Left temporal perfusion associated with suspiciousness score on the Brief Psychiatric Rating Scale in schizophrenia

We evaluated the relationship between regional cerebral blood flow (rCBF) and clinical symptoms in patients with schizophrenia. Single photon emission computed tomography with N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) was used to study 29 patients with schizophrenia. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). We examined the correlation between rCBF and each BPRS item score using Statistical Parametric Mapping software. Corrected P-values < 0.05 were considered as statistically significant. The suspiciousness score on the BPRS was positively correlated with rCBF in the left inferior temporal gyrus. There was no significant correlation between rCBF and any other items of the BPRS. There was no significant correlation between rCBF and chlorpromazine-equivalent dosage. This analysis permits the quantitative assessment of the severity of persecutory delusions in relation to left temporal perfusion in patients with schizophrenia.     

Concomitant chemoradiotherapy as a standard treatment for squamous cell carcinoma of the temporal bone

We sought to characterize the effectiveness of concomitant chemoradiotherapy (CCRT) for patients with squamous cell carcinoma of the temporal bone. We performed a retrospective chart review of 14 patients with cancer of the temporal bone who were provided initial treatment in our hospital from December 2001 to November 2008. Four patients with stage I tumors were treated by radiation therapy alone or with oral administration of S1. One patient with a stage II tumor was treated by radiation therapy concomitant with low dose docetaxel. Nine patients with stage IV tumors were treated by CCRT using the TPF regimen (docetaxel, cisplatin, and 5-fluorouracil). As an initial treatment, all patients but one were treated by radiation therapy with or without chemotherapy. Grade 4 adverse events of patients who received CCRT using the TPF regimen involved the leukopenia in one patient and the neutropenia in two patients. Local recurrences were observed in three patients including two patients with T4 tumors. Five-year disease-specific survival rates for all patients and for patients with T4 tumors were 78% and 67%, respectively. CCRT using the TPF regimen is safe and effective as the first treatment for patients with cancer of the temporal bone.     

Clinical courses and pregnancy outcomes in Japanese women with inflammatory bowel disease

In this study, we analyzed the clinical courses and the pregnancy outcomes in Japanese women with inflammatory bowel disease (IBD) in our hospital in the recent 10 years. We analyzed 49 pregnancies in 38 patients with ulcerative colitis (UC) and 24 pregnancies in 16 patients with Crohn's disease (CD) retrospectively. The results indicated that pregnancy has less influence on the clinical courses of IBD and that IBD also has less influence on the pregnancy outcomes. However, we should pay attention to the results that the patients with CD tend to deteriorate if conception occurs when CD is active and that patients with active UC tend to have more adverse pregnancy outcomes than patients in remission. In conclusion, patients with IBD are recommended to become pregnant when the diseases are in remission and treatment using selected safe medications should be continued during the pregnancy.     

Increased S-100 protein-immunoreactivity of Kupffer cells is associated with lymphohematological malignancy

The distribution of S-100 protein in normal tissue has been studied extensively. However, little is known about its expression in pathologic states. The aim of the present study was to investigate the expression of S100 protein in diseased human liver, especially in Kupffer cells. One hundred cases of autopsy livers originating from patients with various diseases were examined. Increased S-100-immunoreactivity of Kupffer cells was observed in six cases. Of the six cases, four were derived from a lymphohematologic malignancy, such as B cell lymphoma, B cell lymphoblastic leukemia, muitiple myeloma and chronic myelogenous leukemia with lymphoblastic crisis. Lymphohematologic malignancy accounted for 16 out of the 100 cases examined. Thus, increased S-100-positive Kupffer cells was significantly associated with lymphohematologic malignancy (P<0.01); 25% (4/16) in cases with lymphohematologic malignancy versus 2.4% (2/84) in the remaining cases. Moreover, some of these S-100-positive Kupffer cells were positive for S-100 β-subunit, which is not normally expressed by Kupffer cells. Although the reason for this increased S-100-immunoreactivity is speculative, the authors' hypothesis is that tumor cells may produce some factor(s) that induce the expression of S-100 protein in Kupffer cells.     

Time course of the levels of antibodies to Coxiella burnetii and detection of C. burnetii-DNA in three imported cases of acute Q fever]

Three patients developed acute Q fever after returning from an inspection tour of farms and abattoirs to Australia. Serum levels of antibodies to Coxiella burnetii and the presence of C. burnetii-DNA in blood samples were examined for more than 100 days. Four-fold raises of IgM and IgG antibodies against C. burnetii phase 2 were observed within the first three weeks in all the three cases. Maximum titers of IgM and IgG antibodies were 1,024-2,048 and 512-4,096, respectively. According to the temporal diagnostic criteria of acute Q fever in the convalescent serum: the IgM titer of > or = 64 and IgG titer of > or = 512 against phase 2, patient A, B and C were determined to be antibody positive for 45, 199 and 122 days, respectively. The result suggests that this standard is practical and reasonable for diagnosis of acute Q fever. C. burnetti-DNA was detected in the sera and buffy coat samples of patient A who developed high fever, severe thrombocytopenia and liver disfunction, but not in those of patient B and C. This study provides useful information for optimization and standardization of Q fever diagnosis in Japan.