Measles encephalomyelitis in a patient with a history of vaccination

Secondary vaccine failure (SVF) of measles is generally believed to run a milder course of illness than an ordinary course of infection. Severe complications such as central nervous system involvement have rarely been reported. A 12 year old girl, who had received a live attenuated measles vaccine 10 years earlier, developed an encephalomyelitis in the absence of symptoms indicative of ordinary measles such as Koplik spots. Anti-measles hemagglutination inhibition (HI) titer and measles IgM and IgG anitbody titers were measured in a commercial laboratory. Measles virus genomic sequence was detected by polymerase chain reaction. Both serum and cerebrospinal fluid (CSF) samples obtained at acute phase already showed extremely high titers of HI (x 8192 in serum and x 1024 in CSF, respectively) and IgG antibody along with the presence of IgM antibody. Polymerase chain reaction detected the measles virus genomic sequence in the acute phase CSF. The patient's definite history of measles vaccination, high titers of HI and IgG antibodies observed at the very early stage of illness and the clinical course indicated that this patient had an encephalomyelitis due to SVF of measles. It is suggested that measles virus can be a pathogen of encephalitis without symptoms indicative of ordinary measles in individuals who received live attenuated measles vaccines.     

RELATIONSHIP BETWEEN CEREBRAL BLOOD FLOW CHANGES AND CORTICAL EXTRACELLULAR FLUID pH DURING CEREBRAL METABOLIC DEPRESSION INDUCED BY ALTHESIN

Baboons anaesthetized with halothane and nitrous oxide in oxygenwere given Althesin 0.05 ml kg^–1 i.v. Cerebral blood flow(c.b.f.) was measured by an electromagnetic flowmeter and byxenon clearance whilst extracellular fluid (e.c.f.) pH of theparietal cortex was measured with a micro pH electrode. Carotidblood flow (carBF) began to decrease and carotid vascular resistance(carVR) to increase 2.0 s (SEM 0.3) after the slowing of thee.e.g. produced by Althesin, while e.c.f. pH began to changeto alkaline 10.5 s (SEM 1.0) after the e.e.g. change. The firststatistically significant increase in mean e.c.f. pH occurred25 s after the Althesin-induced change in the e.e.g. The durationof the changes in carVR and e.c.f. pH were 7 and 5 min respectively.It is concluded that the change in e.c.f. pH cannot have initiatedthe increase in carVR which followed the cerebral metabolicdepression produced by Althesin. The later alkaline shift ine.c.f. pH may, however, have maintained the increased carVRduring the duration of cerebral metabolic depression producedby Althesin.     

The effects of a high salt diet on gene expression of Na+/H+ exchanger and growth factors in 5/6-nephrectomized rats

SUMMARY: The effects of a high salt diet on renal destruction and the therapeutic effects of amiloride (Na⁺/H⁺ exchanger inhibitor) and furosemide (Na⁺K⁺/2Cl⁻ exchanger inhibitor) were examined in 5/6-nephrectomized rats fed a high salt diet. A simultaneous analysis of the effects of a high salt intake on the renal expression of Na⁺/H⁺ exchanger-1 (NHE-1), transforming growth factor-β1 (TGF-β1) or platelet-derived growth factor-B (PDGF-B) mRNA was performed in this model. the 5/6-nephrectomized Sprague-Dawley rats were given a diet containing 8 or 1% sodium chloride for 5 weeks. This high salt diet accelerated the elevation of blood pressure and aggravated both glomerulosclerosis and interstitial fibrosis in 5/6-nephrectomized rats. the daily administration of amiloride was found to be protective against the elevation of blood pressure, glomerular hypertrophy and the aggravation of renal histology which were induced by a high salt diet. the expression of TGF-β1 and PDGF-B mRNA was up-regulated by a high salt diet, but the expression of NHE-1 mRNA was not. the overexpression of TGF-β1 and PDGF-B mRNA was reduced by the daily administration of amiloride but not by furosemide. In conclusion, the destructive effects of a high salt diet on the kidneys may be mediated through hypertension, glomerular hypertrophy and the overexpression of the growth factors. Amiloride may thus be more protective for high salt induced renal aggravation than furosemide, although the expression of NHE-1 mRNA did not show any substantial increase due to a high salt diet.     

