Outcomes of infants whose mothers are positive for human herpesvirus-6 DNA within the genital tract in early gestation

It has been reported that HHV-6 (human herpesvirus-6) DNA has been identified within the female genital tract. However, the clinical significance of this finding has been unclear. The clinical outcome of the presence of HHV-6 DNA in the genital tract of pregnant women on their infants was evaluated in the present study. One hundred and ten pregnant women were enrolled. Vaginal swabs were collected between 4 and 8 weeks of gestation and the presence or absence of HHV-6 DNA was evaluated by nested polymerase chain reaction (nPCR). The swabs were cultured to isolate the virus. The women were divided into two groups: HHV-6 DNA-positive, and negative. The outcome variables of the infants of these two groups were statistically estimated at birth and at 1 month of age. Saliva and blood cells were collected from the infants at birth and at 1 month of age and were also evaluated by nPCR. HHV-6 DNA was detected in the vaginal swabs of 28 pregnant women (25.5%), but was not detected in any other samples, including saliva and blood cells from their infants. Virus could not be isolated from any vaginal samples. Any outcome variables were not significantly different between the two groups. The presence of HHV-6 DNA within the genital tract of pregnant women did not affect the health of their infants. It is suggested that HHV-6 transmission to infants through the genital tract of their mothers during pregnancy does not occur, or only very rarely.     

Human B-Cell Clones Expressing Lupus Nephritis-Associated Anti-DNA Idiotypes are Preferentially Expanded without Somatic Mutation

Human monoclonal anti-single/double-stranded (ss/ds) DNA anlibodies (NE-1 and NE-13) expressed cross-reactive idiotypes (Id), NE-1 Id, which have been delected on the lupus glomeruli-deposited anti-DNA antibodies. The nucleotide sequences of the variable regions of NE-1 and NE-13 clones were analogous except for one nucleotide difference in the V_k region. The V_H and V_k gene segments of NE-13 clone were identical with germline genes VH4.21 and Vb(or Vb'). respectively. CDR3sof NE-l and NE-13 heavy chains were arginine rich and CDR1s contained an amino acid stretch. SGYY, the inverted sequence of YYGS. which was shared among CDR3s of several anti-DNA antibodies. Clonal frequency analysis using a limiting dilution method revealed that NE-1 Id-positive clones at precursor cell level increased in lupus patients. These findings suggest that some IgM anti-DNA clones which express NE-1 Id associated with lupus nephritis use germline genes without mutation and they may be preferentially expanded at the precursor cell levels as well as at the mature cell level.     

Immunohistochemistry of collagen types II and X, and enzyme-histochemistry of alkaline phosphatase in the developing condylar cartilage of the fetal mouse mandible

We investigated the immunohistochemical localisation of types II and X collagen as well as the cytochemical localisation of alkaline phosphatase in the developing condylar cartilage of the fetal mouse mandible on d 14–16 of pregnancy. On d 14 of pregnancy, although no immunostaining for types II and X collagen was observed, alkaline phosphatase activity was detected in all cells in the anlage of the future condylar process. On d 15 of pregnancy, immunostaining for both collagen types was simultaneously detected in the primarily formed condylar cartilage. Alkaline phosphatase activity was also detected in chondrocytes at this stage. By d 16 of pregnancy, the hypertrophic cell zone rapidly increased in size. These findings strongly support a periosteal origin for the condylar cartilage of the fetal mouse mandible, and show that progenitor cells for condylar cartilage rapidly or directly differentiate into hypertrophic chondrocytes.     

Localization of HIV-1 in human thymic implant in SCID-hu mice after intravenous inoculation

Human immunodeficiency virus type 1 (HIV-1) was immunohistochemically and ultrastructurally localized in human thymus implants in SCID-hu mice 3 weeks after intravenous (i.v.) inoculation of the virus. A viral antigen (gp120) was predominantly distributed in and around the epithelial cells in Hassall's corpuscles as demonstrated by fluorescence immunohistochemistry. Occasional solitary round cells positive for the viral antigen but negative for cytokeratin were detected in the perivascular areas. Ultrastructural examinations clearly revealed a number of mature viral particles in the intercellular spaces of the Hassall's corpuscles. Thus the present study indicates the possibility that thymic epithelial cells in Hassall's corpuscles act as a target and/or reservoir in an early stage of HIV infection.     

Interval sentinel lymph nodes in patients with cutaneous melanoma: A single‐institution study in Japan

Interval sentinel lymph nodes (ISLN) are defined as the lymph nodes located between the primary melanoma and anatomically well‐defined lymph nodal basins. It was reported that the ISLN appeared to be at the same metastatic risk as sentinel lymph nodes (SLN) in the traditional nodal basins. This study aimed to examine the incidence and metastatic risk of the ISLN in melanoma patients. Between June of 1999 and December of 2008, 117 patients enrolled at Nagoya University Hospital underwent SLN biopsy for primary cutaneous melanoma with a Breslow thickness of at least 1.0 mm. Triple techniques with lymphoscintigraphy, blue dye injection and gamma probe were used for the biopsy except for 13 cases that underwent lymphoscintigraphy, ultrasonography and blue dye injection, but without gamma probe. Patients who had melanoma of the head and neck were excluded from this analysis. The SLN were identified in 253 nodal basins from 117 patients, and ISLN were found in six patients (5%). We recognized 41 (17%) SLN metastases in 246 conventional nodal basins and one (14%) in seven ISLN. Although ISLN were identified infrequently, the incidence of metastasis into the ISLN was similar to that into SLN in conventional nodal basins. It is therefore recommended that preoperative lymphoscintigraphy and intraoperative recognition of ISLN should be performed.     

