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Aim: The aim of the present study was to investigate the prevalence of sarcopenia in outpatients attending a geriatric and memory clinic and to investigate its relationship with falling., Methods: We investigated the prevalence of sarcopenia (according to the EWGSOP criteria) among 283 outpatients that were all ≥65 years of age, and who attended the geriatric and memory clinic at Kyorin University Hospital. We also examined comorbidities, CGA items, and fall-related measures, and analyzed the relationships between these factors and sarcopenia., Results: Seventy men (60.9%) and 88 women (52.4%) were diagnosed with sarcopenia. The sarcopenic men were older, had lower BMI values, and had a higher prevalence of dementia. The sarcopenic women had lower BMI values, and a higher prevalence of dyslipidemia. ASMI was not associated with walking speed or fall-related measures, whereas grip strength and walking speed were associated with each other and both were associated with fall-related measures. Ninety-one patients (32.2%) experienced a fall in the previous year. The prevalence of sarcopenia and ASMI among fallers and non-fallers did not differ to a statistically significant extent, whereas the fallers had lower grip strength and walking speed. A multiple logistic regression analysis revealed that weak grip strength in men and slow walking speed and the presence of diabetes in women were significant risk factors for falling., Conclusions: The frequency of sarcopenia in outpatients attending the geriatric and memory clinic was higher than that in the community-dwelling elderly individuals. Falls were more related to the patients' muscle strength and walking speed than their muscle mass or the presence of sarcopenia itself.

A camera based on the digital micromirror device (DMD) technology has been previously developed. In this optical system, the correspondence of each mirror of the DMD to each pixel of the CCD cannot readily be done since the pixel sizes of the DMD and the CCD are very small. An accurate pixel-to-pixel correspondence adjustment in the DMD camera by means of the phase-shifting moiré method is proposed. To perform high accurate adjustment of the optical system, the phase distribution of a moiré fringe pattern is analyzed when the CCD pixels and the DMD mirrors have a mismatch and/or misalignment with each other. This technique does not need a complicated setting or complex image processing to generate the moiré fringe pattern, and it needs only one captured image. In the adjustment experiment, the proposed method provided very accurate adjustment whose error was less than 1/25 pixel. An experiment of phase analysis to demonstrate the usefulness was performed.

The microtubule-binding domain of MAP4, a ubiquitous microtubule-associated protein, contains a Repeat region with tandemly organized repeat sequences. In this study, we focused on the variations of the Repeat region, and searched for MAP4 isoforms with diverse Repeat region organizations. We successfully isolated four types of MAP4 cDNAs, which differed from each other in both the number and the arrangement of the repeat sequences, from a single source (bovine adrenal gland). To examine the functional differences among the isoforms, we prepared the microtubule-binding domain polypeptides of three of the four isoforms, and examined their activities. The isoform fragments showed similar degrees of microtubule assembly promoting activity and microtubule binding affinity. This result suggested that the Repeat region variation is not important for the control of microtubule dynamics, which is believed to be the main function of MAPs. On the other hand, the microtubule bundle-forming activity differed among the isoform fragments. The bundle formation was augmented by increasing the number of repeat sequences in the fragments. Based on these results, we propose the hypothesis that the role of the MAP4 isoforms is to regulate the surface charge of microtubules.

The microtubule-binding domains of microtubule-associated protein (MAP) 2, MAP4, and tau are structurally similar [Aizawa, H., Emori, Y., Murofushi, H., Kawasaki, H., Sakai., H., and Suzuki, K. (1990) J. Biol. Chem. 265, 13849-13855]. To compare the microtubule-binding mechanisms of the three MAPs, we performed a quantitative competition analysis using the three MAPs and the microtubule-binding domain fragment of MAP4 (PA4T fragment). The two-cycled microtubule protein fraction from bovine brain contains MAP1, MAP2, MAP4, and tau. When an excess of the PA4T fragment was added to the microtubule protein fraction, MAP4 and tau were completely released from the microtubules, while MAP1 remained bound. MAP2 was only partially released from the microtubules. The competition between MAP2 and MAP4 was further analyzed using purified MAP2, the PA4T fragment, and tubulin. About half of the MAP2 was still bound to the microtubules, even in the presence of an excess amount of the PA4T fragment. The microtubule-binding mechanisms of MAP2 and MAP4 seem to be different, in spite of their similar primary structures.

