Use of a Test Diet in Screening for Neuroblastoma Reduces False-Positives Attributable to Food Intake

ABSTRACT. We attempted to reduce false-positives during screening for neuroblastoma using a qualitative urine test by introducing a test diet without foodstuffs known to cause false-positive results. In preliminary in-vivo experiments, intake of contra-indicated foods such as orange juice or banana was shown to result in high percentages of false-positive results several hours after food intake. False-positive results were obtained even after 24 hours among breast-fed infants whose mothers received orange juice. In a controlled field trial the false-positive rate was reduced to 2.84% among 540 infants taking the test diet compared with 5.05% among 9844 control infants following conventional guidance on contra-indicated foods (p < 0.05). For comparison, a questionnaire survey of nationwide screening in Japan in 1987 revealed that 66% of the screening centres employed qualitative urine tests, either a Spot or Dip method. False-positive rates, including those due to inappropriate urine collection, ranged from 0.4 % to 33.7% (mean 7.1%). Rates ranged from 0.2% to 18.7% (mean 3.4%) in the remaining 34% of screening centres employing a quantitative method with high performance liquid chromatography.     

Serum Level of Interleukin-4 in Patients with Perennial Allergic Rhinitis During Allergen-Specific Immunotherapy

Interleukin-4 (IL-4) may play a central role in the IgE synthesis system, the development of Th-2-like cells, and co-ordination as well as the persistence of airway inflammatory process in allergic disorders. Therefore, IL-4 plays a key role in airway allergic disorders. This study aimed at investigating the serum concentrations of IL-4 in patients with perennial allergic rhinitis, with special reference to the possible changes and the clinical relevance following long-term immunotherapy. The study has demonstrated that the serum level of IL-4 in allergic rhinitis patients before immunotherapy is significantly higher than that in non-atopic individuals. However, the serum IL-4 level in allergic rhinitis patients did not decrease following anti-allergic medications but significantly decreased following immunotherapy. The percentage decrease in IL-4 was correlated significantly with the percentage decrease in specific IgE antibodies following long-term immunotherapy. Immunotherapy also significantly decreased specific IgE antibodies, but this reduction in specific IgE antibodies was not significantly correlated with the clinical improvement. In contrast, the percentage decrease in serum IL-4 was significantly correlated with the percentage decrease in symptomatic scores. The authors interpret these data to mean that immunotherapy alters T-cell cytokine profiles in the long-term, and a decline of IL-4 following immunotherapy could modulate not only production of specific IgE antibodies but also inflammatory cellular events, leading to symptomatic relief in allergic rhinitis.     

Interaction of lipophilic peptides derived from mastoparan with phospholipid vesicles

Various kinds of lipophilic peptides were prepared by acylation of an ct-helical peptide, mastoparan, to investigate the effects of acyl groups on the interaction of peptides with phospholipid membranes. α-Helicity of the peptides was increased by introduction of long acyl groups. Acyl peptides showed different membrane-perturbation activities for neutral and acidic phospholipid vesicles, whereas a peptide with a dialkycarbamoyl group always exhibited a strong activity. High hemolytic activities were observed for the peptides with long acyls (single or double chain). These results indicate that lipophilic groups introduced to mastoparan contribute greatly to the interaction of the peptide with phospholipid membranes with lengthening of the acyl chain and that the structural character of the lipophilic group also influences the conformation of the peptide.     

Electron Microscopic Study of Cell Lines Established from Adult T-Cell Leukemia--Coexistence of Adult T-Cell Leukemia Virus and Epstein-Barr Virus

Six cell lines established from five patients with adult T-cellleukemia (ATL) were studied by electron microscopy. From onepatient two cell lines were established, an interleukin 2-dependentline and a nondependent line. The interleukin 2-dependent T-cellline had only ATL virus (ATLV) particles. The interleukin 2-nondependentB-cell line had both ATLV particles and Epstein-Barr virus (EBV)particles. In two other B-cell lines and one undetermined cellline, both ATLV particles and EBV particies were seen. In oneB-cell line only a few EBV particles were seen. These findingssuggest that (I) interleukin 2 is necessary for the growth ofleukemic T-cells from ATL tissue samples, and (2) ATLV can infectnot only T-cells but also B-cells.     

