Association Between Body Image Before and During Pregnancy and Gestational Weight Gain in Japanese Women: A Prospective Cohort Study

OBJECTIVES

More than half of women do not achieve appropriate gestational weight gain. Maternal body image may be an important factor associated with gestational weight gain. However, this association has not been thoroughly evaluated. We aimed to elucidate whether body image parameters before and during pregnancy are associated with gestational weight gain in Japanese women.

METHODS

This prospective cohort study was conducted at a hospital in Osaka, Japan from March 2020 to March 2021. We recruited women with singleton pregnancies in their second and third trimesters. Body image was assessed using the Pregnancy and Weight Gain Attitude Scale and additional questions. Gestational weight gain was classified as insufficient, appropriate, or excessive based on recommended ranges in Japan. One-way analysis of variance, chi-square tests, and multinomial logistic regression analyses were performed to identify factors associated with insufficient or excessive weight gain.

RESULTS

Of 266 enrolled women, 47 had insufficient weight gain and 100 had excessive weight gain during pregnancy. Risk factors for excessive gestational weight gain included a history of dietary restriction before pregnancy, negative attitudes toward gestational weight gain, and perception of body shape as fat and body shape dissatisfaction during pregnancy. Perception of body shape as thin during pregnancy was identified as a risk factor for insufficient gestational weight gain.

CONCLUSIONS

Body image before and during pregnancy may be an important factor in preventing insufficient or excessive gestational weight gain in Japanese women. Healthcare professionals should consider body image when providing health guidance on weight management to pregnant women.

Virological, pathological, and glycovirological investigations of an Ezo red fox and a tanuki naturally infected with H5N1 high pathogenicity avian influenza viruses in Hokkaido, Japan

In winter/spring 2021-2022, high pathogenicity avian influenza viruses (HPAIVs) that are genetically closely related to each other were detected worldwide. In a public garden in Sapporo, Hokkaido, Japan, a crow die-off by HPAIV infection occurred from March 29 to May 18, 2022. During the event, H5N1 HPAIVs were isolated from an Ezo red fox (Vulpes vulpes schrencki) and a tanuki (Nyctereutes procyonoides albus) found in the same garden. The fox showed viral meningoencephalitis and moderate virus replication in the upper respiratory tract, whereas the tanuki showed viral conjunctivitis and secondary bacterial infection in the eyes accompanied with visceral larva migrans. Viruses isolated from the fox and the tanuki were genetically closely related to those isolated from crows in the same garden. Various α2-3 sialosides were found in the respiratory tracts of these canid mammals, consistent with HPAIV infections in these animals. This study highlighted the importance of monitoring HPAIV infections in wild carnivore mammals to detect the potential virus spreading in nature.

Sequential variation of super periodic structures emerged in Bi-layered perovskite pillar-matrix epitaxial nanocomposite films with spinel ferrites

The phase stability of Aurivillius bismuth-layer structured Bi5Ti3FeO15 (BTFO15) has been investigated in an epitaxial pillar-matrix nanocomposite system with spinel ferrites.

FRI0580 DISCORDANCE BETWEEN OBJECTIVE ELBOW ASSESSMENT AND PATIENTS REPORTED OUTCOMES (PROS) AFTER TOTAL ELBOW ARTHROPLASTY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Patient-reported outcomes (PROs) have become widespread in daily clinical evaluation in patients with rheumatoid arthritis (RA). However, there are few reports for the relationship or discordance between the subjective assessment by the physician and the objective assessment by the patient with RA in surgical treatment.

Objectives:

We examined the relationship or discordance about the PROs in patients with RA who underwent total elbow arthroplasty (TEA).

Methods:

We retrospectively identified 53 elbows of 48 patients with RA who underwent TEA at Okayama University Hospital, collected from January 2012 to December 2016.

