Vertical transmission of human T-cell leukemia virus type I (HTLV-I): Detection of proviral DNA in HTLV-I carrier gravida

The seroprevalence rate of human T-cell leukemia virus type I (HTLV-I) in pregnant women in the Osaka district was determined by enzyme-linked immunosorbent assay and Western blot analysis. Twenty-one (1.0%) of 2192 samples tested were positive for both assays and the seropositive parturients were found to be integrated with HTLV-I proviral DNA in their mononuclear cells by a DNA dot blot hybridization assay using HTLV-I DNA probe or by a selective DNA amplification technique using the polymerase chain reaction (PCR). On the other hand, proviral DNA was not detected in cord blood of the neonates born to the carrier mothers, indicating that transplacental infection of HTLV-I during pregnancy could be excluded. The results support the hypothesis that postpartum infection via breast milk plays a significant role among the possible perinatal transmission routes.     

Mechanisms responsible for delayed and immediate hemolytic transfusion reactions in a patient with anti-E + Jk(b)+ Di(b) and anti-HLA alloantibodies

Immediate hemolytic transfusion reactions (IHTR) occurred in the course of delayed hemolytic transfusion reactions (DHTR). An 84-year-old man had received a blood transfusion 20 years ago. Progressive anemia developed, because of continuous bleeding from a bladder tumor. He was transfused with concentrated red blood cells (CRC) which were Rh-E antigen negative, because he had anti-E antibodies (day 0). He received CRC on day 3, and underwent resection of bladder tumor on day 6. Although crossmatch-compatible CRCs were prepared for the operation, those were not required and were kept in a refrigerator in the ward. On day 9, when a CRC kept in the ward was transfused, he suddenly had a IHTR. In order to analyze a mechanism of IHTR, the anti-Jk(b) and anti-Di(b) antibodies, anti-HLA antibodies and the concentrations of inflammatory cytokines were measured in serum samples. The anti-Jk(b) and anti-Di(b) antibodies increased prior to IHTR experienced on day 9. The concentrations of IL-6 and IL-1beta increased from day 2, while the concentration of IL-8 increased from day 7. The anti-HLA class I antibody could be detected 2 days before IHTR. Thus, the anti-Jk(b) and anti-Di(b) antibodies induced the production of inflammatory cytokines and symptoms of DHTR and IHTR. The anti-HLA class I antibody could be produced in spite of using the filer for removing leukocytes, and may take part in the induction of IHTR. Further, blood products should be transfused soon after completing a crossmatch test in patients with anti-RBC alloantibodies.     

Morphological evidence for axonal sprouting of cerebellothalamic neurons in kittens after neonatal hemicerebellectomy

Summary Changes in cerebellothalamic projections in kittens after neonatal hemicerebellectomy were studied by the retrograde and anterograde horseradish peroxidase (HRP)-tract-tracing methods. The number of cerebellar nuclear neurons labeled retrogradely with HRP injected into the ipsilateral VA-VL complex of the thalamus was much more numerous in neonatally hemicerebellectomized kittens than in intact kittens. Presumed terminals of ipsilateral cerebellothalamic fibers labeled anterogradely with HRP injected into the cerebellar nuclei were also distributed more densely and extensively in the thalamic areas, especially in the VA-VL complex, of hemicerebellectomized kittens than in the thalamic areas of the control kittens. These results are in good accordance with those obtained from the previous electrophysiological study (Kawaguchi et al., 1979) and offer corroborating evidence for axonal sprouting of cerebellothalamic neurons after neonatal hemicerebellectomy.     

Studies on recurrence of cerebral aneurysm after operation

It seems to be well established that the direct surgical treatment of intracranial aneurysm such as clipping, trapping and wrapping the aneurysm. These operations have brought about excellent results but are not perfect because recurrent aneurysm and rebleeding of aneurysm have been reported shortly after the operation. However, it is very rare that subarachnoid hemorrhage arising from recurrent aneurysm long time after the operation, authors have experienced 3 cases of recurrent aneurysm in the same region long after the surgery. Two cases were readmitted to our hospital following repeat episode of subarachnoid hemorrhage. Carotid angiogram showed a new small aneurysm locating about the same place where previously operated aneurysm was situated. One of them showed development of new aneurysm at the anterior communicating after 4 years artery the neck clipping, the other one was recurrent aneurysm 9 years after the neck clipping of aneurysm at the anterior communicating artery. Two cases were treated by reclipping and got well. It has been reported in the articles that 20 cases of recurrent aneurysm were located about the same place where previously clipping aneurysm was performed. Causes of such recurrence of already clipped aneurysm could be divided into two groups. First group was considered that the treatment was unsatisfactory, because the clip had been improperly placed. The other group was considered as mechanical failure of aneurysmal clip that resulted in "slipped out," or "broken clip", and local fragility of the arterial wall adjacent to clip edge. Last case had a giant pseudoaneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)     

Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO.     

