Inverse Relation of Body-Surface Activation-Recovery Interval and Recovery Time to Activation Time in Normal Subjects: Stronger Correlation and More Heterogeneous Distribution in Activation-Recovery Interval Than in Recovery Time

The activation-recovery interval (ARI), measured directly from the myocardium, has shown a good correlation with the action potential duration (APD) in experiments. APD has been reported to be inversely related to the activation time (AT). However, no studies have examined the correlation between the body-surface ARI and AT in normal subjects. Fifty normal subjects (25 men and 25 women) were studied to elucidate the relationship between the body-surface ARI and AT. The body-surface AT was defined as the duration between the QRS onset and the minimum dV/dt of the QRS wave, and ARI as the interval between the minimum dV/dt of the QRS wave and the maximum dV/dt of the T wave in each lead of an 87 unipolar lead system. We also measured the recovery time (RT) defined as the duration between the QRS onset and the maximum dV/dt of the T wave. ARI was inversely correlated with AT (r = -0.73). RT was also inversely correlated with AT (r = -0.61), however, RT had a less heterogeneous distribution than ARI (148 ms vs 159 ms). There were no differences between male and female subjects in the relation between ARI and RT or in the body-surface distribution of ARI and RT. These findings suggest that the body-surface ARI may reflect recovery properties over the cardiac surface and that APD may distribute inhomogsneously over the human cardiac surface with a longer RT over an area with a shorter AT. ARI calculated from body-surface ECG may be a useful noninvasive and repeatedly measurable estimate of APD.     

Ultra-high Magnification Endoscopic Observation of Carcinoma in situ of the Esophagus

Abstract: Super-zooming observation of carcinoma in situ of the esophagus was achieved utilizing an ultra-high magnification endoscope which has a 150X magnification capacity. Superficial flat and slightly depressed lesions (O-llb and O-llc according to the Japanese classification of esophageal cancer), usually observed as a well-demarcated reddish patch, were revealed to be a composite of scattered red dots and a pinkish homogeneous background. Those red dots were disclosed to be intrapapillary capillary loop changes such as dilatation, meandering and caliber irregularities. These changes were never observed in normal mucosa or in the setting of esophagitis. These characteristic findings were confirmed histologically in the resected specimen.     

Survey of the living conditions and psychosomatic states of the elderly in Japan who receive home help

Abstract The living conditions and psychosomatic states of 2828 elderly people receiving care from home helpers were investigated. The physical condition of men was significantly lower than that of women. With regard to daily life (i.e. eating, sitting, standing, excretion, dressing, bathing, walking, tidiness) 70% were rated as being self-supporting. Eighty per cent of subjects were judged as having normal intelligence. Twenty-two per cent of subjects had more than one psychiatric symptom (e.g. memory impairment, insomnia, talking to oneself, and delusions). Among the various medico-welfare supports, home help was recommended most often.     

Ultra-high Magnification Endoscopy of the Normal Esophageal Mucosa

Abstract: The normal esophageal mucosa was observed in detail using ultra-high magnification endoscopy (UHM endoscopy). The UHM endoscope has a magnification capacity ranging from eight to 150x. High-quality UHM endoscopic pictures can be continuously obtained by attaching a 2-mm depth soft distal attachment to the tip of the UHM endoscope. The vascular architecture, which extends from the submucosal vessels through the proper mucosal layer, can be continuously visualized, thereby demonstrating the characteristic fine-vascular network pattern, and the intrapapillary capillaries in the epithelium. With UHM endoscopy, intrapapillary capillaries can be clearly demonstrated as single loop vessels which we have termed “intrapapillary loops.” These structures cannot be observed with an ordinary magnifying endoscope which is capable of only 35x magnification. We conclude that a technique for obtaining high-resolution endoscopic pictures has been established. The images obtained are useful for elucidating the microstructure of the esophageal mucosa, especially the fine-vascular network and the newly recognized intrapapillary loop.     