We collected clinical data for the grip strength, range of motion, the Mayo Elbow Performance Scale (MEPS) as objective assessments, and the Patient-Related Elbow Evaluation (PREE), Disability of the Arm, Shoulder, and Hand (DASH) Japanese version and Hand20 as subjective assessments.

For statistical analysis, we performed t-tests for pre- and post-operative physical findings and subjective evaluations, and Spearman rank correlation to examine the relationship between objective and subjective assessments.

Results:

The mean age of the patients at the time of arthroplasty was 63 years, the average disease duration was 23 years, and the average postoperative observation period was 32 months. The average DAS28-CRP was 3.01, and biological uses were 18 cases.

The range of motion of the elbow joint and the grip strength was significantly improved postoperatively. All outcome assessments improved significantly except for HAQ (see table1).

There was significantly correlated PREE with DASH, Hand20, and MEPS preoperatively. Postoperative PREE showed a significant and robust correlation in postoperative DASH, Hand20, whereas not associated with postoperative MEPS (see table2).

To investigate the discordance between PREE and MEPS after TEA, we focused on changes in each item of PREE. Pain- and reach-related items improved postoperatively. But, it was difficult to improve in items affected by hand and finger functions, such as “tie shoelaces.”

To explore the effects of finger and hand functions on postoperative assessments, we performed multiple regression analyses. Both preoperative grip strength (unstandardized coefficient [Β] =-0.07; 95%CI -0.148 to -0.006, t value=-2.18, P=0.03) and preoperative Hand20 (B = 0.27, 95%CI 0.029 - 0.518, t=2.25, p=0.02) were significant predictors of postoperative PREE.

Conclusion:

Surprisingly, the PROs of patients and the surgeon’s evaluations correlated well before surgery but resulted in discordance after TEA. We improved elbow functions by TEA, but since rheumatoid arthritis was a polyarticular disorder, improvement of a single joint function did not improve utterly subjective assessment in patients with RA. We found that the upper limb functions after TEA were significantly affected by preoperative finger and hand function. A rheumatologist should consider the dysfunctions of finger and hand when planning for elbow surgery in patients with RA.

Table 1.

Pre- and postoperative range of motion of elbow and forearm, grip strength, and measurement

CharacteristicPreoperativePostoperativeP valueElbow flexion, degree116 ± 19134 ± 9< 0.001- extension-34 ± 21-25 ± 160.005- total arc82 ± 32109 ± 19< 0.001Grip power, mmHg106 ± 66130 ± 740.007DASH50.5 ± 20.535.8 ± 25.4< 0.001Hand2060.4 ± 19.138.9 ± 29.6< 0.001PREE55.6 ± 18.818.5 ± 17.1< 0.001- pain29.7 ± 11.36.5 ± 7.9< 0.001- function25.9 ± 11.512.0 ± 11.9< 0.001- specific function56.9 ± 25.525.4 ± 25.3< 0.001- usual function20.8 ± 11.310.5 ± 11.3< 0.001HAQ-DI1.06 ± 0.701.07 ± 0.800.607MEPS51.3 ± 16.697.9 ± 3.6< 0.001Table 2.

Spearman’s correlation coefficients for pre- and postoperative PREE score*

QuestionnairePreoperative Correlation estimateP valuePostoperative Correlation estimateP valueDASH0.56< 0.00010.84< 0.0001Hand200.58< 0.00010.84< 0.0001MEPS- 0.39< 0.01-0.27N.S.

Disclosure of Interests:

ryozo harada: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Yoshihisa Nasu: None declared, Ryuichi Nakahara: None declared

Pulsed laser deposition with rapid beam deflection by a galvanometer mirror scanner

A pulsed laser deposition system with rapid beam deflection (RBD-PLD) by a galvanometer mirror scanner has been developed for alternating ablation of multiple targets with a single laser instrument. In this system, the alternating deposition of different target materials is carried out by scanning the laser beam between the positionally fixed targets with a galvanometer mirror instead of mechanically switching the target positions on a fixed optical path of the laser beam as is done in conventional pulsed laser deposition (PLD) systems. Thus, the "wait" time required for switching target materials to be deposited, which typically takes several seconds in a conventional system, can be made as short as a few milliseconds. We demonstrate some of the advantages of this PLD system in several technologically important aspects of thin film synthesis: (1) fast fabrication of binary alloy films, (2) preparation of natural composition spread libraries, (3) effect of the target switching time on the deposition of volatile compounds, (4) control of the degree of mixing of two different materials in a film, and (5) efficient growth of compositionally graded thin films.

