We studied the association of body weight and height of school children with their birth weight, birth height, increase of BMI, body weight of their parents, eating habits, and physical activity by multiple regression analysis. Using present body weight of school children as a dependent variable, only the BMI of mothers showed a significant association among independent variables (corrected R²=0.751) . Birth weight of school children was not significantly associated. Analysis by age revealed a significant relationship of body weight at 13 years with BMI of the mother. As for lifestyle parameters, there was a significant correlation of present body weight of school children with frequency of physical activity of the fathers. Birth weight and sleep time showed no significant correlation. Using the present height of school children as a dependent variable, the BMI of mothers showed a significant positive relationship and the BMI of fathers showed a significant negative relationship as independent variables. Since this study followed long period of time (up to 15 years), the results showed a low response rate of 44.5 % and a small number of subjects for the analysis. Nevertheless, we found a few factors which were significantly associated with physical parameters of school children by multiple regression analysis. Further studies on a large scale will be necessary to find other related factors.

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To investigate the significance of immunological competent cells in glomerulonephritis, we studied the effects of adjuvant on experimentally induced glomerulopathy, such as puromycin aminonucleoside (PAN) nephropathy and nephrotoxic serum (NTS) nephritis in rats. Complete adjuvant (CA) containing Mycobacterium tuberculosis was inoculated intradermally into Wistar-Kyoto (WKY) rats. As a control, PBS instead of CA was utilized. After 14 days of the treatment, PAN was i.p. injected into the rats (PAN-nephropathy rats) . A small dose of NTS (1.25 μl/rat) was i.v. injected into the other groups of rats (NTS-nephritis rats) . The rats were sequentially sacrificed and the renal immunopathology was examined. The proteinuria excretion of the rats was determined before sacrifice. Although the PAN-nephropathy rats pretreated with either CA or PBS showed significant proteinuria, there was no difference of histological findings in both groups. The NTS-nephritis rats pretreated with CA showed abnormal proteinuria on day 2, and the amount of proteinuria increased by 196.1±35.7 mg/ day on day 14. Crescent formation appeared on day 4 and reached 62.7% on day 14, whereas the NTS-nephritis rats pretreated with PBS did not show a significant level of proteinuria and the histological changes were very mild. Immunof luorescent staining for rabbit IgG was positive, but negative for rat IgG and rat C3 during 14 days in both groups of NTS-nephritis rats. ED-1 positive cells and CD3 positive cells appeared significantly in glomeruli in CA-treated NTS-nephritis rats. Although a marker of glomerular endothelial cells, RECA-1 disappeared after injection of NTS ; the recovery of RECA-1 staining in the CA-treated NTS-nephritis rats was later than that of PBS-treated NTS-nephritis rats. Thus, CA-treated NTS-nephritis rats developed severe prolif erative glomerulonephritis with prominent crescent formation. However, CA-treated PAN-nephropathy rats did not develop any prolif erative glomerular alteration. The present data suggest that CA aggravated mild NTS-nephritis in WKY rats via activation of immunological competent cells, such as macrophages and T lymphocytes. The existence of foreign protein, that is, rabbit anti-rat GBM antibodies bound to glomeruli may be related to the infiltration of macrophages and T lymphocytes.

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The aim of this study was to analyse more precisely a prototype of nephrotic syndrome, such as minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS) not only clinically and pathologically including light (LM), immunof luorescence (IF), electron microscopical (EM) findings, but also by studying the expression of synaptopodin (SYN) and α dystroglysan (ADG) in the glomeruli on the aspects of responsiveness of steroid puls treatment. Renal biopsy specimens obtained from patients with MCNS (n=8) and FSGS (n12) were divided into responder group (R) and non-responder group (NR) . A significant difference between R (n=3) and NR (n=5) in MCNS was found : not to be present in clinical and LM findings, to be increased in podocyte vacuolation in NR, not to be present in podocyte detachment in both groups, not to be reduced of SYN staining in both groups and to be reduced of ADG staining in NR. A significant difference between R (n=4) and NR (n=8) in FSGS was found : not to be present in clinical findings, not to be present in glomerular sclerosis in both groups, to be increased in glomerular adhesion in NR, not to be present in tubulointerstitial injury in both groups, not to be present in podocyte-vacuolation and -detachment in both groups, to be reducted in glomerular SYN staining in NR and to be reducted in glomerular ADG staining in R. No peculiar IF findings were observed in MCNS and FSGS. These results suggest that the strategy of treatment, such as steroid hormone and immunosuppressant agents, should be proceeded by evaluation according not only of the LM and EM findings, but also of the immunohistochemical study such as both SYN and ADG stainings.

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Background Recently, there has been a rapid increase in the number of patients with food allergies in Japan compared to Western countries. The mainstay of treatment in food allergies is still food avoidance ; however, medical treatment strategies aimed at protecting the gastrointestinal tract are being investigated. To determine the effect of fructooligosaccraide (FOS), a prebiotic, on small intestinal changes in a mouse model of food allergy as a new cure for food allergy. A mouse model of food allergy was performed by ovalbumin (it omits Following OVA) in 52 mice. Mice were randomly assigned to receive either FOS or placebo. Treatment was carried out for 2, 5 and 8weeks. The small intestinal changes were investigated by microscopy. The number of mast cells in the duodenum significantly increased after sensitization with OVA. The FOS-treated group was observed to have a significant decrease in the number of mast cells after 8 weeks of treatment. Moreover, the increase in villus edema noted after OVA-sensitization was prevented in the FOS-treated mice. FOS might be used as a treatment in food allergy treatment by protecting the gastrointestinal tract.

