Search

Floods and landslides caused by extreme weather events, such as localized excessive rainfall in Japan, cause enormous devastation. Multicell clouds, on the other hand, have a common duration of over an hour and greater aerial coverage than single-cell clouds. For flood warning systems to function properly, the hazardous cloud must be detected quickly. Using pseudo and dual-Doppler vorticity approaches, the vertical vorticity estimate was extended from single-cell to multicell transitions case. According to the research, the single cells attained the peak of maximum vorticity of 0.08 and 0.01 s−1 for pseudo-vorticity and dual-Doppler vorticity, respectively. The maximum column of specific differential phase (Kdp) column above the melting layer indicated that the transition with 1 km depth as compared to differential reflectivity (Zdr) column was not observed after the cell merging. However, it was identified 5 min after the cell merged. In contrast, the Kdp column was always identified after the cell merging, and the column showed an increase in intensity 5 min after the cells merged. Vertical vorticity and multi-parameter radar analysis provided an insight into the transition from single-cell to multicell formation.

Understanding the effects of climate change on agricultural crops is an essential part of flood-risk management and adaptation measures. However, the quantitative impact of flood damage on agricultural crops under climate change is still not clearly understood. It is thus crucial to investigate flood damage to agricultural crops under climate change scenarios to understand future crop damage better. In this study, we first explored the relationship between extreme rainfall and damaged paddy area for a historical period, and then focused on the quantitative analysis of flood impact on rice crops under climate change using MRI-AGCM3.2S climate model outputs for the past (1979–2002) and future (2075–2098) climate periods for the Solo River basin in Indonesia. We developed a quantitative damage assessment method by coupling water and energy budget-based rainfall-runoff-inundation model outputs and a flood loss model. Flood damage to rice crops was defined as a function of flood depth and duration, and depth-duration-damage curves were applied to quantify the damage. The results show that flood damage to rice crops will be more severe in the future than in the past, and the findings can be useful in establishing risk reduction and adaptation measures.

Extreme rainfall or heavy rainfall events (HREs) causes significant socio-economic damages annually affecting local development especially in developing countries. Thus, assessing changes in frequency and magnitude of HREs under climate change using global climate model (GCM) projections became ubiquitous to hydrological impact studies. Here, we present a framework for evaluating GCM's ability in reproducing the seasonal frequency of HREs in Davao River basin and the associated weather patterns that led to HREs. Our results show that HREs in MRI-AGCM 3.2S occurred 81 % in DJF and 4 % in JJA, which showed over(under) estimation bias during DJF(JJA) season compared to ERA5 HREs that show occurrence of 50 % in DJF and 18 % in JJA. Furthermore, we examined the weather pattern and anomalies that led to anomalous conditions of the season specific HREs in Davao River basin, which showed MRI-AGCM3.2S was able to reproduce the general structure of anomalous conditions fairly well on both seasons in comparison with ERA5. However, the slight over(under)estimation of the surface anomalous conditions in DJF(JJA) are directly proportional to the over(under)estimation in rainfall magnitude in the basin.

We report a case of thigh emphysema resulting from perforated appendicitis. The patient was an 83-year-old man who had no apparent abdominal signs and was initially misdiagnosed as having psoas abscess. Magnetic resonance imaging of the pelvis revealed appendicitis, and a barium enema showed a leakage of enhanced contrast material from the appendix region down into the thigh. A retroperitoneal perforation of the retrocaecal appendix without peritonitis was diagnosed. The patient underwent an appendectomy and curettage of the retroperitoneal and psoas muscle spaces, as well as the thigh. He recovered gradually, though the abscess had extended into the hip joint and resulted in osteomyelitis, requiring an additional procedure of resection arthroplasty. The patient fully recovered with no signs of infection one year postoperatively.

Functional molecular inorganic-organic hybrids of lacunary polyoxometalates and organic ligands attract much attention for advanced material applications. However, the inherent instability of lacunary polyoxomolybdates hinders the synthesis of hybrids and their utilization. Herein, we present a viable approach for the synthesis of molecular hybrids of trivacant lacunary Keggin-type polyoxomolybdates and multidentate organic ligands including carboxylates and phosphonates, which is based on the use of a lacunary structure stabilized by removable pyridyl ligands as a starting material., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

The hydrolysis of levan using compressed hot water for the production of functional fructooligosaccharides (FOSs) was investigated. Levans from Erwinia herbicola (EH) and Halomonas smyrnensis (HS) were characterized using scanning electron microscopy and light scattering techniques, and hydrolyzed using compressed hot water at four temperatures (120, 140, 160, and 180°C). The hydrolysates were analyzed using high-performance liquid chromatography and electrospray ionization-mass spectrometry. Levan HS showed a crystalline morphology, whereas levan EH showed an aggregated structure. Both levans had molar masses on the order of 10 6  g/mol, but levan EH had a smaller radius of gyration, hydrodynamic radius, and intrinsic viscosity. Levan EH hydrolyzed into FOSs at approximately 120°C, whereas levan HS required a temperature of at least 160°C, possibly because of differences in the degree of branching of the two levans. Both samples were degraded to fructose when treated at 180°C., Competing Interests: The authors declare that they have no conflict of interest., (© 2020 The Authors. Food Science & Nutrition published by Wiley Periodicals, Inc.)

