Solitary neurocysticercosis case caused by Asian genotype of Taenia solium confirmed by mitochondrial DNA analysis

A Japanese woman presenting with neurologic symptoms was presumptively diagnosed with neurocysticercosis based on imaging findings. Hooklets in the scolex of the resected lesion were not confirmed through histopathological observation. However, the illness was confirmed by mitochondrial DNA analysis to be a solitary neurocysticercosis case caused by the Asian genotype of Taenia solium.     

Synergy in antigen presentation by thyroid epithelial cells and monocytes from patients with graves'' disease

The present study was undertaken to examine the ability of thyrocytes from Graves' patients to present purified protein derivative (PPD) to autologous peripheral blood T cells. Normal human thyrocytes which were pre-cultured with interferon-gamma were able to induce the proliferation of T cells in response to PPD antigen, but unstimulated thyrocytes failed to do. Thyrocytes from Graves' patients on which HLA-DR antigens were expressed have an ability to induce the proliferation of T cells. Thyrocytes from Graves' patients which were pulsed with PPD antigen for 4 h were capable of stimulating proliferation of the T cells. However, the stimulation index of T cells co-cultured with thyrocytes and PPD were significantly lower than that of T cells co-cultured with monocytes and PPD. Sub-optimal numbers of monocytes which by themselves were unable to support T-cell proliferation synergistically augmented antigen presentation by thyrocytes. These results suggest that cellular interactions among thyrocytes, monocytes and T cells may perpetuate immune or autoimmune responses in thyroid tissues from Graves' patients.     

Continuous regional arterial infusion effective for children with acute necrotizing pancreatitis even under neutropenia

Severe acute pancreatitis is one of the critical conditions that may develop in children with cancer. The leading cause of death due to acute pancreatitis is infectious pancreatitis or circulation collapse. Therefore, patients who develop acute pancreatitis while undergoing chemotherapy or after hematopoietic transplantation are at risk for a life‐threatening and fatal course. We treated 140 patients with malignancy from April 2002 to March 2009 at our hospital and encountered 3 patients under neutropenia who developed severe acute pancreatitis. Two of them were successfully treated with continuous regional arterial infusion of a protease inhibitor and antibiotic even under agranulocytosis. Another patient was treated with conventional therapy with intravenous antibiotics plus a protease inhibitor and total or partial parenteral nutrition. Even though the two patients treated with continuous regional arterial infusion presented much more severe conditions, their symptoms resolved earlier. In conclusion, acute pancreatitis is one of the severe complications of childhood malignancy. Even under agranulocytosis, continuous regional arterial infusion of a protease inhibitor and antibiotic was well tolerated and effective among our cases and might reduce early death due to pancreatitis.     

Elevated serum levels of soluble Fas/APO-1 (CD95) in patients with hepatocellular carcinoma

Fas (APO-1/CD95)-mediated apoptosis plays an important role in liver cell destruction in viral hepatitis. Using sandwich ELISA, we measured serum levels of soluble Fas (sFas) in patients with hepatocellular carcinoma (HCC) who were positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody. sFas levels were significantly higher in HCC patients (median 4.07 ng/ml; range 0.14–29.18 ng/ml) than levels in age-matched healthy donors (0.29 ng/ml; 0–4.90 ng/ml) (P < 0.0001) and HBsAg or anti-HCV antibody-positive patients with liver cirrhosis (LC) (2.16 ng/ml; 0.24–8.39 ng/ml) (P = 0.0015). An arbitrary cut-off level of 3.03 ng/ml (mean + 3 s.d. of controls) revealed the positive frequency of sFas in each group: 1.7% in healthy subjects, 25.9% in LC, and 59.0% in HCC (sensitivity 59.0% and specificity 74.1%). All HCC sera tested contained transmembrane-deleted sFas and some contained another sFas lacking the Fas C-terminal. The positive frequency of either sFas (59.0%) or α-fetoprotein (AFP) (57.4%) in HCC patients reached 77.0%. HCC patients with multiple tumour foci (7.53 ng/ml; 1.40–29.18 ng/ml) had significantly higher sFas levels than did patients with a solitary tumour (2.70 ng/ml; 0.14–19.0 ng/ml) (P = 0.003). In all of the sFas-positive patients with a solitary tumour, surgical removal of the tumour reduced sFas levels to the negative in the first post-op week. These findings suggest that sFas may be closely linked with HCC and may be a candidate for a clinical parameter for HCC.     

