Higher cerebral dysfunction in a case with atypical multiple sclerosis with concentric lesions

Abstract A patient with atypical multiple sclerosis (MS) with clear concentric structure was studied using high field magnetic resonance imaging (MRI). This case was considered to be Balo's concentric sclerosis. Magnetic resonance imaging showed diffuse multiple concentric demyelinating lesions in the bilateral centrum semiovales, which finally regressed with the necrotic lesions remaining when the patient was discharged. During his clinical course, he showed some higher cerebral dysfunctions, such as memory disturbance, constructual apraxia and acalculia. He was treated with glycerin, prednisone and rehabilitation; all of which were effective in his recovery. Over a 4 month period, the patient recoveredclinically, but some intellectual impairment remained.     

A long-term survivor of ruptured hepatocellular carcinoma after hepatic resection

Abstract We treated a patient who had previously undergone a hepatic resection for ruptured hepatocellular carcinoma (HCC) but developed a solitary peritoneal recurrence at the site of the incision 8 years and 9 months later. Since no other recurrence was evident, we resected the tumour. The primary tumour was 2.5 cm in size and histological examination revealed HCC without any histological risk factors for intrahepatic recurrence. The peritoneal tumour consisted of less differentiated cancer cells than those found in the primary tumour. The positive rates of Ki-67 were 10% in the primary tumour and 23.3% in the peritoneal recurrence. The DNA indexes in both tumours were considered to be identical.
The comparison between the primary and peritoneal tumours suggested that the histological differentiation and proliferation activity can change after recurrence, in spite of consistent DNA ploidy contents. Clinically, a patient who undergoes a hepatic resection for ruptured HCC can survive for a long time, such as 10 years, if they have good liver function and small HCC without any histological risk factors for intrahepatic recurrence. However, since late recurrence is possible, a follow up for as long as 10 years is recommended.     

Bacterial endocarditis of the aortic valve with septic coronary embolism and myocardial infarction in a 4-month old baby

4-month old baby, who developed infective endocarditis of theaortic valve following purulent arthritis of the hip joint,is presented. The baby developed signs of myocardial infarctionand died suddenly at the age of 6 months. Autopsy revealed alocalized healed coronary arteritis, almost certainly due toan infected embolus, as the underlying cause.     

A case of congenital herpes zoster

A 5 day old girl was transferred to the pediatric ward of Kyushu University Hospital because of papules noted since birth. The papules were distributed on her skin corresponding to the dermatomes innervated by the left Th₁-Th₃ and the left L₁-L₃. Varicella-zoster virus antigens were detected in scrapings of incised papules. The diagnosis of herpes zoster was made and acyclovir (ACV) was administered. She responded to ACV well, but she experienced a recurrence twice after discontinuation of ACV. This is the first report of ‘congenital herpes zoster’, which supports the hypothesis that varicella embryopathy is the sequelae of herpes zoster in utero.     

Incidence of Haemophilus influenzae in the throats of healthy infants with different feeding methods

BACKGROUND: Haemophilus influenzae is the major cause of otitis media and lower respiratory tract infection in childhood. In the presence of human milk, which contains numerous host defense factors, Haemophilus influenzae may be inhibited in attaching to and colonizing pharyngeal cells. We investigated the incidence of H. influenzae in the throats of 162 healthy infants with different feeding methods: 70 breast-fed, 49 mixed-fed and 43 formula-fed infants. METHODS AND RESULTS: Haemophilus influenzae was identified using standard microbiological procedures and the API NH system. The incidence of H. influenzae in breast-fed infants, mixed-fed infants and formula-fed infants was 0, 0 and 7.0% respectively. CONCLUSION: The results suggest that the colonization of H. influenzae in the throat was inhibited by the presence of breast milk.     