Longitudinal changes in 18 F-THK5351 positron emission tomography in corticobasal syndrome

BACKGROUND AND PURPOSE

Corticobasal syndrome (CBS) is pathologically characterized by tau deposits in neuronal and glial cells and by reactive astrogliosis. In several neurodegenerative disorders, ¹⁸ F-THK5351 has been observed to bind to reactive astrocytes expressing monoamine oxidase B. In this study, the aim was to investigate the progression of disease-related pathology in the brains of patients with CBS using positron emission tomography with ¹⁸ F-THK5351.

METHODS

Baseline and 1-year follow-up imaging were acquired using magnetic resonance imaging and positron emission tomography with ¹⁸ F-THK5351 in 10 subjects: five patients with CBS and five age-matched normal controls (NCs).

RESULTS

The 1-year follow-up scan images revealed that ¹⁸ F-THK5351 retention had significantly increased in the superior parietal gyrus of the patients with CBS compared with the NCs. The median increases in ¹⁸ F-THK5351 accumulation in the patients with CBS were 6.53% in the superior parietal gyrus, 4.34% in the precentral gyrus and 4.33% in the postcentral gyrus. In contrast, there was no significant increase in the regional ¹⁸ F-THK5351 retention in the NCs.

CONCLUSIONS

Longitudinal increases in ¹⁸ F-THK5351 binding can be detected over a short interval in the cortical sites of patients with CBS. A monoamine oxidase B binding radiotracer could be useful in monitoring the progression of astrogliosis in CBS.

A verification study of gastrointestinal motility-stimulating action of guinea-pig motilin using isolated gastrointestinal strips from rabbits and guinea-pigs

Motilin (MLN), a 22-amino-acid peptide hormone, is generally present in the mucosa of the upper gastrointestinal (GI) tract, mainly the duodenum of mammals, and it regulates GI motility, especially that related to interdigestive migrating contraction. However, MLN and its receptor are absent in mice and rats, and MLN does not cause any mechanical responses in the rat and mouse GI tracts. The guinea-pig is also a rodent, but expression of the MLN gene in the guinea-pig has been reported. In the present study, two guinea-pig MLNs, FIPIFTYSELRRTQEREQNKGL found in the Ensemble Genome Database (gpMLN-1) and FVPIFTYSELRRTQEREQNKRL reported by Xu et al. (2001) (gpMLN-2), were synthesized, and their biological activities were evaluated in the rabbit duodenum and guinea-pig GI tract in vitro. Both gpMLNs showed contractile activity in longitudinal muscle strips of the rabbit duodenum. The EC₅₀ values of gpMLN-1 and gpMLN-2 were slightly higher than that of human MLN (hMLN), but the maximum contractions were as same as that of hMLN. Treatment with GM109 and hMLN-induced receptor desensitization decreased the contractile activity of both gpMLNs, indicating that the two gpMLN candidates are able to activate the MLN receptor (MLN-R) of the rabbit duodenum. In guinea-pig GI preparations, hMLN and gpMLNs did not show any mechanical responses in circular muscle strips from the gastric antrum or in longitudinal strips of the duodenum, ileum and colon although acetylcholine and 1,1-dimethyl-4-phenylpiperazinium (DMPP) caused definite mechanical responses. The DMPP-induced neural responses in the gastric circular muscle and ileal longitudinal muscles were not modified by gpMLN-1. Even in the gastric and ileal strips with intact mucosa, no mechanical responses were seen with either of the gpMLNs. Furthermore, RT-PCR using various primer sets failed to amplify the gpMLN-2 mRNA. In conclusion, gpMLNs including one that was already reported and the other that was newly found in a database were effective to the rabbit MLN-R, whereas they did not cause any contractions or modification of neural responses in the guinea-pig GI tract, indicating that the MLN system is vestigial and not functional in regulation of GI motility in the guinea-pig as well as in other rodents such as rats and mice.

