Prevalence of and risk factors for depressive symptoms in non-tuberculous mycobacterial pulmonary disease

BACKGROUND: The presence of depressive symptoms in patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD) is an important research topic; however, the prevalence of depressive symptoms and the factors that influence their development are unclear.OBJECTIVE: To analyse the association between CES-D (Center for Epidemiological Studies Depression Scale) scores and clinical parameters such as age, disease duration, pulmonary function, imaging findings, blood data, physical functions, sleep disturbances, respiratory symptoms and health-related quality of life (HRQOL).METHODS: We conducted a cross-sectional retrospective study of 114 patients with NTM-PD at a single centre from March 2016 to January 2021 to evaluate the relationship between CES-D scores and clinical parameters.RESULTS: Participants had a median age of 64 years; 32.5% of them had depressive symptoms. Disease duration, albumin, C-reactive protein, pulmonary function, dyspnoea, exercise capacity, respiratory symptoms, cough-related HRQOL and sleep disturbances were associated with depressive symptoms. Binomial logistic regression analyses indicated that the CES-D score was significantly associated with cough-related HRQOL and sleep disturbances.CONCLUSION: A high percentage of NTM-PD patients in this study experienced depressive symptoms, and these patients had abnormalities of various clinical parameters. Cough-related HRQOL and sleep disturbance had a strong influence on the development of depressive symptoms.

Health-related quality of life associates with clinical parameters in patients with NTM pulmonary disease

BACKGROUND: Previous studies have shown a reduction in health-related quality of life (HRQoL) in patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD). However, the causes of this decline and the factors that contribute to it are unknown. This study was conducted to analyse the association between the St George´s Respiratory Questionnaire (SGRQ) and clinical parameters, including age, disease duration, body composition, pulmonary function, chest X-ray findings, blood data and physical function.METHODS: We performed a single-centre, cross-sectional, retrospective study of 101 patients with NTM-PD from December 2016 to October 2019. The relationship between the SGRQ scores and clinical parameters was evaluated.RESULTS: The median patient age was 67.0 years. Pulmonary function, radiological score, albumin levels, C-reactive protein levels and incremental shuttle walk test distance (ISWD) were significantly correlated with the total and component scores on the SGRQ. Multiple regression analysis showed that the SGRQ score was significantly associated with radiological score, pulmonary function and ISWD.CONCLUSION: This study was the first to assess the effect of clinical parameters on the SGRQ in patients with NTM-PD. HRQoL as determined using the SGRQ was associated with the radiological score, pulmonary function and ISWD in patients with NTM-PD.

[Adenocarcinoma of the bladder producing carcinoembryonic antigen and carbohydrate antigen 19-9: report of a case]

We report a case of primary adenocarcinoma of the bladder producing carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). An 85-year old woman presented with gross hematuria. Computerized tomography and ultrasonography demonstrated a mass on the urinary bladder. After clinical examination, she was diagnosed with locally invasive bladder cancer. Serum CEA and CA19-9 levels were increased to 8.9 ng/ml (normal < 2.5) and 870 U/ml (normal < 37), respectively. Simple cystectomy and bilateral cutaneous ureterostomy were performed. The histopathological diagnosis was well-differentiated adenocarcinoma of the bladder with invasion through the entire muscle layer. Postoperatively, the serum CEA and CA19-9 levels decreased to 5.4 ng/ml and 53 U/ml, respectively, and both CEA and CA19-9 were detected by immunohistochemical examination of the tumor.

[Immunohistochemical study on endothelin in rat kidney]

To elucidate the role of endothelin (ET) in the kidney, we immunohistochemically examined the precise distribution of various forms of ET-peptides in the rat kidney, using specific polyclonal antibodies to each precursor (Big ET-1, Big ET-2 and Big ET-3), and anti-mature ET antibodies. Immunoreactivity of Big ET-1 was localized mainly in some vascular endothelial cells, glomerular mesangial cells and epithelial cells of proximal tubules in the renal cortex and inner-medullary collecting ducts. The distribution of immunoreactivity for mature ETs was similar to those of Big ET-1. These observations suggest that mature ET-1 after conversion from Big ET-1 is secreted from these cells. Since similar findings were obtained using anti-Big ET-2 and anti-Big ET-3 antibodies, these two isopeptides are also considered to have certain physiological actions in the kidney. Immunohistochemical studies for ET-A receptor were also performed. The distribution of this receptor was similar to those of Big ETs and mature ETs. This suggests that secreted ET acts on adjacent cells in an autocrine/paracrine manner in the kidney.

[The foreign body granuloma after pyeloplasty: report of a case]

We report a rare case of foreign body granuloma on plain catgut which developed after Anderson-Hynes pyeloplasty for obstruction of the ureteropelvic junction in a 3-year-old boy. We use plain catgut as the suture material on pyeloplasty and seldom experience such a complication. Regarding suture material on pyeloplasty, excessive sutures intended to make anastomosis water-tight to prevent urinary leakage should be avoided in children because they are apt to form foreign body granuloma.

[Hydronephrosis presenting as the first sign of malignant lymphoma of the small intestine: report of a case]

A 45-year-old man was admitted to hospital on November 26, 1985 with the chief complaint of left hypochondrial pain. Excretory and retrograde pyelography revealed left hydronephrosis due to extrinsic obstruction of ureter. Computerized tomography and angiography revealed that a tumor of the small intestine was the cause of ureteral obstruction. In addition to the presence of a tumor, a fistula in the small intestine was disclosed on the upper gastrointestinal series. During the operation, a large mass which involved several organs was identified without mobility. The sophisticated operation was composed of wide resection of small intestine including the tumor, left hemicolectomy, left nephroureterectomy, splenectomy, partial pancreatectomy, duodeno-ileostomy and transverse sigmoidostomy was done on December 19, 1985. Pathological diagnosis was malignant lymphoma, diffuse small cell type infiltrating ureter, kidney and perirenal connective tissue. Because of poor postoperative course systemic chemotherapy was not performed and he died of disseminated intravascular coagulation on April 2, 1986.