Possible factors affecting the cholesterol nucleation time in human bile: A filtration study

This study examined the hypothesis that filtration through the MW 300 kD cut-off membrane (XM-300) may influence factors affecting the cholesterol nucleation time (the appearance time of cholesterol monohydrate crystal). Differences in biliary lipids, biliary protein, mucous glycoprotein and vesicular composition were examined before and after the XM-300 filtration in control and cholesterol gallstone patients. The nucleation time in the cholesterol gallstone patients was significantly faster than that in the control patients. However, the nucleation time in the gallstone patients was significantly prolonged following the XM-300 filtration resulting in a similar value to that of the control patients. No differences in concentrations of total protein, mucous glycoprotein or lipids composition were observed. The nucleation time did not correlate with the total lipid concentration, the concentrations of biliary mucous glycoprotein or total protein. The prolonged nucleation time of gallstone bile by the XM-300 filtration was primarily ascribed to the removal of vesicles, which was confirmed by gel chromatography. It was concluded that vesicles greater than MW 300 kD are primarily responsible for the rapid nucleation time.     

Phylogenetic tree-based epidemiological analysis of hepatitis C virus transmission in a region of Japan with a high prevalence of infection

Local clustering of hepatitis C virus (HCV) infection has been demonstrated in various regions in Japan. HCV genotypes have now been compared between infected individuals from districts of Saga prefecture with either a high (H district) or low (L district) prevalence of HCV-seropositivity. The prevalence of HCV genotype 1b was significantly higher (P<0.001) in the H district (45/50; 90%) than in the L district (19/36; 52.8%). A phylogenetic tree was constructed based on the genomic sequences of viral isolates from 20 patients infected with genotype 1b in the H district. Almost all these HCV strains clustered in the same regions of the tree. With regard to risk factors for HCV transmission, the percentage of patients with a history of surgery was significantly higher in the H district than in the L district (58 versus 33.3%; P<0.05). Of 20 patients infected with similar strains of HCV in the H district, 16 (80%) had at least one parenteral risk factor associated with medical care. These results indicate an increased transmission of similar strains of HCV in the H district as a result of nosocomial infection.     

Gastric microcirculatory disturbance and behaviour of leucocytes after thermal injury: Intravital observation of arteriovenous shunting channels in the gastric submucosal layer

In order to investigate the pathogenesis of acute gastric mucosal lesion after thermal injury, microcirculatory disturbance was assessed and observation of the behaviour of leucocytes was performed. Gastric blood flow decreased at 15 min post-thermal injury, and partially improved at 2 h; however, it decreased again at 5 h post-thermal injury. Mucosal microcirculatory disturbance was observed by using vascular labelling with monastral blue B. Deposits of monastral blue B were observed centring mainly on collecting venules but were also observed in the capillaries. Submucosal microcirculatory disturbance was observed through an intravital microscope. The irregularity of the wall and segmental constriction in the venules and presence of an arteriovenous shunting channel was observed in the submucosal layer at 5 h post-thermal injury. The percentage of rolling or sticking leucocytes that passed the confluence of a prevenule and a venule were significantly increased at 5 h after thermal injury. The present study revealed depression of gastric blood flow, mucosal and submucosal microcirculatory disturbance, and a significant increase of rolling and sticking leucocytes in the peripheral part of venules after thermal injury. Leucocyte-endothelial interactions may occur under such conditions and this interaction may play an important role in inducing the microcirculatory disturbance that results in an acute gastric mucosal lesion after thermal injury. The present study also demonstrated the possibility of intravital study of gastric submucosal arteriovenous shunting channels.     

Acute rheumatic fever and poststreptococcal acute glomerulonephritis caused by T serotype 12 Streptococcus

We present a rare case of a 10 year old Japanese boy with acute rheumatic fever accompanied with poststreptococcal acute glomerulonephritis. We isolated group A Streptococcus serotype T 12, a strain that was thought to be nephritogenic but not rheumatogenic, from throat culture. Although rare, physicians should be aware that acute renal disease may accompany rheumatic fever.     

Glomus tumours of the skin: an immunohistochemical investigation of the expression of marker proteins

Immunohistochemical studies were carried out on cutaneous glomus tumours from 10 patients. The glomus areas in these tumours reacted strongly with anti-smooth muscle (CGA-7), anti-muscle (HHF-35) and anti-vimentin antibodies. Their neural supply was analysed using several nervous tissue markers (anti-neurone specific enolase, anti-S 100, anti-Leu 7, anti-neurofilaments). The results indicate a sprouting and proliferation rather than entrapment of pre-existing nerve fibres.     

Factors Influencing the Prognosis of Transitional Cell Carcinoma of the Renal Pelvis and Ureter

Forty-seven cases of transitional cell carcinoma of the renalpelvis and ureter were treated during the past 19 yr at theNational Cancer Center Hospital, Tokyo. Results of treatmentwere reviewed with special reference to the analysis of fatalcases. In fatal cases there were significantly longer intervalsbetween the onset of the disease and establishment of the diagnosisthan in nonfatal cases. Moreover, the histological grade ofmalignancy was significantly higher in fatal cases. More radicalsurgery was performed on patients who survived, but the contributionof this factor to the end results was not quantitatively elucidated.The 5-yr survival rates for patients with renal pelvic carcinoma,ureteral carcinoma and multiple renal pelvic and ureteral carcinomawere 73.5%, 48.7% and 58.5%, respectively.     

Small mass lesions in cirrhosis: Transition from benign adenomatous hyperplasia to hepatocellular carcinoma?

Abstract Ten patients with cirrhosis, in whom small mass lesions were detected by imaging techniques and histological diagnosis of the resected specimens was difficult, are described. There were 17 grossly discrete lesions measuring 10 × 8 mm to 27 × 22 mm. Four were compatible with so-called adenomatous hyperplasia showing no histological features of malignancy, and eight were equivocal as to whether they were benign or malignant. The other five lesions (in four patients) were hepatocellular carcinoma, co-existing with apparently benign lesions. The eight equivocal lesions were eventually judged to be highly differentiated hepatocellular carcinomas. These benign-appearing lesions, found by advanced imaging in patients with cirrhosis, create a serious problem in regions where primary liver cancer is endemic among cirrhotics, and hepatic resection is the preferred treatment.
It is possible that these lesions represent a transition from adenomatous hyperplasia occurring in cirrhotic livers to hepatocellular carcinoma through a histologically equivocal state and that the current morphological methods are inadequate for differentiating malignant from benign lesions.     

广西HCV高危人群庚型肝炎病毒的新基因型核苷酸序列分析

目的 探讨广西HCv高危人群庚型肝炎病毒(HGv)的感染情况及其新基因型的核苷酸序列。方法 静脉药瘾者(IVDAs)85份、肝病患者(PLDs)80份和献血员(BDs)50份血清标本．用PCR法检测庚型肝炎病毒RNA，EIA法检测HBsAg、抗-HCV和抗-HIV；随机选出62份庚型肝炎病毒RNA阳性标本进行核苷酸序列分析，构建种系发生树作基因分型。结果 215份血清中HGv阳性者85份(39.53％)，HBsAg、抗-HGV和抗-HIV的阳性率分别为39.07％、42．79％和0；11份HGV RNA的测序结果证实其有3种基因型，其中5株为新基因型(亚洲型)，51份补测序，其中GBV—C型占3．23％，HGV型占30.65％，亚洲型占64．51％。结论 HGV的3种基因型中存在不同的基因亚型；广西IVDAs、PLDs和BDs中感染庚型肝炎病毒以亚洲型和HGV型为主。