Focal segmental glomerulosclerosis (FSGS) is a primary glomerular disease that is characterized by progressive proteinuria and declining renal function. Secondary FSGS is known to be associated with various diseases. However, an association of FSGS with essential thrombocythemia (ET) has been reported in few cases. We report a 76-year-old man who presented with nephrotic syndrome and hepatosplenomegaly. He had thrombocythemia after a splenectomy, which had been carried out at a nearby hospital. A renal biopsy showed that he had focal segmental glomerulosclerosis (FSGS), while assessment of the bone-marrow specimen revealed that he had ET. A possible relationship between FSGS, which occurred in association with a dramatic increase of thrombocytes after a splenectomy in a patient with ET, and increased serum levels of transforming growth factor (TGF)-beta, basic fibroblast growth factor (bFGF), and platelet-derived growth factor (PDGF)-BB was suggested.

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Background/Aims: Atherosclerosis and its related complications are the leading causes of death in the hemodialysis (HD) population. Aortic calcification index (ACI), intima-media thickness (IMT) in common carotid arteries, and electrocardiogram (ECG) are atherosclerotic parameters that are available in usual clinical outpatient settings. Macrophage colony-stimulating factor (MCSF) and monocyte chemoattractant protein-1 (MCP-1) play important roles in atherosclerosis. Methods: We performed a cross-sectional study of 133 outpatients on maintenance HD in a single HD outpatient center. We measured serum levels of MCSF and MCP-1, determined the ACI using computed tomography scan and the IMT using high-sensitivity ultrasound B-mode imaging, and performed ECGs. Results: Stepwise multivariate regression analysis revealed that the MCSF level correlated with age-adjusted mean and maximum IMT (F = 10.811, p = 0.001, and F = 6.784, p = 0.010, respectively) as well as with the diastolic blood pressure. Age and MCSF level (F = 4.866, p = 0.029) were independently related to an increased ACI. High-sensitivity C-reactive protein (hsCRP) was not related to IMT and ACI. The hsCRP level (χ² = 5.002, p = 0.025) correlated with ECG changes followed by MCSF (χ² = 3.940, p = 0.047). MCP-1 was not related to the above atherosclerotic parameters. Conclusion: A head-to-head comparison between MCSF and hsCRP revealed that MCSF was more closely associated with IMT and ACI in HD patients.

The purpose of this study was to establish broadband ultrasonic attenuation (BUA: dB/MHz) as bone mineral density (BMD) norms for healthy young Japanese and to evaluate the standard values for an ultrasonic bone analyzer (Cuba Clinical, McCue Ultrasonics Ltd., Winchester, England), which facilitates BMD measurement without exposure to radiation. The subjects were 472 healthy young individuals with no endocrine or skeletal disorders, 197 males (mean age 16y 5m) and 275 females (mean age 15y 7m) aged from 5 to 29 years. BUA was measured at the left calcaneus. The subjects were divided into five age-stratified different age groups of five years intervals. The mean BUA values (dB/MHz) obtained were 40.6, 60.9, 78.0, 90.4 and 86.0 for males, and 41.9, 61.0, 73.4, 68.4 and 70.8 for females in the 5-9, 10-14, 15-19, 20-24 and 25-29 age groups, respectively. A significant positive correlation was observed between BUA and age in both males and females except in the male 25-29 age group and the female 20-24 and 25-29 age groups. A significantly different BUA between males and females was found in the 20-24 and 25-29 age groups (pϽ0.001). The BUA values obtained in this study may serve as BMD norms for children and young adults. It might be thought that measuring BUA from childhood through early adulthood made it possible to determine peak values and peak periods of BMD, providing useful information for assessment of growth and development.

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