RESUMEN
BACKGROUND: Catatonia is a syndrome that may present with stupor, immobility, and postural retention, and appears in various primary disorders including schizophrenia, depressive disorders, and neurodevelopmental disorders. CASE PRESENTATION: In this report, we describe a 34-year-old female patient with schizophrenia, who had previously been treated with antipsychotic agents to improve psychotic symptoms with delusional symptoms and catatonia. However, she relapsed with catatonic symptoms around 1 year after she voluntarily discontinued the prescribed antipsychotic medications by herself. Her catatonia was successfully improved using the transdermal blonanserin patch, a drug formulation globally first approved in Japan in 2019. DISCUSSION: Although benzodiazepines or electroconvulsive therapy have been recommended as the first-line treatment of catatonic manifestation observed in psychiatric patients, this patient responded well to antipsychotic blonanserin. From the differential drug responses, catatonia may be the complex of heterogeneous conditions with different pathophysiologies.
Asunto(s)
Antipsicóticos , Catatonia , Esquizofrenia , Humanos , Femenino , Adulto , Esquizofrenia/tratamiento farmacológico , Antipsicóticos/uso terapéutico , Catatonia/diagnóstico , Catatonia/tratamiento farmacológico , Parche TransdérmicoRESUMEN
This was a case-control study to analyze the associations between calcium urolithiasis and the urokinase polymorphisms, P141L (rs2227564) and 3'-UTR C>T (rs4065), in a Japanese population. Cases consisted of 232 patients with urinary calcium stones (174 men and 58 women) who presented to a general hospital between April 2009 and June 2011. Among these cases, 115 (49.6 %) patients had calcium oxalate stones alone, and 113 (48.7 %) patients had calcium oxalate stones mixed with calcium phosphate stones. Controls consisted of 454 subjects who had a routine health check-up in the same prefecture. The two polymorphisms were genotyped via polymerase chain reaction with confronting two-pair primers. In the control group, the genotype frequencies of P141L were 0.573 for PP, 0.375 for PL, and 0.052 for LL, and those of 3'-UTR C>T were 0.835 for CC, 0.165 for CT, and TT was not identified. Neither of the polymorphisms was significantly associated with urolithiasis. The age- and sex-adjusted odds ratios of urolithiasis were 0.96 [95 % confidence interval (CI), 0.66-1.41] for PL and 1.22 (0.58-2.57) for LL as compared with PP genotype of P141L, and 1.01 (0.62-1.64) for CT as compared with CC genotype of 3'-UTR C>T. When compared with the PP genotype of P141L, the frequency of PL was significantly lower in female cases with a family history of urolithiasis than in females without such family history (p = 0.028). P141L and 3'-UTR polymorphisms of the urokinase gene are not associated with urolithiasis in a Japanese population.
Asunto(s)
Pueblo Asiatico/genética , Oxalato de Calcio/metabolismo , Polimorfismo Genético , Activador de Plasminógeno de Tipo Uroquinasa/genética , Urolitiasis/genética , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Antidepresivos Tricíclicos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Mianserina/análogos & derivados , Enfermedad de Parkinson/complicaciones , Trastorno Depresivo Mayor/etiología , Femenino , Humanos , Mianserina/uso terapéutico , Persona de Mediana Edad , MirtazapinaRESUMEN
The etiology of schizophrenia has been proposed to be neurodevelopmental based on neuroimaging and molecular biological studies. If there is neuronal vulnerability based on neurodevelopment failures in schizophrenic brains, then the impact of aging may have a greater effect on schizophrenic brains than on normal brains. To determine the impact of aging on schizophrenic brains, we investigated the age-related morphological changes of the cross-sectional area of the gray matter (GM) in the left Heschl's gyrus (HG) and the left superior gyrus (STG) in 22 schizophrenic and 24 age- and sex-matched normal control postmortem brains two-dimensionally. The subject groups were divided into younger groups (30-54years of age) and older groups (65-84years of age) on the basis of age at death. Both in schizophrenic and control subjects, the GM area in HG and the STG was significantly smaller in the older group than in the younger group, however, no significant differences were observed between the schizophrenic and control subjects. In the STG, the cross-sectional area of the white matter (WM) was also measured. In the older group, the ratio of the GM area to the WM area in the STG was significantly larger in schizophrenic subjects than controls, although there was no significant difference between the schizophrenic and control subjects in the younger group. These findings indicate that the impact of aging has a greater effect on the WM in the STG in schizophrenic subjects than in normal individuals, although the pathological basis is still unclear.
