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Our purpose is to prove that prolonged inflammation of the chorionic plate, which we have termed subacute chorioamnionitis (SCAM), is a distinctive entity and should be differentiated from acute chorioamnionitis (ACAM) because it is an excellent prognostic indicator of chronic lung disease (CLD), including Wilson-Mikity syndrome (WMS). Ninety singleton placentas with stage-3 chorioamnionitis were delivered at 23 to 32 weeks of gestation during 1993 to 1996, and the infants survived more than 28 days. There were 49 placentas with stage 3 SCAM, 33 placentas with stage 3 ACAM, and 8 placentas with subacute necrotizing funisitis (SNF) and without inflammation of the chorionic plate. Fifty-three of gestation- and birthweight-matched placentas without chorioamnionitis were selected as control. To determine the risk factors for CLD, 27 clinical and 6 histological variables were analyzed. Logistic regression analysis showed that amniotic necrosis (AN) (P =.0168) and low birthweight (P =.0341) were the major contributing risk factors for CLD. SNF was not significantly related to CLD. Patients with SCAM (AN+, SNF-) were highly susceptible to CLD. In conclusion, SCAM, especially when associated with AN, seems to be a unique prognostic indicator of CLD.

Utilising a combination of infiltration and combustion synthesis, a new method for fabricating a high melting point metallic compound (Ni~A1) with only a few pores and little change in the shape, at a low temperature and at atmospheric pressure, has been established. The main procedure for this method is the dropping of molten aluminium or AI-Ni alloys (Ni content up to 18 mass%) onto a sintered nickel sample with 34-36 vol.% pores at 1073 K. Immediately after a molten aluminium or an AI-Ni alloy is dropped onto a sintered nickel sample, the molten metal infiltrates into the sintered material accompamed by an exothermic reaction, When a molten A1-Ni alloy (with a nickel content of over 10 mass%) is dropped, a Ni3A1 material is fabricated with only a few pores and little change in the shape. The addition of nickel to the drop delays the onset of the interfacial reaction though the total heat produced is not very different. The delay in the onset of the interfacial reaction allows the infikration to finish or proceed to some extent before a certain critical point in the interfaclaI reaction. As a result, a uniform Ni3A1 compound is produced. The experimental data clearly relate to the adiabatic combustion temperatures, which indicates that the heat loss is relatively low. As a result, a high melting point metallic compound can be produced at a low temperature and at atmospheric pressure. © 1997 Elsevier Science S.A.

To elucidate possible relationships between triglyceride (TG) levels and fatty acid composition in bovine liver, hepatic TG and seven individual fatty acids were measured in 23 Holstein dairy cows, of them 6 are healthy. Liver TG level was greater than 3 % in 12 cows which were ruled fatty liver. Palmitic and oleic acid proportions were significantly higher in fatty liver cows than in the healthy cows, while stearic acid was lower in fatty liver cows. With increased liver TG, stearic acid proportions decreased dramatically. Results indicate that hepatic lipidosis markedly alters the proportions of the various fatty acids in the liver of dairy cows.

The cDNA clone coding a major vault protein (MVP)-like protein was derived from Echinococcus multilocularis cysts. MVP is a main component of vault particles, which are the largest cytoplasmic ribonucleoprotein particles in eukaryotic cells. We sequenced and characterized E. multilocularis MVP (EmMVP). The nucleotide sequence of the emmvp cDNA clone was 2607 bp in the full length open reading frame and its deduced amino acid sequence had several signature motifs which were specific to MVP families. Immunoblot analysis with mouse anti-EmMVP antiserum revealed that crude antigens of E. multilocularis included EmMVP protein. Furthermore, our results showed that the expression of EmMVP protein in an Sf9 insect cell line using a baculovirus vector directed the formation of particles that shared similar biochemical characteristics with other vault proteins and the distinct vault-like morphology when negatively stained and examined by electron microscopy.