Introduction: Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia, characterized by bilateral macronodular adrenal hypertrophy and autonomous cortisol production, is a rare cause of Cushing's syndrome. Bilateral adrenalectomy is considered the standard treatment for adrenocorticotropic hormone-independent macronodular adrenal hyperplasia but obliges the patient to receive lifetime steroid replacement therapy subsequently, and may increase the patient's risk of adrenal insufficiency. These circumstances require surgeons to carefully consider operative strategies on an individual basis., Case Presentation: We performed successful laparoscopic adrenalectomy on four patients with adrenocorticotropic hormone-independent macronodular adrenal hyperplasia. Computed tomography scans showed bilateral adrenal enlargement in all patients. Case 1: a 56-year-old Japanese woman presented with obvious Cushing's symptoms during treatment for diabetes mellitus and hypertension. Case 2: a 37-year-old Japanese man also presented with Cushing's symptoms during treatment for diabetes mellitus and hypertension. These patients were diagnosed as Cushing's syndrome caused by adrenocorticotropic hormone-independent macronodular adrenal hyperplasia based on endocrinologic testing, and underwent bilateral laparoscopic adrenalectomy. Case 3: an 80-year-old Japanese woman was hospitalized due to unusual weight gain and heightened general fatigue, and was diagnosed as Cushing's syndrome caused by adrenocorticotropic hormone-independent macronodular adrenal hyperplasia. She underwent unilateral laparoscopic adrenalectomy due to high operative risk. Case 4: a 66-year-old Japanese man was discovered to have bilateral adrenal tumors on medical examination. He did not have Cushing's symptoms and was diagnosed as subclinical Cushing's syndrome due to suppressed adrenocorticotropic hormone serum levels and loss of cortisol circadian rhythm without abnormal levels of serum cortisol. He underwent unilateral laparoscopic adrenalectomy. During follow-up, serum cortisol levels were within the normal range in all cases, and serum adrenocorticotropic hormone levels were not suppressed. Further, cases with Cushing's syndrome experienced clinical improvement., Conclusions: We were able to effectively treat adrenocorticotropic hormone-independent macronodular adrenal hyperplasia in patients with obvious Cushing's symptoms by laparoscopic bilateral adrenalectomy, which promptly improved symptoms. Further, unilateral adrenalectomy was effective for treating an older patient at high operative risk and a patient with subclinical Cushing's syndrome.

Using ultraviolet (UV)-excited ozone gas, we prepared high-quality SiO(2) films that can be used as gate dielectric films on poly-silicon or silicon wafers without sample heating. The UV-excited ozone gas was generated by UV irradiation of highly concentrated ozone gas. During the UV-excited ozone process, UV light irradiates the sample surface directly through the ozone gas. Then, the temperature at the sample surface is increased by UV-light absorption at the surface. Estimation of this surface temperature is important for understanding the oxidation mechanism. We estimated the surface temperature obtained during UV irradiation to be about 300 degrees C by investigating the temperature dependence of the oxidation rate for oxygen gas. We have previously determined that almost no thermal decomposition of ozone gas occurs at this temperature, and that oxygen gas does not oxidize the Si substrate. Therefore, we concluded that the only oxidation species in the UV-excited ozone process is UV-excited ozone O((1)D).

Objectives: Ground-glass opacities are typically difficult to inspect and to palpate during video-assisted thoracic surgery. We therefore examined whether ultrasonographic assessments could localize ground-glass opacities and help to achieve adequate resection margins., Methods: An intraoperative ultrasonographic procedure was prospectively performed on 44 patients harboring ground-glass opacities of less than 20 mm in diameter to localize these lesions and to achieve adequate margins. We also examined whether there were any complications resulting from the intraoperative ultrasonogram, such as lung injury, heart injury, or arrhythmia. We excluded patients with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure is more difficult to interpret when residual air is present in the lung., Results: A total of 53 ground-glass opacities were successfully identified by intraoperative ultrasonography without any complications. Of the 20 mixed ground-glass opacities that we examined, 15 were found on palpation. However, only 4 (12.1%) of the 33 pure ground-glass opacities could be palpated. In all instances in which complete collapse of the lung was achieved (30/53 of these cases), high-quality echo images were obtained. Additionally, a strong correlation was found between the resection margins measured by ultrasonogram and the margins determined by histologic examination in the resected lung specimens (r(2) = 0.954, P < .001)., Conclusions: Intraoperative ultrasonography can both safely and effectively localize pulmonary ground-glass opacities in a completely deflated lung. This procedure is also useful for the evaluation of surgical margins in a resected lung. Hence, ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of solitary lung ground-glass opacity.

