Objective: This study investigated whether the angiotensin II type-1 receptor blocker (ARB) candesartan affects markers of oxidative stress in type 2 diabetes mellitus (DM) patients with essential hypertension (EH).
Methods: Urinary excretion of pyrraline (PR), pentosidine (PT), acrolein (AC), and 8-hydroxy-2'-deoxyguanosine (8-OH-dG) and microalbuminuria were assessed in patients with DM complicated by EH who were treated with candesartan 4 mg/day for 3 months.
Results: In a total of 25 patients urinary excretion of PR (nmol/g· cr), PT (pmol/g· cr), and 8-OH-dG (ng/mg· cr) was significantly (all P < 0.05) decreased from (mean ± SEM) 11.9 ± 1.9, 30.6 ± 2.4, and 7.9 ± 0.6, respectively, at baseline to 8.4 ± 1.4, 27.1 ± 2.0, and 6.9 ± 0.6, respectively, at 3 months. Meanwhile, excretion of AC was unaltered from 209.6 ± 40.0 to 189 ± 24.8 nmol/mgcr (P = NS). Urinary albumin excretion was significantly (P < 0.05) reduced from 27.7 ± 4.6 to 14.1 ± 1.1 mg/g· cr. There were weak but statistically significant positive correlations between the change of urinary 8-OH-dG excretion and that of albumin (r = 0.414; P < 0.05) and change of hemoglobin (Hb) A_1c (r = 0.45; P < 0.05).
Conclusion: Candesartan exerts protective effect(s) on the cardiovascular system by suppression of oxidative stress—mainly through inhibiting production of advanced glycation end products (AGEs) rather than of advanced lipoxidation end products (ALEs)—in type 2 DM patients with EH.

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Objectives Some heavy metals are suspected to be pathogenic to both Parkinson's disease (PD) and depression. Common background may exist in them. Methods Subjects comprised PD patients with depression, PD patients without depression and controls recruited from the outpatient clinic in China. Morning blood and urine samples were used to measure concentrations of metals and vitamins. Results Whole-blood manganese was significantly higher in the PD patients without depression than in both the PD patients with depression and the controls. Serum iron was significantly higher in the PD patients without depression than in the controls. Urine iron was also significantly higher in the PD patients without depression than in the controls. Serum copper was significantly lower in the PD patients with depression than in both the PD patients without depression and the controls. Conclusions Excessive intake of iron and accumulation of manganese seemed to be involved in the etiology of non-depressive PD.

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Background/Aim: Several reports have indicated that environmental factors and defects in innate immunity are central to the pathogenesis of inflammatory bowel disease (IBD). Although bacteria producing lipopolysaccharide (LPS), which is a Toll-like receptor (TLR) 4 agonist, play a crucial role in the development of experimental colitis, LPS tolerance following initial exposure to LPS can result in a state of hyporesponsiveness to subsequent LPS challenge. Therefore, we initiated this study to explore the role of LPS tolerance in the development of colitis. Methods: Dextran sulfate sodium (DSS) colitis was induced in Balb/c mice with or without daily intraperitoneal administration of LPS. Disease activity and cytokine mRNA expression in the colon were evaluated. To confirm LPS tolerance, mouse conventional bone marrow-derived dendritic cells (BMDC) were preincubated with or without LPS, and were restimulated with LPS 24 h after first exposure. Cytokine production was measured by ELISA, and mRNA expression was evaluated by RT-PCR. Furthermore, we investigated the expression of negative regulators of LPS tolerance in BMDC. Results: Administration of LPS significantly suppressed colonic inflammation of DSS-induced colitis. After subsequent stimulation with LPS, TNF-α production was reduced in BMDC. IRAK-M, a negative regulator of TLR4 signaling, mRNA expression was up-regulated in LPS-treated BMDC. Conclusion: LPS tolerance was able to protect mice from DSS-induced colitis, and IRAK-M participated in this tolerance. Taken together, these observations suggest that loss of exposure to LPS is involved in the pathogenesis of IBD.

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A 20-year-old woman was found to have a tumor shadow on chest X-ray examination during mass screening and was admitted to our hospital. The chest radiograph revealed a round tumor in the right upper lung field. Chest computed tomography (CT) showed a well-defined, 3-cm-diameter mass in the right upper lobe. The patient underwent a right upper lobectomy under video-assisted thoracoscopic surgery. The postoperative pathological diagnosis was well-differentiated fetal adenocarcinoma (WDFA), stage IA (pT1bN0M0). The patient was well and free of disease four years after surgery. WDFA is a rare pulmonary neoplasm resembling fetal lung and classified as a variant of adenocarcinoma. WDFA occurs in younger people more often than the other histological types of primary lung cancer. An additional young case of WDFA is reported, along with a review of the relevant literature.

