Bacterial tracheobronchitis. A rare cause of adult airway stenosis

Bacterial tracheobronchitis is a rare cause of airway stenosis in adults. This report describes a 73-year-old woman with a recent history of polysialadenitis, who presented with severe airway obstruction due to infection and stenosis of tracheal and bronchial tissue. Tissue culture of the bronchial mucosa showed growth of methicillin resistant Staphylococcus epidermidis (MRSE). Sputum culture showed growth of MRSE, Pseudomonas aeruginosa, Enterobacter cloacae and Enterococcus faecalis ; the same organisms were cultured from the salivary glands. Tracheostomy and antibiotic therapy were effective in controlling the disease.     

Long-term follow up of abdominal aortic aneurysm complicating Kawasaki disease: Comparison of the effectiveness of different imaging methods

A 2 month old boy with Kawasaki disease developed the rare complication of abdominal aortic aneurysm (AAA). He was followed up over 7 years by ultrasonography (2D-ECHO) with and without Doppler flow evaluation, angiography and computed tomography. Calcification was noted 33 months after the onset of the disease but the aneurysm did not decrease in size. 2D-ECHO was adequate for evaluating the size of an aneurysm, but did not show thrombus formation or calcification. Doppler flow studies did not show abnormally high blood flow velocities either at the inflow or outlet of aneurysms, which are indicative of stenosis. On the other hand an abdominal aortogram provided information regarding the luminal shape and abnormalities in flow pattern suggestive of thrombus formation. Fluoroscopy cannot demonstrate calcification in the early stages. Computed tomography (CT) was the imaging method of choice for the evaluation of obstructive or calcific changes; an organizing thrombus was clearly demonstrated and early detection of calcification was possible.     

Evaluation of acute myocarditis and pericarditis by Gd-DTPA enhanced magnetic resonance imaging

Gd–DTPA enhanced magnetic resonance imaging was performedin two adult patients with acute myocarditis and pericarditis.Gd–DTPA enhancement seemed to identify the exact cardiacregion with the higher degree of inflammation.     

Prenatal Diagnosis of Duchenne Muscular Dystrophy (DMD) by the Polymerase Chain Reaction (PCR)

The diagnosis of Duchenne muscular dystrophy (DMD) has been drastically improved by recent advances in DNA analysis. The Southern blot hybridization using the cDNA 8 probe and the restriction enzyme Hind III was conducted in a gravida and her family in blood samples. The diagnosis revealed partial gene deletions in both the gravida and the DMD-affected second child. The prenatal diagnosis was performed by studying the PCR (polymerase chain reaction) for target DNAs of exons 48 and 51 that correspond with cDNA 8 probe. In the affected child, the 506 bp band at exon 48 was detected but 388 bp at exon 51 was missing. On the other hand, both the 506 bp band at exon 48 and the 388 bp band at exon 51 were detected in the cultured amniotic cells. Thus, the fetus was determined to be not affected.     

Prevalence of primary sclerosing cholangitis and other liver diseases in Japanese patients with chronic ulcerative colitis

An association between primary sclerosing cholangitis (PSC) and chronic ulcerative colitis (CUC) is well known in Western countries, but there have been no reports on this association in Japan. We reviewed 163 consecutive CUC patients (91 males and 72 females) diagnosed from 1984 to 1990 at Tokyo Women's Medical College. Abnormal liver function tests were found in 42 patients with CUC (25.8%), but chronic liver disease was only diagnosed in seven patients (4.3%). Among these seven patients, there were four with PSC, one with small-duct PSC, one with transfusion-associated chronic hepatitis and one with Type B liver cirrhosis. No relationship was found between the documented colonic manifestations of CUC and the presence of PSC. The four PSC patients did not have a longer history of CUC at the time of diagnosis of PSC than CUC patients without PSC. At the time of PSC diagnosis, two patients were asymptomatic, one presented with right upper quadrant pain, and the other had fatigue. Three patients were diagnosed as having CUC before the onset of PSC (range 2–13 years), and the other patient had both diseases simultaneously. All four had a good prognosis. Thus PSC was the most common chronic liver disease associated with CUC in our series, and it was present in all our CUC patients with alkaline phosphatase levels exceeding twice the upper limit of normal and mild transaminase elevation.     