Effect of hepatocyte volume on energy status in the cirrhotic rat liver

To evaluate the effect of reduced hepatocyte volume on liver energy status, the relationship between the morphologically quantified hepatocyte volume and biochemical parameters, and the difference in nuclear density between the parenchyma and stroma were assessed in rat livers with thioacetamide-induced cirrhosis. The ratio of hepatocytes to whole liver tissue, defined as the ‘hepatocyte area ratio', and the nuclear densities of the parenchyma and stroma were calculated microscopically with an image analysing system. Adenine nucleotide, protein and DNA contents, and the ornithine carbamoyltransferase activity in the liver were assayed. In the cirrhotic group, adenine nucleotide content, protein content and ornithine carbamoyltransferase activity were positively correlated with the hepatocyte area ratio, whereas DNA content was negatively correlated with this ratio. The adenylate energy charge of the cirrhotic liver was maintained at a constant level regardless of the ratio. Adenine nucleotide content, protein content and ornithine carbamoyltransferase activity per fractional ‘hepatocyte area ratio’ in cirrhotic livers were significantly lower than in control livers. The nuclear density of the stroma was significantly greater than that of the parenchyma. These results suggest that the lowered energy status in the cirrhotic liver is not caused by reduced hepatocyte volume but rather by impaired hepatocyte metabolism. In addition, the morphological measurement with an image analysing system was found to be useful for evaluating the effects of decreased hepatocyte volume on biochemical derangements in cirrhotic tissue.     

Generation and Characterization of Rat Monoclonal Antibodies Against Human Serum Amyloid A

Monoclonal antibodies against human serum amyloid A (SAA) were generated in rat (which seems not to have mature SAA proteins) by immunizing intact human SAA. Thirteen clones selected by initial screening were analysed based on reactivity with synthetic peptides of SAA and with carboxyl-terminal truncated recombinant SAA. Antibodies were divided into four types, i.e. those recognizing the area around residue 18, 30, 90, and 100, respectively, of SAA. The antibody to the carboxyl terminus (around residue 100) of SAA, when subjected to immunohistochemistry for amyloid deposits in specimens from patients with reactive amyloidosis, always yielded negative reactivity, supporting the general concept that the carboxyl terminus of SAA is absent from human AA deposits.     

A Case of Early Gastric Carcinoma with Lymphoid Stroma: Diagnostic Usefulness of Endosonography

Abstract: A case of early gastric carcinoma with lymphoid stroma (GCLS) showing features of submucosal tumor is reported here. A characteristic endoscopic ultrasonographic (EUS) finding was helpful for preoperative diagnosis. The patient, a 75-year-old woman without any previous complaints, visited our hospital for detailed examination of a small gastric lesion. Upper Gl studies revealed a submucosal tumor-like lesion measuring about 1.8 cm with a central slight depression on the greater curvature of the middle gastric body. Histologic findings of the specimens obtained by conventional biopsy indicated a poorly differentiated adenocarcinoma, although the possibility of malignant lymphoma was not completely ruled out. EUS examination was, therefore, performed in order to obtain further detailed information about the tumor. EUS disclosed that the tumor, which existed in the third layer, was composed of many small round clustered lesions, the echogenicity of which was lower than that of the muscle layer, and was almost covered with a normal mucosal layer. Taking these findings into consideration, a gastric cancer with lymphoid stroma whose invasion would be limited within the submucosa was highly suspected. It was proven by histological analysis of a surgically resected specimen that this peculiar multiple small round hypoechoic lesion was equivalent to the lymphoid aggregates infiltrating the GCLS. Since it has been reported that the prognosis of GCLS is better than that of common gastric cancers, accurate diagnosis is important for the selection of optimal treatment. While it is still not definitively proven that EUS is useful for diagnosis of GCLS, this procedure may potentially provide an excellent image of this special tumor and be of use for preoperative diagnosis.     

A case of leiomyosarcoma of the penis

A case of leiomyosarcoma of the penis is reported. A 27-year-old-man presented to our department with a mass at the root of the penis. Biopsy of the tumor showed that the tumor was leiomyosarcoma. The tumor was clinically and pathologically categorized into the deep type. Despite total penectomy and adjuvant chemotherapy, the patient died from disseminated disease 14 months after surgery. This is the 45th case of penile leiomyosarcoma.