Ultrasonographic and serologic studies of experimental cysticercosis in rats infected with Taenia taeniaeformis

Rats experimentally infected with Taenia taeniaeformis were followed-up until 14 weeks post inoculation with eggs (PIE) by hepatic ultrasonographic (US) image and serum antibody response analyses. Parasitic cysts could be imaged as small (2 mm in diameter) anechoic areas with or without a parenthesis-like echogenic small line from two weeks PIE. Immunoblot analysis using antigens from oncospheres (TtO), 30-day-old (TtM-30) and 300-day-old metacestodes (TtM-300) revealed that: (1) these three different developmental stages showed their own unique patterns suggesting the presence of stage-specific antigens; (2) faint IgM antibody responses to some components of TtO and TtM-30 or TtM-300 could be detected from one and two weeks PIE, respectively, and (3) IgG responses to some major components of both TtO and TtM-300, and TtM-30 were easily detected from four and five weeks PIE onwards, respectively. Both TtO and TtM (especially TtM-300) appeared to be highly useful for detection of antibody responses in experimentally infected rats. Due to the easiness in preparation of antigens, fully developed metacestodes may be the best candidate antigens for serodiagnosis. These results strongly suggest that both US image and antibody analyses using antigens from fully developed metacestodes are useful for detection of the early stage of cysticercosis in laboratory animal model .     

Desquamative interstitial pneumonia may progress to lung fibrosis as characterized radiologically

Background and objective: In some patients, desquamative interstitial pneumonia may progress to lung fibrosis. The aim of this study was to assess the long‐term radiological follow‐up results in patients with desquamative interstitial pneumonia. Methods: Among 75 patients suspected of having desquamative interstitial pneumonia, 31 who fulfilled the criteria were included in this study. Clinical characteristics at presentation, responses to treatment and long‐term follow‐up were evaluated. Results: The 31 patients were predominantly males (94%), and the mean age was 55 years; 93% (28/30) had a history of smoking. The clinical findings included high serum levels of lactate dehydrogenase and immunoglobulin G. Bronchoalveolar lavage (26 patients, 84% of cases) frequently showed an increased percentage of eosinophils (mean 17%). Computed tomography (CT) or high resolution (HR) CT at presentation showed ground glass opacities and/or consolidation in all patients, with one third of patients also showing thin‐walled cysts within the ground glass opacities. There was no honeycombing on CT or HRCT scans at presentation. Corticosteroid therapy was effective early in the course of the disease; long‐term follow‐up (mean 99 months) of 31 patients showed only one death due to progression of the disease, but long‐term follow‐up of 14 patients (mean 125 months) by HRCT showed the development of new thin‐walled cysts and honeycombing in five and lung cancer in four patients, respectively. Conclusions: In a proportion of patients, desquamative interstitial pneumonia may progress to lung fibrosis with honeycombing on HRCT, despite therapy.     

Intra-His Bundle Block Corresponds with Interruption of the Branching Portion of the His Bundle

We compared His-bundle electrograms with pathological findings of the atrioventricular conduction system in four patients with complete atrioventricular intra-His block with narrow QRS complexes on ECG. Split His electrograms were recorded at the time of electrophysiological study. The patients died from noncardiac causes at 10 days, 1 year, 4 years, and 9 years, respectively, after the pacemaker implantation. Serial sections through the atrioventricular conduction system revealed strictly localized more than 50% reduction of conducting cells replaced by fibrosis at the branching portion of His bundle. The proximal portions of the bundle branches also exhibited decrease of the conducting cells showing a rough positive relation with the patient's age. Therefore, we considered that the H₁ spikes seen on His-bundle electrograms originated from the penetrating portion of His, which was virtually intact in our cases, and that the H₂ spikes originated from the right side of the distal branching portion of His.     

