Appearance of basophils in the sputum of patients with bronchial asthma

A total of 108 samples of sputum obtained from twenty patients with bronchial asthma were examined for appearance of basophils and eosinophils. Both cell types are present in sputum during an asthmatic attack and disappear at the conclusion of the attack. Their presence correlates with the severity of the disease. It has previously been demonstrated that the blood basophils count falls during attacks of bronchial asthma, and the present study suggests that basophils move from the blood stream into bronchial tissue during the acute phase of an asthmatic attack.     

Contribution of pulmonary hemodynamics on manifestation of allergic asthma in patients with congenital heart disease

The purpose of this study was to determine whether pulmonary hemodynamic abnormalities relate to manifestations of allergic asthma. In 448 patients with congenital heart disease the relationships between asthma and age or pulmonary arterial blood (PA) flow were studied. Asthma (allergic and non-allergic) was more common in 39 (19%) of 201 patients with high PA flow, compared with the incidence in those with normal PA flow (6/117, 5%; P < 0.001) and reduced PA flow (1/130, 1%; P < 0.05). In the high PA flow group, the frequency of asthma declined significantly (P < 0.01) with age, from 25–26% in the 6 month-5 year patient group to 5% in the 6–12 year old patients. The frequency of asthma, including allergic type, was significantly (P < 0.01) greater in patients with pulmonary hypertension (15/24, 63%) than in those without (10/77, 13%) at the age of 6 months to 1 year. Asthma in the high PA flow group was associated with other allergic diseases in 30 (77%) of 39 patients, including food allergy in nine (23%), atopic dermatitis in 14 (36%), allergic rhinitis in seven (18%) and abnormally high total IgE levels in 14 (36%). These findings suggest that high pulmonary flow or pulmonary hypertension enhances the manifestation of allergic disease, particularly asthma.     

Influence of a Bacterial Lipopolysaccharide on the Pharmacokinetics of Tobramycin in Rats

Abstract— The effects of Klebsiella pneumoniae O3 lipopolysaccharide on the renal handling and distribution characteristics of the aminoglycoside tobramycin were investigated in rats. Tobramycin (2 mg kg^?1) and inulin (100 mg kg^?1) were administered intravenously 2 h after administration of 50,250 or 500 μg kg^?1 lipopolysaccharide. Lipopolysaccharide delayed the disappearance of tobramycin from plasma in a dose-dependent manner. A dose-dependent decrease in systemic clearance of tobramycin was observed, although the elimination rate constant and fraction of urinary recovery of unchanged drug were not significantly different in any group. Lipopolysaccharide significantly decreased the central compartment volume of distribution of tobramycin, but did not influence the steady-state volume of distribution. A dose-related increase in the ratio of the rate constant of transfer to the peripheral compartment to the rate constant of transfer from peripheral compartment to central compartment was observed. The glomerular filtration rate was significantly decreased by pretreatment with 250 μg kg^?1 lipopolysaccharide and the clearance ratio was decreased by 20%, indicating that lipopolysaccharide increases the tubular reabsorption of tobramycin. Our findings suggest that K. pneumoniae O3 lipopolysaccharide modifies the glomerular filtration rate and tubular reabsorption without change in the terminal half-life and that drug distribution characteristics from the rapidly-distributing compartment to the peripheral compartment were altered without expansion of the extracellular fluid volume.     

A case of pelvic malignant paraganglioma

We report a rare case of pelvic malignant paraganglioma that was treated with surgery, combination chemotherapy and radiation. A 47-year-old man was diagnosed with pelvic malignant paraganglioma that had metastasised to the thoracic vertebrae. The pelvic mass, which was 6 cm in size, was on the posterior side of the bladder and had invaded the prostate, seminal vesicle and bladder neck. We resected the intrapelvic tumor and lymph nodes using cystoprostatectomy. Metastases to bilateral obturator lymph nodes and the right internal iliac lymph node were shown by pathology. Adjuvant therapies included six courses of the combination chemotherapy (cyclophosphamide, vincristine and dacarbazine), and 12 courses of VP-16 therapy. Radiation therapy was done for metastasis of the thoracic vertebrae. Local recurrence, progression of bone metastasis and new metastasis have not been detected since these treatments. The patient has been clinically stable during 20 months of follow-up. Chemotherapy of cyclophosphamide, vincristine and dacarbazine and VP-16 with radiation appears to be effective in treating advanced malignant paraganglioma.     

A clinical case of neuro-Behçet syndrome without mucocutaneo-ocular symptoms: Relationship with brain stem encephalitis

Abstract The case of a 50 year old man with personality changes, dementia, and brain stem symptoms is presented. Magnetic resonance imaging (MRI) disclosed high signal areas mainly in the brain stem. Both a positive skin prick test and an HLA-B51 were demonstrated. These clinical findings were suggestive of neuro-Behçet syndrome, although there were no mucocutaneo-ocular symptoms characteristically associated with this disease. The relationship between neuro-Behçet syndrome and brain stem encephalitis, including a discrimination from multiple sclerosis, is discussed.     

