Myocardial and vascular uptake of a bone tracer associated with secondary hyperparathyroidism

A patient on chronic hemodialysis, with secondary hyperparathyroidism was referred for a radionuclide bone-imaging study. Deposition of ^99mTc-methylene diphosphonate (^99mTc-MDP) was apparent in the myocardium and abdominal blood vessels, as well as in the skeleton by four-color processed scintigraphy. Plain radiographs of the chest and abdomen demonstrated no calcification in the myocardium or abdominal blood vessels. Several possible mechanism for this uptake are discussed briefly.     

Long-term prognosis of membranous nephropathy

One hundred and four consecutive patients with idiopathic membranous nephropathy have been followed for 24 years. The actuarial survival rates in 5, 10 and 15 years were 94.6, 90.0 and 80.3%, respectively. Within the first 5 years clinical status improved gradually, but thereafter entered into an equilibrated state, when approximately 70% of the patients were in remission of absent (40%) or less than 1.0 g/24 hour urinary protein. As for renal function, within the initial 5 years around 80% of the patients revealed a glomerular filtration rate (GFR) greater than 80 ml/min. This percentage reduced approximately to 70 and 50% over periods of 10 and 15 years, whereas a mean reduction rate of GFR was only 15 ml/min over a period of 8 years. The clinical status at the 5th year correlated well with its outcome (rs = 0.676, p less than 0.001) and GFR estimated around the 5th year with the final estimate (r = 0.796, p less than 0.001). These data suggest that membranous nephropathy follows a fairly good clinical course, and that the 5th year clinical status and renal function are valuable prognostic indices of the disease.     

Antigenic and genetic conservation of H3 influenza virus in wild ducks

The hemagglutinins of H3 influenza viruses isolated from migratory ducks on the Pacific flyway in Japan during the period 1977 to 1985 were analyzed antigenically and genetically. Antigenic analysis using monoclonal antibodies to the hemagglutinins of A/Aichi/2/68 (H3N2) and A/duck/Hokkaido/8/80 (H3N8) viruses showed that antigenic drift occurred extensively in human strains, whereas the hemagglutinins of duck viruses were highly conserved. It was also found that the hemagglutinins of duck viruses were antigenically closely related to that of human 1968 H3 prototype strains. Nucleotide sequence analysis of seven duck H3 hemagglutinin genes showed a limited number of changes among the six duck isolates and between these duck isolates and Aichi/68. The deduced amino acid sequence revealed amino acid changes randomly distributed throughout the molecule and not confined to antigenic sites. These findings indicate that the duck virus hemagglutinin genes are conserved in nature and that viruses of different lineages cocirculate.     

Proteinase inhibitor alpha 1-antichymotrypsin has different expression in various forms of neuronal ceroid lipofuscinosis.

Defective proteolytic degradation is most widely maintained as the major pathogenetic factor in neuronal ceroid lipofuscinosis (NCL). The goal of the present study was to examine the expression in NCL brain tissue of one of the serine proteinase inhibitors, alpha 1-antichymotrypsin. Our study was based on previous findings of alpha 1-antichymotrypsin association with CNS amyloidoses related to amyloid beta protein deposits and our previous findings suggesting abnormal processing of amyloid beta-protein precursor (ABPP) in NCL brains. Immunocytochemical study was performed on formalin-fixed brain tissues collected from 15 NCL cases representing four different forms of the disorder and from 16 control cases comprising age-matched controls, older nondemented individuals, and Alzheimer disease cases. Our present study has shown that the expression of alpha 1-antichymotrypsin is generally higher in NCL cases than in control cases; however, it manifests in distinct variations of intensity and proportions of immunostained cells. The strongest immunoreactivity was found in the infantile form of NCL, which is characterized by a rapid clinical course and widespread tissue damage. We found no evidence of direct involvement of alpha 1-antichymotrypsin in either the ceroid lipopigment accumulation or the abnormal processing of ABPP in NCL. However, our findings may reflect the heterogeneity of the pathomechanism underlying this group of disorders and suggest that, similarly to blood circulation, alpha 1-antichymotrypsin can also represent an acute-phase protein in brain tissue.     

Male siblings with Takayasu's arteritis suggest genetic etiology

Summary Takayasu's arteritis is a nonspecific arteritis involving the aorta and its major branches. The disease mainly affects young females and familial incidence is uncommon. In this paper, two rare cases of male siblings with Takayasu's arteritis and the results of their HLA typing are described. The HLA haplotype of the two cases was completely identical—A2-B40-Cwl and A24(9)-Bw59-Cwl, DR2, and DR4. It is reported that BW52(5) is strongly associated with the disease. However, in our cases, Bw52(5) was not found, while DR2 and DR4, which have been reported in association with several autoimmune disease, were detected. Accordingly, in these cases, genetic factors might be associated with the pathogenesis of the disease through an autoimmune mechanism.