A case of aortitis syndrome diagnosed with 18F-fluorodeoxyglucose-positron tomography (18F-FDG-PET) in the early pre-pulseless phase]

A 14-year-old girl with aortitis syndrome in the early pre-pulseless phase was admitted to our hospital because of slight fever, neck bruit, asymmetrical blood pressure, stenosis or dilatation of the main branch arteries in aorta on chest computed tomography. Laboratory examination revealed a high level of C-reactive protein and an elevated erythrocyte sedimentation rate, as well as hypergammaglobulinemia, and 18F-FDG-PET revealed an accumulation of 18 fluorodeoxyglucose in the great vessels. She was first given pulse therapy with a combination of methylprednisolone and intravenous cyclophosphamide, and then maintenance therapy with oral prednisolone and azathioprine. All the abnormal laboratory parameters improved to normal levels within a month. We suggest that early diagnosis of aortitis syndrome may permit early treatment in the early pre-pulseless phase and could possibly prevent progression to the occlusive phase.     

Congenitally corrected transposition with normally positioned atria, straddling mitral valve, and isolated posterior atrioventricular node and bundle

A heart is described with congenitally corrected transposition of the great arteries, normally positioned atria, and a straddling mitral valve. Instead of an anteriorly positioned atrioventricular node, a regularly positioned posterior node and bundle were observed. This observation has important clinical and surgical implications and underlines that close inspection of the alignment of atrial and ventricular septa during operations is mandatory.     

Isolation and characterization of bacteria from the copepod Pseudocaligus fugu ectoparasitic on the panther puffer Takifugu pardalis with the emphasis on TTX.

A total of 50 bacterial isolates was obtained from the copepod Pseudocaligus fugu, which is a common parasite, collected from the body surface of the panther puffer Takifugu pardalis. On the basis of colony characteristics, these bacterial isolates were grouped into six types, of which only two (Types-I and -II) showed a high affinity for adhesion to the carapace of the banana shrimp Penaeus merguiensis. These two types of adhesive bacteria were identified through 16S rRNA sequence analysis as Shewanella woodyi (Type-I) and Roseobacter sp. (Type-II). Representative isolates of these two adhesive bacteria were examined for tetrodotoxin (TTX) production by high-performance liquid chromatography (HPLC)-fluorometric system, gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS). It was rather unexpectedly revealed that TTX and anhydroTTX were present in the supernatant of culture of the Type-II isolate Roseobacter sp.     

Systematic measurement errors involved in over‐refraction using an autorefractor (Grand‐Seiko WV‐500): is measurement of accommodative lag through spectacle lenses valid?

PURPOSE: Lags of accommodation in ametropic children are often evaluated through spectacle lenses (over-refraction). This study investigated the validity of over-refraction when using an autorefractor. METHODS: Using an autorefractor (Shin-Nippon SRW-500/Grand-Seiko WV-500), refractive readings were obtained in 25 cyclopleged eyes (mean +/- S.D. refraction: -3.44 +/- 3.56 D, range: from -10.56 to +0.25 D) while placing spherical lenses of different power (from -5.00 to +5.00 D) in front of the eye at a vertex distance of 12 mm. Based on the refractive readings with and without the lens, and the lens power, measurement errors were estimated. Similarly, the measurement errors were estimated also in model eyes of -10.00, -4.75, 0.00 and +10.00 D. The results were compared with ray-tracing simulations based on the internal specifications of the autorefractor. RESULTS: Measurement errors were found unless the power of the spectacle lens was equal to the refractive error of the eye. When the spectacle lens power was greater (less myopic or more hyperopic) than the refraction of the eye, the measurement error was negative in sign and greater than -0.3 D. It follows that, when an accommodative response is measured in myopic subjects, the refractive reading usually becomes more myopic than the refraction of the eye including the accommodative response; hence, the accommodative response is overestimated, and the lag of accommodation is underestimated. CONCLUSIONS: The autorefraction through spectacle lenses involved systematic measurement errors. The extent of the errors is usually small but needs to be taken into account in a comparative study of accommodative responses among different refractive groups.     

Internal fixation for osteochondritis dissecans of the knee

Eight knees of seven patients with osteochondritis dissecans of the knee underwent internal fixation of the fragments. The affected location was the medial femoral condyle in four knees, the lateral femoral condyle in one knee and the patellar groove in three knees. At the time of surgery, patient age ranged from 13 to 20 years (mean 16.9 years). Open reduction and internal fixation of the unstable fragments was performed with autologous bone pegs in one knee. In the other seven knees, the procedures were carried out with biodegradable poly-L-lactide pins. At a mean follow-up of 5 years (range 4–6.8 years), seven fragments were united, whereas one knee required arthroscopic removal of the loose fragment. Neither effusion nor synovitis was noticed in any of the patients treated with biodegradable pins. The technique is simple and provides satisfactory results, suggesting a valid option for the treatment of osteochondral defects where possible.     

Usefulness of helical computed tomography in diagnosing pulmonary vein stenosis in infants

We investigated the usefulness of helical computed tomography(CT)in the morphological diagnosis of pulmonary vein stenosis, particularly that in infants and small children. In total, 20 helical CT examinations were performed in 10 post-operative cases of Total Anomalous Pulmonary Venous Drainage(TAPVD), 3 cases of single right ventricle, and 1 case of single left ventricle. In all cases, distinct morphological imaging was possible. Pulmonary vein stenosis could be categorized into three types: (1)stenosis from the anastomosis of the common pulmonary vein (CPV)-the left atrium (LA) to the peripheral pulmonary vein; (2) stenosis only at the anastomosis of CPV-LA; and (3) stenosis due to compression by nearby organs. Coronal views by multiplanar reconstruction (MPR) provided morphological information along the up-down direction of the body axis. Morphological diagnosis of pulmonary vein stenosis is important in deciding prognosis and therapeutic regimens, and helical CT was considered useful for such diagnosis in our 14 young patients.