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Aims To identify factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus, using decision-curve analysis. Methods A retrospective cohort study was performed. The participants were 123 Japanese women with gestational diabetes who underwent 75-g oral glucose tolerance tests at 8-12 weeks after delivery. They were divided into a glucose intolerance and a normal glucose tolerance group based on postpartum oral glucose tolerance test results. Analysis of the pregnancy oral glucose tolerance test results showed predictive factors for postpartum glucose intolerance. We also evaluated the clinical usefulness of the prediction model based on decision-curve analysis. Results Of 123 women, 78 (63.4%) had normoglycaemia and 45 (36.6%) had glucose intolerance. Multivariable logistic regression analysis showed insulinogenic index/fasting immunoreactive insulin and summation of glucose levels, assessed during pregnancy oral glucose tolerance tests (total glucose), to be independent risk factors for postpartum glucose intolerance. Evaluating the regression models, the best discrimination (area under the curve 0.725) was obtained using the basic model (i.e. age, family history of diabetes, BMI ≥25 kg/m2 and use of insulin during pregnancy) plus insulinogenic index/fasting immunoreactive insulin <1.1. Decision-curve analysis showed that combining insulinogenic index/fasting immunoreactive insulin <1.1 with basic clinical information resulted in superior net benefits for prediction of postpartum glucose intolerance. Conclusions Insulinogenic index/fasting immunoreactive insulin calculated using oral glucose tolerance test results during pregnancy is potentially useful for predicting early postpartum glucose intolerance in Japanese women with gestational diabetes. [ABSTRACT FROM AUTHOR]

Severe hyponatremia is a critical electrolyte abnormality in allogeneic stem cell transplantation (allo- SCT) recipients and >50% of cases of severe hyponatremia are caused by the syndrome of inappropriate secretion of antidiuretic hormone ( SIADH). Here, we present a patient with rapidly progressive severe hyponatremia as an initial sign and symptom of human herpesvirus-6-associated post-transplantation acute limbic encephalitis ( HHV-6 PALE) after allo- SCT. A 45-year-old woman with acute lymphoblastic leukemia received unrelated bone marrow transplantation from a one locus-mismatched donor at the DR locus. On day 21, she developed a generalized seizure and loss of consciousness with severe hyponatremia, elevated serum antidiuretic hormone ( ADH), and decreased serum osmolality. A high titer of HHV-6 DNA was detected in cerebrospinal fluid. Treatment with foscarnet sodium and hypertonic saline was started with improvement of neurological condition within several days. Although an elevated serum ADH, low serum osmolality, and high urinary osmolality persisted for 2 months, she had no other recurrent symptoms of encephalitis. Our experience suggests that hyponatremia accompanied by SIADH should be recognized as a prodromal or concomitant manifestation of HHV-6 PALE, and close monitoring of serum sodium levels in high-risk patients for HHV-6 PALE is necessary for immediate diagnosis and treatment initiation. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection not only causes chronic liver diseases but shows extrahepatic manifestations as oral lichen planus (OLP) and oral cancer. To elucidate the direct relationships among these diseases and HCV infection, we investigated the detection of positive- and negative-strand HCV-RNA from serum, OLP (n=19), and oral cancer (n=17) tissues. We used a sensitive reverse transcription to polymerase chain reaction (RT-PCR) method, and analyzed sequences from the HCV El/E2 region of the genome from serum and tissue. Positive and negative HCV-RNA strands were observed in 13 (92.9%) and 3 (21.4%) OLP tissues, respectively. In oral cancer tissues, positive HCV-RNA strands were detected in all tissues from anti-HCV positive patients. Negative HCV-RNA strands were observed in 5 of 7 (71.4%) patient's tissues. Furthermore, it was confirmed that the sequence from one of each OLP and oral cancer patient differed between serum and tissue HCV-RNA. These results may indicate that HCV persists and replicates in these lesions, suggesting a pathological role for HCV, although the mechanisms are unclear. [ABSTRACT FROM AUTHOR]