Light and scanning electron microscopic studies on wrinkles in aged persons' skin

Wrinkles in six aged persons (67–82 years of age) have been investigated by light microscopy (LM) and scanning electron microscopy (SEM). There are two types of wrinkles. One is a deep wrinkle which develops on the sun-exposed skin and does not disappear on stretching (permanent wrinkle). The LM and SEM showed less elastotic change in the upper dermis in the area of wrinkle than in that of the surroundings. The other type is a shallow wrinkle which develops on sun-protected skin and disappears on stretching (temporary wrinkle). The LM and SEM showed the decrease or loss of the elastic fibres in the papillary dermis as seen in ageing skin.     

Comfortable zone of the mandible evaluated by the constant stimuli method

summary For evaluation of the comfortable zone (CZ) and the most comfortable position (MCP) of the occlusal vertical relation of the mandible, the constant stimuli method with three subjective categories of judgements was applied in 10 edentulous subjects.
The evaluated CZ was stable and about 3 mm in width. The occlusal vertical dimension (OVD) of the existing dentures was found to be located within the CZ in nine of the 10 subjects.     

Detection of human T-cell lymphotropic virus type-1 proviral DNA in the saliva of an adult T-cell leukaemia/lymphoma patient using the polymerase chain reaction

We report a case of adult T-cell leukaemia/lymphoma (ATLL), in whom the polymerase chain reaction (PCR) on genomic DNA from saliva demonstrated the monoclonal integration of human T-cell lymphotropic virus type-1 (HTLV-1) proviral DNA in lymphocytes in the saliva. These results provided evidence of the possibility of saliva-borne transmission of HTLV-1.     

消炎痛能部分翻转脂多糖诱导的加压素能及去甲肾上腺素能神经元的Fos表达

目的　探讨消炎痛对脂多糖诱导的下丘脑视上核、室旁核加压素能神经元及脑干蓝斑去甲肾上腺素能 (酪氨酸羟化酶阳性 )神经元的Fos表达的影响。方法　采用双重免疫组织化学的研究方法 ,观察脂多糖诱导大鼠脑内Fos的表达。结果　两种剂量 (0 0 2 5mg·kg-1,1 2 5mg·kg-1)的脂多糖均可以诱导视上核和室旁核内部分加压素能神经元和蓝斑的部分去甲肾上腺素能神经元Fos表达 ,静脉给予消炎痛 (10mg·kg-1)能抑制低剂量脂多糖诱导的上述核团加压素及去甲肾上腺素能神经元Fos表达 ,而对高剂量脂多糖诱导的Fos表达无效。结论　脂多糖能激活下丘脑视上核和室旁核加压素能神经元及脑干蓝斑去甲肾上腺素能神经元 ,参与神经内分泌免疫的中枢反应 ,前列腺素至少部分地参与这种激活过程     

Frequency- and Time-Domain Analysis of P Wave in Patients with Paroxysmal Atrial Fibrillation

We investigated the usefulness of the time- and frequency-domain analysis of the P wave triggered signal-averaged ECG (P-SAECG) for detecting patients with paroxysmal atrial fibrillation (Paf). In previous studies, the usefulness of the time domain of the P-SAECG to detect patients with Paf was described but that of the frequency domain is unknown. We analyzed the P-SAECG in the time and frequency domain in 23 patients with Paf and 19 controls. The 32-unipolar chest lead ECGs and the standard bipolar limb lead ECGs were obtained. The time-domain analysis showed that the filtered P duration (fPd) was significantly longer (P < 0.01) in patients with Paf than controls: the predictive accuracy of Paf with fPd > 120 ms was 69%. The frequency domain analysis showed that the area ratio of power spectrum area of 0–20 Hz to 20–100 Hz (AR20) was significantly higher (P < 0.01) and the magnitude ratio at 30 Hz (%Mag.30) calculated by dividing the magnitude at 30 Hz by the maximal magnitude was significantly (P < 0.01) lower in patients with Paf than controls in the left lateral chest leads. The predictive accuracy of Paf with AR20 ≥ 1.5 and that with %Mag.30 < 40% was 83% and 73%, respectively. Our results indicate that the frequency-domain analysis of P waves in lateral leads is useful as is the time-domain analysis to detect patients with Paf. The AR20 ≥ 1.5 and %Mag.30 < 40% provides accurate predictability of Paf.