With the extensive adoption of transgenic crops, an understanding of transgene flow is essential to manage gene flow to non-GM crops. Thus, a flexible and accurate numerical model is required to assess gene flow through pollen dispersal. A three-dimensional atmospheric model combined with a diffusion transport model would be a useful tool for predicting pollen dispersal since it would be flexible enough to incorporate the effects of factors such as the spatial arrangement of crop combinations, land use, topography, windbreaks, and buildings. We applied such a model to field measurements of gene flow between two adjacent maize (Zea mays) cultivars, with suppression effects due to windbreaks, in an experimental cornfield in Japan. This combined model reproduced the measured cross-pollination distribution quite well in the case of maize plots with plant windbreaks slightly taller than the maize and without windbreaks, but the model underestimated the effect of a 6-m-tall windbreak net beyond 25 m from the donor pollen source on cross-pollination. The underestimation was most probably due to the problem of assimilated wind data. The model showed that the 6-m-tall windbreak and the plant wind break suppressed average cross-pollination rate by about 60% and 30%, respectively. Half-tall and coarser mesh windbreak net suppressed cross-pollination rates by 40% by reducing the swirl of donor pollen by reduced wind speed., (© ISBR, EDP Sciences, 2010.)

Background: The association between 5-fluorouracil (5-FU)-related enzyme activity and the sensitivity of bladder urothelial carcinoma (BUC) to 5-FU were investigated, and methods to improve 5-FU sensitivity were analyzed., Materials and Methods: Tumor specimens were obtained from 127 patients. Orotate phosphoribosyl transferase (OPRT) activity was analyzed by the paper disc method and thymidine phosphorylase and dihydropyrimidine dehydrogenase (DPD) activities were measured by ELISA. 5-FU sensitivity was assessed in 99 cases by an in vitro chemosensitivity test., Results: A significant positive correlation between OPRT activity level and the sensitivity of BUC to 5-FU was identified. Moreover, the combination of 5-FU and 5-chloro-2,4-dihydroxypyrimidine significantly enhanced 5-FU sensitivity in BUC, particularly in cases showing higher DPD activity., Conclusion: OPRT was the most important enzyme in predicting sensitivity to 5-FU in BUC. These results may have implications for tailor-made medication using 5-FU-related compounds as postoperative adjuvant chemotherapy in BUC patients.

The aim of this study was to evaluate the plasma trough concentrations (C(0)) of mycophenolic acid (MPA) and its major metabolite MPA 7-O-glucuronide (MPAG) in metal cation (MC)(-) (non-treated) and MC(+) (co-treated) patients who received tacrolimus (Tac) or cyclosporine (CyA). Fifty-nine Japanese stable kidney transplant recipients receiving immunosuppressive regimens containing mycophenolate mofetil (MMF) and a calcineurin inhibitor (CNI) were included in this study. Seven in the 25 patients receiving Tac and 8 in the 34 patients receiving CyA were treated with concomitant MCs administration. Multiple regression analysis revealed that concomitant MCs and CyA administration influenced MPA C(0). Their standardized partial regression coefficients were -0.29 and -0.41, respectively. Stratified analysis based on CNI treatment revealed that MPA C(0) decreased significantly by 56% with concomitant MCs administration in Tac-treated patients. There was no significant difference in MPA C(0) between the MC(-) and MC(+) groups in CyA-treated patients. With respect to MPAG C(0), MC(+) group tended to be lower by 26% than MC(-) group in Tac-treated patients. There was no significant difference in MPAG C(0) between the MC(-) and MC(+) groups in CyA-treated patients. Concomitant MCs administration did not affect the C(0) ratio of MPAG to MPA in either Tac- or CyA-treated patients. In conclusion, MCs co-administration decrease MPA C(0) in patients receiving Tac and may cause lower MPA exposure. There are little pharmacokinetic interactions between MMF and concomitant MCs in CyA-treated patients.

