Prevalence of pterygium in a population in Northern Japan: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study

Purpose

The aim of the study was to determine the prevalence and risk factors for pterygium in a population aged 40–74 years in Fukushima Prefecture, Japan.

Methods

Of 4185 citizens of the towns of Minamiaizu-machi and Tadami-machi, 2312 (55.2%) gave consent to an ocular examination during a health examination. Pterygium was diagnosed when a radially oriented fibrovascular lesion growing over the limbus into the cornea was observed. Eyes with a history of pterygium excision were also diagnosed with pterygium. Prevalence and factors associated with pterygium were investigated.

Results

Of the 2312 subjects, 101 (4.4%; 95% confidence interval, 3.6–5.3%) had pterygium in at least 1 eye. The average age (±SD) of the subjects was 64.3 ± 8.0 years. Gender, age, outdoor job history and smoking history were examined as possible associated factors, but only age was found to be significantly associated with pterygium in logistic regression analysis.

Conclusion

The prevalence of pterygium was 4.4% in the study population. This low rate may be due to the northern latitude of these towns. Age was associated with a risk of pterygium, but gender and outdoor job history were not associated with onset of pterygium in this study.

Remitting seronegative symmetrical synovitis with pitting edema syndrome caused by crystal-induced arthritis of the wrist: a case report

OBJECTIVE

To describe a rare case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome caused by gouty arthritis.

CLINICAL PRESENTATION AND INTERVENTION

A 76-year-old man presented with swelling and pain in the dorsum of feet and hands bilaterally. From the laboratory and radiologic findings, the diagnosis of gout-induced RS3PE syndrome was made. Conservative therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and intra-articular corticosteroid injection in the wrist joint completely and rapidly resolved all symptoms. The patient was successfully treated with oral administration of NSAIDs and a one-time intra-articular corticosteroid injection in the left wrist joint.

CONCLUSION

This case demonstrated the importance of considering the possibility of crystal-induced arthritis such as gout and pseudogout, as well as malignant disease, when diagnosing the primary disease responsible for RS3PE syndrome.

Numerical Calculations of Heating Patterns around a Coaxial-Slot Antenna for Microwave Hyperthermia - Aiming at Treatment of Brain Tumor and Bile Duct Carcinoma-

Hyperthermia is one of the modalities for cancer treatment, utilizing the difference of thermal sensitivity between tumor and normal tissue. The authors have developed a coaxial-slot antenna for microwave hyperthermia. In this paper, calculated results of temperature distributions around the coaxial-slot antenna for the treatment of brain tumor and bile duct carcinoma are described.

Stromal cells expressing hedgehog-interacting protein regulate the proliferation of myeloid neoplasms

Aberrant reactivation of hedgehog (Hh) signaling has been described in a wide variety of human cancers including cancer stem cells. However, involvement of the Hh-signaling system in the bone marrow (BM) microenvironment during the development of myeloid neoplasms is unknown. In this study, we assessed the expression of Hh-related genes in primary human CD34⁺ cells, CD34⁺ blastic cells and BM stromal cells. Both Indian Hh (Ihh) and its signal transducer, smoothened (SMO), were expressed in CD34⁺ acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)-derived cells. However, Ihh expression was relatively low in BM stromal cells. Remarkably, expression of the intrinsic Hh-signaling inhibitor, human Hh-interacting protein (HHIP) in AML/MDS-derived stromal cells was markedly lower than in healthy donor-derived stromal cells. Moreover, HHIP expression levels in BM stromal cells highly correlated with their supporting activity for SMO⁺ leukemic cells. Knockdown of HHIP gene in stromal cells increased their supporting activity although control cells marginally supported SMO⁺ leukemic cell proliferation. The demethylating agent, 5-aza-2′-deoxycytidine rescued HHIP expression via demethylation of HHIP gene and reduced the leukemic cell-supporting activity of AML/MDS-derived stromal cells. This indicates that suppression of stromal HHIP could be associated with the proliferation of AML/MDS cells.

Headache prevalence and long working hours: the role of physical inactivity

OBJECTIVES

Headaches and long working hours are important issues for workers. This study investigated the association between hours worked and the prevalence of headaches, and how that association varies with physical activity.

STUDY DESIGN

Cross-sectional study with two-stage cluster sampling.

METHODS

Using data from a nationally representative sample of households in Japan, people aged 20-65 years who worked ≥35 h/week were studied, and the cross-sectional association between the number of hours worked per week (35-45, 46-55 and >55 h/week) and the prevalence rates of headaches of different severity was evaluated.

