Differences in liver pathology and clinical outcome between two patients with hepatitis B virus and graft verses host disease

Our two patients undergoing allogeneic bone marrow transplantation (AlloBMT) had both Hepatitis B virus (HBV) and graft-versus-host disease (GVHD). In the first patient, liver enzymes elevated three months after AlloBMT, and GVHD was diagnosed. Two weeks after the diagnosis of GVHD, HBsAg appeared in his serum. At that time, liver biopsy was not able to discriminate two disorders, but his sequential liver biopsies disclosed GVHD. Despite the patient was treated with cyclosporin A (CsA), he died for chronic GVHD. In contrast to the first patient, the second patient had HBsAg prior to GVHD. His liver enzymes deterioration was detected in the first month after AlloBMT, and reached the highest level in the third month while withdrawing CsA. In the fifth month he developed scleradermatous skin changes, and skin biopsy revealed chronic GVHD, whereas concurrent liver biopsy revealed chronic active hepatitis. This observation showed that immunosuppressive conditions such as GVHD or its prophylaxis may affect the appearance of liver pathology caused by HBV, which depends on the time of GVHD development, and the duration and depth of GVHD prophylaxis.     

Comparison of allergenic components between German cockroach whole body and fecal extracts.

BACKGROUND: Cockroaches have been demonstrated to be an etiologic factor in allergic diseases. Further, sensitivity to cockroach places patients with asthma at risk for exacerbations that require emergency medical care. OBJECTIVE: This study compared the differences in allergenic components between German cockroach whole body and German cockroach fecal extracts (GWBE and GFE). METHODS: Patients with asthma and/or allergic rhinitis were skin prick tested with German cockroach extract (Bayer Corporation, West Haven, CT). Serum specimens from these patients, 25 with positive skin tests and 8 with negative tests, were used for the ELISA and immunoblot experiments. RESULTS: By ELISA, 72% (18 of 25) and 60% (15 of 25) of positive responders' sera showed IgE antibodies to GWBE and GFE, respectively, and the IgE levels to GWBE were highly correlated with those to GFE (r = .84, P < .01). In inhibition ELISA experiments, extensive cross-reactivity was observed between GWBE and GFE, slight cross-reactivity between GWBE and Dermatophagoides farinae, and no cross-reactivity between GFE and D. farinae. The two-site monoclonal antibody ELISA detected more of the German cockroach major allergens in GFE compared with GWBE; 6.2 times (2420 vs 390 U/mL) for Bla g 1 and 3 times (15.32 vs 5.07 microg/mL) for Bla g 2. In the immunoblot comparison of patients' sera, the IgE antibodies binding to GWBE were apparently different from those binding to GFE in all the positive responders' sera; eg, 50% or more of the 25 positive responders' sera reacted to 43- to 67-kDa proteins in GWBE and to 28- to 30-kDa proteins in GFE, respectively. No IgE antibodies bound to components in GWBE and GFE in the 8 negative responders' sera. CONCLUSIONS: There are major differences between the allergenic components of GWBE and GFE. Based on the amounts of major allergens (Bla g 1, Bla g 2), German cockroach feces are a more important source of allergen than the whole body in respiratory allergic diseases.     

Centrosome overduplication induced by rotenone treatment affects the cellular distribution of p53 tumor suppressor protein in the neuroblastoma B65 cell line

Abstract  Recently, the formation of inclusion bodies in several neurodegenerative diseases, including Parkinson's disease, has been associated with the aggregation of unfolded proteins recruited in the centrosome. We have reported previously that rotenone, an insecticide that is used to produce experimental models of Parkinsonism, induced the aggregation of the α-synuclein protein in the centrosome, and it notably affected the structure and function of this organelle in primary cultures of mesencephalic neurons and astrocytes. However, it is still obscure the mechanisms through which the disorganization and centrosomal dysfunction could induce cell death. In this study the rat neuroblastoma B65 cell line was chronically exposed to rotenone, and then the distribution of the centrosomal protein γ-tubulin was studied by immunocytochemistry and Western blot analyses. Finally, the configuration of mitotic spindles and distribution of the p53 protein was observed in the control and rotenone-treated groups. Rotenone treatment increased the number of cells having centrosome overduplication and multipolar mitotic spindles. In contrast, rotenone induced redistribution of the p53 protein, which was colocalized with the γ-tubulin protein in the perinuclear region of cells having overduplicated centrosomes. In addition, the p53 positive signal was markedly intense in cells containing aberrant chromosome segregation and micronuclei. Our results suggest that centrosome overduplication may play an important role in the redistribution of the p53 protein in rotenone-treated cells, and this could represent an alternative mechanism of rotenone to induce apoptosis in neuronal cells.     

