Mechanisms of autoantibody production and the relationship between autoantibodies and the clinical manifestations in Sjögren's syndrome

The major target organs of Sj?gren's syndrome (SS) are lacrimal glands and salivary glands where prominent lymphocytic infiltration occurs, which may induce varying levels of autoantibody production. Multiple factors, including environmental stress, viral infection, hormonal imbalance, and apoptosis, are thought to be involved in the pathogenesis of SS. Production of anti-SS-A/Ro and anti-SS-B/La antibodies is thought to be regulated by the presentation of autoantigens in context with an aberrant expression pattern of human leukocyte antigen (HLA) in situ. Molecular mimicry with some viral sequences is also hypothesized. The apoptosis-resistance phenotype of B cells in labial salivary glands (LSGs) of SS is important in autoantibody production. CD40/CD40L (CD40 ligand) and Bcl-2 family proteins, in tandem with B cell-activating factor (BAFF), are supposed to protect infiltrating lymphocytes from apoptosis. Anti-muscarinic3 receptor antibody plays an important role in cholinergic hyperresponsiveness in SS. Fragmentation of autoantigens such as SS-B/La or alfa-fodrin during the process of apoptosis causes the redistribution of these autoantigens, leading to the production of autoantibodies in SS. In this review, the role of autoantibodies found in SS, corresponding to clinical aspects of each antibody as well as the mechanisms of production, is discussed.     

Relationship between the pharyngeal airway space and craniofacial morphology, taking into account head posture

This study assessed the relationship between craniofacial characteristics and the size of the pharyngeal airway space (PAS), taking into account head posture. Sixty dental students 25-30 years of age (30 men and 30 women) were examined by lateral cephalometry. The data were corrected with the use of appropriate regression equations for the PAS. The PAS significantly correlated with hyoid position, maxillary and mandibular size, maxillary and mandibular prognathism, and mandibular inclination. A large, anteriorly positioned mandible was associated with a large PAS-TP (the most proximal distance between the posterior pharyngeal wall and the tongue base). Uvula length and PNS-Ba (the distance between the most posterior point of the hard palate and the most inferior point of the anterior foramen magnum) correlated with PAS-UP (the most proximal distance between the posterior pharyngeal wall and uvula). Our results suggest that the anteroposterior dimension of the PAS is substantially affected by the size of the enclosure surrounding the PAS, including the maxilla, mandible and soft palate.     

A novel method for the self-collection of blood, "thenar lancing phlebotomy" and investigation of its accuracy

"Thenar lancing phlebotomy" is a novel method for the self-collection of blood using a special phlebotomy device for the thenar and a self-collection blood kit. The thenar is punctured with a special lancet, the vein is subjected to automatic avascularization at the wrist and at the same time, a small centrifuge tube, attached to the suction cylinder of the device, is applied to the puncture and the blood is collected by suction. The small centrifuge tube containing the whole blood is centrifuged with a portable centrifugal separator to obtain plasma. In comparison with conventional finger prick phlebotomy, there is less pain and sufficient blood may be obtained. To investigate the accuracy of the method, we collected blood from the antecubital vein of 140 subjects and thenar lancing phlebotomy was simultaneously carried out on the same 140 subjects. The results of many blood tests currently included in medical check-ups were almost identical in the blood samples of both groups, suggesting that this method can be utilized in medical check-ups using self-collected blood sampies.     

Non-contact respiratory monitoring system using a ceiling-attached microwave antenna

Using a microwave antenna attached to the room ceiling, we conducted non-contact monitoring of respiratory chest wall motions of subjects in bed and covered by a soft comfortable bedding, to measure the vital signs of patients under nursing care in a welfare institution. Long-term vital sign monitoring using electrodes places a heavy burden on monitored individuals. Our non-contact respiratory monitoring system comprises a 1,215 MHz-microwave radar (LDR-1), antenna box attached to the ceiling, and personal computer with analyzing software. The system was tested on eight healthy volunteers (mean age, 25 years; range, 21–44 years) and eight elderly volunteers with some disorders (mean age, 69 years; range, 66–75 years). Respiratory rates of subjects measured using this system correlated with rates measured using respiration sensors (r = 0.97, P < 0.001 for healthy volunteers, r = 0.98, P < 0.0001 for elderly volunteers). The system could monitor subtle changes in respiratory rate, and monitoring respiratory rate increases caused by disorders such as pneumonia will be possible.     