RESULTS

Of 721 workers, 307 reported experiencing at least one headache per month. Compared with working 35-45 h/week, the prevalence ratios of severe or disabling headaches among individuals working >55 h/week were 1.38 [95% confidence interval (CI) 1.06-1.78] and 1.63 (95% CI 1.09-2.43), respectively. After stratification by the level of physical activity, the prevalence ratios were greater in the low-physical-activity group: 1.56 (95% CI 1.11-2.19) for severe headaches and 2.20 (95% CI 1.31-3.68) for disabling headaches. The number of hours worked was not associated with headaches in the high-physical-activity group.

CONCLUSIONS

Among workers in the general population, long working hours were associated with the prevalence of headaches, and the association may depend on a lack of physical activity.

Impact of screening with thyroid ultrasonography in myasthenia gravis patients

OBJECTIVES

This study was conducted to screen thyroid abnormality evaluated with ultrasonography (US) in patients with myasthenia gravis (MG) and investigate further when malignancy is suspected.

METHODS

Thyroid screening using US was conducted in 162 patients with MG. In cases where malignancy was suspected, further investigations were performed.

RESULTS

Abnormal US findings were detected in 125 of 162 patients with MG (72 patients with nodules, 74 patients with cysts, 27 patients with diffuse findings such as enlargement, atrophy, a hypoechoic pattern or a heterogenous echoic pattern, and 28 patients with calcification). From among these 125 subjects, 30 patients underwent further examinations such as needle aspiration cytology. As a result, six patients (3.7% of 162 cases) were positive for papillary carcinoma. The size of the carcinoma in three patients was <10 mm, yet the stage of thyroid carcinomas was high (stage III or IVa) in all six cases.

CONCLUSIONS

Our data suggest that the prevalence of thyroid carcinoma in cases of MG may be higher than that of the general population. Furthermore, in patients with MG, there is a possibility that the stage of the carcinoma is higher even when the carcinoma is of a very small size. Patients with MG, when diagnosed, should be advised to undergo US screening of the thyroid because most cases of thyroid carcinoma are highly curable.

Mesoscopic models of neurotransmission as intermediates between disease simulators and tools for discovering design principles

Two grand challenges have been declared as premier goals of computational systems biology. The first is the discovery of network motifs and design principles that help us understand and rationalize why biological systems are organized in the manner we encounter them rather than in a different fashion. The second goal is the development of computational models supporting the investigation of complex systems, in particular, as simulation platforms in personalized medicine and predictive health. Interestingly, most published systems models in biology contain between a handful and a few dozen variables. They are usually too complicated for systemic analyses of organizing principles, but they are at the same time too coarse to allow reliable simulations of diseases. While it may thus appear that the modeling efforts of the past have missed the declared targets of systems biology, we argue in this article that midsized mesoscopic models are excellent starting points for pursuing both goals in computational systems biology.

Intraosseous spindle cell hemangioma of the calcaneus: a case report and review of the literature

Spindle cell hemangioma, a rare benign tumor characterized by cavernous blood vessels and spindled areas, typically arises in the subcutis of the distal extremities, particularly the hand. The case of intraosseous spindle cell hemangioma is extremely rare, and only 1 case arises in the frontal bone has been reported previously. We describe herein a case of intraosseous spindle cell hemangioma occurring in the left calcaneus in a 65-year-old woman. The patient was successfully treated by the operation. The present case is instructive especially in the differential diagnosis of primary bone tumor structured by spindle cells, for which the possibility of spindle cell hemangioma should be considered.

A randomized, controlled trial of fingolimod (FTY720) in Japanese patients with multiple sclerosis

BACKGROUND

Fingolimod (FTY720) has previously shown clinical efficacy in phase II/III studies of predominantly Caucasian populations with multiple sclerosis (MS).

OBJECTIVES

To report six-month efficacy and safety outcomes in Japanese patients with relapsing MS treated with fingolimod.

METHODS

In this double-blind, parallel-group, phase II study, 171 Japanese patients with relapsing MS were randomized to receive once-daily fingolimod 0.5 mg or 1.25 mg, or matching placebo for six months. The primary and secondary endpoints were the percentages of patients free from gadolinium (Gd)-enhanced lesions at months 3 and 6, and relapses over six months, respectively; safety outcomes were also assessed.

RESULTS

147 patients completed the study. Higher proportions of patients were free from Gd-enhanced lesions at months 3 and 6 with fingolimod (0.5 mg: 70%, p = 0.004; 1.25 mg: 86%, p < 0.001) than with placebo (40%). Odds ratios for the proportions of relapse-free patients over six months favoured fingolimod versus placebo but were not significant. Adverse events related to fingolimod included transient bradycardia and atrioventricular block at treatment initiation, and elevated liver enzyme levels.

