The frequency of patients with positive HIV-antibody in the various groups and the prognosis of these patients treated with SNMC

Among 300 patients receiving blood and/or blood products because of blood disorders, 3 (1%) were positive for HIV by ELISA. However, 3 patients were thought to be false positive because they had received bolus injection of gamma-globulin and their serum became negative after 6 months. Moreover, no viral inclusion or HIV-antigen was detected. In 30 patients with hemophilia and related disorders, 21 (70%) were positive by ELISA, Immunofluorescence, Passive-agglutination and Western Blot method. Immunodeficiency, as reflected by decreases of CD 4/8 ratio and NK activity, was successfully treated with high-dose of Stronger Neo-Minophagen C.     

Creutzfeldt-Jakob disease--alteration in ganglioside sphingosine in the brain of a patient.

Gangliosides isolated from the brain of patients with Creutzfelt-Jakob (C-J) disease were analyzed. The ganglioside current was abnormally low, and the percentage distributions of individual gangliosides and the long-chain base compositions were abnormal. The C20-sphingosine contents of all the ganglioside fractions were low. Abnormalities in ganglioside long-chain bases in adult human brain have been reported previously only in patients with inherited metabolic disorders. These abnormalities in C-J disease seem to be closely related to the cause of the disease.     

Roentgenographic diagnosis of bone tumors--its basic knowledge and clinical application

Roentgenographic diagnosis of bone tumors is considered to be extremely important to decide whether a new patient should be biopsied immediately to make the proper diagnosis or the patient could be followed up without operative treatment. The basis knowledge important in making the proper decision on the roentgenogram of the bone tumor, are presented and four cases of bone tumors or tumor-like conditions are presented to show how such knowledge becomes useful. First of all, the basic knowledge based on the anatomical peculiarities are described. Chordoma deriving from the remnant tissue, notochord, should be placed in the midline of the body. Metaphyseal region of the growing child showed a local immune deficient state because of the special anatomic arrangement of the vascular structure for the sake of the open epiphyseal line. This is thought to be related with the high rate of primary malignant bone tumors in this area and in this age group, for example, osteosarcoma. Next, roentgenographic changes are described separately: intracortical changes, cortical changes, periosteal reaction and soft tissue extension. These changes are summarized to differentiate the benign lesion from the malignant one. Thirdly, the peculiar location of the tumor is described. Examples are giant cell tumor, chondroblastoma and clear cell chondrosarcoma in the epiphyseal region, osteoid osteoma, intracortical abscess and the osteofibrous dysplasia in the intracortical region.     

Ganglioglial Differentiation in Medulloblastoma

A case of cerebellar medulloblastoma with clusters of mature ganglion cells and glial cells is described. The patient, a 15 -year -old girl, underwent three operations followed each time by radiation and chemotherapy during the four-year clinical course. Histologically, the ganglion cells were clearly identifiable by their abundant eosino-philic cytoplasm, round nuclei with prominent nucleoli, tigroid granules, and argyrophilic fibrils and axons. Im-munohistochemically, the cells were NSE- and NF positive, and ultrastructurally they contained abundant tubules and filaments, neurosecretory granules and well developed rough endoplasmic reticulum. There were many cells transitional in appearance between primitive cells and mature ganglion cells. The tumor also had many mature yet atypical astrocytes and oligodendrocytes. The exact mechanism of the extensive neuronal and glial maturation of medulloblastoma cells is unclear, but the repetitive surgical interventions, radiation and chemotherapy might have had certain cytostatic effects on rapidly dividing medulloblastoma cells, giving them a chance to mature into postmitotic cells with potential for neuronal and glial differentiation. Acta Pathol Jpn 40: 50–56, 1990.     

Detection of t(14; 18)(q32;q21) in hyperdiploid cells by fluorescence in situ hybridization in a patient with Hodgkin disease

The most frequent nonrandom chromosome rearrangements in B-cell non-Hodgkin lymphoma (NHL) is the t(14;18)(q32;q21) found in follicular lymphomas. The t(14;18) in Hodgkin disease (HD) was rarely observed using cytogenetic techniques. Although Southern blot analysis failed to demonstrate the t(14;18), there have been conflicting reports concerning the occurrence of the translocation using polymerase chain reaction (PCR) methods in HD. In some HD tissues, the translocation might be derived from background lymphocytes rather than Hodgkin and Reed-Sternberg (HRS) cells, because B-cells with t(14;18) are regularly generated in normal individuals. However, the cells bearing the translocation have remained unidentified. We describe a patient with HD who showed t(14;18) in hyperdiploid cells using fluorescence in situ hybridization (FISH) and HRS cells which were strongly positive for BCL2 by immunohistochemistry. These findings suggest that HRS cells may have a t(14;18).     

Electron microscopic evidence of a viral nature for osteoclast inclusions in Paget's disease of bone

Circumstantial evidence from electron microscopic and immunological studies support the view that Paget's disease of bone represents a slow virus infection. However, there is only limited information available regarding its electron microscopic, enzyme and immunocytochemical characteristics. Two cases were studied using electron microscopy with particular emphasis on the inclusions in osteoclasts. Detailed ultrastructural and cytochemical studies including immuno-electron microscopy were performed. Some osteoclasts demonstrated specific virus-like structures composed of aggregations of microtubules in the nucleus and cytoplasm. The structures were easily digested by trypsin or protease, and were sensitive to RNase, which provided substantial evidence of a proteinaceous nature and inclusion of ribonucleic acid. Immunocytochemical examination identified binding of anti-respiratory syncytial virus and anti-measles virus antibodies in the tissue obtained from one of the two cases examined. The presence of viral antigens in structures in the cytoplasm of Pagetic osteoclasts supports the theory of paramyxovirus involvement in this disease.