The present study was aimed to clarify the virologic status, liver histologies, and the results of follow-up liver tests in symptom-free individuals with anti-HCV antibodies and normal liver tests. Forty-nine individuals with normal liver tests and positive second generation anti-HCV antibody assay were entered into this study. Cases with hepatitis C viremia were evaluated for HCV genotype, amount of circulating HCV-RNA, and liver histology and were followed-up for more than one year. Of the forty-nine individuals, 36 had hepatitis C viremia, indicated by polymerase chain reaction (PCR) assay. Liver histology was as follows: 3 had non-specific changes, 25 had chronic persistent hepatitis (CPH), and 8 had chronic active hepatitis (CAH). Twenty-four cases with CPH and CAH developed an elevated AST and/or ALT concentration (> 30IU/1) between 12 and 32 months of follow-up. The amount of circulating HCV-RNA ranged from 102 to 107 copies/50 μl serum. The distribution of HCV genotypes was nearly the same as that for symptomatic CAH. These data suggest that the histological examination and follow-up examination are very important for following symptom-free individuals with hepatitis C viremia because there are some candidates for interferon therapy among them. There are few individuals who will remain healthy among asymptomatic HCV carriers. [ABSTRACT FROM AUTHOR]

To clarify whether immunological heterogeneity exists among liver macrophages and whether this possible heterogeneity corresponds to varying degrees of phagocytic activity, we fractionated liver macrophages according to size via centrifugal elutriation and studied their ability to ingest latex beads, to express Ia antigen and to secrete interleukin-1 (IL-1) in vitro. Larger liver macrophages were found to be more active in ingesting latex beads than smaller ones (p>0.01), while smaller liver macrophages were more active in Ia antigen expression and evidenced greater fluorescence at cytofluorometric examination. In addition, smaller liver macrophages elaborated more IL-1 than the larger liver macrophages (p>0.05). These results indicate that liver macrophage heterogeneity is seen in at least two important macrophage functions: phagocytosis of large molecules, which provides an important scavenger function, and Ia antigen expression and IL-1 secretion, important components of the immune response. [ABSTRACT FROM AUTHOR]

We studied the incidence of GBV-C infection in patients with oral cancer or oral lichen planus (OLP). Subjects included 38 patients with oral cancer and 34 patients with OLP from whom serum was collected to detect GBV-C-RNA using reverse transcription (RT) "nested" PCR. GBV-C-RNA was positive in 1 (2.6%) oral cancer patient and 3 (8.8%) OLP patients. All 4 GBV-C-positive patients were also positive both for the antibody for hepatitis C virus (anti-HCV) and HCV-RNA, indicating simultaneous infection with GBV-C and HCV. In conclusion, GBV-C infection was found in 5.5% (4/72) of oral cancer or OLP patients and all patients infected with GBV-C also had HCV infection. This suggests that GBV-C infection is unlikely to play an important role in the pathogenesis of oral cancer and OLP. [ABSTRACT FROM AUTHOR]

We have investigated the correlation between the prevalence of hepatitis C virus (HCV), which is detectable in saliva, and oral cancer and other digestive tract cancers in the Northern Kyushu region of Japan. Anti-HCV antibodies were detected in sera from 24 of the 100 patients with oral cancer (24%, p<0.05 vs the control group, p<0.01 vs the stomach cancer group), in 11 of 104 patients with non-malignant diseases receiving dental treatment (the control group, 10.6%), and in 12 of 113 patients with stomach cancer (10.6%). HCV-RNA was detected in sera from 17 of 100 oral cancer patients (17%, p<0.05 vs the control group) and 4 of 104 patients of the control group (3.9%). These results indicate a high prevalence of HCV infection in oral cancer patients, which warrants a systematic study of etiological associations between oral cancer and HCV. [ABSTRACT FROM AUTHOR]