Effects of topical antiglaucoma eye drops on prostaglandin E(2)-induced aqueous flare elevation in pigmented rabbits

PURPOSE: To evaluate the role of topical instillation of some antiglaucoma agents on experimental elevation of aqueous flare induced by prostaglandin E(2) (PGE(2)) in pigmented rabbits. METHODS: Transcorneal diffusion of PGE(2) (25 microg/mL or 7.09 x 10(-2) mM) with the use of a glass cylinder was achieved to produce aqueous flare elevation in pigmented rabbits. An antiglaucoma agent was topically administered before application of PGE(2). Aqueous flare was measured with a laser flare cell meter. RESULTS: A single instillation of apraclonidine 1.15%, two instillations of epinephrine 1.25%, two instillations of dipivefrin 0.1%, and two instillations and one instillation of dipivefrin 0.04% eye drops inhibited 98%, 96%, 87%, 73%, and 47% of PGE(2)-induced aqueous flare elevation, respectively. Timolol 0.5%, nipradilol 0.25%, dorzolamide 1%, and pilocarpine 2% eye drops had no effects on the increase of PGE(2)-induced flare. CONCLUSIONS: Apraclonidine, epinephrine, and dipivefrin eye drops inhibit PGE(2)-induced elevation of aqueous flare in pigmented rabbits.     

A case of esophageal squamous cell carcinoma metastatic to the breast

Metastasis to the breast from extramammary malignancies is rare. There are especially few reports of metastasis from esophageal cancer. We report the pathological and autopsy findings of a 44-year-old man with advanced esophageal cancer and a left breast tumor. Squamous cell carcinoma invading the mammary glands was demonstrated histologically. Immunostains for ER, PgR, and ErbB-2 were negative. At autopsy, metastatic lesions were found in lung, liver, diaphragm, peritoneum, spine, and mediastinal lymph nodes, with no evidence of metastasis to the skin. While metastatic breast tumors are rarely the initial sign of malignancy, it is important to distinguish a metastasis from primary breast cancer to avoid unnecessary conflicting treatments.     

Acute Myeloblasts Leukemia Associated with an Intermediate State Between the Healthy Carrier State and Adult T-cell Leukemia

This report describes an intermediate state between the human T-cell lymphotropic virus type I (HTLV-I) healthy carrier and adult T-cell Leukemia (ATL) who developed acute myeloblasts leukemia (AML, FAB subtype M2). The polyclonal integration of HTLV-I proviral DNA was demonstrated in the peripheral blood lymphoid cells, whereas AML cells had no HTLV-I proviral DNA. The patient achieved remission after combination chemotherapy but cells with lobulated nuclei persist at a low level and the polyclonal integration of HTLV-I proviral DNA is still demonstrated. We suggest that the patients with the integration of HTLV-I proviral DNA might develop secondary neoplasms more frequently than healthy carriers and this case stresses the need to exercise caution with these patients. The relationship between HTLV-I and AML is briefly discussed.     

Identification of asynergic but viable myocardium in patients with chronic coronary artery disease by gated blood pool scintigraphy during isosorbide dinitrate and low-dose dobutamine infusion: Comparison with thallium-201 scintigraphy with reinjection

To evaluate the ability of low-dose dobutamine and isosorbite dinitrate (ISDN) gated blood pool scintigraphy (GBPS) and thallium SPECT with reinjection to identify viability in asynergic myocardium, both procedures were performed in 38 consecutive patients with chronic coronary artery disease and left ventricular dysfunction. Twenty-two of the 38 patients with successful revascularization were analyzed. GBPS was performed at the baseline and during continuous infusion of low dose dobutamine (5 μg/kg/min) and ISDN (2 μg/kg/min). Cine mode GBPS wall motion was scored from normal (0) to dyskinesis (4) semiquantitatively. Forty-seven of 110 segments with severe asynergy at the baseline were analyzed. Viability determined by GBPS was defined as wall motion score improvement by more than 1 grade. Thallium viability was defined as the segment with redistribution or fill in with severe initial perfusion defect. GBPS was 76.7% sensitive and 70.6% specific for predicting post vascularization wall motion improvement (p < 0.005). Of 47 segments with severe asynergy, concordance of judgement was obtained in 40 segments (85.1 %), and reversibility was correctly diagnosed in 34 of 40 patients (85.0%), but thallium with reinjection correctly identified tissue viability in 6 of 7 segments with discordance between 2 studies. These data suggest that most cases of reversible asynergy (hibernating myocardium) respond to ISDN and dobutamine, suggesting the possibility of predicting improvement by revascularization, although some underestimation of tissue viability remained to be resolved. Thallium with reinjection is superior to low-dose dobutamine + ISDN GBPS for the assessment of myocardial viability.     

