Reflex sympathetic dystrophy in childhood: A case report

A case report is presented of a 15-year-old girl with reflex sympathetic dystrophy (RSD). She was referred to hospital because of left upper limb pain. Her left upper limb was cold, edematous and blue with a limited active range of movement. The serum concentration of noradrenaline was lower on the painful side than on the healthy side, and neurotropin, which has an antinociceptive effect to hyperalgesia, was clearly effective. Early diagnosis and management is essential in the treatment of RSD and administration of neurotropin is a useful and non-invasive treatment without severe adverse effects.     

Defective activity of Epstein-Barr virus (EBV) specific cytotoxic T lymphocytes in children with chronic active EBV infection and in their parents

Antibodies of Epstein-Barr virus (EBV), EBV-specific cytotoxic T lymphocyte (EBVCTL) activity and the lymphocyte subset of CTL were examined in 13 Japanese children with chronic active EBV infection (CAEBV) and their parents (eight fathers and 10 mothers). Anti-virus-capsid antigen (VCA)-IgG antibody titers ranged from 1: 640 to 1: 5120 in the patients with CAEBV and from 1: 40 to 1: 640 in the parents. While anti-VCA-IgM antibody was detected in three patients, anti-VCA-IgA antibody in five and anti-early-antigen (EA)-IgG antibody in 11, no antibody was detected in the parents except anti-EA antibody, which was positive in the mothers of cases 5 and 13 (1: 10 and 1: 40). Anti-EBV-associated nuclear antigen (EBNA) antibody was ≥ 1: 10 in six out of 13 patients with CAEBV and in 10 out of 18 parents tested. Epstein-Barr virus activity was significantly lower (P < 0.005) both in the children with CAEBV and in their parents than in seropositive age-matched controls. Proportions of a CTL subset (CD8⁺ CD11^? lymphocytes) in the patients with CAEBV were significantly higher (P< 0.005) than in controls, while those in the parents were at the same level as in controls. Defective EBVCTL activity and anti-EBNA-antibody responses were frequently observed both in children with CAEBV and in their parents, which may suggest that the abnormal immune response to EBV may be based on a familial disorder, though no familial involvement has been reported in Japanese children with CAEBV.     

Spectral analysis of changes in electroencephalographic activity after the chewing of gum

Abstract  The present study aimed to examine the psychosomatic effect in the chewing of marketed gum using eletroencephalogram (EEG) as an index. The EEG were taken in two sets: (i) a resting period before chewing (control recording) and a resting record (post-resting recording) for examining reproducibility; and (ii) a control recording and resting period after gum-chewing for 3 min (post-chewing recording). The ratio of each frequency band to the total frequency power, the mean frequency of the alpha band and laterality of the frequency power was calculated. In the examination of the reproducibility, no statistically significant differences were observed between control recording and post-resting recording in all indices. In the reflection of EEG after gum-chewing, there were no significant differences between control recording and the post-chewing recording. However, a significant interaction was observed among these indices by analysis of variance. In addition, the alpha power in the post-chewing recording was significantly higher than that in the control recording at almost all the positions. In conclusion, the intra-individual reproducibility of EEG was confirmed in the recording method. Furthermore, it was suggested that a significant interaction and a rising trend of the mean frequency of the alpha band after gum-chewing reflected 'arousal' psychosomatic responses by the chewing of marketed gum.     

VACCINE-ASSOCIATED POLIOMYELITIS IN AN INFANT WITH AGAMMAGLO BULINEMIA

Abstract. Sakano, T., Kittaka, E., Tanaka, Y., Yamaoka, H., Kobayashi, Y. and Usui, T. (Department of Paediatrics, Hiroshima University Hospital and Hiroshima City Hospital, Hiroshima, Japan). Vaccine-associated poliomyelitis in an infant with agammagiobulinemia. Acta Paediatr Scand, 69:549, 1980.—We describe a female infant with agammaglobulinemia who contracted vaccine-associated poliomyelitis. Poliovirus type 2 was isolated from the initial stool specimen. In our patient, temporary changes in the cerebrospinal fluid resembled those in patients without immunodeficiencies, although gammaglobulin therapy had not yet been started. Pleocytosis was observed for a short time after viremia, but soon there was a return to normal without antibody production.     