[Does the bilateral internal thoracic artery harvesting increase wound infection?]

The aim of this study is to compare the frequency of wound infection between bilateral and single internal thoracic artery (ITA) harvesting in coronary artery bypass grafting (CABG) cases. Two hundreds and thirty-four consecutive CABG cases performed harvesting either bilateral ITA (BITA) or single ITA (SITA) from January 2004 to December 2008, with or without concomitant surgery were studied. Harmonic Scalpel was used for the harvesting with skeletonization technique. The cases were divided into 2 groups: BITA group (n = 180) and SITA group (n = 54). The frequencies of wound infection were 3.7% in SITA group and 6.1% in BITA group. As to deep sternal infection, they were 1.9% in SITA group and 1.1% in BITA group. There was no significant difference between the 2 groups. Multivariate analysis of all patients showed that emergency cases, hypertension, congestive heart failure, and reopening for bleeding were identified as independent risk factors for wound infection. There were 113 diabetes mellitus (DM) patients out of all patients ; SITA group (n = 22) and BITA group (n = 91). Their wound infection rates were 4.5% and 6.6%, and those of deep sternal infection were 0% and 2.2%, respectively. There was no significant difference between them. In conclusion, BITA harvesting with skeletonized technique may be used as safely as SITA harvesting even in DM patients.

[Thoracic surgery for the penetrating lung or tracheal trauma]

Seven cases suffered from a chest trauma (stab wound in 6 and impalement injury in 1) were emergently transferred to our hospital. Open thoracotomy was performed for the intolerable bleeding immediately after admission. Injured lung was treated by lobectomy in 1 patient, lingual segmentectomy in 2, lower basal segmentectomy in 2, partial resection in 4 and direct suture in 2. The penetrating trachea was carefully repaired by direct suture with additional midsternal thoracotomy. To accomplish appropriate partial resection of the injured lung, a metallic straight suction tube inserted into a pulmonary stab wound was retracted and a stapling instrument was applied underneath the suction tube. With the segmentectomy and the partial resection, the volume of the residual lung was maximally saved. As a result, all 7 patients were successfully alive.

Streptococcus anginosus infection in oral cancer and its infection route

OBJECTIVE

To elucidate a possible involvement of Streptococcus anginosus in oral cancer, we assessed the frequency of S. anginosus infection in oral cancer tissues, and investigated its infection route.

MATERIALS AND METHOD

The tissue specimens were obtained from 46 oral cancer and three precancerous leukoplakia subjects. Frequency of S. anginosus infection was assessed by a species-specific polymerase chain reaction (PCR) assay. The genotype of the clinical isolates taken from cancer tissue and dental plaque samples was analyzed using pulsed-field gel electrophoresis (PFGE).

RESULTS

S. anginosus DNA was frequently detected in squamous cell carcinoma (19/42), but not in other types of cancer (lymphoma and rhabdomyosarcoma) or leukoplakia samples. A subject-based analysis revealed that S. anginosus was solely detected in dental plaque and not in saliva from all 19 S. anginosus-positive squamous cell carcinoma cases. Further, the genotype of S. anginosus isolated from cancer tissue was identical to that from dental plaque of the same patients.

CONCLUSION

Infection of S. anginosus could occur frequently in oral squamous cell carcinoma and that dental plaque could be a dominant reservoir of the S. anginosus.