Emergence of basophils at sites of local allergic reactions using a skin vesicle test

Vesicular exudate, produced by the application of cantharides plaster over normal skin and sites of intradermal allergen injection, was examined for the presence of basophils and eosinophils in normal subjects and patients with bronchial asthma. In comparison with the normals, the asthmatic group demonstrated a high rate of basophil appearance in vesicular fluid derived from areas of untreated skin. Basophil appearance was even more prominent in vesicular fluid from skin injected intradermally with various allergens. Modest numbers of basophils appeared at skin sites injected with house dust, but relatively large numbers appeared in areas injected with Candida, ragweed or tuberculin extracts. Patients with severe, intractable asthma frequently demonstrated large numbers of basophils in vesicular exudates. Intradermal injections of anti-IgE caused the greatest number of basophils to appear in the vesicular fluid, The numbers of eosinophils migrating into such vesicular lesions were not statistically significant though their numbers were proportional to those of the basophils. A significant correlation was shown to exist between both basophil and eosinophil blood counts and the numbers of these cells appearing in cutaneous vesicular fluid. This study demonstrates that basophil leukocytes, together with eosinophils, migrate from blood into extravascular tissues at sites of allergic reaction—especially reaginic hypersensitivity. The skin vesicle technique described is simpler than the skin window technique and may be of use in detection of allergens and evaluation of allergic disease states.     

A neuropathologic study of long-term, Economo-type postencephalitic parkinsonism with a prolonged clinical course

Abstract In this report, the neuropathologic features of five autopsied cases of postencephalitic parkinsonism of the Economo-type (PEPE) with a mean age of 66.6 years and a mean duration of the illness of 53.6 years are described. All five patients had presented with personality changes and severe parkinsonism. In addition, four patients had also had ocular symptoms. A pronounced chronic progression of the symptoms characterized all five cases. Active degenerating lesions were found in the substantia nigra (patients 3, 4 and 5) and the oculomotor nucleus (patient 5) which might explain the clinical observation of chronic active disease in these patients. We found that the intraneuronal neurofibrillary tangles (NFT) were immunoreactive to paired helical filaments (PHF), tau and ubiquitin; but ghost tangles demonstrated immunoreactivity only to glial fibrillary acid protein (GFAP). The ghost tangles consisted of dispersed bundles of abnormal tubules, and electron-dense glial filaments would surround and occasionally invade the ghost tangles. The present study suggests that NFT in PEPE are similar in their immunohistochemistry and ultrastructure to those observed in the case of Alzheimer-type dementia.     

SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE-CONTROL EPIDEMIOLOGIC STUDY IN JAPAN

Background. Systemic lupus erythematosus (SLE) is designated by the Japanese government as one of the intractable diseases and all patients, who suffer from these diseases, are registered to get financial aid for treatment. Using newly registered SLE patients, a case-control study was conducted to evaluate potential risk factors. Methods. Two-hundred and eighty-two women SLE patients, newly registered to receive financial aid for treatment, and 292 randomly selected health examination participants at public health centers (controls) were surveyed from April 1988 through March 1990. By means of a self-administered questionnaire, data concerning demographic variables, smoking and drinking habits, past medical and reproductive history, and family history were collected. Results. Based on unconditional logistic regression analysis, the risk of SLE was significantly increased for current smokers (age-adjusted odds ratio (OR) = 2.31, 95% confidence interval (CI) (1.34–3.97). Alcohol and milk intake were inversely associated with risk. Family histories of asthma and collagen diseases, including SLE, were associated with significantly elevated risk of SLE (OR = 2.07, 95% ci 1.14–3.77; OR = 5.20, 95% CI 1.08–24.95, respectively). Regarding reproductive function, women with menarche at age 15 or later had significantly higher risk than those, who started menstruating before age 12 (OR = 3.82, 95% CI 1.66–8.81 for menarche at > 15 years and OR = 2.90, 95% a 1.14–7.39 for menarche at 16y). Conclusions. Our study suggests several risk factors, including smoking, family history, and reproductive history that may increase the risk of SLE.     

Morphological changes of basophils in immunological reactions—effect of sodium cromoglycate

The morphological changes in blood basophils, from patients with bronchial asthma, were studied in vitro during immunological reactions, with particular reference to interaction with anti-IgE. Anti-human IgE results in an absolute reduction in basophil numbers in buffy coat preparations as well as basophil cytoplasmic degranulation. An increase in the numbers of pear-shaped (A-form) basophils is also observed. Sodium cromoglycate impairs all these anti-IgE induced basophil changes, providing further insight into the mechanism of action of this compound in bronchial asthma.