Detection of serum IgE class anti-SSA antibodies in mothers with foetal loss

We previously reported a close relationship between serum immunoglobulin (Ig)E and anti-SSA antibody levels in mothers with foetal loss. Here, we investigated the existence of IgE class anti-SSA antibodies (IgE anti-SSA antibody) and the relationship of such antibodies with foetal loss. Serum samples from 24 women who were positive for IgG class anti-SSA antibody (IgG anti-SSA antibody) were examined for IgE anti-SSA antibody by enzyme-linked immunosorbent assay (ELISA). Then, a retrospective analysis of the relationship between the IgE anti-SSA antibody positivity and the frequency of foetal loss was performed. Using our ELISA system, IgE anti-SSA antibodies were detected in the serum samples, and the frequency of foetal loss was increased among the mothers with higher IgE anti-SSA antibody titers. Our results indicate that IgE anti-SSA antibodies may be a useful marker for the risk of foetal loss in mothers with anti-SSA antibodies.     

Relationship of genotype rather than race to hepatitis B virus pathogenicity: a study of Japanese and Solomon Islanders

The aim of this study was to determine the predominant hepatitis B virus (HBV) genotype in the Solomon Islands and determine if there is any racial correlation between genotype and hepatitis B e antigen (HBeAg) production in Japanese and Melanesian individuals. A total of 403 serum samples from 206 Melanesian HBV carriers in the Solomon Islands and 197 Japanese carriers from Fukuoka (n = 106) and Okinawa (n = 91) living in Japan in 2001 were tested. The HBV genotypes of 206 Melanesian subjects were 114 with genotype C (55.3%) and 92 with genotype D (44.7%). The HBV genotypes of 197 Japanese subjects were 74 with genotype B (37.6%) and 123 with genotype C (62.4%). The total HBeAg prevalence of subjects in Fukuoka (36.8%) was significantly higher than that of subjects in Okinawa (14.3%) (P < 0.0001) and subjects in the Solomon Islands (35.0%; P = 0.0014, by the Mantel-Haenszel test). The genotype C prevalences were significantly different, ranging from 24.2% in Okinawa, to 54.4% in the Solomon Islands, to 95.3% in Fukuoka (all P < 0.0001, by chi-square test). The prevalence of HBeAg positivity was significantly higher in Melanesian genotype C subjects (42.0%) than Melanesian genotype D subjects (26.6%) (P = 0.0310). Similarly, the prevalence of HBeAg positivity was significantly higher in Japanese genotype C subjects (36.6%) than Japanese genotype B subjects (9.5%) (P < 0.0001). These findings indicate that that HBV was of genotypes C and D in the Solomon Islands, and that the pathogenesis of HBV-infected patients is related to HBV genotype rather than race.     

Successful diagnosis and resection of icteric type hepatocellular carcinoma

We report a rare case of icteric type hepatocellular carcinoma with successful preoperative diagnosis and curative resection. A 50-year-old man was admitted to our hospital with fever elevation and jaundice. Endoscopic retrograde cholangiography revealed a tumor at the hepatic hilum, which caused obstruction of the right and left hepatic duct. The tumor was suspected of being a hilar cholangiocarcinoma, but it was diagnosed as being a hepatocellular carcinoma by endoscopic retrograde bile duct biopsy. After percutaneous transhepatic biliary drainage a right hemihepatectomy was performed. Subsequent pathological finding showed the tumor to be moderately-differentiated hepatocellular carcinoma (Edmondson III) which invaded into the right hepatic duct. The patient survived for three years without recurrence. Although patients with icteric type hepatocellular carcinoma have been reported to have a poor prognosis, earlier diagnosis and curative resection may occasionally bring them an improved prognosis.     

Tokyo Centenarian Study: Aging inflammation hypothesis

The biomedical characteristics of centenarians are (1) low level of albumin, cholesterol, and HDL-cholesterol; (2) high level of CRP and Il-6; (3) high level of thrombin-antithrombin complex, suggesting centenarians are malnourished, in proinflammatory status and prothrombotic conditions. The score of ADL and MMSE is also low. The nutritional status is associated with inflammation, the level of ADL and MMSE. Since proinflammatory cytokines, such as IL-6 and TNFα are known to cause malnutrition, we think that inflammation is partly responsible for the malnutrition. We proposed an 'aging-inflammation 'hypothesis. Aging causes excessive inflammatory response, resulting in malnutrition, which in turn contributes to the low level of ADL and cognitive function in centenarians.
The suppression of excessive inflammatory reaction may ameliorate the low objective QOL.     

Recurrence of inflammatory pseudotumor of the lung with endobronchial lesion after resection]

A 74-year-old man was admitted to our hospital because of an abnormal shadow in the left middle lung field on chest radiography. Since a transbronchial biopsy was not diagnostic, a left lower lobectomy was performed. Histopathologically, the patient was diagnosed as having an inflammatory pseudotumor of the lung. Four months after the surgery, the patient was readmitted with hemosputum. Bronchoscopically, an endobronchial lesion was found in the left main bronchus. Transbronchial biopsy of the lesion showed proliferation of inflammatory cells compatible with inflammatory pseudotumor. Therefore, a recurrent inflammatory pseudotumor was diagnosed. Treatment with corticosteroid resulted in the disappearance of the endobronchial lesion and the erythrocyte sedimentation rate (ESR) returned to normal. The patient showed a prolonged elevation of ESR even after the resection, suggesting that the ESR may be a good indicator of the activity of this disease.     

Lobulated inflammatory myoglandular polyp in the ascending colon observed by magnifying endoscopy and treated with endoscopic polypectomy

The patient was a 33-year-old man with hematochezia. Colonoscopy revealed a Iobulated peduncular polyp with bleeding, about 40 mm in diameter, in the ascending colon. The polyp had both red and white components and a mosaic pattern. Magnifying observation revealed a red rugged surface component, and smooth white nodules with enlarged round or oval crypt openings. Endoscopic polypectomy was performed. Histological examination of the specimen revealed inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with cystic change. This polyp was diagnosed as inflammatory myoglandular polyp （IMGP）. Lobulated-type IMGP in the ascending colon is rare.