Asunto(s)
Envejecimiento/patología , Giro del Cíngulo/patología , Cambios Post Mortem , Esquizofrenia/patología , Lóbulo Temporal/patología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Lateralidad Funcional , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Índice de Severidad de la EnfermedadRESUMEN
Continued exposure of endothelial cells to mechanical/shear stress elicits the unfolded protein response (UPR), which enhances intracellular homeostasis and protect cells against the accumulation of improperly folded proteins. Cells commit to apoptosis when subjected to continuous and high endoplasmic reticulum (ER) stress unless homeostasis is maintained. It is unknown how endothelial cells differentially regulate the UPR. Here we show that a novel Girdin family protein, Gipie (78 kDa glucose-regulated protein [GRP78]-interacting protein induced by ER stress), is expressed in endothelial cells, where it interacts with GRP78, a master regulator of the UPR. Gipie stabilizes the interaction between GRP78 and the ER stress sensor inositol-requiring protein 1 (IRE1) at the ER, leading to the attenuation of IRE1-induced c-Jun N-terminal kinase (JNK) activation. Gipie expression is induced upon ER stress and suppresses the IRE1-JNK pathway and ER stress-induced apoptosis. Furthermore we found that Gipie expression is up-regulated in the neointima of carotid arteries after balloon injury in a rat model that is known to result in the induction of the UPR. Thus our data indicate that Gipie/GRP78 interaction controls the IRE1-JNK signaling pathway. That interaction appears to protect endothelial cells against ER stress-induced apoptosis in pathological contexts such as atherosclerosis and vascular endothelial dysfunction.
Asunto(s)
Proteínas Portadoras/metabolismo , Retículo Endoplásmico/metabolismo , Células Endoteliales/metabolismo , Proteínas de Microfilamentos/metabolismo , Estrés Mecánico , Respuesta de Proteína Desplegada/fisiología , Proteínas de Transporte Vesicular/metabolismo , Animales , Apoptosis/fisiología , Células COS , Proteínas Portadoras/genética , Células Cultivadas , Chlorocebus aethiops , Chaperón BiP del Retículo Endoplásmico , Endorribonucleasas/genética , Endorribonucleasas/metabolismo , Células Endoteliales/citología , Activación Enzimática , Aparato de Golgi/metabolismo , Proteínas de Choque Térmico/genética , Proteínas de Choque Térmico/metabolismo , Humanos , Proteínas Quinasas JNK Activadas por Mitógenos/metabolismo , Masculino , Proteínas de la Membrana/genética , Proteínas de la Membrana/metabolismo , Proteínas de Microfilamentos/genética , Proteínas Serina-Treonina Quinasas/genética , Proteínas Serina-Treonina Quinasas/metabolismo , Interferencia de ARN , Ratas , Ratas Wistar , Transducción de Señal/fisiología , Células U937 , Proteínas de Transporte Vesicular/genéticaRESUMEN
Bladder cancer is one of the most common malignant diseases. Since a high-rate of recurrence is a serious problem for early stage urothelial carcinomas, new strategies for the management of recurrent urothelial carcinomas have been explored. CD109 is a glycosylphosphatidylinositol-anchored glycoprotein and is expressed in various cancer tissues, mainly squamous cell carcinomas. CD109 negatively controls transforming growth factor (TGF)-ß/Smad signaling in vitro. In this study, we analyzed the clinical significance of CD109 expression in bladder cancer using immunohistochemistry. Of 156 urothelial carcinoma tissues, 69.9% were positive for CD109, whereas CD109 was not expressed in seven normal bladder epithelia. CD109 expression was significantly higher in non-muscle-invasive (pTa+pT1) or low-grade (G1+G2) tumors than in muscle-invasive (pT2-4) or high-grade (G3) tumors, and was associated with cancer-specific survival. Simultaneous immunostaining of CD109 and phosphorylated Smad2 showed an inverse immunoreactivity relationship between the two, suggesting that CD109 inhibits TGF-ß/Smad signaling in tumor tissues. Interestingly, CD109 was found to be highly expressed in the basal layer of non-invasive urothelial carcinomas, and the expression pattern was similar to that of CD44, a marker of cancer stem cells. These findings suggest that CD109 is involved in bladder tumorigenesis and is a potential target for cancer immunotherapy.
Asunto(s)
Antígenos CD/metabolismo , Carcinoma/patología , Proteínas de Neoplasias/metabolismo , Neoplasias de la Vejiga Urinaria/patología , Urotelio/patología , Carcinoma/metabolismo , Femenino , Proteínas Ligadas a GPI/metabolismo , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Estadificación de Neoplasias , Fosforilación , Proteína Smad2/metabolismo , Neoplasias de la Vejiga Urinaria/metabolismo , Urotelio/metabolismoRESUMEN
Angiography depicted the arteriovenous fistula at the peripheral cortex of the kidney, which was treated superselective transcatheter arterial embolization (TAE). Bleeding was controlled and did not recur. The contrast-enhanced computed tomographic (CT) scan performed on the 27th day after the procedure revealed a parenchymal perfusion deficit of 3% and the return of serum creatinine concentration to pre-injury levels. We considered the selective coil embolization as the best treatment for the aneurysmal arteriovenous fistula located in the renal cortex to keep ischemic damage at a minimum and preserve renal function. To our knowledge, this is the 4th report of a spontaneous rupture in the retroperitoneum of an aneurysmal arteriovenous fistula.