To investigate the rate and risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR).Five hundred and twelve patients (512 eyes) with PDR who underwent vitrectomy between January 1, 2003 and June 30, 2009 at Kumamoto University Hospital, Japan, were retrospectively evaluated. Postoperative NVG was defined as neovascularization in the anterior segment and intraocular pressure (IOP) ≥ 22 mm Hg after vitrectomy. Kaplan-Meier survival analysis was applied to calculate the rate of NVG after vitrectomy. Risk factors for NVG after vitrectomy were identified by multivariable analysis using the Cox proportional hazards model.The mean follow-up period was 422 days. Twenty-seven of 512 patients (5.3%) developed postoperative NVG after vitrectomy. The probability of NVG occurrence at 6 and 12 months after vitrectomy was 6.0% and 7.1%, respectively. Male sex [relative risk (RR)=4.247; P=0.0032), younger age (RR=0.956/y; P=0.0237), higher baseline IOP (RR=1.203/mm Hg; P=0.0335), preoperative neovascularization in the anterior chamber angle (RR=8.899; P0.0001), and presence of NVG in the fellow eye (RR=5.355; P=0.0013) were significant risk factors for postoperative NVG.The frequency of NVG in PDR eyes within 1 year after vitrectomy was estimated as 7.1%. The risk is independently associated with male sex, younger age, higher baseline IOP, preoperative neovascularization in the angle, and NVG in the fellow eye.

The aim of this study was to investigate the risk factors for tail chasing behaviour that occurs when a dog spins in tight circles to chase its tail, sometimes biting it. The behaviour is a sign of canine compulsive disorder (CD). A questionnaire about tail chasing behaviour and general information about the animals was used to collect data on seven breeds of pet dogs. The data were gathered at a dog event and at veterinary practices. To determine which variables were associated with tail chasing behaviour, stepwise multiple regression analyses were performed. Regardless of cohort, 'breed' and 'source of acquisition' were significantly associated with tail chasing behaviour. Using a chi-square test, the association between 'source of acquisition' and the behaviour was examined separately in two breeds (Shiba inu and Dachshund) that had the largest number of individuals chasing their tails accompanied by biting and/or growling at them. This factor showed a significant and consistent association across the two breeds. With respect to the risk factors of 'breed' and 'source of acquisition', high percentages of Shiba inu and dogs originating from pet stores were included in the group chasing their tails with biting and/or growling. The results suggest that distinct risk factors exist for tail chasing behaviour and such factors appear to be regulated by both genetics and the environment.

In serodiagnosis of cystic echinococcosis (CE) by Echinococcus granulosus infection, antigen B (AgB) has been utilized worldwide. However, it is known that about 40% of sera with alveolar echinococcosis (AE) by Echinococcus multilocularis infection recognize AgB. Furthermore, cross-reaction against AgB was also reported in sera from polycystic echinococcosis (PE) patients with Echinococcus vogeli infection. These findings indicate that AgB is widely common to the genus Echinococcus. On the other hand, AgB has several subunits, which are composed of the smallest 8-kDa subunit. In this study, reactivities of patient sera with three kinds of Echinococcus infections (CE, PE, and AE) were compared simultaneously under the same condition against three subunits of AgB (8, 16, and 24 kDa). Many articles have referred the fundamental 8- kDa subunit as a diagnostic antigen for CE. However, the reactivity for the 8-kDa subunit of the CE patient was not so high (47.7%) in this study. Furthermore, there are many cases in which serum of patients with PE or AE also recognizes this subunit (66.7% in PE; 45.9% in AE). AgB is effective for the detection of the genus Echinococcus infections, but it does not have high species specificity. Therefore, we need to pay attention to cross-reaction in serodiagnosis of CE in areas where plural species coexist.

A simple and rapid ion-pair high-performance liquid chromatographic (HPLC) method for the simultaneous determination of the lactone and hydroxy acid forms of camptothecin and its derivatives CPT-11 and SN-38 was developed. The method allows the hydroxy acid form to be eluted before the lactone form for each compound. The application of this method is limited by the minimum interval between subsequent injections and the void time for starting a measurement. However, it is possible to determine the lactone and hydroxy acid forms in aqueous solutions at the pH and the temperature near to biological conditions.

OBJECTIVE. The aim of this study was to assess whether periventricular leukomalacia findings are sufficiently sensitive for predicting the severity of motor prognosis by conventional MRI in the near term.METHODS. Preterm infants with T1 hyperintensity or cysts in the periventricular regions on term MRI were selected, and their gross motor functions were evaluated at the age of 3 to 5 years. Sixty-two infants had findings of T1 hyperintensity or cysts, and except for infants with these findings, none were diagnosed later as periventricular leukomalacia.RESULTS. All 37 patients with cerebral palsy had periventricular lesions with T1 hyperintensity or cysts in the corona radiata above the posterior limb of the internal capsule on coronal sections. Small T1 hyperintensity lesions were seen on coronal slices and were often difficult to detect on axial slices. All of the 17 infants with T1 hyperintensity findings sparing the corona radiata above the posterior limb of the internal capsule showed normal motor development, irrespective of findings of ventriculomegaly. There was a tendency for the presence of widespread lesions in corona radiata above the posterior limb of the internal capsule to be correlated with the severity of motor handicap.CONCLUSIONS. Lesions in the corona radiata above the posterior limb of the internal capsule on a coronal view by term MRI were useful for predicting motor prognosis in preterm infants with periventricular leukomalacia.

