Associations between Chest CT Abnormalities and Clinical Features in Patients with the Severe Fever with Thrombocytopenia Syndrome

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus. It involves multiple organ systems, including the lungs. However, the significance of the lung involvement in SFTS remains unclear. In the present study, we aimed to investigate the relationship between the clinical findings and abnormalities noted in the chest computed tomography (CT) of patients with SFTS. The medical records of 22 confirmed SFTS patients hospitalized in five hospitals in Nagasaki, Japan, between April 2013 and September 2019, were reviewed retrospectively. Interstitial septal thickening and ground-glass opacity (GGO) were the most common findings in 15 (68.1%) and 12 (54.5%) patients, respectively, and lung GGOs were associated with fatalities. The SFTS patients with a GGO pattern were elderly, had a disturbance of the conscious and tachycardia, and had higher c-reactive protein levels at admission (p = 0.009, 0.006, 0.002, and 0.038, respectively). These results suggested that the GGO pattern in patients with SFTS displayed disseminated inflammation in multiple organs and that cardiac stress was linked to higher mortality. Chest CT evaluations may be useful for hospitalized patients with SFTS to predict their severity and as early triage for the need of intensive care.     

Mutation analysis of a Japanese patient with fucosidosis

Fucosidosis is a rare autosomal recessive disorder resulting from a deficiency of α-L-fucosidase. Recently, various mutations have been reported in this disease, but it is difficult to elucidate the phenotype from the genetic mutations. We report a patient with chronic infantile type fucosidosis, with a compound heterozygote of a nonsense mutation (W148X, Trp at codon 148 to stop codon) and a large deletion, including all exons. This is the first report of a large deletion demonstrated in fucosidosis. It is interesting that this patient has a relatively mild clinical course despite the absence of the mRNA. This case also indicates the difficulty in determining the phenotype from the genotype in fucosidosis. Received: February 19, 1999 / Accepted: April 16, 1999     

Maintenance of CD8+ memory T lymphocytes in the spleen but not in the bone marrow is dependent on proliferation

It is current belief that numbers of CD8⁺ memory T lymphocytes in the memory phase of an immune response are maintained by homeostatic proliferation. Here, we compare the proliferation of CD8⁺ memory T lymphocytes, generated by natural infections and by intentional immunization, in spleen and bone marrow (BM). Fifty percent of CD8⁺ memory T lymphocytes in the spleen are eliminated by cyclophosphamide within 14 days, indicating that numbers of at least 50% of splenic CD8⁺ memory T lymphocytes are maintained by proliferation. The numbers of CD8⁺ memory T lymphocytes in the BM, however, were not affected by cyclophosphamide. This stability was independent of circulating CD8⁺ memory T cells, blocked by FTY720, showing that BM is a privileged site for the maintenance of memory T lymphocytes, as resident cells, resting in terms of proliferation.     

Thyroid calcifications: sonographic patterns and incidence of cancer

We investigated the incidence of cancer in surgically resected 151 thyroid nodules in 101 patients according to their calcification patterns on preoperative ultrasonography (US). Calcification was detected in 57 (38%) nodules, 31 (54%) of which was histologically diagnosed as cancer. According to the calcification types, 9 of 11 nodules with microcalcifications, 15 of 29 nodules with intranodular coarse calcification, 6 of 14 nodules with peripheral calcification and 1 of 3 calcified spots without surrounding tumor were diagnosed as cancer.     

Difference of osteopontin gene regulation between bone and kidney

 Osteopontin is a sialoprotein that is expressed in various cells. It plays a variety of important roles in cell adhesion, migration, signaling, calcification, and immunity. Its diverse functions indicate that the regulation of osteopontin may also vary extensively among tissues. Although osteopontin promoter has been studied in vitro, in vivo analyses may be more appropriate for elucidating osteopontin's functions. In an attempt to investigate osteopontin gene expression, we generated transgenic mice in which the bacterial β-galactosidase reporter gene was conjugated downstream of osteopontin promoter. The osteopontin promoter was a mouse −910 bp upstream fragment, which we had previously found functional in 3T3 cells. Among 34 transgenic founders, 13 mice were transgenic, as determined with the polymerase chain reaction. Osteopontin and β-galactosidase signals were evaluated with in situ hybridization. Among the 13 transgenic mice, 3 were β-galactosidase-positive. In these transgenic mice, osteopontin signals were observed in bones and kidneys, whereas β-galactosidase message was detected only in bones. This suggests that the −910 bp osteopontin promoter is active in bones but not in kidneys. These data imply that the promoter region required for osteopontin expression in kidneys may differ from that in bones. Received: March 22, 2002 / Accepted: December 5, 2002 RID="*" ID="*" Offprint requests to: T. Sakuma Acknowledgments. We greatly appreciate the excellent histotechnological assistance of Mr. Kenji Morihana. This work was supported in part by a grant from The Ministry of Education, Science, and Culture, Japan (no. 12470056).     

Second Hepatic Resection for Recurrent Hepatocellular Carcinoma in Patients with Chronic Hepatitis C

Background Although a second hepatic resection (SHR) for recurrent hepatocellular carcinoma (HCC) is widely accepted, the indications for SHR have not been established. The risk factors for HCC recurrence after SHR were evaluated to investigate the indications for SHR. Methods Subjects included 51 patients who underwent a second hepatic resection for recurrence of HCV-related HCC. Sixteen patients received interferon therapy before or after the first operation. Six patients attained a sustained viral response (SVR) that was defined as return of the alanine aminotransferase (ALT) activity to within the reference range and no detectable serum HCV RNA for at least 1 year after interferon therapy. A biochemical response (BR), defined as a normalized ALT activity for at least 1 year after interferon therapy with or without the transient disappearance of serum HCV RNA, was attained in three patients. The other seven patients were defined as the nonresponse (NR) group. Results By univariate analysis, NR and lack of interferon therapy, high indocyanine green retention rate at 15 min (ICGR15), high aspartate aminotransferase activity, high ALT activity, large tumor, and multiple tumors were risk factors for HCC recurrence after SHR. By multivariate analysis, NR and lack of interferon therapy, high ICGR15, large tumor, and multiple tumors were independent risk factors. Conclusions Patients in whom active hepatitis has been controlled by interferon therapy are the best candidates for SHR. Interferon therapy should be recommended in patients undergoing resection of an HCV-related HCC because SHR can prolong life in SVR and BR patients.