Evaluation of hearing recovery and a grading system established by the Research Group on Sudden Deafness of the Japanese Ministry of Health and Welfare

A grading system for sudden deafness has been established by the Research Group on Sudden Deafness of the Japanese Ministry of Health and Welfare. According to this grading system, sudden deafness cases are classified according to the initial hearing level and the vestibular symptoms. Few clinical analyses of sudden deafness cases have been made using this grading system. In this study, 263 sudden deafness cases were classified into 6 groups based on the grading system. All of the cases presented with an initial hearing level of more than 40 dB and underwent treatment within 1 week of the onset of symptoms. The relationship between the grading system and hearing recovery is discussed. Fixed hearing levels with a good prognosis were grades 2b, 2a, 3b, 3a, 4b and 4a. To quantitatively evaluate hearing recovery, the average hearing recovery rate and the percentage of the complete recovery cases were analyzed for each group. Average hearing recovery was ranked into five levels, regardless of the evaluation method. Grades 2b and 3b were the best, and grade 4a was the worst. After grades 2b and 3b, grade 2a was the second best, grade 3a was the third, and grade 4b was the fourth. The cases included in grades 2 and 3 were more strongly effected by whether the cases had vestibular symptoms or not than by their initial hearing levels. When grade 4 cases were classified by their initial hearing level, a large difference existed among grade 4a cases with regard to whether they presented with an initial hearing level of under or more than 100 dB. The hearing recovery of grade 4a cases with an initial hearing level of less than 100 dB was almost the same as that of grade 3a. However, the hearing recovery of grade 4b cases varied only slightly. Consequently, some ranges of initial hearing level exhibited similar degrees of hearing recovery. In cases without vestibular symptoms, the range of initial hearing levels was 40-89 dB. These cases had a 60% chance of complete recovery, and the hearing recovery rate was 80% on average. In cases with vestibular symptoms, the range of initial hearing levels was 60-99 dB. These cases had a 40% possibility of complete recovery, with an average hearing recovery rate of 60%. After comparing the initial grades and the final grades using the same grading system, the majority of grade 2 and 3 cases attained a grade 1 fixed hearing level. However, most grade 4 cases had a grade 3 fixed hearing level.     

Immunohistochemical studies of complement receptor (CR1) in cases with normal sinus mucosa and chronic sinusitis

Summary The complement receptor (CR1) in the maxillary sinus mucosa of normal patients and in cases of chronic sinusitis was studied with the peroxidase-antiperoxidase, avidin-biotin peroxidase and immunofluorescent methods. CR1 was localized on the ciliary surface and in the cytoplasm of the covering epithelium in both normal controls and the cases of chronic sinusitis. CR1 tended to be denser in the mucosa of chronic sinusitis than in normal mucosa. CR1-binding capacity was also studied with the immunofluorescent method, using C₃b-conjugated zymosan. Although CR1 did not bind to C₃b in vivo, it was found to bind to C₃b in the normal maxillary mucosa when it was treated with C₃b-conjugated zymosan. CR1-binding capacity could not be detected in the mucosa from cases with chronic sinusitis, indicating that CR1 was already bound to activated C₃b in these cases.     

Efficacy of defibrinogenation and steroid therapies on sudden deafness

Effects of defibrinogenation therapy and steroid therapy for sudden deafness were compared by paired double-blind testing. The average hearing recovery for five frequencies (250 to 4000 Hz) was more than 30 dB; overall improvement rate was 57.3% (47/82) for the patients assigned to defibrinogenation therapy and 38.7% (31/80) for the patients assigned to steroid therapy. Thus, the former treatment resulted in significantly better hearing recovery.     

Effects of anti-motion sickness drugs on motion sickness in rats

Pica, the eating of nonnutritive substances such as kaolin, can be induced by rotation in rats. We used this rotation-induced pica as a behavioral index of motion sickness in rats and examined whether diphenhydramine, methamphetamine and scopolamine, which are anti-motion sickness drugs for humans, are effective for reducing motion sickness in rats. Intraperitoneal injection of diphenhydramine or methamphetamine suppressed the rotation-induced kaolin intake of rats. Intraperitoneal injection of scopolamine had no effect on the rotation-induced kaolin intake, but its transdermal administration reduced this kaolin intake. These findings show that human anti-motion sickness drugs also prevent motion sickness in rats. Since the pharmacological mechanisms for preventing motion sickness in rats and humans are similar, we conclude that rats are a suitable animal model for use in studies on putative anti-motion sickness drugs.