Immunohistochemical evaluation of epidermis overlying basal cell carcinomas

We have examined the character and carcinogenic properties of the normal-appearing epidermis overlying basal cell carcinomas by immunohistochemical methods, employing a series of monoclonal antibodies. The labelling index was significantly increased in the atrophic epidermis overlying basal cell carcinomas (solid type, n=20). compared with the epidermis overlying or adjacent to squamous cell carcinoma (n=20). keratoacanthoma (n= 10). dermatofibroma (n=10), neurofibroma (n= 10). soft fibroma (n=10). pyogenic granuloma (n=10) and cutaneous leiomyoma (n=5). Cells which expressed epidermal growth factor (EGF) receptor were detected in all layers of the epidermis over the basal cell carcinomas, hut not the other tumours. Basement membrane-related antigens, including bullous pemphigoid antigen and GB3 antigen, were decreased in the epidermis. AEl. the monoclonal antibody against basal cell keratin, reacted with the uppermost layers of the normal-appearing epidermis overlying the basal cell carcinomas. ICAM-1 expression was very weak in the overlying epidermis. The dermis subjacent to the proliferating epidermis showed staining for transforming growth factor-α (TGF-α). strong positive PECAM-1 staining of endothelium. and numerous HLA-DR-positive cells. From these results, we suggest that the proliferative activity in the epidermis overlying basal cell carcinomas is not a state induced by the dermal infiltrate, but represents carcinogenic activity of the epidermis.     

TSUTSUGAMUSHI DISEASE (SCRUB TYPHUS)

Two patients with Tsutsugamushi disease (fever) were successfully treated with tetracycline derivatives after typical eschars were found, although one of the patients was initially misdiagnosed as having a drug reaction eruption. Prompt diagnosis and treatment are important because this disease can be associated with considerable morbidity and simple effective treatment is easily available.     

Epidermolysis bullosa acquisita: report of a case with comparison of immunogold electron microscopy using pre- and postembedding labelling

Summary A patient with epidermolysis bullosa acquisita (EBA). who has been diagnosed as having bullous pemphigoid for 7 years, is reported. By immunoblotting, both the latest serum and a 4-year-stored serum sample of the patient, were shown to react with the 290-kDa EBA antigen or type VII collagen, but not with bullous pemphigoid antigens. Pre-embedding immunogold electron microscopy demonstrated that the serum bound to the 'anchoring plaque' and to both ends of the anchoring fibrils in the fashion reported previously. In contrast, postembedding immunoelectron microscopy showed binding mainly to the lamina densa. These results indicate that EBA antigens are localized mainly at the lamina densa. Further studies are necessary for confirmation.     

Fine Structure of Unmyelinated Nerves in Neonatal Skin

The fine structure of unmyelinated cutaneous nerve fibers in newborns was examined in lesions of adnexal polyp of neonatal skin. In the neonatal cutaneous nerves, unmyelinated fibers outnumbered myelinated ones. The unmyelinated fibers consisted of Schwann cells, axons and basal lamina. Their ultrastructural organization was basically similar to that in the adult skin. However, some of the unmyelinated fibers contained axonal bundles which suggested a state of cytoarchitectural immaturity or incomplete growth. Phagocytosis of melanosomes by Schwann cells was also observed.     

Renal impairment in very low birthweight infants following antenatal indomethacin administration

Three cases of neonatal renal insufficiency in very low birthweight (VLBW) infants following repeated antenatal administration of indomethacin to prevent premature labor are reported. Three pregnant women received indomethacin (total doses of 150–850 mg) for 3–14 days from admission until delivery. The gestational ages and birthweights of the infants ranged from 24 to 28 weeks and 612 to 1432 g, respectively. Oliguria, early onset of hyperkalemia and prolonged renal dysfunction occurred after birth. Renal failure did not improve in one infant. Despite the efficacy of indomethacin for tocolysis in premature labor, VLBW infants born after repeated maternal administration near the time of delivery may have developed impairment of the premature kidney.