Decreased expression of 20-kD homologous restriction factor (HRF20, CD59) on T lymphocytes in Epstein–Barr virus (EBV)-induced infectious mononucleosis

HRF20 (CD59) is one of the membrane-associated complement regulatory proteins. The characteristic function of CD59 is to prevent membrane attack complex (MAC) formation on the cell surface and to protect the cell from complement-mediated cell lysis. We examined the expression of CD59 antigen on T cell subpopulations in patients with acute infectious mononucleosis (IM) and analysed the relationship between the amount of CD59 expression and activation-induced cell death of mature T cells with apoptosis. Decreased expression of CD59 on CD8⁺ T cells, especially on CD45RO⁺ and HLA-DR⁺ activated T cells, was marked in acute IM patients. In contrast, activated CD4⁺ T cells from IM patients expressed as much CD59 antigen as CD4⁺ T cells from healthy volunteers. After incubation-induced cell death, viable CD8⁺ T cells showed normal amounts of CD59 antigen on their surface. CD59^dim CD8⁺ T cells were more susceptible to apoptosis than CD59^bright CD8⁺ T cells. These findings suggest that decreased expression of CD59 on CD8⁺ T cells may discriminate the susceptibility of activated CD8⁺ T cells to activation-induced cell death in IM.     

SUCCESSFUL TREATMENT OF VITILIGO WITH PUVA-PIGMENTED AUTOLOGOUS EPIDERMAL GRAFTING

Background. The methoxypsoralen-ultraviolet A-light (PUVA)-induced pigmented epidermal grafting procedure appears to be a more effective treatment for vitiligo than similar treatments presently available. This finding was based on: 1) a more vigorous and completely homogeneous repigmentation was observed in the vitiliginous area and 2) that the treatment was safe, easy, inexpensive, and not time-consuming (approximately 3–4 hours), thus making it a suitable outpatient clinic treatment procedure for vitiligo patients. Patients and Methods. Twenty-eight patients with amelanotic depigmented lesions that had been refractory to conventional therapy were treated using suction blisters from autologous epidermal sheets. These had 8-methoxypsoralen (8-MOP) solution applied and had been exposed to ultraviolet A light (topical PUVA) in order to stimulate melanogenesis. Results. Successful repigmentation was obtained after transplantation in all patients with segmental and localized vitiligo. The most homogeneous repigmentation was obtained within 3 months after grafting. Conclusions. This novel procedure is an excellent tool by which to treat segmental and localized vitiligo lesions that have failed to respond to other therapies.     

Expression of c-Met correlates with grade of malignancy in human astrocytic tumours: an immunohistochemical study

 

Aims:

Recent studies suggest the involvement of hepatocyte growth factor/scatter factor (HGF/SF) in glioma cell invasion and tumour progression. We investigated the distribution and rate of tumour cells that express c-Met protein, which is the cell-surface receptor for HGF/SF, in astrocytic tumours. The type of cells that express c-Met in tumour tissues was also identified.  

Methods and results:

c-Met expression was screened immunohistochemically in a total of 43 astrocytic tumours, including 14 low-grade astrocytomas (A), 13 anaplastic astrocytomas (AA) and 16 glioblastoma multiforme (GBM). c-Met reactivity was demonstrated predominantly in the cytoplasm of tumour cells. Bizarre large tumour cells tended to stain intensely. Higher c-Met expression levels (≥ 2 +, more than 25% cells were positive) were noted in 21.4% of (A) vs. 53.8% in (AA) and 87.5% in (GBM) ( P  < 0.001), indicating a clear relationship between c-Met protein staining and higher grade astrocytic tumours. Moreover, c-Met immunoreactivity was also shown in tumour microvasculature, reactive astrocytes, and neurones in the cortex infiltrated by glioma cells. In 85.7% of cases containing infiltrated cortex, neurones were positive vs. no neurones in non-neoplastic regions ( P  < 0.002).  

Conclusions:

This evidence suggests that c-Met expression in the brain could be associated with astrocytoma progression and also reactive process. Immunohistochemical determination of c-Met-expressing cell types helps to understand possible roles of c-Met in tumour tissues.     

Change of immunological parameters in the clinical course of a myasthenia gravis patient with chronic graft-versus-host disease

The change in immunological parameters was studied during the clinical course of a myasthenia gravis (MG) patient with chronic graft-versus-host disease (GVHD), which developed after bone marrow transplantation from an HLA-identical donor. Anti-acetylcholine receptor antibody gradually decreased in the patient treated with immunosuppressive agents, but was not detected in the donor. Lymphocyte numbers were low just before the onset of MG, increased abruptly within several days and then gradually decreased with treatment. The percentage of CD3⁺ and CD19⁺ lymphocytes was higher at onset than before, the percentage of CD4⁺ cells was higher at onset and gradually decreased with treatment, while CD8⁺ cells showed the lowest level just before onset and gradually increased during the clinical course. CD4⁺/CD45RA^? cells also showed the highest levels at onset and a gradual decrease with treatment. Cellular, as well as humoral immune responses, might be associated with the pathogenesis of MG with chronic GVHD.