Transient low level of IgG3 induced by sepsis

Staphylococcus aureus sepsis developed in a 14 year old girl. Immunological evaluation revealed low level of IgG3, although total IgG level was normal. The level of IgG3 increased gradually along with the recovery from sepsis. Immunoglobulin replacement therapy might have been useful in this patient, even though the total immunoglobulin level was within normal limits.     

RETARDED MESANGIAL TRANSPORT AND ITS PATHOMORPHOLOGIC SEQUELAE IN HUMAN AND EXPERIMENTAL RENAL DISEASES

Human renal biopsy specimens (472 cases) from varied kidney diseases, especially minimal glomerular change group and other idiopathic glomerular diseases having nephrotic manifestation of mainly juvenile individuals, showed morphologic evidence of paraarterial deposits of afferent arterioles at the glomerular entrances in more than 50% of examined cases. Because these deposits were often accompanied with concomitant mesangial, intraarterial and subendothelial deposits of afferent arterioles, it was felt that retarded mesangial transport which is ordinarily associated with certain glomerular diseases might be an important factor to produce these particular paraarterial deposits. The referred deposits of minimal glomerular change group cases were thought to predispose the occurrence of focal sclerotic capillary lesions at the vascular poles of glomeruli. The experimental chronic nephrotic rats produced by daily administration of aminonucleoside of puromycin revealed mesangial dysfunction with increased uptake and retarded disposal of secondarily overloaded aggregated human gamma globulin at mesangial areas in glomeruli. Besides, the increased deposits of autologous serum proteins in mesangial areas and arteriolar walls were common findings in those rats, and these deposits were observed to be always preceded to the occurrence of segmental sclerotic changes of glomeruli, which were often associated in the later stage of this experiment. ACTA PATHOL. JPN. 33: 219∼236, 1983.     

Phagocytosis of heat‐killed Staphylococcus aureus by eosinophils: comparison with neutrophils

Eosinophils are characterized by several functional properties, such as chemotaxis, adhesion, superoxide anion production, and degranulation. In this article, we have studied the role of bacterial ingestion by eosinophils in comparison with that by neutrophils. Eosinophils and neutrophils were purified by using the Percoll gradient method followed by selection with CD16‐coated immunomagnetic beads and centrifugation through a Ficoll‐Hypaque gradient combined with dextran sedimentation, respectively. Both cells were preincubated with anti‐FcγRIIa mAb (CD32 mAb), anti‐FcγRIIIb mAb (CD16 mAb), anti‐CR3 (CD11b mAb), or anti‐CR1 (CD35 mAb) before being examined for phagocytosis of opsonized heat‐killed Staphylococcus aureus (S. aureus). Phagocytosis and production of hydrogen peroxide were simultaneously measured by flow cytometry using S. aureus labeled with propidium iodide and stained with 2′,7′‐dichlorofluorescein diacetate. Eosinophils showed significantly lower activity than neutrophils in both phagocytosis and hydrogen peroxide production. Phagocytosis by both cells was decreased by heat‐inactivated serum. Phagocytosis by neutrophils was significantly inhibited by CD16 mAb and CD32 mAb, whereas that by eosinophils was only inhibited by CD35 mAb. Whereas the mechanism of phagocytosis by neutrophils was mediated by CD16 and CD32, that of eosinophils was modulated by complement receptor 1 (CD35).     

TREATMENT OF GOUT WITH ALTERNATE-DAY HYPO-URICAEMIC DRUGS

In the treatment of gout, an alternate-day hypo-uricaemic drugwas tried in order to reduce the amount of hypo-uricaemic drugprescribed and to lessen its possible side-effects. The serumurate level in the alternate-day therapy with benzbromarone(100 mg/day) was higher than that found with daily therapy,but was conversely lower than that in half-dose daily therapy.The serum urate level in alternate-day therapy with five hypo-uricaemicdrugs increased by 0.7 mg to 1.4 mg/100 ml, compared with thatin the daily therapy. The incidence of hyperuricaemia (serumuric acid over 7 mg/100 ml) in alternate-day therapy with along-acting hypo-uricaemic drug was relatively low (0 % forbucolome, 20 % for probenecid and 25.0 % for benzbromarone).The incidence of hyperuricaemia in alternate-day therapy withsulphinpyrazone and allopurinol was 42.9 % and 66.7 %, respectively.The frequency of gouty attacks in alternate-day therapy withfive drugs was not significantly different, when compared withdaily therapy.     

博莱霉素与博莱霉素A5诱导小鼠肺组织损伤的差异

目的探讨静脉注射博莱霉素(BLM)和博莱霉素A5(BLM-A5)对小鼠肺组织损伤的不同作用。方法8周龄雌性C57BL/6小鼠49只,随机分为BLM组19只、BLM-A5组20只和对照组10只,分别经尾静脉一次性注射BLM 150 mg/kg、BLM-A5 150 mg/kg和生理盐水。观察每组小鼠体重、生存率,肺组织病理改变及肺组织羟脯胺酸的含量。结果①BLM组和BLM-A5组小鼠最低体重分别为静脉注射处置前的65.46%和66.87%,均较对照组明显降低(P值均小于0.001)。②BLM组、BLM-A5组和对照组小鼠的生存率分别为:43%、55%和100%。③BLM组小鼠注射处置后28 d,在胸膜下及血管周围形成广泛、稳定的间质纤维化病理改变,而BLM-A5组无明显纤维化形成。BLM组与BLM-A5组、正常组比较,肺纤维化病理评分均明显增高(P值均小于0.001)。④BLM-A5组和对照组注射处置后28 d,右肺羟脯氨酸含量分别为471.6±49.4 nmol和405.0±74.6 nmol,两组间无统计学差异。BLM组为978.4±106.1 nmol,与BLM-A5组、对照组比较分别存在显著性差异(P值均小于0.01)。结论静脉注射BLM与BLM-A5,对小鼠肺组织损伤的作用存在着明显的差异,BLM可导致肺间质形成广泛的纤维化,而BLM-A5仅引起轻微的肺组织损伤,不形成明显的间质纤维化。     

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.     

