Urinary free cortisol (UFC), 17-hydroxycorticosteroids (17-OHCS) in urine and dexamethasone suppression test (DST) were examined in patients with dementia of Alzheimer type (DAT) and multi-infarct dementia (MID), and nondemented elderly. Eight of 19 patients (42.1%) were DST nonsuppressor. UFC was significantly elevated in patients with dementia, compared with that in nondemented elderly. There was no difference in UFC levels between DAT and MID. The UFC level correlated with post-DST plasma cortisol level at 1600 in demented patients. The mean level of 17-OHCS in demented patients was increased, although the difference was not significant statistically. In demented patients, UFC levels, not 17-OHCS levels in urine were correlated with Mini-Mental State Examination scores. These results suggest that a hypothalamo-pituitary-adrenal axis function is activated in demented patients and that this activation relates generally to dementation itself, not to an etiology of dementia. Measurement of UFC might be a biological marker of dementia and may have a value in diagnosis of dementia.

17-Hydroxycorticosteroids↗

PubMedDate not supplied

Significance of sublobular hepatic necrosis in the progression of chronic hepatitis C.

The clinical characteristics of hepatitis C virus associated chronic liver diseases (C-LD) in 17 patients were compared with hepatitis B virus associated diseases (B-LD) in 47 patients, by analysing the histological findings of the liver and the change in serum alanine aminotransferase (ALT) level. The persistence of the moderate abnormality in ALT (> 100 IU/L) for longer than 1 year was more frequently seen in the C-LD group (P < 0.01), although the severe exacerbation of the disease with ALT higher than 500 IU/L was more frequent in the B-LD group (P < 0.01). The patients with the histological finding of sublobular hepatic necrosis (SN) in the C-LD group progressed to advanced stages more frequently than those with SN in the B-LD group (P < 0.05). Furthermore, nine of 10 patients with SN in C-LD finally progressed to hepatocellular carcinoma (HCC) in 52 +/- 23 months, whereas three of 16 with SN in B-LD developed HCC in 81 +/- 34 months. Although the morphological features of SN in C-LD and B-LD were almost the same, SN in C-LD seemed to be a more significant diagnostic condition for the progression to liver cirrhosis or HCC. The patients with SN in the C-LD group should be closely followed for the early detection of HCC, although further study with a greater number of patients is necessary.

Adult↗