This report describes a patient with pyoderma gangrenosum (PG) complicated with myelodysplastic syndrome (MDS) followed by rapidly progressing pyothorax-associated lymphoma (PAL). A 74-year-old man was admitted with cutaneous gangrene associated with MDS. We diagnosed him as having PG, and high-dose oral prednisolone was started. Two months after admission he developed lymphoma rapidly. The patient died in spite of radiation therapy. On autopsy, the pathological diagnosis was diffuse large cell lymphoma. Epstein-Barr virus (EBV)-encoded RNA, and EBV-encoded nuclear antigen (EBNA) were detected in lymphoma cells. This case suggested that immunosuppressive therapy might favour the clonal proliferation of EBV-infected cells.

Diurnal fluctuations in glucose levels continuously monitored during normal daily life are investigated using an extended random walk analysis, referred to as detrended fluctuation analysis (DFA), in 12 nondiabetic subjects and 15 diabetic patients. The DFA exponent α = 1.25 ± 0.29 for healthy individuals in the “long-range” (>2 h) regime is shown to be significantly ( P < 0.01) smaller than the reference “uncorrelated” value of α = 1.5, suggesting that the instantaneous net effects of the dynamical balance of glucose flux and reflux, causing temporal changes in glucose concentration, are long-range negatively correlated. By contrast, in diabetic patients, the DFA exponent α = 1.65 ± 0.30 is significantly ( P < 0.05) higher than that in nondiabetic subjects, evidencing a breakdown of the long-range negative correlation. It is suggested that the emergence of such positive long-range glucose correlations in diabetic patients—indicating that the net effects of the flux and reflux persist for many hours—likely reflects pathogenic mechanisms of diabetes, i.e., the lack of long-term stability of blood glucose and that the long-range negatively correlated glucose dynamics are functional in maintaining normal glucose homeostasis.

Recent characterization of several genes involved in plant defense responses suggested that ubiquitin-mediated protein degradation has a role in these responses. We isolated two cDNAs (NtUBA1 and NtUBA2) encoding ubiquitin-activating enzyme (E1) from Nicotiana tabacum cv. BY-2. The open reading frames of both encoded 1080 amino acids, corresponding to molecular masses of 120 kDa. The E1s and corresponding transcripts were upregulated by infection with tobacco mosaic virus (TMV) and tomato mosaic virus (ToMV), and to a lesser extent by cucumber mosaic virus (CMV). Furthermore, they were also upregulated by wounding stress, and the plant hormones salicylic acid, jasmonic acid and the ethylene precursor, aminocyclopropane-1-carboxylic acid (ACC). Our findings support the idea that the ubiquitin-proteasome system plays a role in plant disease defenses.

The similarity of symptoms produced by tick-borne encephalitis (TBE) and Japanese encephalitis (JE) and the high degree of cross-reactivity between TBE and JE viruses by serological tests make the development of a differential diagnostic test a priority. In this study, recombinant prM/E proteins of TBE virus strain Oshima 5-10 expressed in mammalian cells resulted in the release of subviral particles (SPs) into the culture medium. Using the SPs as antigens, enzyme-linked immunosorbent assay (ELISA) systems were developed to detect TBE virus-specific IgM and IgG antibodies, designated SP-IgG and SP-IgM ELISAs, respectively. Of 83 serum samples from encephalitis patients in Khabarovsk, Russia, which were positive with the neutralization test (NT), 82 were positive by the SP-IgG ELISA, for a sensitivity of 98.8%, which was higher than that of a commercial ELISA kit. All 12 NT-negative samples were also negative by the SP-IgG ELISA (specificity, 100%). Of 17 patient samples that were NT-positive, 16 (94.1%) were positive by the SP-IgM ELISA. Of 15 paired serum samples that yielded equivocal results by NT, 11 had positive results with the SP-IgM ELISA, indicating a diagnosis of TBE infection. The SP-IgG and SP-IgM ELISAs showed no cross-reactivity with antibodies to the JE virus. The results indicate that these ELISAs will be useful for the detection of TBE-specific antibodies.

