Effect on carotid atherosclerosis of probucol plus levofloxacin for <Emphasis Type="Italic">Chlamydia pneumoniae</Emphasis> infection

To investigate the effect of levofloxacin on carotid atherosclerosis, patients with hypercholesterolemia whose carotid atherosclerosis was not improved by probucol therapy (500 mg/day) for 24 months were enrolled. All patients were seropositive for anti C. pneumoniae IgA and/or IgG. Carotid atherosclerosis was evaluated by ultrasonic measurement of the maximum intima-media thickness (Max-IMT). All subjects were prescribed three courses of levofloxacin (each course, 400 mg/day for 2 weeks, followed by 14 days off drug treatment). At 12 months after combined therapy with probucol and levofloxacin, Max-IMT was significantly decreased compared with the value before treatment (P < 0.01). These results suggest that the combination therapy was effective for improving carotid atherosclerosis in C. pneumoniae-seropositive patients.     

Hemodynamics of the posterior cerebral arteries in neonates with periventricular leukomalacia

PURPOSE: The purpose of this study was to evaluate the cerebral blood flow of the posterior cerebral arteries (PCAs) in neonates in relation to the onset of periventricular leukomalacia (PVL). METHODS: Among 57 low-birth-weight neonates studied, 7 were diagnosed with PVL with cyst formation on sonography and MRI. The mean cerebral blood flow velocity (CBFV) was measured in all the neonates by Doppler sonography through the posterior fontanel separately in the right and left PCA at days 0, 1, 2, 3, 4, 5, 7, 10, 14, 21, 28, 42, 56, and 70 following birth. RESULTS: In the 7 neonates with PVL the mean CBFV in the right PCA was significantly lower than that in neonates without PVL at days 10, 14, 21, 28, 42, 56, and 70; the mean CBFV in the left PCA of neonates with PVL was significantly lower than that in those without PVL at days 7, 10, 14, 21, 28, 42, 56, and 70. CBFV measured in neonates without PVL exhibited a gradual increase postnatally. In contrast, CBFV values for neonates with PVL plateaued after day 5 or 7. CONCLUSIONS: The serial measurement of PCA CBFV postnatally may prove useful as a predictor of the development of PVL.     

Single tuberculous stricture in the jejunum: Report of 2 cases

Intestinal tuberculosis is now considered rare. It usually involves the ileocecal region and often produces multiple ulcers in the small intestine. This is a report of 2 patients who presented with a single tuberculous stricture in the jejunum, an exceedingly rare manifestation of this disease. The stricture in each case consisted of a short girdle ulcer with irregular margins, detected by double-contrast studies of the small intestine.     

Current state and effectiveness of abdominal ultrasonography in complete medical screening

Purpose The current state and effectiveness of abdominal ultrasonography (US) were investigated by reviewing statistical data for US of the kidney as part of complete medical screenings conducted at our institution between April 1994 and March 2004. Methods Among 4339 individuals with US findings, computed tomography (CT) was performed on 129 individuals at our institution. Among these individuals, US findings and CT diagnoses were compared and analyzed. Results US findings indicated renal tumors in 73 of the 129 subjects, and the breakdown of CT diagnoses for these 73 individuals was as follows: no lesion, n = 45 (61.6%); simple renal cyst, n = 13 (17.8%); complicated renal cyst, n = 5 (6.8%); suspected malignant tumor, n = 5 (6.8%); renal angiomyolipoma, n = 2 (2.7%); pelvic dilatation, n = 1 (1.4%); granuloma, n = 1 (1.4%); teratoma, n = 1 (1.4%). Magnetic resonance imaging (MRI) was performed on 4 of the 5 subjects with suspected malignant tumor, and surgery was performed in all 4 cases with suspected kidney cancer. Kidney cancer was histopathologically confirmed in 2 patients, resulting in a detection rate of 0.046% for kidney cancer by US as part of a complete medical screening. In the 2 patients with kidney cancer, differentiating cystic renal cell cancer from a renal cyst was not possible based on US findings alone in 1 patient, and no thorough examinations were performed in the 3 years leading up to surgery. Conclusions These results suggest that additional US and thorough examinations are necessary if a lesion cannot be confirmed as a simple renal cyst on initial US. Furthermore, to improve the skill levels of healthcare professionals who perform and interpret US, a feedback system should be established where data related to complete medical screenings are available to the personnel involved.     