[Prevention of acute exacerbation of interstitial pneumonia in the patients operated for lung cancer]

Eight patients with interstitial pneumonia (IP) underwent pulmonary surgery for lung cancer. The first patient died due to postoperative exacerbation, but the subsequent 7 patients had good postoperative course without exacerbation by the following careful management. 1) Avoidance of administration of high concentration of oxygen keeping the PO2 about 100 mmHg during the operation. 2) Short-term administration of low-dose steroid before the operation. 3) Administration of erythromycin, tocopherol acetate, and inhalation of N-acetylcysteine before and after the operation. 4) Long-term drainage of the postoperative thoracic discharge to release the local cytokines. These treatments inhibit secretion of the inflammatory cytokines which influence exacerbation of IP.

[Removal of the intrapleural hematoma after extrapleural pneumonectomy]

Three cases of pleuropneumonectomy, which have been performed in our institution between 1996 and 2003, are studied. All of them received re-thoracotomy to remove intrapleural hematoma for prolonged high fever, anemia and high level of CRP. Post re-operative courses were satisfactory without any signs of infection. The residual intrapleural hematoma sometimes causes pyothorax and would be an obstacle to the intrapleural instillation of anticancer medications. The removal of the hematoma should be scheduled at an early period after the pleuropneumonectomy.

Autocrine motility factor enhances hepatoma cell invasion across the basement membrane through activation of beta1 integrins

Autocrine motility factor/phosphohexose isomerase (AMF/PHI) is a cytokine that is linked to tumor invasion and metastasis. In hepatocellular carcinoma (HCC) tissues, hepatoma cells produce AMF/PHI and its receptor, Mr 78,000 glycoprotein (gp78), is strongly detected in hepatoma cells invading into the stroma and tumor thrombi in the portal vein. Here, we investigated the mechanism of hepatoma cell invasion through Matrigel induced by AMF/PHI using 3 hepatoma cell lines. Production of AMF/PHI, phosphorylation of MEK1/2, and Rho activity were investigated by immunoblotting. Expression of AMF/PHI and gp78 was observed by confocal fluorescence microscopy. The influence of AMF/PHI on activated integrin beta1 subunit expression was evaluated by flow cytometry. Changes in invasion, adhesion, and motility induced by AMF/PHI were evaluated using chemoinvasion, adhesion, and phagokinetic track motility assays. The effect of AMF/PHI on matrix metalloproteinase (MMP) secretion was evaluated by gelatin zymography. Hepatoma cells produced AMF/PHI and expressed gp78. Although AMF/PHI was ubiquitously detected, gp78 was strongly expressed in migrating cells. AMF/PHI induced up-regulation of activated integrin beta1 subunit expression. AMF/PHI stimulated hepatoma cell invasion through Matrigel, and stimulated the adhesion, motility, and MMP-2 secretion of hepatoma cells. The latter effects were suppressed by the function-blocking antibody for integrin beta1 subunit. AMF/PHI also enhanced Rho activity and the phosphorylation of MEK1 and MEK 2. Our results indicate that AMF/PHI enhances hepatoma cell invasion through Matrigel in an autocrine manner by stimulating the adhesion, motility, and MMP-2 secretion of these cells through activation of beta1 integrins.

[Two cases of Trichophyton mentagrophytes infection contracted from a hamster and a chinchilla]

We report two cases of Trichophyton mentagrophytes infection. Case 1: A 10-year-old girl visited Tokyo Electric Power Hospital in June 1994 for evaluation of an erythematous lesion on her head. Three months of topical steroid therapy exacerbated the lesion with pustular formation. Histopathological and mycological examination revealed that the patient had tinea capitis caused by T. mentagrophytes. T. mentagrophytes was also isolated from her pet, a hamster. Case 2: A-14-year-old girl was referred to Shonan Clinic in January 1996 with scaly erythema on her face. She had been treated with neticonazole hydrochloride at another clinic, but the lesion became worse. Direct microscopic examination of the scale was negative at that time, so treatment with topical steroid was started. After 10 days, the lesion was almost cured, but one month later it recurred with an annular distribution. KOH preparation of the scale revealed mycelia and T. mentagrophytes was isolated on culture. T. mentagrophytes was also isolated from her pet, a chinchilla. In both cases, the oral administration of itraconazole at 50 mg/day was effective. The isolated pathogen was identified as Arthroderma vanbreuseghemii with species-specific primers of chitin synthase 1 gene. T. mentagrophytes is one of the most common dermatophytes isolated from man and animals. Rodents like the hamster and the chinchilla have recently become popular as pets in Japan. We should be aware that rodents may carry this kind of fungal pathogen as they become even more popular as pets.