Antibodies to hepatitis C virus and elevated transaminase levels in a town of hyperendemicity in Iwate, Japan

In an annual survey for liver function tests in persons aged > xs35 years in Iwate Prefecture, Japan, a town was identified where high levels of alanine aminotransferase abounded. Of 5152 inhabitants aged > 35 years in this town, antibodies to hepatitis C virus (HCV) determined by enzyme-linked immunosorbent assay with HCV core peptides were detected in 798 (15.5%) people, hepatitis B surface antigen was detected in 47 (0.9%) people and antibodies to hepatitis B surface antigen and/or hepatitis B core antigen unaccompanied by surface antigenaemia were detected in 1748 (33.9%) people. Antibodies to HCV core peptides correlated closely with the antibodies detected by passive haem-agglutination with recombinant HCV proteins of the second generation. Antibodies to HCV core peptides were particularly common in one of the nine districts of the town (district 8), where 276 (45.3%) of 609 inhabitants tested positive; there were no differences in the frequency of serological markers of hepatitis B virus (HEV) infection among residents in the nine districts. Of the 798 individuals with antibodies to HCV core peptides, 257 (32.2%) were found to have elevated transaminase levels. A history of transfusion was associated with a high frequency of antibodies to HCV core peptides, except in district 8 where such antibodies were equally frequent in residents irrespective of transfusions. These results indicate an epidemiology of HCV distinct from that of HBV in this town and a very local spread of HCV, as well as a high frequency of hepatic injuries in individuals with antibodies to HCV.     

Erythema nodosum-like eruption in sarcoidosis

Two cases of sarcoidosis with tender, erythematous nodules on the legs are reported. The cutaneous lesions were clinically similar to those of erythema nodosum, but histologically showed non-caseating epithelioid granulomas. A review of 14 cases of this particular sarcoid eruption reported in Japan showed that 13 had ocular involvement as in our cases. In the light of the high frequency of ocular involvement, a skin biopsy should be considered in patients presenting with erythema nodosum-like eruptions situated on the legs.     

Predicting optimal continuous positive airway pressure in Japanese patients with obstructive sleep apnoea syndrome

Background and objective: Several algorithms that predict the optimal CPAP have been developed for Caucasian patients with OSA syndrome, but these algorithms do not allow for racial differences in craniofacial anatomy. We investigated whether an equation that included data on craniofacial structure, physique and severity of OSA could more accurately predict the optimal CPAP for Japanese patients with OSA syndrome. Methods: In 170 Japanese patients with OSA syndrome, the optimal CPAP was determined by manual titration during polysomnography. An equation predicting the optimal pressure was derived from anthropometric, polysomnographic and cephalometric data. This equation was validated in another 110 Japanese patients with OSA syndrome. Results: Stepwise multiple regression analysis identified AHI, BMI, mean SaO₂ and a cephalometric parameter: the angle between a line from point B to the menton (Me) and a line from Me to the hyoid bone (H) (BMeH), as independent predictors of optimal CPAP. The following equation was constructed to predict the optimal CPAP: 27.78 + (0.041 × BMeH) + (0.141 × BMI) + (0.040 × AHI) ? (0.312 × mean SaO₂). This equation accounted for 47% of the variance in optimal pressure (R² = 0.47, P < 0.0001). The measured optimal pressure and the pressure calculated using this equation were very similar in the other 110 patients with OSA syndrome (9.5 ± 3.0 and 9.2 ± 2.1 cmH₂O, respectively). Conclusion: Optimal CPAP was more accurately predicted by combining a cephalometric parameter with BMI and polysomnographic data in Japanese patients with OSA, suggesting that craniofacial structure may be important in the pathogenesis of OSA syndrome among Asians.