Background: Hypergammaglobulinaemia and various auto-antibodies which are commonly seen in autoimmune hepatitis are also found in patients with chronic hepatitis C. We recently reported that ursodeoxycholic acid (UDCA) improved liver function tests and immunoserological markers in patients with type I autoimmune hepatitis. The aim of this study was to prospectively evaluate the efficacy of UDCA on autoimmune-associated chronic hepatitis C., Methods: Immunoglobulin G (IgG), anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA) were determined in 95 patients with chronic hepatitis C. All patients were positive for hepatitis C virus RNA. Autoimmune-associated chronic hepatitis C (C-AIH) was defined by elevated serum IgG level (> or = 2.0 g/dL) and high titres of ANA and/or ASMA (> or = 1 : 160). Nine (9%) of 95 patients were diagnosed as C-AIH. All the C-AIH patients and 30 of the remaining 86 chronic hepatitis C patients without autoimmune features (CHC) were treated with UDCA (600 mg/day) for 1 year., Results: Autoimmune-associated chronic hepatitis C patients included one man and eight women and their AIH scores, as defined by the International Autoimmune Hepatitis Group, were significantly higher than the CHC patients. Before UDCA therapy, there were no significant differences in aspartate aminotransferase (AST), alanine aminotransferase (ALT) and y-glutamyl transpeptidase (gamma-GTP) levels between C-AIH and CHC patients. However, after 1 year UDCA therapy, AST, ALT and gamma-GTP were significantly lower in C-AIH patients (P< 0.05) than in CHC patients. In C-AIH, ANA titres in seven of nine patients and ASMA titres in five of seven patients were reduced after 1 year UDCA treatment., Conclusions: These results suggest that UDCA is a useful therapeutic agent for autoimmune-associated chronic hepatitis C.

A case of ovarian clear cell carcinoma associated with hypercalcemia is reported. A 67-year-old woman developed the lung metastasis 8 months after primary surgery. The patient manifested symptoms of humoral hypercalcemia of malignancy (HHM) during the last 3 months of her clinical course. Serum and urinary C-terminus parathyroid hormone-related protein (PTHrP) levels were remarkably high. No increase in interleukin (IL) 1beta, tumor necrosis factor (TNF) alpha, vitamin D3 metabolites or intact PTH was detected. Pamidronate disodium treatment was transiently suppressed her serum calcium level. The patient died despite seven courses of chemotherapy. Autopsy showed multiorgan metastases and accelerated osteoclastic bone resorption; skeletal metastasis was not detected. Immunohistochemical analysis clearly showed the localization of PTHrP at both the primary and metastatic sites. The transcripts of PTHrP at pulmonary metastatic sites were revealed by in situ hybridization and the reverse transcription polymerase chain reaction (RT-PCR) method. PTHrP was the causative factor for HHM in this case. It is therefore suggested that hypercalcemia may have occurred after PTHrP production had overcome the homeostatic level during the terminal stage, although PTHrP production continued irrespective of the patient's serum calcium level.

We report a male newborn with typical clinical signs of idiopathic infantile hypercalcemia (IIH); that is, hypercalcemia, hypercalciuria, an elfin face and nephrocalcinosis without giving Vitamin D3 supplementation to the patient. He had been treated with a vitamin D-free, low calcium milk and rectal administration of exogenous calcitonin (elcatonin). The latter seemed to be more effective as a treatment for IIH. The serum calcium level came within the normal range and the serum 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) level decreased from 101.5 to 75.6 pg/mL with the treatments mentioned above. These results suggest that a high serum concentration of 1,25(OH)2D3 is part of the pathogenesis of IIH. However, we were not able to clarify the pathogenesis of the high serum concentration of 1,25(OH)2D3.

We analysed immunoglobulin (Ig) gene rearrangements in 28 patients with multiple myeloma by Southern hybridization method. We used 5 probes which cover C kappa and kappa de loci of Ig light chain kappa gene, and JH, 5'S mu and S gamma 3 loci of Ig heavy chain gene. In 11 out of 12 patients with kappa-producing myeloma, DNA rearrangements were observed using C kappa probe. Among them, kappa de region was rearranged in 7 patients and kept germline configuration in 4 patients. In all of 14 patients with lambda-producing myeloma, C kappa region was deleted and kappa de region was rearranged. 5'S mu-probe was very useful for detecting class switch recombination, and furthermore by using S gamma-probe together, S mu-S gamma joining could be detected. In all of 10 patients with gamma-producing myeloma, 5'S mu and S gamma-probes detected the rearranged band of the same size on at least 1 allele, which suggested the presence of S mu-S gamma joinings. In 8 of 10 patients with Bence-Jones myeloma, 5'S mu-probe detected rearranged bands and the presence of class switch recombinations were suggested as observed in other Ig secretory myelomas. In other 2 patients with Bence-Jones myeloma, non-functional class switch recombinations were detected. The results of this study indicated that genotypes corresponded well to phenotypes in multiple myeloma, and further analysis in other types of B cell malignancies will be interesting.

Recently, one of the major objectives was to observe cellular structures in biological-materials including microorganisms as raw as possible. For this purpose, Actinomyces israelii ATCC 12102, an experimented strain, was fixed by a fast freeze method using liquid nitrogen as a cryogen, followed by transmission electron microscopic observations on fine structures. Then, the following results were obtained. 1) Cell wall was an electron dense and thick monolayer. In certain cells, numerous granules were found on cell walls, showing lamellar structures. The cell wall surface to be a wave like structure of which limit was unclear. 2) Cytoplasmic membrane consisted of two electron less dense layers holding an electron dense layer in then. However, fine layers with different electron density crossed over one another, representing a formation of stripe structure in other cells. 3) In cytoplasm, we observed that fine fibers with high electron density crossed over fine fibers with low electron density. 4) We also observed that the specialized ring structure in cytoplasm.