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Rheumatoid arthritis (RA) is a cryptogenic, destructive and progressive inflammatory articular disease that is accompanied with multiplex joint pain and joint swelling as the predominant symptoms. The characteristic feature of the disease is a series of processes from synovial inflammation to destruction of articular cartilages and bones, and joint markers are used in for determining the activity of destruction and restoration of joint components by analyzing synovial fluids, sera, and others. The authors have analyzed matrix component-related joint markers in the synovial fluids of patients with various diseases in the first step and determined the concentration of joint markers, the number of MMPs-positive cells in synovial tissues, and the histological evaluation index of synovial membranes in individual RA cases. Hyaluronic acid (HA) in the collected synovial fluids is determined by the Morgan-Elson method, chondroitin tetrasulf ate (C4S) and hexasulf ate (C6S) by HPLC, and pCOL II -C (chondrocalcin ) and keratan sulfate (KS) by the ETA method. In addition, KS in sera is measured by the ETA method. Synovial tissues were collected during entire prosthetic knee joint replacement or synovectomy under an arthroscope ; the synovial membranes were subjected to immunohisto-chemical staining by H-E and ABC methods ; and the MMPs (MMP-1, 3, 8, and 9) -positive cells thus stained were counted. Synovial histological evaluation index is an inflammation score calculated from five parameters excluding fibrosis out of the six parameters used in the method of Rooney et al., (synoviocyte hyperplasia, fibrosis, proliferating blood vessels, perivascular infiltrates of lymphocytes, focal aggregates of lymphocytes, and diffuse infiltrates of lymphocytes) . A significant difference in the values of HA, C4S, C6S/C4S, and C6S/ HA of osteoarthritis (OA) synovial fluids and in the values of HA, C4S, C6S, and C6S/C4S in RA synovial fluids from synovial fluids of normal healthy subjects were observed. A drop in HA concentration seemed to result from lowered production in synovial tissues, accumulation of synovial fluid, and others. In addition, a high concentration of C4S was likely caused by enhanced production of C4S in synoviocytes or accelerated effusion of blood components. H-E staining revealed that RA synovial membranes grew in the villus-like shape and the cortical cells in the multilayer structure. Neutrophils, macrophages, and lymphocytes infiltrated in the diffuse state, as well as in the lymph follicles with a germinal center in the lower layer. In addition, there were observed granulation tissues due to blood vessel hyperplasia, fibroblast growth, and others were observed. In IHC, MMP-1 and 3-positive cells were present in a greater amount in the cortical layer of the synovial membrane, while MMP-8 and 9-positive cells were present throughout the synovial membrane from the cortical layer to the deeper layer. In particular, MMP-8 was more expressed in neutrophils, while MMP-9 was more expressed in neutrophils, monocytes and osteoclasts of granulation tissues. There were significant differences in MMPs (MMP-1, 3, 8, and 9) and inflammation scores between OA and RA. These differences seem to be related to the fact that cartilage destruction is predominant in rheumatoid arthritis while cartilage destruction and regeneration proceed simultaneously in osteoarthritis. Although MMP-3 in RA is considered to be possibly a reflection of synovitis, there was no correlation with HA. The fact suggests that HA is not necessarily a joint marker indicating inflammation. Significant correlations among all MMPs, as well as between MMP-1, 3, and 9 and the inflammation score were observed. The findings above suggest that MMPs are cooperatively involved in the destruction of RA joints.

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We report a rare case of Cushing's syndrome due to bilateral adrenocortical adenomas in a 46-year-old Japanese woman who suffered from diabetes mellitus and hypertension for several years. The patient was admitted to the hospital because of an evaluation for Cushing's syndrome. Physical examination revealed a moderately obese woman with a round face, truncal obesity and a buffalo hump. The serum cortisol was elevated with loss of the diurnal rhythm, and the urinary excretion of free cortisol was high. The plasma level of ACTH was undetectable. The plasma DHEA-sulfate was low. Cortisol and its metabolites were nonsuppressible with a high dose of dexamethasone. Plasma cortisol and ACTH did not respond to the administration of metyrapone or human CRH. The plasma cortisol responded well to synthetic ACTH. The laboratory data were consistent with ACTH-independent Cushing's syndrome. Abdominal computed tomography revealed bilateral round-shaped adrenal masses (right mass, 3 cm ; left mass, 1 cm) . Abdominal MRI revealed similar findings. An iodecholesterol scintigram showed bilateral adrenal gland activities. A presumptive diagnosis of bilateral adrenocortical adenomas was made. The patient underwent bilateral adrenalectomy. The right and left tumors was encapsulated and consisted mainly of compact cells and clear cells, respectively, while the surrounding cortexes were atrophic. Immunohistochemical analysis of the following steridogenic enzymes was performed ; P450scc, 3 β HSD, P450c21, et al. Immunoreactivity of all the enzymes was intense in cells of both right and left adrenocorical adenomas, while it was negative in the surrounding cortexes.

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A 72-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) underlying hemodialysis repeatedly had febrile episodes and abdominal pain. On the second admission, both ascites and liver cyst fluids were purulent. The diagnosis of purulent peritonitis due to liver cyst infection was made. Although treatment strategies including the percutaneus drainage of liver cysts were considered, her condition gradually deteriorated and she died of multiple organ failure. When ADPKD patients have a frequently relapsing cystic infection of either the kidneys or the liver, nephrectomy as one of the treatment strategies has occasionally been performed in the USA or European countries with good outcomes. In Japan, compared with these countries, nephrectomy is not a commonly selected procedure. Recently, laparoscopic nephrectomy and renal transcatheter arterial embolization (renal TAE) has been carried out for the treatment of highly symptomatic ADPKD. Nephrectomy and other surgical procedures should be considered for the treatment of ADPKD when complicated by bacterial infections.

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