CONCLUSIONS

This study demonstrated the clinical efficacy of fingolimod for the first time in Japanese patients with MS, consistent with the established effects of fingolimod in Caucasian patients.

Biodegradation of bisphenol A and 4-alkylphenols by Novosphingobium sp. strain TYA-1 and its potential for treatment of polluted water

We investigated the use of Novosphingobium sp. strain TYA-1 for the simultaneous removal of bisphenol A (BPA) and 4-alkylphenols (4-APs) from complex polluted waters. Strain TYA-1 degraded BPA and utilized it as a sole carbon and energy source via oxidative skeletal rearrangement involving the cytochrome p450 monooxygenase system. Strain TYA-1 also degraded 4-APs with branched side alkyl chains (4-tert-butylphenol [4-tert-BP], 4-sec-butylphenol, 4-tert-pentylphenol, 4-tert-octylphenol [4-tert-OP], and branched nonylphenol mixture) via 4-alkylcatechols but could not degrade 4-APs with linear side alkyl chains. Degradation of 4-APs, like that of BPA, involved the cytochrome p450 monooxygenase system in strain TYA-1. A sequencing batch bioreactor (100 mL of polluted water [50 mg/L BPA, 50 mg/L 4-tert-BP, and 5 mg/L 4-tert-OP]; 6 h of reaction time/cycle; 12 cycles in total) containing alginate-immobilized TYA-1 cells (15 mg dry cells) simultaneously removed BPA, 4-tert-BP, and 4-tert-OP from complex polluted waters. These immobilized TYA-1 cells could be reused for a total of 9 cycles without any loss of degradation activity. Our results support the potential of using immobilized TYA-1 cells for the simultaneous removal of BPA and 4-APs from complex polluted waters.

Development and validation of a quality of life scale specific for lumbar spinal stenosis

STUDY DESIGN

A cross-sectional study.

OBJECTIVE

To develop a reliable and valid instrument to measure quality of life (QOL) specifically targeting patients with lumbar spinal stenosis (LSS).

SUMMARY OF BACKGROUND DATA

Studies on LSS have investigated the effectiveness of various types of treatments using health-related QOL. However, patients with LSS have various symptoms, and these symptoms change with posture, typical activities of daily living, etc. Thus, an LSS-specific scale to measure QOL is needed.

METHODS

We postulated 7 subdomains for LSS-specific QOL and accordingly, item pool was developed, focus group interviews of patients with LSS and qualitative analysis were conducted, resulting in preliminary version of QOL scale. Then, 189 patients with a diagnosis of LSS completed this preliminary version. Exploratory factor analysis was conducted to examine the factorial validity. Cronbach alpha coefficient and the test-retest method were used to assess the reliability. The criterion-based validity was determined using walking capacity, recommended treatment level judged by orthopedists, and LSS symptom scale scores.

RESULTS

Qualitative study confirmed the 7 domains but showed needs of addition and deletion of some items, resulting in 31 items. With factor analysis, after exclusion of 3 items, the remaining 28 items demonstrated strong unidimensionality. Cronbach alpha was 0.96. The coefficient of test-retest reliability was 0.86. Walking capacity, recommended treatment level, and LSS symptom scale scores were significantly correlated with the QOL scale scores.

CONCLUSION

A 28-item QOL scale specifically targeting patients with LSS was developed, and its reliability and validity were confirmed.

Effects of dopamine and glutamate on synaptic plasticity: a computational modeling approach for drug abuse as comorbidity in mood disorders

Major depressive disorder (MDD) affects about 16% of the general population and is a leading cause of death in the United States and around the world. Aggravating the situation is the fact that "drug use disorders" are highly comorbid in MDD patients, and VICE VERSA. Drug use and MDD share a common component, the dopamine system, which is critical in many motivation and reward processes, as well as in the regulation of stress responses in MDD. A potentiating mechanism in drug use disorders appears to be synaptic plasticity, which is regulated by dopamine transmission. In this article, we describe a computational model of the synaptic plasticity of GABAergic medium spiny neurons in the nucleus accumbens, which is critical in the reward system. The model accounts for effects of both dopamine and glutamate transmission. Model simulations show that GABAergic medium spiny neurons tend to respond to dopamine stimuli with synaptic potentiation and to glutamate signals with synaptic depression. Concurrent dopamine and glutamate signals cause various types of synaptic plasticity, depending on input scenarios. Interestingly, the model shows that a single 0.5 mg/kg dose of amphetamine can cause synaptic potentiation for over 2 h, a phenomenon that makes synaptic plasticity of medium spiny neurons behave quasi as a bistable system. The model also identifies mechanisms that could potentially be critical to correcting modifications of synaptic plasticity caused by drugs in MDD patients. An example is the feedback loop between protein kinase A, phosphodiesterase, and the second messenger cAMP in the postsynapse. Since reward mechanisms activated by psychostimulants could be crucial in establishing addiction comorbidity in patients with MDD, this model might become an aid for identifying and targeting specific modules within the reward system and lead to a better understanding and potential treatment of comorbid drug use disorders in MDD.