Quantitation of basal dyssynchrony and acute resynchronization from left or biventricular pacing by novel echo-contrast variability imaging

OBJECTIVES: This study sought to test a novel echocardiographic method based on contrast variability imaging (CVI), to quantify cardiac dyssynchrony and magnitude of resynchronization achieved by left ventricular (LV) and biventricular (BiV) pacing therapy. BACKGROUND: Left ventricular or BiV pacing is a promising new therapy for patients with heart failure and intraventricular conduction delay. However, precise quantitation of the extent of resynchronization achieved remains scant. METHODS: Ten patients treated with BiV or LV pacing therapy were studied. Echo-contrast was infused slowly, and gated images were acquired before and during contrast appearance. The temporally normalized variance derived from 30 to 50 sequential beats was determined at each pixel to yield the CVI image-displaying improved wall delineation. Systolic regional fractional area of radial sectors was calculated with active and temporarily suspended (AAI) pacing. All analyses were performed blinded to both patient and treatment. RESULTS: Pacing increased septal inward motion from -20.4 +/- 9.6% to -30.5 +/- 14.0%, whereas lateral wall motion occurred earlier with no net magnitude change. Both spatial and temporal dyssynchrony in the LV declined nearly 40% with LV or BiV pacing (p < or = 0.001), and this correlated with increasing ejection fraction (31% to 39%; p < 0.02; p < 0.004 for correlation with dyssynchrony). CONCLUSIONS: The new imaging and regional dyssynchrony analysis methods provide quantitative assessment of resynchronization analogous to that previously obtained only by tagged magnetic resonance imaging. This could provide a useful noninvasive method for both identifying candidates and following long-term therapy.     

Correction to: Association of initial prednisolone dose with remission,relapse, and infectious complications in adult‑onset minimal change disease

Clinical and Experimental Nephrology - In the original publication, the author has found few errors. The corrections are given below.     

Prognostic impact of count of extratumoral lymphatic permeation in lung adenocarcinoma and its relation to the immune microenvironment

Extratumoral lymphatic permeation (ly‐ext) has been reported as an independent poor prognostic factor for lung adenocarcinoma, but whether or not the number of ly‐ext foci is associated with prognosis and its relationship to the immune microenvironment is unclear. We counted the number of ly‐ext foci on pathological slides from patients with completely resected lung adenocarcinoma with ly‐ext, and divided them into two groups: a group with a high number of ly‐ext foci (ly‐ext high) and one with a low number of ly‐ext foci (ly‐ext low). Among the patients with ly‐ext, only a high number of ly‐ext foci was an independent poor prognostic factor. The 3‐year recurrence‐free survival (RFS) rate of the ly‐ext high group was significantly lower than that of the ly‐ext low group (14.7% vs. 50.0%, P < 0.01). Then, we analyzed the immune microenvironment of pT1 lung adenocarcinoma with ly‐ext (13 cases of ly‐ext high and 11 cases of ly‐ext low tumor) by immunohistochemistry using antibodies for stem cell markers (aldehyde dehydrogenase 1 A1 and CD44), tumor‐promoting mucin (MUC1), tumor‐infiltrating lymphocytes (CD4, CD8, FOXP3, and CD79a), and tumor‐associated macrophages (CD204). The number of CD8+ TILs within the primary lesion was significantly lower and the number of FOXP3+ TILs within the primary lesion was significantly higher in the ly‐ext high group (P < 0.05 and P < 0.01, respectively). Our results indicated that a high number of ly‐ext foci was an independent poor prognostic factor. Moreover, tumors with high numbers of ly‐ext foci had a more immunosuppressive microenvironment.     

Two groups of corticofugal neurons identified with the pontine stimulation in the cat parietal association cortex: an intracellular HRP study

A classification of the parietal corticofugal neurons was performed in cats under Nembutal anesthesia. Eighty-eight neurons were identified with antidromic activation by the pontine stimulation. Thirteen neurons were furthermore identified with intracellular HRP staining. In these neurons, we found the close correlation between morphological features and conduction velocities. The faster conducting group of the neurons had relatively large somata, sparsely spinous apical dendrites, tap root basal dendrites and wide apical dendritic fields. The slower group had small somata and numerous dendritic spines.