Epidemiological study of human herpesvirus-6 and human herpesvirus-7 in pityriasis rosea

BACKGROUND

Pityriasis rosea (PR) is a common papulosquamous skin disorder that is suspected to have an infectious aetiology.

OBJECTIVES

We aimed to study the role of human herpesvirus (HHV)-7 and HHV-6 in the pathogenesis of PR.

METHODS

We performed seroepidemiological studies (indirect immunofluorescence test) and polymerase chain reaction (PCR) analysis for HHV-6 and HHV-7 in patients with PR. Seventy-two serum samples and 37 samples of peripheral blood mononuclear cells (PBMC) from 44 patients with PR were obtained. Twenty-five patients with other skin disorders such as drug eruption, urticaria or herpes zoster were studied as controls in the PCR analysis.

RESULTS

HHV-7 DNA was detected in 13 of 30 (43%) samples of PBMC of the patients with PR and 14 of 25 (56%) samples of PBMC of controls. HHV-6 DNA was detected in six of 29 (21%) patients with PR and nine of 23 (39%) controls. Thus there was no difference in the prevalence of HHV-6 or HHV-7 in PBMC between patients with PR and those with other skin disorders. In the seroepidemiological study, two cases of at least a fourfold rise in titre and five cases of a fourfold decrease in titre to HHV-7 antibody, and two cases of a fourfold rise in titre and two cases of a fourfold decrease in titre to HHV-6 antibody, were observed in 24 patients with PR. This seroepidemiological study revealed antibody responses consistent with active infection in several PR patients, but the greater proportion of the patients had no definite increase in the antibody titres.

CONCLUSIONS

We conclude that HHV-7 and HHV-6 may play a part in some patients with PR, but that other causative agents may exist. Further analyses are needed to determine the causative agents of PR.

Regulation of granulocyte colony-stimulating factor and parathyroid hormone-related protein production in lung carcinoma cell line OKa-C-1

Previously we have established a clonal squamous cell carcinoma cell line OKa-C-1 derived from lung cancer of a patient with marked leukocytosis and hypercalcemia. OKa-C-1 cells simultaneously produce granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP) at the single cell level and cause paraneoplastic syndromes in nude mice bearing the tumor. It is known that the production of G-CSF and PTHrP is individually regulated by inflammatory cytokines in various malignant cells. To investigate the common factors in the regulation of G-CSF and PTHrP production in OKa-C-1 cells, we examined the effects of some inflammatory agents [lipopolysaccharide (LPS), phorbol-12-myristate-13-acetate (PMA), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1) beta and IL-6] on G-CSF and PTHrP production, by means of enzyme-linked immunosorbent assay (ELISA), immunoradiometric assay (IRMA) and quantitative reverse transcription-polymerase chain reaction (RT-PCR). TNF-alpha or IL-1beta induced both G-CSF and PTHrP production in the conditioned medium. TNF-alpha synergized with IL-1beta to significantly increase G-CSF production. In addition, TNF-alpha and IL-1beta strongly induced G-CSF mRNA with peaks at 2 and 6 h respectively. Although PTHrP production was also strongly induced by TNF-a PTHrP mRNA expression was more strongly induced by PMA than by TNF-alpha. Thus, TNF-alpha and IL-1beta could be common factors that individually and synergistically regulate G-CSF and PTHrP production in OKa-C-1 cells. Moreover, G-CSF and PTHrP production could be not only transcriptionally, but also posttranscriptionally regulated by other factors.