The dielectric relaxation process of water was investigated for polymer/water mixtures containing poly(vinyl methyl ether), poly(ethyleneimine), poly(vinyl alcohol), and poly(vinylpyrrolidone) with a polymer concentration of up to 40 wt % at frequencies between 10 MHz and 10 GHz in subzero temperatures down to -55 degrees C. These polymer/water mixtures have a crystallization temperature TC of water at -10 to -2 degrees C. Below TC, part of the water crystallized and another part of the water, uncrystallized water (UCW), remained in a liquid state with the polymer in an uncrystallized phase. The dielectric relaxation process of UCW was observed, and reliable dielectric relaxation parameters of UCW were obtained at temperatures of -26 to -2 degrees C. At TC, the relaxation strength, relaxation time, and relaxation time distribution change abruptly, and their subsequent changes with decreasing temperature are larger than those above TC. The relaxation strength of UCW decreases, and the relaxation time and dynamic heterogeneity (distribution of relaxation time) increase with decreasing temperature. These large temperature dependences below TC can be explained by the increase in polymer concentration in the uncrystallized phase C(p,UCP) with decreasing temperature. C(p,UCP) is independent of the initial polymer concentration. In contrast to the relaxation times above TC, which vary with the chemical structure of the polymer and its concentration, the relaxation times of UCW are independent of both of them. This indicates that the factor determining whether the water forms ice crystals or stays as UCW is the mobility of the water molecules.

Background: We investigated whether thymidine phosphorylase (TP) protein level in renal cell carcinoma (RCC) correlates with clinicopathological characteristics and clinical outcomes., Methods: TP protein level was measured in 116 RCC specimens and in 90 non-neoplastic kidney tissues using a sandwich-type enzyme-linked immunosolvent assay., Results: The median TP protein level in RCC tissues was 9.76-fold (range, 3.2-933.9) higher than those in non-neoplastic kidney tissues (P < 0.0001). TP protein level was correlated with T classification, histological grade and mode of infiltration. TP as a prognostic variable was studied using a logistic regression model. TP at higher levels (128 U/mg protein or greater) would play a role as an independent prognostic factor (odds ratio, 13.73; 95% confidence interval, 2.09-90.41; P = 0.0064)., Conclusion: TP at high levels can be regarded as an unfavorable independent prognostic factor. These results may pave a way for a novel approach to effective treatment of RCC.

Mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil (MMF) has been introduced into renal transplant immunosuppressant protocols in combination with calcineurin inhibitors (CNIs) and steroids. This study compared the pharmacokinetic profiles of MPA and its major metabolite MPA glucuronide (MPAG) in combination with tacrolimus (TAC) or cyclosporine (CyA) during the maintenance period (>6 months) following renal transplantation. There was no difference between TAC and CyA-treated groups in MPA plasma concentration before drug administration (C(0)). MPA C(0) in TAC and CyA-treated patients did not differ from that in patients who were not treated with a CNI. In patients treated with a CNI, MPAG C(0) was significantly greater in those treated with CyA compared with TAC. The MPAG/MPA ratio in CyA-treated patients was significantly greater than that in the TAC-treated group. We observed that C(0) of MPA was negatively correlated with that of TAC and CyA. Positive correlation between MPA C(0), MPAG C(0) and serum creatinine was stronger in patients treated with CyA compared with TAC. Our study suggests that CyA, but not TAC, inhibits enterohepatic circulation of MPAG as a secondary excretion pathway, and that renal function makes a major contribution to elimination of MPA and MPAG. We indicate that it may be necessary to estimate biliary excretion of MPAG to avoid the risk of intestinal injury in patients receiving combination therapy with TAC during the maintenance period.

A 64-year-old female was admitted to hospital for acute abdominal pain with ascites. The patient had received postoperative pelvic irradiation for carcinoma of the uterine cervix 7 years previously. Serum creatinine (Scr) was elevated to 2.70 mg/dl, and urinary output was reduced to below 200 ml/day. Cystoscopy revealed a small perforation from the bladder diverticulum. Following transurethral catheterization, urinary output was promptly increased, and Scr was returned to 0.65 mg/dl 4 days later. This rare case suggested that spontaneous rupture of the urinary bladder following postoperative radiotherapy could occur very late with laboratory features of oliguric acute renal failure.

It is necessary and important to quantify the handicap sustained by individuals with spinal cord injury (SCI); however, few instruments are available to measure the level of the disability. One of the best developed and most often used measures is the Craig Handicap Assessment and Reporting Technique (CHART). Nevertheless, a Japanese version has not yet been developed and tested for SCI individuals. The purpose of this study was to develop a Japanese version of the CHART (CHART-J) and to investigate its test-retest reliability and discriminant validity in SCI in Japan. Fifty-four individuals with SCI participated in the test-retest reliability study and 293 participated in the discriminant validity analysis. We have shown that the test-retest reliability coefficients of the CHART-J range from 0.57 to 1.00. In addition, its discriminant validity is acceptable for individuals with SCI in Japan. Therefore, the CHART-J is useful as a measure of disability for Japanese individuals with SCI.