This article describes a patient with rheumatoid arthritis (RA) with crescentic glomerulonephritis (CrGN) associated with myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA), who responded well to methotrexate (MTX). A 48-year-old woman with a 4-year history of RA was admitted with fever and elevated C-reactive protein. On laboratory evaluation, her level of MPO-ANCA was 422 EU, and urinalysis revealed proteinuria and hematuria. Because she was also suffering from episcleritis, vasculitis was considered. A renal biopsy was performed, which revealed necrotizing CrGN. We diagnosed RA complicated with MPO-ANCA-associated vasculitis. We considered treatment with high-dose oral prednisolone for vasculitis, but the patient refused this treatment. We started MTX at a dose of 8 mg/week for RA from the time of admission, and the patient responded immediately. Biochemical parameters, including C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, and MPO-ANCA, improved. Seven months later, MPO-ANCA had decreased to 46 EU. In clinical studies, few patients have been reported with RA complicated with ANCA-associated CrGN. This case differs from previous cases in the treatment given. No high-dose steroid with intensive immunosuppression or plasma exchange was required.

The tick-borne encephalitis (TBE) virus has two membrane glycoproteins (prM and E), which each has one N-linked glycan. Constructs that express prM and E proteins of TBE virus have been shown to produce virus-like particles (VLPs), which have surface properties that are similar to those of infectious viruses. To reveal the function of glycosylation of the TBE virus prM and E proteins in the secretion of VLPs, we expressed glycosylation-mutated prM and E proteins and compared the secretion levels and biological properties of the VLPs. In the prM protein glycosylation-deficient mutant, the level of secreted E protein was reduced to 60% of the wild-type level. On the other hand, in the E or prM-E protein glycosylation-deficient mutant, the level of secreted E protein was reduced to 10% of the wild-type level. Furthermore, the mutant which was glycosylated at positions 66 and 154 in protein E, the level of secreted E protein was four-fold higher than that of the wild-type. However, in the mutant which was glycosylated at position 66 only, E protein secretion was reduced to only 10% of the wild-type level. These data suggest that the glycan associated with the N-linked glycosylation site at position 154 in protein E plays an important role in VLP secretion.

Objective. Our purpose was to examine the significance of diffuse chorioamniotic hemosiderosis (DCH) on neonatal morbidity and mortality. Methods. Using data from a retrospective case-control study, we analyzed 46 singleton placentas with DCH from infants who were delivered and/or admitted to the neonatal intensive care unit of Kanagawa Children’s Medical Center during 1987–2001 and 92 control placentas without DCH from infants of comparable gestational age, birth weight, and duration. Results. Mean and standard deviation of gestational age and infants’ birth weight at delivery from the DCH group were 27 ± 3 weeks and 939 ± 342 g, respectively. Macroscopically, the placentas with DCH were more likely to show old peripheral blood clots (46% in the DCH group vs 8% in control group), subchorionic hematoma (20% vs 1%), and circumvallation (13% vs 1%). Histologically, amniotic necrosis was significantly more frequent in the DCH group (63% vs 24%). Of the obstetric factors, incidence of recurrent episodes of vaginal bleeding (70% vs 11%), oligohydramnios (59% vs 8%), and chronic abruption-oligohydramnios sequence (57% vs 5%) were significantly higher in the DCH group. Of the neonatal factors, persistent pulmonary hypertension of the newborn (29% vs 8%) and dry lung and/or pulmonary hypoplasia (20% vs 4%) were more common. However, respiratory distress syndrome was rare (15% vs 45%) in the DCH group. Neonatal death including stillbirth was increased in the DCH group but was not significant (24% vs 15%). Of infants who survived beyond day 28, chronic lung disease (CLD) was more frequent in the DCH group (51% vs 22%). The association of DCH, especially accompanied by amniotic necrosis, with CLD was still evident using likelihood ratio test. Conclusion. DCH is closely associated with preterm delivery, pulmonary hypertension of the newborn, and dry lung syndrome and is a significant risk factor for CLD.

