymptomatic female with Fabry disease immunohistochemically diagnosed by renal biopsy. She was initially diagnosed as having nephrotic syndrome, and renal biopsy was performed for pathological diagnosis. The renal specimen revealed non-specific findings (minor glomerular abnormalities) for nephrotic syndrome. Numerous laminated bodies in glomerular epithelial cells in electron microscopic findings and accumulations of ceramidetrihexoside immunohistochemically were observed and she was diagnosed with Fabry disease. However, no other laboratory data or clinical findings supported the diagnosis of Fabry disease. Since the efficacy of recombinant human alpha-galactosidase replacement therapy in this disease has been reported, whether enzyme replacement therapy for subclinical Fabry female patients is indicated or not is an important issue.

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