The relationship between usual coffee consumption and serum C-reactive protein level in a Japanese female population

BACKGROUND: Usual coffee consumption may decrease insulin resistance and type 2 diabetes incidence, and reduce cardiovascular disease risk. As a mechanism, coffee-induced lower levels of C-reactive protein (CRP), a marker for the development of these diseases, can be considered. The associations between coffee consumption and CRP should be established by studies on various populations, yet studies in Japanese people, who do not necessarily consume as much coffee daily, are limited. METHODS: In total, 459 community-living Japanese women, aged 23-83 years, were investigated. Clinical data including age, body mass index, blood pressure, HbA(1c), serum high sensitive CRP (hsCRP) and lifestyle habits, such as coffee consumption, were included in the analyses. All analyses were performed in two groups of the population, i.e., age < 60 and > or = 60 years. RESULTS: Significantly lower levels of hsCRP were observed in the group of > or = 1 cup/day than in that of < 1 cup/day in the respective groups of < 60 years (p = 0.001) and > or = 60 years (p < 0.0001). In multiple regression analysis, coffee consumption was significantly, independently and inversely correlated to log-hsCRP in the respective groups of < 60 years (p = 0.017) and > or = 60 years (p < 0.0001). CONCLUSIONS: It was noteworthy that the benefits of coffee consumption, even if > or = 1 cup/day, on serum hsCRP levels were confirmed in Japanese women, following similarly to other ethnic data.     

Protection against hemorrhagic pneumonia of mink by Pseudomonas aeruginosa multicomponent vaccine.

An attempt to prevent epidemics of hemorrhagic pneumonia in mink due to Pseudomonas aeruginosa was made in the course of epidemics with injection of the multicomponent vaccine consisting of common protective antigen (OEP) of P. aeruginosa mixed with toxoids of protease and elastase of the bacillus. Enzootics of hemorrhagic pneumonia, due to P. aeruginosa serotype 8, broke out from August to October 1977 in a total of 13 sheds of 3 farms (A, B and C) which were located in the northeast area of Hokkaido. These farms were raising 7,452, 2,553 and 10,639 mink respectively. The mortality rate of the mink on farms A, B and C were 11.8%, 13.0% and 1.0% respectively. The vaccination was performed on the 3 farms 5, 8 and 21 days after the onset of the disease. Inoculation of each mink with 200 micrograms or 100 micrograms of each of the three components of the multicomponent vaccine was effective in most of the male and female groups of mink. The period required for revealing the effect of the vaccination was very short, in some cases only a few days. Administration of the vaccine 21 days after the onset of the enzootic was also effective.     

Consensus Paper: Neuroimmune Mechanisms of Cerebellar Ataxias

In the last few years, a lot of publications suggested that disabling cerebellar ataxias may develop through immune-mediated mechanisms. In this consensus paper, we discuss the clinical features of the main described immune-mediated cerebellar ataxias and address their presumed pathogenesis. Immune-mediated cerebellar ataxias include cerebellar ataxia associated with anti-GAD antibodies, the cerebellar type of Hashimoto’s encephalopathy, primary autoimmune cerebellar ataxia, gluten ataxia, Miller Fisher syndrome, ataxia associated with systemic lupus erythematosus, and paraneoplastic cerebellar degeneration. Humoral mechanisms, cell-mediated immunity, inflammation, and vascular injuries contribute to the cerebellar deficits in immune-mediated cerebellar ataxias.