Gas-forming liver abscess after transcatheter arterial embolization for hepatocellular carcinoma: Report of a case

A case of a gas-forming liver abscess developing after transcatheter arterial embolization for recurrent hepatocellular carcinoma (HCC) in a 65-year-old man is presented herein. He was admitted to hospital with fever and jaundice, following which ultrasonography (US) and computed tomography revealed a gas-containing abscess in the posterior segment of the hepatic lobe with multiple HCC. Percutaneous transhepatic drainage was performed using US. Antibiotics which were sensitive to theEscherichia coli bacteria detected in the abscess were administered both intravenously and through the drainage tube into the abscess. Four months later, the abscess had diminished and the patient was discharged after receiving percutaneous ultrasonographically guided ethanol injection therapy for the recurrent HCC.     

IgE-secreting cells in the thymus: correlation with induction of tolerance to IgE.

We have shown previously that normal mice become tolerant to endogenous IgE when they are approximately 2 weeks old and that this corresponds closely with the initial appearance of IgE in serum. Tolerance evidently is restricted to T cells, since B cells responsive to IgE are present in neonatal and adult mice. The present report shows that IgE-secreting cells can be detected in the thymus between days 7 and 11 after birth and that the onset of tolerance to IgE occurs at the age of 11 days. Similar results were obtained in A/J and (BALB/c x A/J)F1 mice. This suggests that tolerance is induced in the thymus, probably by cells bearing peptide fragments of IgE. The order of appearance of IgE-secreting cells is thymus, spleen, and mesenteric lymph nodes.     

Continuous decrease in serum brain-derived neurotrophic factor (BDNF) levels in a neuropsychiatric syndrome of systemic lupus erythematosus patient with organic brain changes

In the present study, the authors reported on a case in neuropsychiatric syndromes of systemic lupus erythematosus (NPSLE) with irreversible organic brain changes. The authors also longitudinally investigated serum brain-derived neurotrophic factor (BDNF) levels in the patient. We found that serum BDNF levels in the NPSLE patient with irreversible organic brain change were consistently low, independent of the severity of psychiatric symptoms. Thus, the longitudinal measurement of serum BDNF levels might be useful in predicting the prognosis of NPSLE.     

Epicardial formation in embryonic chick heart: Computer-aided reconstruction,scanning, and transmission electron microscopic studies

Epicardial formation in the embryonic chick heart from initial to final stages was revealed by means of computer-aided reconstructions based on serial resin sections for light microscopy, with further detailed observations using scanning and transmission electron microscopy. The origin of the epicardium was recognized as protrusions of mesothelial cell clusters on the right side of the external surface of the sinus venosus at 23 somites (stage 14⁺). These protrusions elongated to give rise to several villous processes, the tips of which eventually touched the dorsal wall of the embryonic heart at 30 somites (stage 17). Originating from these adhesion sites, mesothelial cells spread gradually onto myocardial cells in all directions to form a monolayered sheetlike cover. Thus, by stage 23, the ventricle was completely overlaid with epicardium, and blood-island-like structures appeared within the subepicardial layer. The atrium was not enveloped by epicardium until stage 25, and the extreme distal end of the bulbus cordis was reached by the advancing epicardium at stage 27. A chronological table of epicardial formation in the chick heart is presented.     

Changing patterns in cervical cytology among oral and non-oral contraceptive users

9634 patients (21-39 years, with at least 1 normal pregnancy) with no previous experience with oral contraceptives or IUDs, seen at clinics in Rio Piedras, Caguas, and Ponce, Puerto Rico from July 1961 to October 1969 to study their changing patterns in cervical cytology were divided randomly into 2 groups, of which 4846 were given oral contraceptive, Enovid, and 4788 provided with a vaginal contraceptive excluding IUDs, and followed for a period of 6 months-8 years. Separate Pap smears were obtained at admittance to the study by an endocervical aspiration with the pipette and cervical sample with Ayre spatula scraped over the cervico-columnar junction. The cervix was diagrammed showing any erosion. Schiller tests were done. Possible presence of Trichomonas vaginalis was treated. Repeat smears were done at 3-month intervals. 2129 oral patients and 2249 nonoral patients experienced either regression or progression in cytological patterns throughout the 8 years of observation. The analysis is divided into 3 groups, irrespective of the time at which they were observed. Of the 2129 oral patients showing a first change, 55.5% progressed to a higher Pap class, 44.5% regressed to a lower Pap class. In the nonoral group, 55.2% progressed and 44.4% regressed. 1255 patients had a second change: in the oral group, 37.5% progressed, 62.5% regressed. In the nonoral group, 36.7% progressed, 63.3% regressed out of 1258 patients. 690 oral patients showed a third change: 46.1% progressed and 53.9% regressed. Of the 718 nonoral patients 47.1% progressed and 52.9% regressed. There was no significant difference in the pattern of progression and regression between oral and nonoral groups. Oral contraceptives do not aggravate the conditions which lead to development of premalignant lesions in the uterine cervix.     

