Carbamazepine-induced drug-induced hypersensitivity syndrome in a 14-year-old Japanese boy

Drug-induced hypersensitivity syndrome (DIHS) is a life-threatening idiosyncratic drug reaction, and an early accurate diagnosis is essential for its treatment. We describe a 14-year-old boy with localization-related epilepsy, who developed severe adverse cutaneous and systemic reactions after 3 weeks of carbamazepine administration. During the course of the clinical symptoms, reactivation of human herpesvirus 6 (HHV-6) was proven by detection of the HHV-6 genome in serum and elevation of HHV-6 immunoglobulin G (IgG). He fulfilled the newly established criteria for DIHS. Among eight identified medications that can precipitate DIHS, four are antiepileptic drugs. Establishing a treatment strategy for DIHS is warranted to improve its outcome. Therefore, it is important to raise awareness of DIHS among epileptologists.     

Infantile generalized pustular psoriasis: Successful disease control with intermittent etretinate

Infantile generalized pustular psoriasis is a rare form of psoriasis and the best treatment is controversial. We experienced a 2‐year‐old female with erythema on her neck and axilla starting at 3 months of age. She presented with recurrent annular and geographic scaly erythema with a few pustules on the neck, precordium and axilla, but no fever. The histopathology revealed subcorneal neutrophilic infiltration and microabscesses without Kogoj's spongiform pustules. The initial diagnosis was subcorneal pustular dermatosis. However, she developed widespread geographic erythema and numerous pustules over her entire body with a fever when she got a cold. A second skin biopsy revealed monolocular pustules and Kogoj's spongiform pustules in the subcorneal layer. Etretinate was administrated after a diagnosis of pustular psoriasis was made and her condition improved gradually. The choice of treatment depends on patient age, general condition and the disease severity.     

Coexistence of calcitonin gene-related peptide and enkephalin in single neurons of the lateral superior olivary nucleus of the guinea pig that project to the cochlea as lateral olivocochlear system

Immunocytochemical double staining analysis revealed that some of the calcitonin gene-related peptide-containing neurons in the lateral olivary nucleus contained enkephalin in the guinea pig.     

Production of multiple growth factors by a newly established human thyroid carcinoma cell line.

A multiple growth factor-producing tumor cell line (NIM-1) was newly established from a patient with thyroid cancer and remarkable neutrophilia. NIM-1 cells also caused severe neutrophilia in nude mice bearing tumors. NIM-1-conditioned medium (NIM-1CM) contained activities that supported not only granulocyte, macrophage and eosinophil colony formation of human bone marrow cells but also the growth of colony-stimulating factor (CSF)-dependent cell lines, NFS60-KX and TF-1. Northern blot hybridization analysis revealed the constitutive expression of granulocyte-CSF (G-CSF), granulocyte/macrophage-CSF (GM-CSF) and interleukin(IL)-6 mRNAs in NIM-1 cells. Enzyme-linked immunosorbent assays (ELISA) using NIM-1CM also confirmed the production of IL-1 alpha and a small amount of IL-1 beta besides G-CSF, GM-CSF and IL-6 in NIM-1 cells. In addition, unexpected production of IL-11 in NIM-1 cells was detected by northern blot hybridization analysis and by bioassay using an IL-11-dependent cell line. Therefore, NIM-1 cell line is shown to produce multiple cytokines including potentially megakaryopoietic growth factors such as GM-CSF, IL-6 and IL-11.     

High-field MRI of the central nervous system: current approaches to clinical and microscopic imaging.

Introduction of clinical high-field MRI has raised interest in the use of clinical imaging--the efficacy of which has not yet been fully established--in daily practice. A high signal-to-noise ratio and profound susceptibility effects can improve the spatial resolution and image contrast of clinical imaging, whereas the heating effects of the radio frequency tend to prolong acquisition time. As well, inhomogeneities in the static or local magnetic fields can have a negative effect on image quality. The T(1) prolongation may affect T(1) contrast yet improve the enhancement effect of gadolinium chelate and the inflow effect of MR angiography. High-contrast imaging, such as the short inversion-time inversion recovery technique, can provide excellent intra- and extracerebral contrast comparable to microscopic or macroscopic specimens. High-field systems can also be applied to microscopic imaging. High-field MRI is expected to have an increased clinical impact in the near future. Technological advances tailored to high-field systems, as well as the accumulation of scientific evidence, will be necessary to establish its predominance over conventional MRI.     

The GABAA receptor gamma 1 subunit is expressed by distinct neuronal populations.

The distribution of GABAA receptor gamma 1 subunit was examined in the rat central nervous system using in situ hybridization histochemistry. The gamma 1 subunit was expressed in relatively limited areas compared to other subunits investigated previously. The brain regions strongly expressing this subunit were the septum, globus pallidus, bed nucleus of the stria terminalis, hypothalamic periventricular nucleus, supraoptic nucleus, medial and central nuclei of the amygdaloid complex, medial part of the medial geniculate body, substantia nigra pars reticulata, interpeduncular nucleus, lateral parabrachial nucleus, Purkinje cell layer of the cerebellum, and inferior olivary nucleus. This relatively limited expression implies a possible role of gamma 1 subunit in relation to some specific neuronal circuit.     

Actin bundles on the right side in the caudal part of the heart tube play a role in dextro-looping in the embryonic chick heart

Summary The role of actin bundles on the heart looping of chick embryos was examined by using cytochalasin B, which binds to the barbed end of actin filaments and inhibits association of the subunits. It was applied to embryos cultured according to New's method. Looping did not occur when cytochalasin B was applied diffusely in the medium. Further, we disorganized actin bundles in a limited part of the heart tube to examine the role of actin bundles in each part in asymmetry formation. A small crystal of cytochalasin B was applied to the caudal part of the heart tube on either the left or right side. The disorganization of actin bundles on the left side resulted in the right-bending of the heart, an initial sign of dextro-looping (normal pattern), and right side disorganization resulted in left-bending. We suggest that actin bundles on the right side of the caudal part of a heart tube generate tension and cause dextro-looping. Embryos whose hearts bent to the right rotated their heads to the right, and embryos with left-bent-hearts rotated their heads to the left. The rotation of the heart tube may therefore decide in which direction the body axis rotates.     

Neurotensin immunoreactivity in the human cingulate gyrus, hippocampal subiculum and mammillary bodies. Its potential role in memory processing

Neurotensin immunoreactive neurons comprise the majority of large perikarya in the human subiculum and project axons to the alveus, fimbria, fornix and neuropil of the mammillary bodies. These regions are prominently involved in conditions such as Wernicke's and Alzheimer's disease in which memory is impaired. Neurotensin has potential significance as a peptide in a human brain circuit which may serve a role in memory processing.     

Five-hour hepatic arterial infusion of high-dose 5-FU on weekly schedule for liver metastases from colorectal cancer

The study of 5-hour hepatic arterial infusion of high-dose 5-FU on a weekly schedule (weekly high-dose 5-FU HAI: WHF) was conducted to reveal a new pump-free regimen to avoid the reduction of QOL due to continuous infusion pumps. By the phase I study, the recommended dose was determined to be 1.000 mg/m2/5 hrs qw. Thus far, 20 cases entered the phase II study of this regimen, and 1 CR and 10 PRs were observed in 15 evaluated cases without major toxicity. This regimen is highly effective for liver metastases from colorectal cancer without reduction of QOL in patients by pumps. A study of this regimen involving a large number of cases is required.