Conductive Property of the Zone of Slow Conduction of Reentrant Ventricular Tachycardia and Its Relation to Pacing Induced Terminability

In order to assess the functional characteristics of the zone of slow conduction of reentrunt VT, rapid pacing was performed to entrain VT. The orthodromic conduction time was measured as the interval between the stimulus and the orthodromically captured electrogram recorded distal to the zone of slow conduction, hut not precisely at the exit point, and its response to rapid pacing was evaluated. In 32 of 33 consecutive patients, rapid pacing was performed to entrain VT. Of these, rapid pacing was repeated in 28 patients at 3–10 cycle lengths in steps of 10 msec before VT was terminated, or rapid pacing produced an acceleration of the rate. A pacing induced prolongation of the orthodromic conduction time (slowed conduction) was observed in 16 (57.1%) patients and in another 12 (42.9%) patients, the conduction time was constant. The pacing induced termination was observed in 93.8% of VT with slowed conduction and in 50% of VT with constant conduction, and the difference was significant (P < 0.05). There was no difference in the cycle length of VT or the shortest paced cycle length between VT with and without slowed conduction. The zone of slow conduction in human VT showed different conductive properties and VT with slowed conduction was associated with an easier and safer terminability with rapid pacing. The fact might be useful in selecting patients for antitachycardia pacing.     

Neuropsychological and functional correlates of clock‐drawing test in elderly institutionalized patients with schizophrenia

Background: There has been a growing need for a cognitive assessment tool that can be used for older adults with schizophrenia in clinical settings. The clock‐drawing test (CDT) is a brief cognitive test that covers a wide range of cognitive function. Although it is widely used to assess patients with dementia, limited data are available on its usefulness in older patients with schizophrenia. Thus, we investigated the psychometric properties of the CDT and their relationship with life functions to examine the test's usefulness for assessing cognitive function in older adults with schizophrenia. Methods: Seventy‐three older adults with chronic schizophrenia who had been hospitalized for over 1 year participated in the study. We adopted the executive clock‐drawing task for administration and scoring of the CDT, which consists of free‐drawn and copy conditions. The Mini‐Mental State Examination and the Brief Assessment of Cognition in Schizophrenia were administered. Symptom severity and life functions were assessed with the Positive and Negative Syndrome Scale and the Life Skills Profile, respectively. Results: Both free‐drawn and copy scores significantly correlated with the Mini‐Mental State Examination score and the Brief Assessment of Cognition in Schizophrenia composite score. These scores also significantly correlated with symptom severity and length of current hospitalization. Stepwise regression analysis showed that only the copy score, together with symptom severity, predicted the Life Skills Profile score. Conclusions: The CDT can assess cognitive function in older adults with schizophrenia. Moreover, CDT performance is associated with life functions independent from other clinical variables. These results suggest that the CDT is a useful cognitive assessment tool for this population.     

Treatment of Osmidrosis with the Cavitron Ultrasonic Surgical Aspirator

BACKGROUND: Axillary osmidrosis is an uncomfortable condition that can be a personal or social handicap. OBJECTIVE: The objective was to present the treatment of osmidrosis with the Cavitron ultrasonic surgical aspirator (CUSA). MATERIALS AND METHODS: Fifteen patients (3 males and 12 females) underwent surgery for bilateral axillary osmidrosis with the CUSA. RESULTS: The outcome of this operation with the CUSA was evaluated by the patients themselves according to the following criteria. Postoperative improvement was evaluated as good when the odor was decreased by >75%, fair when it was decreased by > or =50 and < or =75%, and poor when it was decreased by <50%. A total of 15 patients (3 males and 12 females) were evaluated. Eight patients (53.3%) had a good result, 6 patients (40%) had a fairly good result, and 1 patient (6.7%) had a poor result. None of the patients experienced any complications, such as skin necrosis, infection, or serous cyst. One dissatisfied patient underwent reoperation and achieved a good result after the second procedure. CONCLUSIONS: This treatment of osmidrosis with the CUSA achieves satisfactory therapeutic efficacy.     

Renal Excretion of Vancomycin in Rats with Acute Renal Failure

We have investigated the renal excretion of vancomycin in rats with acute renal failure (ARF) induced by uranyl nitrate or cisplatin. The renal clearance of the antibiotic after uranyl nitrate or cisplatin injection was separately evaluated by calculating the glomerular filtration rate (GFR) and secretory clearance. The reduced renal clearance of vancomycin in these ARF rats was a result of a decrease in both GFR and secretory clearance. The extents of the decreases in GFR and in secretory clearance were not, however, proportional, the extent of the decrease in secretory clearance being more pronounced. These results suggest that the renal tubular secretion of vancomycin was reduced more predominantly than glomerular filtration in these ARF models.