Successful Treatment of Antibody-mediated Pure Red Cell Aplasia Induced by Continuous Erythropoietin Receptor Activator with Prednisolone

Pure red cell aplasia (PRCA) associated with erythropoiesis-stimulating agents (ESAs), which were first reported in 1998, usually occurs with subcutaneous administration of epoetin alfa (Eprex^Ⓡ). Improvements in ESA storage, handling, and administration methods have reduced the PRCA incidence. Continuous erythropoietin receptor activator (CERA) is a third-generation ESA that is rarely reported to induce PRCA. We herein report a case of CERA-induced PRCA presenting with positive anti-erythropoietin (EPO) and anti-CERA antibodies, which was successfully treated with prednisolone. Clinicians should be aware of the possibility of antibody-mediated PRCA induced by an ESA in CKD patients with anemia with reticulocytopenia and low serum EPO levels.     

Decreased cardiac uptake of MIBG is a potential biomarker for the presence of Lewy bodies

Journal of Neurology - Decreased cardiac uptake of meta-iodobenzylguanidine (MIBG) has been reported in patients with Parkinson's disease (PD), dementia with Lewy bodies (DLB) and pure...     

Myoclonic activity associated with cefmetazole, with a review of neurotoxicity of cephalosporins

We reported a case of a 66-year-old female with uremia who developed myoclonic activity after administration of cefmetazole (4g/2 days). Curiously, the level of the antibiotics (236 μg/ml) in the cerebrospinal fluid (CSF) was higher than that in the blood (103 μg/ml). Myoclonic activity faded away after cessation of the antibiotics. This is the first case reported developing neurotoxicity associated with intravenous administration of cefmetazole. In addition, the curious pharmacokinetic dynamics of cephalosporin in uremia is discussed.     

Increased CSF tau protein in corticobasal degeneration

Using a sensitive sandwich enzyme-linked immunosorbent assay (ELISA) method, we measured the concentration of total tau protein in the cerebrospinal fluid (CSF) from nine patients with corticobasal degeneration (CBD) in comparison with 12 normal control subjects in order to assess its diagnostic value. The CSF concentration of tau in patients with CBD (0.69, 0.20 ng/ml: mean, SD) was higher than that in the normal controls (0.48, 0.14 ng/ml, P = 0.0076 unpaired t test). This increase in CBD patients may reflect widespread tau pathology in CBD, but should be interpreted with reserve as an aid to diagnosis. Received: 30 June 1997 Received in revised form: 1 September 1997 Accepted: 7 September 1997     

Separation and partial purification of wax and fatty alcohol from Okinawan sugar cane rind lipids

A composition analysis of Okinawan sugar cane rind materials was conducted, and it was found that the main components were lipids, crude fiber and water indicating about 27%, 19.6% and 14.6%, respectively. The lipids were effectively extracted from rind materials by benzene. Wax (18%) and fatty alcohol (8%) were found to be the main components, totaling up to 96% of the lipids. Separation and partial purification of wax and fatty alcohol were attempted by means of silica gel column chromatography, thin-layer chromatography (TLC), infrared (IR) absorption spectra and gas-liquid chromatography-mass spectrometry (GC-MS). The major components of the wax were considered to be two compounds with the molecular weights of 408 (C-26) and 436 (C-28), and those of fatty alcohol were di-ol with molecular weights of 440 (C-29) and 468 (C-31). Both wax and fatty alcohol were purified by rechromatography on a silica gel column and the samples obtained seemed to be satisfactory for use in experimental rats' diets.     

LEPRECHAUNISM (DONOHUE'S SYNDROME) – TWO AUTOPSY CASES

Two autopsy cases of female newborns with numerous morphologic and metabolic abnormalities were reported. These were considered Identical with a disorder which has been called leprechaunism or Donohue's syndrome, and were believed to be the first and second autopsy cases reported in this country. Although it has been presumed that these might be abnormalities of endocrine system or of metabolism, the authors could not find any factors which caused the disorder in spite of minute analysis of steroid hormones In urine, investigation of laboratory data as well as autopsy findings.     

Atomic identification of fluorescent Q-dots on tau-positive fibrils in 3D-reconstructed pick bodies

Pick body disease, characterized by the presence of Pick bodies, is distinguished from neurofibrillary tangles in Alzheimer disease on the basis of their smooth, spherical shape. Quantum dots (QDs) are nanometer-scale, water-soluble fluorophores that are detectable both as a fluorescent signal by light microscopy and as electron-dense particles under electron microscopy. In this study, tau-positive Pick bodies were immunofluorescently labeled with QD nanocrystals composed of cadmium selenide for three-dimensional (3D) reconstruction and subsequently subjected to electron microscopic observation to identify QD immunolabeling on the same Pick body for comparison in detail. The identity of the QD nanocrystals, which label the tau-positive fibrils, was confirmed by the presence of both cadmium and selenium on these nanocrystals, demonstrated as parallel peaks corresponding to these atoms on energy-dispersive X-ray spot analysis under super-resolution scanning transmission electron microscopy. This confirmation of the specificity of the QD labeling through both its fluorescence and energy-dispersive X-ray spectra reinforces the reliability of the labeling. In addition, this exact comparison of the same structure by electron microscopy and 3D light microscopy demonstrates how its ultrastructural details are related to its surrounding structures on a 3D basis, providing further insights into how molecules woven into specific pathological ultrastructures are at work in situ.     

Previous fracture surgery is a major risk factor of infection after total knee arthroplasty

Purpose  

Total knee arthroplasty (TKA) has been proven to be the most effective treatment for patients with severe joint disease. Although infection is not a frequent complication, it is certainly one of the most dreaded. The purpose of this study was to identify factors associated with infection after TKA.