Evaluation of gender differences in caregiver burden in home care: Nagoya Longitudinal Study of the Frail Elderly (NLS-FE)

Background: Japan is presently experiencing a growth in the number of male caregivers and this situation has given rise to some concerns over gender differences. Previous studies have suggested that there are gender differences in caregiver burden in home care, however, it is still unclear whether or not gender differences exist. We therefore conducted this study to attain a better understanding of the Japanese male caregiver burden in home care, using data from the Nagoya Longitudinal Study of Frail Elderly (NLS‐FE). Methods: NLS‐FE is a large prospective study of community‐dwelling elderly persons eligible for public long‐term care insurance who live in Nagoya city and use the services of the Nagoya City Health Care Service Foundation for Older People, which comprises 17 visiting nursing stations and corresponding care‐managing centers, from November to December 2003. Data used in this study included the Japanese version of the Zarit Caregiver Burden Interview, caregivers’ and dependents’ characteristics, and the caregiving situation. The differences in dependent and caregiver characteristics between male and female caregiver groups were assessed using the χ²‐test for categorical variables or the unpaired t‐test for continuous variables. Multiple logistic regression was used to examine the association between dependent and caregiver characteristics and caregiver burden. Results: A total of 399 male caregivers and 1193 female caregivers were included in our analysis. Before and after controlling baseline variables, we did not detect a difference between male and female caregivers with respect to caregiver burden. Conclusion: Our study suggests that differences in caregiver burden may not necessarily exist between male and female caregivers in Japan.     

Bone marrow transplantation for erythroleukemia: A case report

A 2 year old girl was diagnosed as having erythroleukemia (EL; M6 according to the French-American-British classification). After one course of low-dose cytosine arabinoside (Ara-C), complete remission was obtained. After three courses of low-dose Ara-C for consolidation, allogeneic bone marrow transplantation was performed from HLA-identical sibling. The course of post-transplantation was uneventful. Two years after transplantation, she continues to have durable engraftment and remission. In children with EL, conventional chemotherapy appears to be inadequate for producing durable long-term disease-free survival. Bone marrow transplantation should be considered in children with EL, in cases where suitable donors are available.     

Heterogeneity of Epstein-Barr virus infection in angioimmunoblastic lymphadenopathy type T-cell lymphoma

To investigate the relationship of Epstein-Barr virus (EBV) and angioimmunoblastic lymphadenopathy with dysproteinemia, we performed DNA analysis using the polymerase chain reaction (PCR), Southern blot, in situ hybridization, and immunohistochemical analysis of lymph nodes in five patients who were followed up and biopsied more than once. In the course of the disease, nodal architecture diminished, cellular atypia worsened, and clear cells increased in number. In the DNA analysis of the receptor genes, the clonal population increased in number. EBV nucleic acid sequences were found by either PCR or in situ hybridization in all examined nodes. The number of EBV-positive cells varied widely among the cases and throughout the course of the disease in the same patients. The analysis of EBV terminal repeats or lymphocyte-determined membrane antigen genes showed polyclonal populations of EB-infected cells. EBV-positive cells possessed intermediate- to large-sized nuclei, and the cells with large nuclei, especially, expressed latent membrane protein of EBV. These large cells varied in number among the cases. Double-labelling immunohistochemistry/in situ hybridization studies demonstrated that most of the EBV-positive cells expressed B-cell antigen (CD20). The presence of EBV seems to be associated with the selective defects of the immune system, rather than with the direct pathogenesis of angioimmunoblastic lymphadenopathy.     

Defective suppressor function of spleen cells by neonatal thymectomy and persistence of experimental auto-immune hepatitis in mice

The effects of neonatal thymectomy on a model of auto-immune hepatitis prepared by immunizing A/J mice with syngeneic crude liver proteins were studied. Hepatitis was more severe in neonatally thymectomized mice (Group B) than in non-thymectomized controls (Group A). Changes in the hepatic lobules were reduced in both groups 3 months after the final immunization, but inflammation around the portal areas tended to persist in Group B; only this group showed frequent infiltration of mononuclear cells accompanied by destruction of the limiting plate in the portal area. The serum level of auto-antibody to liver-specific membrane lipoprotein complex (LSP) and delayed-type hypersensitivity (DTH) to LSP were higher in Group B than in Group A. The auto-antibody to LSP was positive in both groups 3 months after the final immunization. Although it was significantly reduced in Group A compared with the level 3 days after the final immunization, it remained high in Group B. Liver damage, production of the auto-antibody to LSP and DTH to LSP were reduced by adoptive transfer of normal murine spleen cells, but the spleen cells of neonatally thymectomized mice showed no such effects. These results suggest that normal spleen cells possess the capability of suppressing auto-immune hepatitis, and the defect of this capability due to T-cell dysfunction by neonatal thymectomy contributes to the promotion and persistence of auto-immune hepatitis.