We present a case of pyogenic lumbar discitis and septic hip arthritis, accompanied by a psoas abscess and pyogenic iliopsoas bursitis, for which the correct diagnosis was delayed. The patho-mechanism was speculated to be initial hematogenous infection in the lumbar spine that spread along the psoas muscle as a psoas abscess and then extended into the hip joint via the iliopsoas bursa. For an early correct diagnosis, clinicians should be aware that the lumbar spine and hip joint regions communicate through the psoas muscle space and iliopsoas bursa, making it possible for infection to spread.

Background: Recent studies have shown that adipose tissue is an endocrine organ that releases various cytokines., Objective: To investigate the production of growth factors and proinflammatory cytokines in infrapatellar fat pad specimens., Methods: Infrapatellar fat pad tissues were obtained from patients during knee surgery. Protein levels of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), tumour necrosis factor (TNF)alpha, and interleukin (IL)6 in homogenised tissues were measured by an enzyme immunoassay. Gene expressions for those cytokines were examined by reverse transcription-polymerase chain reaction (RT-PCR). Localisation of bFGF and VEGF was evaluated by immunohistochemistry and in situ hybridisation., Results: Infrapatellar fat pads were found to contain various protein levels of bFGF, VEGF, TNF alpha, and IL6. Further, gene expressions for these cytokines were detected by RT-PCR. Immunohistochemistry and in situ hybridisation showed that the expressions of both bFGF and VEGF were localised in immature adipocytes, interstitial undifferentiated mesenchymal cells, and vascular endothelial cells., Conclusion: The production of bFGF, VEGF, TNF alpha, and IL6 in the infrapatellar fat pad was demonstrated. Although synovial cells and articular chondrocytes are thought to be primary sources of cytokines found in knee synovial fluids, the results suggest that they may also originate from this fat pad.

Charcot-Marie-Tooth disease is classified into hereditary motor and sensory neuropathy (HMSN) types I and II, and affected patients present with progressive peripheral neuropathy. Some previous orthopedic studies have revealed the association of hip dysplasia with HMSN, in addition to pes cavovarus, scoliosis, and recurrent dislocation of the patella. We describe three patients from the same family who were each diagnosed as having HMSN type I with associated bilateral severe hip dysplasia, borderline abnormalities of both acetabula, and dysplastic osteoarthritis. Based on our experience with these patients and a review of previous reports, we concluded that routine screening of hip joints, especially for those with a family history of HMSN, is necessary for early diagnosis.

Objective: To determine ethnic variations of large-joint osteoarthritis (OA) in past populations., Methods: One thousand two hundred and nine adult skeletons, excavated from archaeological sites in Japan, China and France were assessed for OA as defined by the presence of eburnation., Results: Within Asian skeletal populations, elbow OA and patellofemoral joint OA were more common in hunter-gatherers than in agriculturalists. Compared with Caucasians, the Asian skeletal population had a higher prevalence of tibiofemoral joint OA., Conclusion: The relative frequencies of OA within and between ethnic groups at certain joint sites have changed over time from the past to the present.

Study Design: A retrospective study., Objectives: To investigate the risk factors of vesicoureteral reflux in the early stage of spinal cord injury., Setting: Japan., Methods: Urological evaluation, including cystography and urodynamic study was performed in patients in the early stage of spinal cord injury. The patients were divided into two groups. Group 1 included 13 patients with vesicoureteral reflux. Group 2 included 97 patients without vesicoureteral reflux. We compared Group 1 and Group 2 regarding bladder deformation, the level of spinal cord injury, bladder behaviour, bladder compliance, high urethral closure pressure and method of urine evacuation., Results: The patients injured between Th10 and L2 showed a significantly higher incidence of vesicoureteral reflux than those injured in other areas (P<0.01). Furthermore, bladder compliance among patients with vesicoureteral reflux tended to be low. Other factors showed no differences between patients with and without vesicoureteral reflux., Conclusion: Injuries between Th10 and L2 involve the sympathetic nervous system. Patients with such injuries often exhibited vesicoureteral reflux in the early stage of spinal cord injury.

Objective: In view of the importance of estrogen and IL-6 in the pathogenesis of rheumatoid arthritis (RA), the effects of 17 beta-estradiol (E2) on interleukin (IL)-6 production in cultured rheumatoid fibroblast-like synoviocytes were investigated., Methods: Cultured fibroblast-like synoviocytes obtained from RA joints were treated with the vehicle (control), as well as 10(-8) and 10(-6) M of E2, with or without IL-1 beta stimulation. After 72 hours of culture, the levels of IL-6 in supernatants were measured by ELISA., Results: Treatment with 10(-8) and 10(-6) M of E2 had no effect on the constitutive production of IL-6 in cultured fibroblast-like synoviocytes. However, E2 increased IL-1 beta-induced IL-6 production in a dose-dependent manner, with a mean 12.5% increase with 10(-8) M of E2 (p = 0.048) and 33.4% with 10(-6) M (p < 0.0001) versus the control., Conclusion: Estrogen up-regulates IL-1 beta-induced IL-6 production in cultured fibroblast-like synoviocytes, possibly contributing to the enhancement of rheumatoid inflammation in synovial tissues.

