Cold activation of complement in sera from patients with persistent hepatitis C virus infection on interferon therapy

The loss of haemolytic activity in sera during storage at low temperature (the cold activation of complement) was observed in 136 of 184 (74%) patients with chronic liver disease associated with hepatitis C virus (HCV) infection. This was more frequent than observed in the three of 40 (8%) patients with chronic hepatitis B (P < 0.001) or none in 43 normal controls (P < 0.001). Of 103 patients with chronic hepatitis C who had completed a full course of recombinant interferon-α2a therapy (total dose: 516×10⁶U), 40 responded completely and 21 responded partially, as judged by the normalization or decrease of alanine aminotransferase levels 6 months after the completion of therapy; 42 patients did not respond at all. The cold activation of complement persisted in five (13%) complete responders, less often than in 33 (79%) non-responders (P < 0.001). At the completion of interferon therapy, the cold activation of complement persisted in 12 of 54 patients despite the normalization of alanine aminotransferase. Spontaneous exacerbation of hepatitis occurred in seven of 12 (58%) patients with cold activation, which was more frequent than in the four of 42 patients (10%) without it (P < 0.01). The cold activation of complement disappeared along with the loss of HCV-RNA in five of six responders during the 6 month period after the completion of interferon therapy, while both cold activation and HCV-RNA persisted in all eight non-responders. These results indicate that the cold activation of complement may be useful as a marker of HCV viraemia for monitoring the response to interferon in patients with HCV infection.     

Overexpression of p53 protein correlates with a high risk of malignant transformation of adenomas in patients with multiple colorectal adenomas

To assess the correlation of p53 oncoprotein expression with the high risk of developing carcinomas in patients with multiple colorectal adenomas, 25 cases with histologic carcinoma in adenoma (CIA) were examined by immunohistochemistry using a monoclonal antibody specific to human p53 protein (wild and mutant). The 25 cases were classlfied into multiple and single groups. The former contained 13 cases with synchronous multiple colorectal adenomas (one to six adenomas) and adenocarcinoma. The latter included 12 cases with single CIA only. This study revealed an overall incidence of 57.14% of p53 overexpression in carcinomatous lesions and 31.9% in adenomatous lesions, which was statistically significant ( P <0.05). The carcinomatous lesions showed a diffuse staining pattern, whereas the adenomatous lesions showed a focal pattern. A significant finding was that the incidence of p53 overexpression was slgnificantly higher in multiple groups (81.25%) than in single groups (31.43%) in the carcinomatous ( P <0.01) rather than in the adenomatous ( P >0.05) lesions. There were no correlations between p53 overexpression and proliferation activity or carcinoembryonic antigen expression. The results indicate that p53 abnormality may be an important genetic factor responsible for the high risk of developing carcinomas in patients with multiple adenomas.     

Transient erythroblastopenia due to human parvovirus B19 infection: A case report of a boy suffering from purpura

Transient erythroblastopenia of childhood (TEC) was observed in a boy infected by human parvovirus B19 (B19) before the manifestation of the typical clinical picture of erythema infectiosum (EI). He did not have any apparent symptoms of anemia, and spontaneous resolution of erythroblastopenia was observed before the manifestation of the symptoms of EI. The difference between primary B19 infection and classical TEC is discussed.     

Clostridium Difficile in Young Children

ABSTRACT. Clostridium difficile was isolated from the stools of 11/52 (21 %) of children aged 0 to 2 years hospitalized with diarrhoea, and from 17/52 (33 %) of a control group of hospitalized children with no diarrhoea; this difference was not significant. Direct demonstration of C. difficile toxin from the stools was positive in 1 case with diarrhoea and in 5 control cases. The children with positive stool culture for C. difficile had had significantly more treatments with antibiotics or chemotherapeutics than those with negative C. difficile culture (3.3 ± 2.7 vs. 1.6 ± 1.8, p < 0.001), but there was no significant difference in the incidence of diarrhoea in the past. During a 4–6-month follow-up, C. difficile disappeared from the stools of 24 out of 28 initially culture-positive children; 3 of the 4 children with persistent C. difficile had received antibiotics during the follow-up period. We conclude that the presence of C. difficile is common in the stools of young children up to the age of 2 years, and that C. difficile is more frequently found in children who have received antimicrobial therapy. Most cases of C. difficile carriage state are symptomless at this age.     

TRANSIENT REMISSION OF JUVENILE RHEUMATOID ARTHRITIS AFTER MEASLES

ABSTRACT. Yoshioka, K., Miyata, H. and Maki, S. (Department of Paediatrics, Kinki University School of Medicine, Osaka, Japan). Transient remission of juvenile rheumatoid arthritis after measles. Acta Paediatr Scand, 70:419, 1980.–A 4-year-old Japanese girl with systemic juvenile rheumatoid arthritis had an attack of measles. On the day following the first signs of measles she became afebrile and free of joint pain even though aspirin therapy was discontinued. The remission lasted for 10 days. It appears that the measles virus infection may have been responsible for the brief remission in this patient. The observation of a remission of juvenile rheumatoid arthritis after measles is extremely rare.     