An ultrastructural and immunohistochemical study on mandibular lesion of Letterer-Siwe disease

A mandibular lesion from an infant with Letterer-Siwe disease was studied by electron microscopy and immunohistochemistry. Ultrastructurally, two types of cells were identified; clear and dark cells. Clear cells had indented nuclei and Langerhans cell granules, while dark cells were characterized by the occasional presence of a large number of lysosomes. Lysozyme was usually not detectable in proliferating cells with indented nuclei, but it was strongly positive in cells without indented nuclei. The latter also usually contained IgG, although the occurrence of cytoplasmic IgM, A, D and E seemed to be negative in both types of cells. Thus clear cells showed a close resemblance to Langerhans cells and dark cells had features of ordinary histiocytes. Although the intimate relationship between these two types of cells remains obscure, our findings suggest that Letterer-Siwe disease may be a reactive or tumorous condition of a cellular subpopulation of Langerhans cells with a proliferation of differentiated histiocytes.     

Pick's Disease and Head Trauma

Abstract: This is a clinico-pathological study of the relationship between Pick's disease and head trauma. Seven of our autopsied cases with Pick's disease had clinical histories and/or neuropathological evidence of a head trauma. Two cases showed no pathological evidence of traumatic brain damage, although they had clinical histories of a head trauma. The other five cases had old contusions located chiefly on the frontal and temporal bases. As far as we know, there is no reported case of Pick's disease with old contusions in the literature. Therefore, our five cases are of great importance to the study of the relationship between Pick's atrophic processes and traumatic brain damage. The conclusion of our study is that traumatic brain damage involving the atrophy centers of Pick's disease or the adjacent regions could evoke or intensify Pick's atrophic processes.     

Induction and properties of syngeneic murine anti-immunoglobulin D.

High titers of autoantibodies directed to isotypic determinants of IgD were produced by inoculation of syngeneic monoclonal IgD, conjugated covalently to keyhole limpet hemocyanin, into adult or neonatal inbred mice. Anti-idiotypic antibodies were induced at the same time. The average affinity of the mouse antibodies (Ka approximately equal to 10(7) M-1) is similar to that of rabbit anti-IgD and of syngeneic anti-IgE induced by the same procedure. Results indicate that B cells of the mice are not tolerant to serum IgD and that tolerance is maintained at the level of T cells. Direct interaction of the syngeneic anti-IgD with cell-surface IgD was minimal, and there was no convincing evidence that cell-surface IgD was down-regulated in the anti-IgD-producing mice. Further studies, preferably employing monoclonal anti-IgD, are required to determine whether epitopes on cell-surface IgD can be recognized by syngeneic anti-IgD. The ability to generate in vivo high titers of anti-IgD should facilitate the production of such monoclonal antibodies.     

Clinicopathological study of minute cancer of the stomach

Nineteen patients with solitary minute carcinoma (single cases) and 16 with foci of minute cancer, found as a component of multiple early gastric carcinoma (multiple cases) were studied. The results were as follows; 1) The histological type of the single cases was the differentiated type in 95%. 2) All lesions of the multiple cases were mucosal invasive carcinoma, while 16% of the single cases (3/19) had submucosal invasive carcinoma. 3) As for the distribution of the single and multiple cases according to the surrounding mucosal atrophy, the single eases were in the pyloric gland zone, the multiple cases in the intermediate zone.