Objective: : To determine ethnic variations of acetabular morphology, and to delineate their relationship with hip osteoarthritis (OA)., Methods: : Radiographs of 283 French men, 118 French women, 414 Japanese men and 368 Japanese women, aged 20-79 yr, who underwent intravenous urography were assessed by a single observer for morphometric measurement and hip OA scoring., Results: : The standardized morbidity ratio (SMR) for hip OA was highest in French men and lowest in Japanese men, whereas the SMR for acetabular dysplasia was highest in Japanese women and lowest in French men. French men and women had the highest centre-edge angle, followed by Japanese men then Japanese women., Conclusion: : In a large number of subjects assessed by a single observer, this study confirms other previous reports that the relationship between acetabular dysplasia and risk of hip OA is negative.

Objective: In view of a possible role of androgens in the pathogenesis of ankylosing spondylitis (AS), we investigated the association between Japanese male patients with AS and CAG microsatellites of the androgen receptor (AR) gene which related to the AR transactivation function., Methods: Peripheral blood was collected from 39 men with AS and 305 male control subjects. The number of CAG repeats in exon 1 of the AR gene was determined., Results: CAG repeat lengths in AS patients were significantly shorter than those in the controls (median value 22 vs 23; P = 0.03). However, there was no significant difference in CAG repeats between HLA-B27-positive and -negative patients (median value 22 vs 22; P = 0.78)., Conclusions: Shorter CAG repeats of the AR gene, presenting high levels of transactivation activity, may play a role in male AS.

Objective: To investigate the association between vitamin D receptor (VDR) gene polymorphisms andJapanese female patients with osteoarthritis (OA) of the hand, hip, and knee., Methods: BsmI,ApaI, andTaqI restriction fragment length polymorphisms (RFLPs) of the VDR gene were analysed in 270Japanese female patients with radiographic OA of the hand, hip, tibiofemoral (TF) joint, andpatellofemoral (PF) joint, as well as in female controls., Results: There was no significant association between the VDR gene RFLPs and OA of the hand, hip, TFjoint, PF joint, or polyarticular involvement. The previously detected preventive genotype of the VDRgene was uncommon in our test population., Conclusion: The relative importance of VDR gene polymorphism in the development of OA may vary betweenethnic groups.

Objective: To evaluate secular trends in the incidence and prevalence of rheumatoid arthritis (RA) in Japan., Methods: The incidence and prevalence of RA were determined in a longitudinal population based study in the Kamitonda district, Wakayama, Japan, from 1965 to 1996., Results: In the study area consisting of about 3000 inhabitants, 16 incident cases, satisfying definite RA by the Rome criteria were detected during the study period. The age and sex adjusted incidence in both men and women combined and the age adjusted incidence in women significantly decreased (p<0.025 and p<0. 01, respectively). The age and sex adjusted prevalence in all inhabitants tended to decrease (p<0.1), and the age adjusted prevalence in women significantly declined (p<0.025). In men, however, neither incidence nor prevalence showed significant change., Conclusions: The decline of incidence and prevalence of female RA may be reducible to some environmental changes preferentially occurring more obviously in Japanese women than in men. Because the use of oral contraceptives has been extremely low in Japan, the decline should be explained by other factors.

Objective: To investigate the gene expression of estrogen receptor (ER) alpha and ERbeta in human articular chondrocytes., Methods: 16 articular cartilage specimens were obtained from 15 patients during surgery. Three of the specimens were from men and 13 from women; three from hip joints and 13 from knee joints; four were normal and 12 showed osteoarthritic cartilage. Total RNA was extracted from the articular chondrocytes and the expression of both ERalpha and ERbeta genes was investigated by the reverse transcription-polymerase chain reaction (RT-PCR) method., Results: Gene expressions of ERalpha were detected in all specimens and those of ERbeta were found in 15 specimens by the RT-PCR method. There was a significant correlation between the amounts of ERalpha and ERbeta. Expression levels of both genes were significantly higher in men than in women. There were no significant differences in the expression levels of both ER genes between the hip and knee joint sites, nor between normal and osteoarthritic tissues., Conclusion: This study is to our knowledge the first to demonstrate the gene expression of both ERalpha and ERbeta in human articular chondrocytes. Since there are some functional differences between the two receptors, the effects of estrogen on cartilage metabolism should be elucidated by two different receptor mechanisms., (Copyright 1999 OsteoArthritis Research Society International.)

