Infective Endocarditis Due to Treponema pallidum: A Case Diagnosed Using Polymerase Chain Reaction Analysis of Aortic Valve

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Syphilitic aortitis might coexist in a dysfunctional aortic valve, but the etiology remains unclear, because microbiological diagnosis is difficult. A 62-year-old man with low-grade fever was diagnosed with aortitis and infective endocarditis, due to Treponema pallidum infection, using polymerase chain reaction analysis. This case suggests that syphilis might cause infective endocarditis.     

Benzylpenicillin preparations can evoke a systemic anaphylactic reaction in guinea pigs

All of the five commercially available benzylpenicillin preparations obtained from different sources and a PcG preparation prepared by filtration of a commercial PcG on Sephadex G10 elicited the systemic anaphylactic reactions in guinea pigs which had been immunized with benzylpenicilloyl (BPO)-Ascaris extract conjugate (BPO-As) mixed with aluminum hydroxide gel. These preparations could evoke no such reactions in guinea pigs immunized with BPO-bovine gamma globulin conjugate (BPO-BGG) emulsified with complete Freund's adjuvant. The severity of the systemic anaphylactic reactions correlated significantly with the titers of either 8-day passive cutaneous anaphylactic (8-day PCA) reactions or 4-hr PCA reactions evoked with the same benzylpenicillin preparations. In vitro benzylpenicillin preparation contracted the tracheas of the guinea pigs immunized with BPO-As. These results indicated that the commercially available benzylpenicillin preparations have enough antigenicity to evoke systemic anaphylactic reactions in guinea pigs immunized with BPO-As mixed with aluminum hydroxide gel. Such guinea pigs represent an animal model for investigation of penicillin allergy.     

Relations between various fiber groups of vagal and splanchnic nerves and gastric motility in rats

Gastric motility changes evoked in rats by electrical stimulation of centrally transected vagal and splanchnic B and C fibers were investigated. Gastric motility was slightly facilitated by repetitive stimulation of vagal B fibers and was greatly facilitated by similar stimulation of the C fibers. In addition, vagal C fiber stimulation evoked a transient, initial inhibition of motility. Splanchnic C fiber stimulation inhibited gastric motility, but the B fiber contribution to inhibition was much greater.     

Axonal trajectory of single group Ia and Ib fibers in the cat spinal cord

Intracellular staining with HRP of physiologically identified group Ia and Ib afferent fibers in the adult cat lumbosacral cord revealed that group Ia and Ib fibers take a similar course in the dorsal funiculus, but the collaterals emerging from them show a different topographical distribution and a different mode of branching in the gray matter. Ia collaterals terminate in laminae VI, VII, IX, and sometimes VIII, whereas Ib collaterals terminate only in lamina VI, or both VI and IX. In lamina IX, two large motor-type neurons received terminations of both Ia and Ib fibers at the same time.     

Chronic myelogenous leukemia with a complex Ph1 translocation in an XYY male

We encountered a 38-year-old Japanese male patient with chronic myelogenous leukemia (CML), whose bone marrow and peripheral blood cells during the chronic and blastic phases contained a complex Ph¹ translocation and an extra Y chromosome [i.e., 47,XYY,t(9;22;13)(q34;q11;q14)]. A karyotypic analysis of PHA-stimulated lymphocytes showed the constitutional karyotype to be 47,XYY. Thus, it was considered that CML with a complex Ph¹ translocation developed in an XYY male; such a case has not been reported, so far. A B-lymphocyte cell line with the complex Ph¹ translocation was established by the procedure of Epstein-Barr virus transformation. The presence of the complex Ph¹ translocation in the B-lymphocyte cell line suggests that some of the B lymphocytes in this patient originated from the CML clone.     

Breast-Conserving therapy: Experience of the breast cancer research group of Tokyo women’s medical college

Conclusion  We are morally obligated to select therapies which are maximally beneficial for patients. Promoting or discouraging the use of a particular treatment modality, such as BCT, should never be a consideration. To meet this goal, our society must establish guidelines as a part of comprehensive policy. The specialist system, launched under the auspices of the specialist system committee, will hopefully lead to further development of the Japanese Breast Cancer Society.     

Metropolitan researchers undertaking rural research: benefits and pitfalls

Can or should metropolitan residents research their rural counterparts and if they do are there inherent pitfalls or benefits? Throughout the history of social and anthropological research there has been debate on the insider–outsider/native–stranger controversy as to who should carry out the field work. This discourse will explore the author’s personal experiences in the context of planning a rural health project, entering the field, accessing the informants, interviewing the informants and leaving the field.     

Anticoagulation after valve replacement: a multicenter retrospective study

Anticoagulant therapy after cardiac valve replacement was evaluated retrospectively in 1,200 patients attending 8 cardiac surgery clinics in the Tokyo area as part of the Tokyo Area Study on Anticoagulation After Cardiac Valve Replacement Using PT-INR (TAS). A prospective trial is also in progress and will be reported later. The prothrombin time international normalized ratio (PT-INR) was determined at the time of thromboembolic and bleeding complications in 1,200 patients. During the 5 year study period, thromboembolisms occurred in 21 patients, and bleeding complications occurred in 15 patients. In 71% of patients with thromboembolism and 47% of those with bleeding complications, the PT-INR was within the range of 1.6 to 2.8, which is the accepted therapeutic range in Japan. Therefore, the correct PT-INR therapeutic range for Japanese patients with mechanical heart valves needs to be reexamined, and data from the prospective TAS trial that is currently underway will be used for this purpose.