CHERRY RED MACULAR DEGENERATION

ABSTRACT. Cherry red macular degeneration was presented in a 6-month-old Japanese girl suffering from classical features of the diencephalic syndrome. The association of cherry red macular degeneration with the diencephalic syndrome was previously undescribed.     

Early Gastric Lymphoma Coexisting with Reactive Lymphoreticular Hyperplasia (RLH) -A Case Report-

A 34-year-old female visited our hospital because of epigastralgia. We performed an upper gastrointestinal x-ray examination, and both conventional endoscopy and dye-spraying endoscopy (indigo-carmine contrast method). We diagnosed early gastric lymphoma which simulated Borrmann 3 type gastric cancer with IIb type early gastric cancer on the middle body and reactive lymphoreticular hyperplasia (RLH) of cobble stone-like granular pattern by endoscopic appearance on the lower body. Although dye-spraying endoscopy showed the details of the mucosa, it was very difficult to diagnose the lesions correctly by gross appearance alone. Because gastric lymphoma arises from the mucosal or submucosal layer and spreads in the mucosa diffusely, ultrasonic visualization by echo-endoscopy might be useful in the diagnostic procedure. We report a case of early gastric lymphoma coexisting with RLH; both lesions showed uncommon endoscopic features.     

Modification of Atrioventricular Conduction Using a Combined Laser-Electrode Catheter

Ablation of the AV junction is an accepted technique for the management of selected supraventricular tachyarrhythmias. Radiofrequency ablation appears to be safe and effective for AV junction ablation in most patients, but the need for firm tissue contact may make it less effective for ventricular tachycardia and certain ectopic atrial tachycardias. Laser energy can also be delivered through a catheter, and thus it may be an attractive alternative energy source for ablation. A new laser-electrode catheter was developed for modification of conduction through the AV node as a model for ablation of an arrhythmia substrate. A window for delivery of continuous-wave Nd:YAG laser energy was placed between the two electrodes of a bipolar electrode catheter. In vitro studies using a matrix of power versus time were performed to determine the energy that would create lesions of the appropriate size in vivo. Using this information, advanced AV block was successfully created in 16 of 17 dogs (94%) with the laser-electrode catheter. Advanced AV block was successfully created in all four dogs in the chronic study, and it persisted for 1-24 weeks of follow-up until sacrifice of the animals. Histologic examination demonstrated discrete thermal damage at the AV junction with no instances of septal perforation in the acute studies or progressive necrosis in chronically maintained dogs. Advanced AV block may be produced consistently and safely in dogs using a combined laser-electrode catheter.     

Defective natural killer cell activity and deficient production of interferon-γ in children with acute lymphoblastic leukemia

Natural killer (NK) cell activity, OK-432-augmented-NK cell activity, concentrations of interferon-γ (IFN-γ) in the culture supernatants of lymphocytes stimulated with OK-432, and subsets of NK cells and memory T cells were analyzed in 42 children with acute lymphoblastic leukemia (ALL) receiving maintenance chemotherapy. Natural killer and augmented-NK cell activities, and concentrations of IFN-γ in the supernatants of cultured lymphocytes, were significantly lower in the patients with ALL than in age-matched control children. Among the NK cell subsets, proportions of CD57⁺ cells in the patients with ALL were significantly higher than in the controls, and proportions of a memory T cell subset (CD4⁺ CD29⁺ T cells) in the patients were also significantly higher than in the controls. These results suggest that the function of NK cells and memory T cells that are considered as IFN-γ producing cells, may be defective in ALL, and that CD57⁺ cells and CD4⁺ CD29⁺ cells may be resistant to or recover rapidly from suppression by cytotoxic chemotherapy.