Objective: The etiologic role of sex hormones in rheumatoid arthritis (RA) has been discussed. Cytochrome P450c 17 alpha (CYP17) regulates steroidogenesis and the restriction fragment length polymorphisms (RFLPs) of the CYP17 gene are related to serum sex hormone production. In this study, the relationship between CYP17 gene RFLPs and RA was investigated., Methods: Genomic DNA was extracted from the peripheral blood of 91 male and 285 female patients with RA, as well as from 380 male and 579 female controls, and the RFLPs of the CYP17 gene (denoted as the A1 and A2 alleles) were determined. Clinical variables were recorded for the RA patients., Results: There were no significant differences in CYP17 genotype distribution between the male RA patients and male controls, nor between the female RA patients and female controls. RA patients with the A2 allele tended to develop the disease at a younger age than those without (in men 50.1 vs 54.7 yrs, p = 0.15; in women 43.9 vs 47.4 yrs, p = 0.038). In women, having the A2 allele was a weak protective factor against developing RA at an older age (odds ratio: 0.63, 95% confidence interval: 0.41-0.95, p = 0.026)., Conclusion: The RFLPs of the CYP17 gene may constitute a disease modifying factor through sex hormone production.

Objective: In view of the possible role of androgens in the pathogenesis of rheumatoid arthritis (RA), this study investigated the association between repeat lengths of CAG microsatellites of the androgen receptor (AR) gene and RA., Methods: The number of CAG repeats in exon 1 of the AR gene was determined in 90 men and 276 women with RA, as well as in 305 male and 332 female controls., Results: The male RA patients tended to have shorter repeats than the male controls (22.5 versus 23.1, p=0.07), whereas the female RA patients had similar repeats to the female controls (22.7 versus 22.9, p=0.17). Patients of both sexes were divided into younger and older age at onset groups, and compared with younger and older controls. Younger onset male RA patients had significantly shorter CAG repeat lengths than the younger male controls (21.8 versus 23.2, p=0.007) or the older onset male RA patients (21.8 versus 23.2, p=0.04). Older onset male RA and both younger and older onset female RA patients had similar CAG repeat lengths when compared with their controls. Neither seropositivity nor rheumatoid nodule positivity had a significant relation with CAG repeat lengths., Conclusion: Shorter CAG repeats of the AR gene, presenting high levels of transactivation activity, are related to younger age onset male RA, suggesting the possible role of androgens as a modulating factor.

We investigated gene expression of antiinflammatory mediators in the interfacial membranes retrieved at hip revision arthroplasty using reverse transcription-polymerase chain reaction (RT-PCR). Levels of RT-PCR products were compared with those of synovial tissue from patients with osteoarthrosis or rheumatoid arthritis. Antiinflammatory mediators such as type II interleukin (IL)-1 receptor, IL-4, IL-10, IL-1 receptor antagonist, and transforming growth factor-beta 1 (TGF-beta 1) were expressed in the interfacial membrane. In interfacial tissue, the level of IL-10 was lower, but that of the IL-1 receptor antagonist higher than in diseased synovial tissue.

Objective: In view of the possible role of oestrogens in the pathogenesis of rheumatoid arthritis (RA), this study investigated the association between oestrogen receptor (OR) gene polymorphisms and RA., Methods: Pvu II and Xba I restriction fragment length polymorphisms of the OR gene were analysed in 70 male and 240 female patients with RA, and in 300 male and 350 female controls. The absence or presence of restriction sites were represented as P, p (Pvu II) or X, x (Xba I). The distribution of OR genotypes was compared between the RA and control subjects by sex. RA patients were divided into subgroups according to their OR genotypes, then the age at onset, seropositivity, and rheumatoid nodule positivity were compared between the subgroups., Results: The OR genotype frequency of distribution did not have significant differences between the male RA and male controls nor between the female RA and female controls. In women with RA, there was a significant difference of age at onset between the subgroups (uncorrected p = 0.047, corrected p = 0.94). Female patients with the OR genotype PPxx (homozygote of Px) tended to have developed RA at a younger age, whereas those with PPXX and ppxx (lack of Px haplotype) developed RA at an older age. In men with RA, there was no association between the OR genotype and age at onset. In seropositivity and rheumatoid nodule positivity, there was no significant difference between subgroups for either sex., Conclusions: Some variants of the OR gene are related to the onset of RA in women in certain age periods, suggesting the role of the interaction between the OR gene and serum concentrations of oestrogen at the onset of the disease.