The influence of ageing and seasons on infantile eczema - a population-based cohort study of babies aged 4 months and 10 months]

BACKGROUND: This is probably the first report of a population study on infantile eczema performed for 12 months at two ages of 4 months and 10 months on the same infant group. METHODS: The Fujiidera Health Center services the health needs of 181,994 inhabitants of Habikino and Fujiidera cities. Between September 1990 and August 1991,1775 newborns were called for a health check-up performed twice a months when they reached 4 months of age. This was repeated for a year when the infants reached 10 months of age. A total of 1493 4-month old infants and 1264 10-month old infants were examined. An expert dermatologist joined this and performed a complete skin examination throughout the study. The eczematous skin changes were evaluated at 50 different points on the body and scored using an originally made chart. Scratch marks were also evaluated at each area. Based on the scores computed eczema was diagnosed when the total score crossed a threshold number. Based on this the examiner diagnoses were categorized as follows: Degree 1: no need to visit a doctor, Degree 2: visit to doctor required, Degree 3: treatment required. Gender was not considered. The data was analyzed by an originally made software using DEC-7000 computer. RESULTS: Of all the 4-month old infants examined 329 (22.0%) were initially diagnosed to have eczema while of all the 10-month old infants examined 268 (21.2%) were initially diagnosed to have eczema. Further, out of the 329 4-month old infants initially diagnosed with eczema, 228 were again examined when they were 10-months old. Of this sample; 123 (9.7%) infants showed continued symptoms of eczema and 165 (13.1%) infants no longer showed signs of eczema. In addition, out of the 976 4-month old infants initially diagnosed without eczema, 145 (11.5%) newly developed eczema at 10 months. Hence the cumulative diagnosis rate of eczema reached 34.3%. Meanwhile the monthly diagnosis number was significantly higher in Feb (OR 1.84, p=0.031) and significantly lower in Aug (OR 0.21, p<0.001) than the expected number calculated from monthly examination number and the annual diagnosis rate at 4 months. This observation was also the case at 10 months (Feb; OR 2.19, p=0.02, Aug; OR 0.36, p=0.015). The degree of eczema was significantly higher (p<0.001, Mann-Whitney's U test) at 4 months than 10 months. When this was seen monthly, degree 3 was most prevalent in February-March, while degree 2 was most prevalent in October-January for the 4-month olds. For the 10-month olds, both the degree 3 and degree 2 were quite low throughout the year and only degree 1 showed a monthly change similar to degree 2 plus degree 3 of the 4-month olds. CONCLUSION: We therefore conclude that eczematous skin manifestations of infantile eczema are easily changeable by age at less than 1 year and are strongly influenced by seasons.     

Absent inner dynein arms in a fetus with familial hydrocephalus-situs abnormality

We report a family in which a healthy, unrelated couple had a male fetus with bilateral ventriculomegaly, a normal liveborn girl, a hydatidiform molar pregnancy, a female fetus with ventriculomegaly and situs abnormalities, and a male fetus with hydrocephalus, a three-lobed left lung, and defective tracheal cilia with absent inner dynein arms and a single centriole. A mutation analysis of FOXJ1 and POLL in the last fetus with ciliary defect revealed no mutation within their coding regions. The presence of three affected fetuses of both sexes in a family with phenotypically normal parents suggests that the condition was inherited as an autosomal recessive trait. A thorough evaluation of the thoracic and abdominal situs is recommended before counseling a family of a child with hydrocephalus, because the recognition of situs defects may point to the diagnosis of primary ciliary defect and recurrence risk of 25% for siblings. This figure is much higher than the general risk of 1-2% for siblings of a patient with isolated hydrocephalus.     

Clear cell adenocarcinoma of the uterus--ultrastructural and hormonal study

A clear of clear cell adenocarcinoma of the uterus combined with early invasive squamous cell carcinoma of the cervix was reported. The adenocarcinoma was found to be in histologic continuity with the squamous cell carcinoma as well as with the cervical glandular epithelium. Ultrastructurally, the epithelial cells of the adenocarcinoma showed junctional complexes, well developed microvilli, parallel stacks of granular endoplasmic reticulums and twisted rope-like nucleoli, all of which were in accord with the cytologic characteristics of endometrial carcinoma. Hormonal study of the tumor suggested the presence of estrogen receptor and a lack of endocrine productibility. These findings provide an additional support for the Müllerian duct origin of uterine clear cell adenocarcinoma.     

Role for complement receptors (CD21/CD35) in the regulation of recombination activating gene expression in murine peripheral B cells

A population of peripheral B cells have been shown to express recombination activating gene products, RAG-1 and RAG-2, which are considered to be involved in revising the B cell antigen receptor (BCR) in the periphery. BCR engagement has been reported to turn off RAG expression in peripheral B cells, whereas the same treatment has an opposite effect on immature B cells in the bone marrow. In contrast to receptor editing that is involved in the removal of autoreactivity in immature B cells, it has been shown that secondary V(D)J rearrangement in peripheral B cells, termed receptor revision, contributes to affinity maturation of antibodies. Here, we show that RAG-2 expression in murine splenic B cells was abrogated by the coligation of BCR with complement receptors (CD21/CD35) much more efficiently than by the engagement of BCR alone. On the other hand, the same coligation augmented proliferation of anti-CD40-stimulated B cells. These findings suggest a crucial role for CD21/CD35 in directing the conservation or the revision of BCRs in peripheral B cells.     

MINOR SALIVARY GLAND SWELLING IN PATIENT WITH SJOGREN'S SYNDROME

A case of Sjögren's syndrome with an unusual minor salivary gland swelling is reported. The patient was a 63-year-old female with a chief complaint of palatal swelling and dry mouth. Clinical examination revealed diffuse swelling of the hard palate and bilateral parotid regions, and sialographic examination of the parotid gland showed evidence of sialoangiectasia. His-topathological findings of the palatal and parotid lesions revealed intense lymphoid cell infiltration replacing the salivary gland parenchyma, and scattered epimyoepithelial islands throughout the lesions. Although it is well known that major salivary gland swelling caused by marked lymphoid cell infiltration is one of the common features in patients with Sjogren's syndrome, a similar swelling in the region of the minor salivary glands is not usually apparent.