Aryl radical cyclizations: one-Pot syntheses of protoberberine and pavine alkaloids

Treatment of 2-(2'-bromo-beta-phenethyl)isocarbostyrils 7 with AIBN-Bu(3)SnH in boiling benzene gave 8-oxoberbines 3 in good yields. A similar treatment of 2-(2'-bromo-beta-phenethyl)isoquinolinium bromides 6 and their nor- and homoanalogues (10,11) induced 6-, 5-, and 7-exo radical closures in a one-pot manner to give protoberberines 2, dibenzo[b,g]indolizidine 14a and, dibenzo[a, h]-1-azabicyclo[5.4.0]undecane 15a, respectively. A one-pot radical cyclization of 1-(2'-bromobenzyl)isoquinoline methiodide 18a gave a pavine alkaloid, (+/-)-algemonine (19a).

Inhibition of tissue factor pathway during intermittent pneumatic compression: A possible mechanism for antithrombotic effect

Intermittent pneumatic compression (IPC) devices are an effective prophylaxis against lower extremity deep vein thrombosis. Their antithrombotic effect has been attributed to a reduction in venous stasis and enhanced fibrinolysis. The initiating mechanism for blood coagulation is the tissue factor (TF) dependent pathway, which is inhibited by tissue factor pathway inhibitor (TFPI). We have investigated the effect of IPC on the TF pathway in 6 normal subjects and 6 patients with postthrombotic venous disease undergoing IPC for 120 minutes; all subjects were studied with each of 5 IPC devices. In normal subjects and patients, plasma factor VIIa (FVIIa) activity (the activated form of factor VII [FVII]) declined from mean values ranging 51 to 65 and 50 to 53 mU/mL before IPC with different devices to 10 to 13 and 20 to 22 mU/mL at 180 minutes, respectively (P<0.001 for all groups). FVII antigen levels were unchanged. Plasma TFPI (P<0.001) rose from mean baseline values ranging 69 to 79 and 57 to 61 ng/mL to 76 to 123 and 71 to 79 ng/mL at 180 minutes in normal subjects and patients, respectively (P<0. 001 for all groups). Plasma prothrombin fragment F1.2 levels showed minimal changes. There was an inverse relationship between TFPI and FVIIa in normal subjects (r=-0.31, P=0.001) and patients (r=-0.37, P<0.001). IPC results in an increase in plasma TFPI and decline in FVIIa. Inhibition of TF pathway, the initiating mechanism of blood coagulation, is a possible mechanism for the antithrombotic effect of IPC.

Endometrial expression of cellular protooncogene c-ski and its regulation by estradiol-17beta

The expression of the cellular protooncogene c-ski was examined in the rat uterus. In situ hybridization revealed that c-ski mRNA was expressed in the uterus of the adult rat on the day of estrous and localized mainly in the luminal and glandular epithelia. To test the possibility that the expression of c-ski mRNA is induced by estrogen, rats were ovariectomized and estradiol-17beta (E2) was injected. The expression of c-ski mRNA was upregulated 3 h after E2 treatment, reaching the highest level at 6 h and this persisted until 24 h; the E2-induced expression of c-ski mRNA was restricted to the luminal and glandular epithelia. These results suggest that the c-ski gene plays a role in uterine epithelial cell proliferation and mediates the proliferative action of E2.

[A case of human infection with Clinostomum sp]

The genus Clinostomum is a cause of parasitic laryngo-pharyngitis. We report the 15th case of Clinostomum sp. infection in Japan. A 29-year-old female visited our hospital because of throat discomfort and expectoration of a worm by sneezing on November 17, 1997. The pharyngitis was caused by the worm. The worm was morphologically identified as the adult of the genus Clinostomum.