To identify the sociodemographic and lifestyle factors related to development of aseptic loosening after a cemented total hip arthroplasty (THA), 151 consecutive primary THAs performed at a single hospital in a rural district of Japan, at a mean follow-up of 7.5 years, were reviewed. Based on the medical records collected during hospital admission for THA, in which sociodemographic and lifestyle backgrounds had been recorded by the nurse, answers regarding residence, education, employment, engagement in agricultural work, marital status, family members living together, religion, recreational activity, smoking, and alcohol intake were analyzed in relation to the development of loosening, using a multivariate Cox proportional hazards model. With adjustment for cementing technique, diagnosis, age, and sex, agricultural work had a significant relation with prosthetic loosening (relative risk=2.85, P=0.03). Restriction of physical work in agriculture for patients undergoing THA should be considered.

We performed a case-controlled study to determine whether previous gynecological surgery is associated with severe osteoarthritis (OA) of the knee, the hip or the spine, as well as mild OA of the knee. Patients who underwent surgical treatment for OA were defined as having severe OA. Patients with knee pain and radiographic grade 2 OA in a tibiofemoral joint on the Kellgren and Lawrence scale were defined as having mild knee OA. An increased rate of hysterectomy was observed in the severe knee OA group after adjustment for age and number of children, or even after adjustment for body mass index. Hysterectomy in this group was most often performed for myoma uteri. Patients with mild knee OA tended to have previous hysterectomy. From the results, we speculate that certain subsets of OA which often take a progressive course might be related to hysterectomy.

Seminal emission from the ejaculatory duct (SEED) by direct electrical stimulation of the vas deferens was investigated in the dog, and the technique was applied to men. The stimulus parameters used were 2 msec, 10 Hz, and 8 V for dogs or 15-20 V for humans. In vitro studies using tetrodotoxin demonstrated that the major portion of the muscle contraction under the above stimulation was neurogenic. The stimulation of the pars epididymica, the middle vas, or the ampulla of the vas caused SEED in all dogs having intact hypogastric nerves (HNs) and receiving transection of bilateral HNs 1, 6, and 12 months before electrical stimulation. The dye instilled into the canine cauda epididymis was transported to the ampulla and emitted into the posterior urethra by electrical stimulation of the vas regardless of the site stimulated. The electrical stimulation of eight vasa deferentia (pars epididymica) of five prostatic carcinoma patients generated emission from the severed proximal end of all vasa examined at orchidectomy. All of the stimulations of 13 middle vasa of seven patients with emission loss caused SEED. The above results indicate that direct electrical stimulation of the canine and human vas deferens causes SEED regardless of the site stimulated or the absence of HNs, which are the major pathway of the efferent signal for SEED.

Plasma immunoreactive corticotropin-releasing factor (I-CRF) levels were determined by using a human CRF radioimmunoassay and an immunoaffinity procedure. The basal plasma I-CRF level in normal subjects was 6 +/- 0.5 pg/ml (mean +/- SD). We found that most plasma I-CRF levels were affected by stress, negative feedback, and circadian rhythm. Basal I-CRF levels were high in patients with Addison's disease, Nelson's syndrome, hypopituitarism stemming from pituitary macroadenoma, and CRF- and adrenocorticotropic hormone-producing tumors. A very low, but significant, amount of I-CRF was detected (1-3 pg/ml) in patients with Cushing's syndrome, in corticosteroid-treated patients, and in a patient with hypothalamic hypopituitarism. These results suggest that a major component of plasma I-CRF is of hypothalamic origin, however, other extrahypothalamic tissues cannot be ruled out as a minor source of plasma I-CRF.

The effects of corticotropin-releasing hormone (CRH) and dexamethasone on proopiomelanocortin (POMC) mRNA levels in cultured pituitary adenoma cells were studied in 10 patients with Cushing's disease. As a control, POMC mRNA levels in cells from nonadenomatous tissues were examined in four patients. Human POMC mRNA in the cells was analyzed by Northern blot hybridization. Human POMC DNA probe hybridized with only a single size class of RNA (approximately 1,200 nucleotides) from the adenoma and nonadenoma cells of each patient. The size of POMC mRNA did not change through the culture or after incubation with CRH or dexamethasone. CRH increased POMC mRNA levels in these cells in a dose- and time-dependent manner. The minimum concentration of CRH required to elevate POMC mRNA levels in these cells exposed for 15 h was 0.1 nM. The minimum duration of 1 nM CRH treatment required to increase these levels was 3 h under our conditions. Inhibitory effects of 1 and 10 micrograms/dl dexamethasone on ACTH release and POMC mRNA levels in nonadenoma cells were greater than those in adenoma cells. These results suggest the following: (a) that the mRNA in cultured pituitary adenoma cells is qualitatively the same as that in vivo; (b) that responses of mRNA levels to CRH are time- and dose-dependent; and (c) that adenoma cells resist the inhibitory effect of dexamethasone on POMC mRNA levels and ACTH release.