Pre-existing ILD was the most important risk factor for LEF-induced ILD. We suggest that LEF should not be prescribed for RA patients complicated with ILD.

In order to elucidate the distribution of elements in organs from healthy Japanese, instrumental neutron activation analysis (INAA), based on the preliminary examination, was applied to quantitative determination of multielements in nine organs autopsied (brain, heart, kidney, liver, lung, muscle, pancreas, spleen, and thyroid). The following results were obtained: (1) The values obtained for each element could be considered to be representative as "normal values" and "ranges" in organs from healthy Japanese males; (2) the essential elements Br, Cl, Co, Cu, Fe, K, Mn, Na, Rb, Se, and Zn were not affected by external environmental factors or by racial difference; (3) renal and hepatic Cd levels were very high in several cases and the accumulation has still been in progress in the Japanese, whereas the contaminant elements are low in each organ except for lung.

Background: The aims of this clinical study were to investigate the associations of urinary free fatty acid (FFA) levels with tubulointerstitial damage, and to determine the clinical significance of urinary liver-type fatty acid binding protein (L-FABP) in diabetic nephropathy. Methods: Fifteen patients with nephrotic syndrome due to diabetic nephropathy and 12 patients with minimal-change nephrotic syndrome (MCNS) were studied. Urinary and serum FFA concentrations (palmitic, oleic, linoleic, and arachidonic acids) were measured by gas chromatography, and urinary L-FABP levels were quantified using an ELISA technique. Tubulointerstitial damage was assessed using renal biopsy specimens. Results: The levels of urinary linoleic and arachidonic acids were significantly elevated in diabetic nephropathy compared to MCNS patients, though serum FFA levels were lower in diabetic nephropathy than MCNS patients. The degree of tubulointerstitial damage was significantly severer in the patients with diabetic nephropathy than MCNS. Urinary L-FABP and 8-OHdG (8-hydroxydeoxyguanosine) concentrations were significantly higher in the diabetic nephropathy subjects. Conclusion: Elevated urinary excretion of FFA may be a reflection of FFA overload in the proximal tubules, and FFA may be an important promoter of tubulointerstitial damage in diabetic nephropathy patients. Urinary L-FABP levels may reflect the stress induced by FFA to the proximal tubules, leading to severe tubulointerstitial damage.

No abstract

Pre-existing interstitial pneumonia, extremely high serum CRP and low albumin levels, severe hypoxaemia and mechanical ventilation indicated poor prognosis. Peripheral blood lymphocytopenia developed in association with lung injury, and a sustained low lymphocyte count indicated a fatal outcome.

Activation of neutrophil by the dialysis membrane and peroxidative stress plays an important role on the pathogenesis of complications in hemodialysis (HD) patients. Vitamin E is one of the potent scavengers for reactive oxygen species. Recent studies suggest that a vitamin E-modified multilayer membrane (Excebrane, CL-EE dialyzer) has an inhibitory effect on serum lipids peroxidation in HD patients. To determine the effect of CL-EE on biocompatibility in clinical use, we measured the superoxide anion radical producing ability (SOPA) of polymorphonuclear leukocytes (PMNLs), the plasma hydroxyl radical producing ability (OHPA) and superoxide anion radical scavenging activity (SSA). SOPA was measured after stimulation of PMNLs with phorbol myristate acetate using electron paramagnetic resonance (EPR) method. Plasma OHPA and SSA were also determined using the EPR method. In addition, the plasma concentrations of malondialdehyde (MDA) and oxidized low-density lipoprotein (LDL), as the parameters for lipid peroxidation, were measured. SOPA was decreased in patients who used conventional filter membrane compared with healthy controls. In the patients using the CL-EE membrane, SOPA gradually increased and reached control levels after six months. However, no significant increase was observed in patients who used a conventional filter membrane. OHPA of HD patients was significantly decreased compared with controls. In the CL-EE membrane patient group, OHPA was significantly increased at six months. SSA was significantly higher in the conventional filter membrane group than controls. In the CL-EE membrane patient group, SSA gradually decreased at six months. Plasma MDA and oxidized LDL levels were significantly higher in HD patients compared with controls. These values slowly decreased, and significant differences were found after nine months of using the CL-EE membrane. These findings suggest that activation of PMNLs and plasma OHPA and SSA in HD patients is attenuated by antioxidant effects of the CL-EE.

Robot-assisted gait training following acute stroke could allow patients with severe disability to receive a high dosage and intensity of gait training compared with conventional physical therapy (CP). However, given the limited data on gauging the efficacy of Hybrid Assistive Limb (HAL) on gait training in patients with acute stroke, we aimed to evaluate several outcome measures following gait training with HAL. Patients with first-ever stroke, who required a walking aid and were able to start gait training within 1 week of stroke onset were included in the current study. Patients were assigned to either the CP or HAL group. Outcome measures were collected at baseline, and at the 2nd (at 2-6 weeks), and 3rd (at 3-5 months) assessments. All patients underwent physical therapy until the 3rd assessment; patients in the HAL group underwent gait training using HAL until the 2nd assessment. Thirty-seven patients (19 from CP and 18 from HAL, median age = 69 years) completed the study. At the 2nd assessment, the total Functional Independence Measure (FIM) score was higher in the HAL group than in the CP group (90.1 vs. 79.0, p = 0.042). In conclusion, the FIM scale could be used to identify responsiveness to acute stroke rehabilitation using HAL.

Preprandial administration provided a more stable absorption profile of cyclosporine compared with postprandial administration. From the correlation with AUC 0-4 , we concluded that C 2 , and not C 0 , is a reliable marker for monitoring cyclosporine exposure.