Discovery of a Highly Potent and Selective MEK Inhibitor: GSK1120212 (JTP-74057 DMSO Solvate)

Inhibition of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) represents a promising strategy for the discovery of a new generation of anticancer chemotherapeutics. Our synthetic efforts, beginning from the lead compound 2, were directed at improving antiproliferative activity against cancer cells as well as various drug properties. These efforts led to the discovery of N-{3-[3-cyclopropyl-5-(2-fluoro-4-iodophenylamino)-6,8-dimethyl-2,4,7-trioxo-3,4,6,7-tetrahydro-2H-pyrido[4,3-d]pyrimidin-1-yl]phenyl}acetamide dimethylsulfoxide solvate (GSK1120212, JTP-74057 DMSO solvate; 1), a selective and highly potent MEK inhibitor with improved drug properties. We further confirmed that the antiproliferative activity correlates with cellular MEK inhibition and observed significant antitumor activity with daily oral dosing of 1 in a tumor xenograft model. These qualities led to the selection of 1 for clinical development.

Pseudogout of the acromioclavicular joint: report of two cases and review of the literature

Although calcium pyrophosphate dehydrate (CPPD) deposition disease, including pseudogout, is a relatively common disease affecting the major joints, especially the knee, pseudogout in the acromioclavicular (AC) joint is very uncommon. We describe two cases of acute pseudogout attacks of the AC joint in elderly patients. Radiological findings showed chondrocalcinosis in the AC joints. Microscopically, aspirated articular synovial fluid demonstrated CPPD crystals. Conservative therapy with non-steroidal anti-inflammatory drugs completely resolved all symptoms within 1 week.

Intramuscular Castleman's disease of the deltoid: a case report and review of the literature

Castleman's disease (CD), a rare benign disease characterized by lymphoid hyperplasia, typically arises in the mediastinum as a solitary tumor. We describe herein a rare case of intramuscular CD occurring in the left deltoid in a 28-year-old woman. The present case is instructive in the differential diagnosis of primary soft tissue tumors, for which the possibility of CD should be considered.

Chance fracture of the lumbar spine in an amateur snowboarder: a case report

"Chance fracture" is an unusual type of spinal fracture caused by flexion-distraction of the back. We describe herein a rare case of a male amateur snowboarder who suffered lumbar Chance fracture caused by a fall after freestyle jumping. Radiological findings of plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) showed a loss of vertebral height in the anterior L1 vertebral body with a horizontal splitting fracture extending across the vertebral body, bilateral pedicles, and lamina. On the basis of the aforementioned findings, the diagnosis of Chance fracture of the L1 vertebra was established. The fracture healed without any subsequent disabilities following conservative medical management with a thoracolumbar orthosis, and no impairments to activities of daily living were encountered, including job or sports performance. Although Chance fracture caused by a fall is rare, particularly in sports, the possibility of this fracture should be considered when diagnosing spinal injuries in snowboarders.

Establishment and characterization of a novel human malignant peripheral nerve sheath tumor cell line, FMS-1, that overexpresses epidermal growth factor receptor and cyclooxygenase-2

Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma. We established a new human MPNST cell line (designated FMS-1) from MPNST of the right brachial plexus of a 69-year-old woman with NF1. The cell line has been maintained for >24 months with >100 passages. FMS-1 cells showed a fibrosarcoma-like or epithelioid pattern in the heterotransplanted tumor, compared with a fascicular growth pattern of short-spindle tumor cells in the primary tumor. Immunophenotypically, FMS-1 cells showed almost the same characteristics as the primary tumor. Cytogenetic and molecular analyses revealed a deletion in exons 5-8 of the p53 gene. Epidermal growth factor receptor (EGFR) and cyclooxygenase (COX)-2 were expressed in FMS-1 cells. To improve the highly aggressive course and poor prognosis and establish new therapeutic methods, molecular genetic and biological characterizations of MPNST are required. Thus, FMS-1 cells might be useful for investigating biological behaviors and developing new molecular-targeting antitumor drugs for MPNST expressing EGFR or COX-2.