Possible vascular role of increased plasma arginine vasopressin in congestive heart failure

BACKGROUND: The present study was undertaken to determine the relation of cardiac dysfunction with hormonal release in patients with congestive heart failure. METHODS: Seventy-two patients with congestive heart failure were examined, who were divided into four subgroups classified by the criteria of the New York Heart Association (NYHA). Also, 10 age-matched subjects were served as a control. Plasma arginine vasopressin (AVP), norepinephrine, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were determined. Cardiac index and pulmonary capillary wedge pressure (PCWP) were measured in 51 of 72 patients. RESULTS: Plasma AVP levels were significantly increased according to the severity of NYHA classes; control: 1.7 +/- 0.2; NYHA I: 4.9 +/- 0.8, NYHA II: 5.5 +/- 0.9, NYHA III: 13.4 +/- 2.6 (p < 0.05), NYHA IV: 26.9 +/- 5.6 pmol/l (p < 0.001). Similar results were obtained with plasma norepinephrine, ANP and BNP. Plasma AVP levels had negative correlation with cardiac index (r = -0.36, p < 0.01), but did not with PCWP and plasma osmolality. Plasma BNP levels positively correlated with PCWP (r = 0.44, p < 0.001), but did not with cardiac index. There was no correlation between plasma AVP and BNP. Intensive therapy profoundly reduced all the hormones according to the improvement of cardiac index in the patients with NYHA class III and IV. The percent decrease in plasma AVP was 60.0%, a value greater than that in plasma BNP. CONCLUSION: The present study indicates that increased AVP may deteriorate cardiac function through V(1a) as well as V(2) action, and that plasma AVP level is also a proper marker for the presence and severity of congestive heart failure.     

Alteration in risk factor accumulations of acute myocardial infarction during the last one decade: analysis of patients admitted in Coronary Care Unit

The present study was undertaken to determine accumulation of risk factors in acute myocardial infarction during two periods of 2002 and 1990-1991. We collected 173 and 153 patients with acute myocardial infarction in 2002 and 1990-1991, respectively, and analyzed the history of multiple risk factors, including diabetes mellitus, impaired glucose tolerance, hyperlipidemia, hypertension and obesity, and laboratory findings. The numbers and their percentages of all the risk factors increased in 2002 compared with 1990-1991. According to plasma glucose level, the patients who had type 2 diabetes mellitus, and impaired fasting glucose or impaired glucose tolerance had increased markedly from 41 to 65%. Multiple accumulation of risk factors had increased during the last one decade, and only one or no risk factor per se was not the case in the patients with acute myocardial infarction. Hyperlipidemia and hypertension became fairly controlled in the patients, but not hyperglycemia in type 2 diabetes mellitus in the period of 2002. These findings may indicate that increased multiple accumulation of risk factors accelerates the occurrence of acute myocardial infarction in 2002 as compared to 1990-1991.     

Mutagenic potentials of Amberlite XAD-2-resin extracts obtained from river and drinking waters in the Northwest district of Chiba, Japan

Amberlite XAD-2 resin extracts of river and drinking water sampled from the Northwest district of Chiba Prefecture in each month during the period from January to December 2008 were investigated to characterize and determine their mutagenic potentials and polycyclic aromatic hydrocarbon (PAH) levels. The extracts from the river water were shown to be mutagenic in Salmonella typhimurium TA98 (a flameshift mutagen) without S9 mix, with higher mutagenic responses in summer and early fall seasons. While the drinking water extracts exhibited weak mutagenicity in both the TA98 and TA100 strains (a base-pair substitution mutagen) without S9 mix, with high mutagenic responses in fall and early winter seasons. GC/MS determinations of the water concentrates showed some seasonal scatter in PAH levels in river water. In contrast, comparatively high concentrations of PAHs were observed for drinking water samples collected during warmer seasons. Statistical studies revealed that there is a lower correlation between the levels of flameshift mutagenicity and the concentrations of PAH in the river water concentrations, but a higher correlation between them in the drinking water samples.     

Ribosomal protein L3 mediated the transport of digoxin in Xenopus laevis oocyte

Ribosomal protein L3 (RPL3) is known to be an indispensable and essential component for the peptidyltransferase center. In the present study, we found a novel function of RPL3 using a Xenopus laevis oocyte expression system. When expressed in X. oocytes, RPL3 mediated the high affinity transport of [(3)H]digoxin (K(m) = 213.3 ± 46.8 nM) in a time-, concentration-, and sodium-dependent manners. The maximum velocity of the transport of [(3)H]digoxin via RPL3 produced at physiological pH. However, we did not observe RPL3-mediated transport of several organic solutes such as [(14)C]androstenedione, [(3)H]dexamethasone, [(3)H]dehydroepiandrosterone sulfate, [(3)H]L-tryptophan, [(14)C]L-ascorbic acid, [(14)C]α-ketoglutarate, [(14)C]glutarate, [(3)H]methotrexate, [(3)H]bumetanide, [(3)H]probenecid, [(14)C]salicylic acid, [(14)C]theophylline and [(3)H]valproate. Our results suggest that RPL3 functions as a drug carrier protein and may be involved in the digoxin toxicity in the human body.