紫杉醇聚氰基丙烯酸正丁酯纳米粒制备研究

目的 评价紫杉醇聚氰基丙烯酸正丁酯纳米粒(PTX-PBCA-NPs)的不同制备工艺对紫杉醇的包封率和载药量的影响,优选PTX-PBCA-NPs的制备工艺.方法 以包封率和载药量为主要评价指标,分别采用界面缩聚法和乳化聚合法制备PTX-PBCA-NPs,进行对比研究.用正交设计优选处方.结果 界面缩聚法、乳化聚合法制备的PTX-PBCA-NPs的包封率范围均在94.39%～9.23%(n=3)之间,界面缩聚法制备的PIX-PBCA-NP的载药量可达(1.07±0.03)%(n=3),而乳化聚合法制备的PTX-PBCA-NP的载药量可达(0.86:±0.01)%(n=3).用正交试验优选出最佳工艺条件,PTX-PBCA-NPs载药量为0.80%,包封率为95.71%,粒径为235.6nm.结论 两种制备方法制备出来的PTX-PBCA-NPs的包封率符合药典要求.经比较研究,界面缩聚法可能是提高PTX-PBCA-NPs载药量较好的一种制备方法(P<0.05).     

A SUGGESTED CURRICULUM FOR THE PROFOUNDLY HANDICAPPED CHILD

The authors, all experienced hospital school teachers in Essex, feel that it is both possible and necessary to educate the profoundly handicapped child, rather than merely mind him. They have devised a basic teaching programme which can be used with the most severely handicapped of the ESN(S) school population.     

Quantification of red blood cell fragmentation by the automated hematology analyzer XE‐2100 in patients with living donor liver transplantation

The fragmented red cell (FRC) is a useful index for diagnosing and determining the severity of thrombotic thrombocytopenic purpura (TTP), thrombotic microangiopathy (TMA) and other similar conditions, as it is found in peripheral blood in patients with these diseases. The FRC expression rate has conventionally been determined by manual methods using smear samples. However, it is difficult to attain accurate quantification by such methods as they are time consuming and prone to a great margin of error. With cases of living donor liver transplantation, the current study examined the possibility of using a multi‐parameter automated hematology analyzer, the XE‐2100 (Sysmex Corporation) for FRC quantification. While there was a notable correlation between the manual and automated measurements, the manual measurement resulted in higher values. This suggested remarkable variations in judgment by individuals. The FRC values had a significant correlation with the reticulocyte count, red blood cell distribution width (RDW), fibrin/fibrinogen degradation products (P‐FDP) and lactate dehydrogenase (LDH) among the test parameters, and this finding was consistent with the clinical progression in patients. The automated method can offer precise measurements in a short time without inter‐observer differences, meeting the requirement for standardization. The determination of FRC count (%) by the XE‐2100 that enables early diagnoses and monitoring of TTP or TMA will be useful in the clinical field.     

Effects of mineralocorticoid and angiotensin II receptor blockers on proteinuria and glomerular podocyte protein expression in a model of minimal change nephrotic syndrome

Aim: Several proteins constituting the slit diaphragm are considered important for maintaining capillary wall permselectivity. Early intervention with blockers of angiotensin II receptors (AR) and mineralocorticoid receptors (MR) is effective against proteinuria in models of chronic hypertensive and protein‐induced renal damage. However, the effects of AR and/or MR blockers in a model of acute nephrotic syndrome remain unknown. The effects of AR and MR blockers were examined in puromycin aminonucleoside (PAN)‐treated rats. Methods: Six week old male Sprague–Dawley (SD) rats were injected with PAN or vehicle and assigned to groups as follows: vehicle (group C); PAN (group P); PAN followed 3 days later by administration of the MR blocker, eplerenone (group MR), and by the AR blocker, losartan (group AR). Blood pressure and urinary protein excretion were measured and all rats were killed for immunohistochemical investigation on day 14 after PAN administration. Results: Blood pressure did not change throughout the study period. Proteinuria was decreased in groups MR and AR compared with group P (on day 14 after PAN administration, respectively; group P vs AR, P < 0.01; group P vs MR, P < 0.05). Nephrin, podocin and podocalyxin staining was preserved in the glomeruli of groups MR and AR compared with group P. Conclusion: The MR and AR blockers decreased proteinuria in the acute model of nephrotic syndrome with preserved expression of glomerular podocyte protein independently of blood pressure.