Immunological Follow-up in Children Born to HIV-1 Infected Mothers

ABSTRACT. From November 1985 to January 1990 we examined 156 children born to 154 HIV-1 seropositive mothers every 3 months. Eighty-seven infants were over 18 months by January 1990. Six of them met the CDC criteria of HIV-1 infection or died from AIDS; a transmission rate of 7%. Six of the children aged less than 18 months also met the CDC criteria of HIV-1 infection. These 12 infected children were compared with the 81 presumably unifected children. The perinatal findings were similar in both groups. Most of the HIV-1 infected babies showed early abnormalities in humoral and cellular immunity, hypergammaglobulinemia, low percentage of CD4 circulating lymphocytes and increased spontaneous in vitro immunoglobulin production. These changes were persistent in the HIV-1 infected children, but sporadic in those uninfected. Immunological abnormalities were frequently found before clinical symptoms appeared. We conclude that repeated immunological abnormalities in babies born to HIV-1 seropositive mothers are suggestive of HIV-1 infection.     

Successful topical hemotherapy with a new occlusive dressing for an intractable ulcer on the toe

Topical hemotherapy is a method of applying heparinized venous blood directly onto the surface of an ulcer, which is covered with an occlusive hydrocolloidal dressing. It is often effective on chronic ulcers with thick necrosis, because some proteinases and growth factors in plasma are probably involved in the digestion of necrotic tissues and the acceleration of granulation and epithelization. We treated a patient with an intractable ulcer on the toe caused by a peripheral circulatory disturbance due to her systemic sclerosis. As conventional topical hemotherapy cannot be applied to ulcers on the round tip of a toe, we made a device for occlusive dressing of topical hemotherapy which could successfully improve the previously refractory ulcer.     

Diurnal variation in baseline heart rate of anencephalic fetuses

Abstract The diurnal change in baseline fetal heart rate (FHR) of four anencephalic fetuses at 20, 23, 24 and 30 weeks of gestation were examined. The mean baseline FHR in 00.00–06.00 h, 06.00–12.00 h, 12.00–18.00 h and 18.00–24.00 h were compared by one-factor ANOVA and Scheffe's test in each case. The diurnal variations in baseline FHR were recognized in all subjects ( P < 0.01). In 3/4 subjects, the lowest values were at 00.00–06.00 h. The diurnal variation in baseline FHR might be caused by maternal factors because it was present even in the anencephalic fetuses that had no central nervous system having the oscillators of the circadian rhythm.     

“Para-lesional” Saline Injection Method for Assessment of Small Gastric Cancers by Endoscopic Ultrasonography

Abstract: Accurately diagnosing the depth of invasion in small early gastric cancers is essential for determining whether endoscopic resection of a lesion is indicated. It is often difficult, however, to demonstrate such small lesions by conventional endoscopic ultrasonography (EUS) which is considered to be a useful tool for assessing depth of invasion. To facilitate demonstration by EUS, we injected 2-5 ml of saline into the submucosal layer at an appropriate point 1 -2 cm from the lesion. With the collection of saline serving as a guide, the lesion was demonstrable on the same EUS image (“para-lesional” injection method). Using this method, we were able to evaluate all 12 of the small early gastric cancers we examined. Five of these lesions were endoscopically resected uneventfully after EUS examination. The accuracy of the diagnosis of vertical invasion with this method was 83% (10/12). Histologically, fibrotic changes were observed beside the lesion, but no EUS-related effects were recognized beneath the lesion. The present results suggest that the “para-lesional” injection method is useful for assessing small early gastric cancers by conventional EUS.     

Cough-reflex sensitivity to inhaled capsaicin in COPD associated with increased exacerbation frequency

Background and objective:   The causes of exacerbations in COPD patients are poorly understood. This study examined the association between cough-reflex sensitivity in patients with stable COPD and the frequency of subsequent exacerbations.
Methods:   The sampling frame for cases and controls for this study was patients attending a hospital outpatient clinic. cough-reflex sensitivity was evaluated using the log concentration of capsaicin causing five or more coughs (log C₅). Subsequent COPD exacerbations were identified prospectively via symptom-based diaries over a 12-month period.
Results:   The study group comprised 45 COPD subjects and 10 controls. Mean log C₅ was lower in the COPD group than in the control group (0.97 (95% confidence interval (CI): 0.76–1.18) versus 1.26 (95% CI: 0.81–1.71), P  = 0.095). In the COPD group, log C₅ was negatively correlated with serum CRP level ( r  = −0.36, P  = 0.02) and significantly associated with the exacerbation frequency ( r  = −0.38, P  = 0.01). Stepwise multiple regression analysis showed that cough-reflex sensitivity was significantly associated with exacerbation frequency ( r ² = 0.15, P  = 0.01).
Conclusions:   Hypersensitivity of the cough reflex to inhaled capsaicin might reflect airway inflammation in stable COPD patients, which predisposes to frequent exacerbations.     

MOLECULAR IDENTIFICATION AND ANTIMICROBIAL RESISTANCE PATTERN OF SEVEN CLINICAL ISOLATES OF Nocardia spp. IN BRAZIL

Nocardia is a ubiquitous microorganism related to pyogranulomatous infection, which is difficult to treat in humans and animals. The occurrence of the disease is on the rise in many countries due to an increase in immunosuppressive diseases and treatments. This report of cases from Brazil presents the genotypic characterization and the antimicrobial susceptibility pattern using the disk-diffusion method and inhibitory minimal concentration with E-test® strips. In summary, this report focuses on infections in young adult men, of which three cases were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary, neurological and systemic cases were attributed to immunosuppressive diseases or treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four isolates of Nocardia farcinica, two isolates of Nocardia nova and one isolate of Nocardia asiatica. N. farcinica was involved in two cutaneous, one systemic and other pulmonary cases; N. nova was involved in one neurological and one pulmonary case; and Nocardia asiatica in one cutaneous case. The disk-diffusion antimicrobial susceptibility test showed that the most effective antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin (100%) and ceftiofur (100%), while isolates had presented most resistance to gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However, on the inhibitory minimal concentration test (MIC test), only one of the four isolates of Nocardia farcinica was resistant to sulfamethoxazole/trimethoprim.     

Clinical features of anti-chromo antibodies associated with anti-centromere antibodies

Anti-chromo antibodies (AChA) are autoantibodies accompanying anti-centromere antibodies (ACA). We determined the frequency and clinical significance of AChA in autoimmune rheumatic diseases. Serum samples from 252 patients with rheumatic diseases were examined by immunoblotting with HeLa nuclear extract and with recombinant N-terminus of 25-kD chromo protein (p25). AChA were detected in 28 (36%) of 77 sera with ACA. AChA were found only in ACA-positive sera. Twenty-two (79%) of 28 recognized a recombinant N-terminal portion of p25, including the chromo domain which is conserved among species. AChA were related to leucopenia, thrombocytopenia, elevated erythrocyte sedimentation rate, and existence of Sjögren*s syndrome (SS). In ACA-positive patients, AChA might be a serologic indicator of systemic sclerosis (SSc), having features of systemic lupus erythematosus and/or SS or diseases other than SSc.     

Cyclization under mild conditions of anthraniloyl- and N-methyl-anthraniloyl dipeptides*

Anthraniloyl- and N-methyl-anthraniloyl dipeptides containing C-terminal L and D proline residues have been synthesized and subjected to cyclization reaction under mild conditions. The influence of substituents and of the chirality of the residues on the output of the reaction is discussed.