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We report on a 58-year-old man with an anomalous systemic artery to the basal segments of the left lung. The anomalous systemic artery originated from the descending thoracic aorta, distributed to the basal segments of the left lower lobe, and drained into the normal left inferior pulmonary vein. The pulmonary artery to the basal segments was not recognized. His bronchoscopic findings were normal. He underwent left lower lobectomy with division of the aberrant artery. The patient has remained well without any complications since surgery.

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A 52-year-old man noticed physical weariness and anorexia in November 2008. Severe anemia was found. Pneumomediastinum was detected using x-ray and CT scanning. Esophagogastroduodenoscopy revealed a submucosal tumor with a deep ulcer in the anterior wall of the upper stomach, causing anemia. Partial gastrectomy was performed because microperforation was suspected. The resected specimen showed spindle-shaped tumor cells that were c-kit positive and CD34 positive on immunohistological staining, suggesting a diagnosis of gastrointestinal stromal tumor (GIST). Although emphysema in the abdominal cavity was not observed, air leakage from gastric GIST with necrosis in the upper stomach was inferred as the cause of pneumomediastinum.

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Aggressive treatment is necessary for continuous high-range proteinuria in cases of pediatric Henoch-Schönlein purpura nephritis (HSPN) as the long-term prognosis is sometimes poor. Cyclosporine (CyA) has immunosuppressive effects as well as a very selective inhibitory effect on T-helper cell function. Here we report two 7-year-old boys with steroid-resistant HSPN treated with CyA. After diagnosis of HSPN, we treated both patients with methylprednisolone and urokinase pulse therapy (MUT) combined with multiple drugs; however, high-range proteinuria persisted and CyA was added to the treatment regimen. The proteinuria subsequently decreased gradually and pathological findings at the second renal biopsy were improved. Furthermore, neither patient showed any adverse effects, such as hypertension, encephalopathy, or chronic nephrotoxicity, to the CyA treatment.
In conclusion, these results suggest that CyA may be a safe and effective treatment for steroid-resistant severe HSPN.

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Abstract: The radioactive materials released in the accident at the Fukushima Dai'ichi Nuclear Power Plant have forced many residents in Fukushima Prefecture, including members of Co-op Fukushima, currently living as they do in an environment exposed to radiation, to live in the shadow of anxiety that they may be subject to internal radiation exposure. A dietary survey was therefore conducted using the duplicate diet method on 300 participating Co-op member families over three periods for the purpose of investigating the intake of radioactive materials through everyday meals and thereby providing accurate information about existing conditions of internal radiation exposure. Neither ¹³⁴Cs nor ¹³⁷Cs was detected in excess of the lower detection limit of 1 Bq/kg in the meals of 283 of the 300 families (i.e., 94%). In the meals of 17 families, ¹³⁴Cs or ¹³⁷Cs was detected in excess of 1 Bq/kg. Of these, the greatest internal exposure dose for both of the radionuclides was observed in the period “ I winter” (November 2011 thru April 2012) of the three-period survey. This coincided with the implementation period of the Provisional Regulation Values, which set a maximum annual exposure dose of 5 mSv. On the supposition that the family in question had continued to eat the sample for a whole year, the resulting annual exposure dose would have amounted to 0.135 mSv. This is far below the current annual radiation dose standard of 1 mSv. Accordingly, we conclude that a sufficient level of dietary safety has been attained and that there are no grounds for concern that the consumption of foodstuffs currently on the market will have any adverse effects on health as a result of internal radiation exposure.

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Abstract: Following the accident at Tokyo Electric Power's Dai'ichi Reactor, Fukushima Prefecture has conducted tests to detect the presence of radioactive materials in the breast milk of mothers applying for such tests. Of 467 mothers who applied for testing between June 2012 and March 2013, it was found that ¹³⁴Cs and ¹³⁷Cs were absent from all cases. The passage of time since the accident has seen a decrease in the number of mothers applying for the tests. Nonetheless, the prefectural government has decided to continue to conduct the testing as a means of allaying the anxiety of breast-feeding mothers in the future.

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