Analysis of Erythema after Er:YAG Laser Skin Resurfacing

BACKGROUND Postoperative erythema can be expected to occur in every patient after laser resurfacing, and pigmentary disturbances may be related to the intensity and the duration of erythema.
OBJECTIVE This study was undertaken to assess the clinical features of erythema, the factors that influence its duration, and the relation between the duration of erythema and the incidence of hyperpigmentation and hypopigmentation in skin of Asian persons after Er:YAG laser resurfacing.
METHODS A total of 218 patients (skin phototypes III to V) were recruited and treated with a short-pulsed Er:YAG laser, a variable-pulsed Er:YAG laser, or a dual-mode Er:YAG laser for skin resurfacing. Clinical assessments were performed retrospectively using medical charts and serial photographs.
RESULTS Postoperative erythema was observed in all patients after Er:YAG laser resurfacing with a mean duration of 4.72 months. In 98.2% of patients, erythema faded completely within 12 months. Postinflammatory hyperpigmentation was observed in 38.1% of patients after Er:YAG laser resurfacing.
CONCLUSIONS Skin phototype, level of ablation, and depth of thermal damage caused by a long-pulsed laser appear to be important factors that affect the duration of erythema. Moreover, prolonged erythema was related to the risk of postinflammatory hyperpigmentation.     

Transmission dynamics of Simulium damnosum in rural communities of Akwa Ibom State, Nigeria

BACKGROUND & OBJECTIVES: Onchocerciasis is endemic in some parts of Akwa Ibom State, Nigeria. This study describes the entomological parameters of transmission in three rural communities of Akwa Ibom State, prior to ivermectin intervention in 2004. METHODS: Blackflies were caught using human bait and 90% of the flies were dissected for parity. All parous flies were further dissected for the presence of filaria larvae. Monthly and annual biting rate, and transmission potential were calculated using standard methods. RESULTS: A total of 4296 adult Simulium damnosum were caught on human bait, 4119 were dissected of which 208 (5.1%) were infected with Onchocerca volvulus larvae. Transmission parameters varied significantly (p < 0.05) in the three villages. Annual biting rates, ranged from 9490 to 11,218 bites per person per year. The annual transmission potential ranged from 131 to 189 infective larvae per person per year, monthly biting rate and monthly transmission potential varied significantly (p < 0.05) in the three villages. Transmission was highly seasonal occurring during the peak of rainy season from August to October. There was no transmission during the dry periods--November to March, and the early rainy periods--April to May. The diurnal biting activity of the fly exhibited a bimodal pattern with a morning peak (0900-1000 hrs) and a more marked evening peak (1600-1700 hrs). INTERPRETATION & CONCLUSION: The results indicate that there is a temporal and spatial variation in the transmission dynamics of S. damnosum in the study area.     

Clinical Significance of Induced Atrial Tachycardia After Termination of Longstanding Persistent Atrial Fibrillation Using a Stepwise Approach

Induced Atrial Tachyarrhythmia During Atrial Fibrillation Ablation. Introduction: The utility of inducibility test of atrial tachycardia (AT) in patients with longstanding persistent atrial fibrillation (AF; LPAF) is unclear. This study aimed to evaluate the significance of induced AT and the impact of their ablation on the clinical outcome. Methods: In 194 patients with LPAF (>1 year) who underwent catheter ablation (pulmonary vein isolation with substrate ablation), an inducibility test was performed after AF termination. Results: AT was induced in 108 (56%) patients (induced AT group); neither AT nor AF was inducible in 37 (19%, noninduction group). During 39 ± 21 months, AT recurred in 30 patients (28%), AF in 19 (17%), and no arrhythmia in 56 (52%) among induced AT group, although there was a recurrence of AT in 9 (24%, P = 0.68), AF in 6 (16%, P = 0.85), and no arrhythmia in 22 (60%, P = 0.42) among noninduction group (P = NS). Note that 10 patients with repeated ablation in induced AT group revealed 8 different and 2 similar recurrent ATs compared to the induced ATs at first session. The mean cycle length of induced AT that terminated by ablation (271 ± 64 ms) was longer than that without (249 ± 58 ms, P < 0.05). In induced AT group, AT recurrence rate in patients who achieved AT termination by ablation was lower than those without termination (5% vs 36%, P < 0.05). Conclusions: ATs that are inducible after LPAF termination do not necessarily become clinical AT. However, patients who achieved noninducibility of AT by ablating slower cycle length of AT had better outcomes. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1171–1178, November 2012)     

Microscopic polyarteritis presenting with chest infections and acute appendicitis

We describe a 38-year-old male with antineutrophil cytoplasmic auto-antibody (ANCA) positive microscopic polyarteritis who presented with recurrent chest infections, lung haemorrhage, renal insufficiency and acute appendicitis. Appendectomy was followed by resolution of abdominal symptoms and the surgical specimen revealed vasculitis of the serosal vessels. A renal biopsy was performed because of impaired renal function and this revealed focal necrotising glomerulonephritis with absence of immune deposits. Chest infections were treated with antibiotics resulting in partial clinical response, but pulmonary symptoms relapsed and a complete resolution was achieved only after plasma exchange and the administration of cyclophosphamide. Our observation emphasises the protean manifestations of microscopic polyarteritis and the relationship between ANCA and disease activity. (Aust NZ J Med 1992; 22: 56–59.)