Pseudomembranous Colitis with Recurring Diarrhoea and Prolonged Persistence of Clostridium Difficile in A 10-Year-Old Girl

ABSTRACT. A 10-year-old girl developed, after treatment with amyxocillin, a clinically and sigmoidoscopi-cally apparent pseudomembranous colitis with positive Clostridium difficile stool culture. Treatment with vancomycin resulted in rapid clinical cure, but there was a relapse of diarrhoea and reappearance of C. difficile , with no pseudomembranous colitis, within one month. Clinical symptoms subsided spontaneously but C. difficile persisted for 2 more months in the stools. This case reflects three different aspects of C. difficile infection in one child: pseudomembranous colitis, ordinary diarrhoea, and symptomless carrier state.     

Myeloid differentiation is impaired in transgenic mice with targeted expression of a dominant negative form of retinoid X receptor β

To investigate the in vivo function of retinoid X receptor (RXR) on myelopoiesis, we generated transgenic (Tg) mice with targeted expression of a dominant negative form of RXR β in myeloid cells. In these Tg mice the transgene is expected to suppress the function of heterodimeric receptors composed of RXR and its counterparts, such as retinoic acid receptor. Out of 12 mice analysed, one Tg mouse exhibited a severe maturation arrest at the promyelocytic stage. Three other Tg mice showed a mild inhibition of myeloid differentiation, which was further augmented when mice were treated with 5-fluorouracil (5-FU). Furthermore, four Tg mice showed impaired myeloid differentiation in response to the treatment by 5-FU or granulocyte-colony stimulating factor (G-CSF), although they exhibited apparently normal myelopoiesis in the untreated state. The phenotype of Tg mice observed after G-CSF treatment correlated with the expression level of the transgene, although the correlation was not found in untreated mice. These results indicated that myeloid differentiation is perturbed in the Tg mice by the dominant negative effect of the transgenic RXR, indicating that RXR plays a role in myelopoiesis.     

Kidney transplantation and liaison psychiatry, part II: A case of dissociative identity disorder

Abstract  The authors examined the case of an adolescent patient with dissociative identity disorder secondary to psychological shock of a transplant rejection response. Psychiatric symptoms consisted ot three components: visual hallucinations and delusions as a psychological defense against the anxiety of a transplant rejection; appearance of three personalities including proper self, the dead child (donor), and a prophet with strong predicting power; and a twilight state. These psychiatric symptoms may have been related to two psychological factors; immature personality characteristics formed during hemodialysis, and post-traumatic stress caused by a chronic rejection reaction from the patient's first transplant.     

A PROSPECTIVE CLINICAL STUDY OF ROTAVIRUS DIARRHOEA IN YOUNG CHILDREN

Abstract. Mäki, M. (Department of Paediatrics, Tampere Central Hospital, Tampere, Finland). A prospective clinical study of rotavirus diarrhoea in young children. Acta Paediatr Scand, 70:107, 1981.–The clinical and laboratory features of 96 children aged 6 to 36 months with acute rotavirus diarrhoea were compared to findings on 63 children of the same age with acute non-rotavirus diarrhoea. Of the rotavirus-associated cases 80% occurred between January and June. In general, the diarrhoea was more severe in these patients than in the others, but no difference was seen in duration of symptoms. Clinical features characteristic of rotavirus-associated cases included: dehydration and acidosis upon admission, vomiting, fever, neutropenia and sugar in the stools (Clinitesf® 0.5 %). In contrast, no difference was seen in the occurrence of respiratory symptoms (53 % in the rotavirus, 62% in the non-rotavirus group), or in the presence of mucus strands, occult blood or leucocytes in stools. A combination of the above criteria may be helpful in the presumptive diagnosis of rotavirus diarrhoea.     

Extensive intraductal component (EIC) and estrogen receptor (ER) status in breast cancer

The extensive intraductal component (EIC) of primary breast carcinoma is a special spread pattern observed In the breast. Extensive intradwtal component may extend diffusely over the entim breast. Therefore, EIC Is considered to be an important risk factor for local recurrence in breast-conserving therapy. However, the pathogenesis of EIC remains uncertain. Whether or not the estrogen receptor (ER) has an influence on its biologic behavior has not been fully studied. A consecutive series of 142 breast carcinomas submitted to the pathology department were examined on step gross dons of 5.0 mm thick. Extensive intraductal component was determined and divided into three types. Estrogen receptor was examined using both immunohistochemistry (ER-IHC) and enzyme immunoassay (ER-EIA). Extensive intraductal component was found In 78 of 138 (56.52%) invaslve carcinomas including invasive ductal carcinoma with a predominant intraductal component. Estrogen receptor-IHC positivity was 42.96% (61/142) in the Invasive breast carcinoma. Estrogen receptor positivity showed no significant difference between ElC-positive and -negative cases, as well as between EIC and Invasive main tumor in the ElC-positive cases. But within the ElC-positive group, ER positivity was found to be higher in the peripheral type of ElC-II and ElC-III than in the central type of ElC-I ( P <0.05). Although ER may not play an essential role in the pathogenesis of EIC, it has shown some significance in the development of peripheral type EIC because of its higher presence in the peripheral type of EIC-II and EIC-III than in the central type of EIC-I.