We compared the biological properties of Oshima 5-10 (tick-borne encephalitis [TBE] virus isolated in Hokkaido, Japan) and Sofjin-HO (Far-Eastern subtype TBE virus) including plaque formation, virus replication and virus protein synthesis in BHK-21 cell cultures to reveal strain differences. We also determined the complete nucleotide sequences of both strains and compared the deduced amino acid sequences. Plaques of Oshima 5-10 were smaller than those of Sofjin-HO. Virus titers in culture fluid of Oshima 5-10 were 1/100 of those of Sofjin-HO at 9 and 12 hr after infection. Less viral protein and RNA syntheses of strain Oshima 5-10 was observed than with Sofjin-HO. Genetic analysis revealed 1.4% of amino acids to differ with Sofjin-HO. No difference between the two strains was detected in the motif sequence of the viral enzyme, cleavage sites of viral protein or glycosylation sites of NS1.

Direct hemoperfusion with polymyxin-B has been reported to improve hemodynamics in postsurgical patients. In 2012, the Japanese Guidelines for the Management of Sepsis were published and mention the efficacy of polymyxin-B direct hemoperfusion. But how to use and the target patients are varied by facilities. We investigated the effective use of polymyxin-B direct hemoperfusion in nonsurgical patients.

Purpose It has been reported that the Pulse Contour Cardiac Output (PiCCO) is very useful mainly in the field of intensive care and treatment to grasp the pathophysiological conditions of pulmonary edema because of its capability of obtaining data such as Pulmonary Vascular Permeability Index (PVPI) and Extra Vascular Lung Water (EVLW). Furthermore, a high degree of usability of various markers has been reported for better understanding of the pathological conditions in cases with septicemia. Materials and Methods The correlation between the cardiorespiratory status based upon the PiCCO monitor (EVLW and PVPI) and inflammatory markers including C reactive protein, procalcitonin (PC), and Endotoxin Activity Assay (EAA) were evaluated in 11 severe cases that required treatment with a respirator in an intensive care unit. Results The EAA values were significantly higher in patients with abnormal EVLW at 0.46±0.20 compared to the normal EVLW group at 0.21±0.19 (p=0.0064). In a similar fashion, patients with abnormal PVPI values tended to have higher PC levels at 18.9±21.8 compared to normal PVPI cases at 2.4±2.2 (p=0.0676). On the other hand, PVPI was significantly higher in the abnormal EAA group at 3.55±0.48 in comparison with the normal EAA group at 1.99±0.68 (p=0.0029). The abnormal EAA group tended to have higher PVPI values than the normal EAA group. Conclusion The EAA is a measurement method designed to estimate the activity of endotoxins in the whole blood. Our results suggest that the EAA value, which had the greatest correlation with lung disorders diagnosed by the PiCCO monitoring, reflects inflammatory reactions predominantly in the lungs.

To evaluate the efficacy of the European TBE vaccine in east-Siberian and far-eastern regions of Russia, we examined the immune responses of the vaccine against recent TBE virus Siberian (Irkutsk) and far-eastern (Khabarovsk and Vladivostok) isolates. The sera of vaccinated humans showed efficient neutralizing antibody titers (> or =20) against Siberian and far-eastern strains. To evaluate the efficacy of the vaccine in vivo, mice were vaccinated and challenged with lethal doses of the viruses. All vaccinated mice survived each virus challenge. These results suggest that the European vaccine can prevent the TBE virus infection in east-Siberian and far-eastern regions of Russia.

In this study, tick-borne encephalitis (TBE) viruses from Siberia and far-eastern Asia were characterized in order to determine virus subtype distribution. TBE viruses were isolated from ticks (Ixodes persulcatus) collected in the far-eastern (Khabarovsk and Vladivostok) and Siberian (Irkutsk) regions of Russia in 1999. Phylogenetic analysis showed that isolates formed distinct clusters of far-eastern and Siberian subtypes. There was also a minor difference in antigenicity between the Irkutsk isolates and other TBE virus strains, as demonstrated by the reactivity of monoclonal antibodies. Amino acid alignments of the E gene showed that the Irkutsk isolates had a single amino acid change at position 234 (Q or H); this amino acid position is considered to be a ‘signature’ of Siberian subtype TBE viruses. Strains isolated in Irkutsk also exhibited equivalent or somewhat higher virulence in mice compared with far-eastern TBE virus isolates. All viruses isolated in this study (i.e. far-east Asian and Siberian isolates) have 3′ non-coding regions (NCRs) of almost the same length, which contrasts with the various sizes of 3′NCRs of other TBE viruses strains reported previously. The data presented in this study show that the 3′NCR is uniform among TBE viruses isolated from Siberia and far-eastern Asia and that the 3′NCR is essential for TBE virus growth in tick and/or rodent host cells.

Aligned carbon nanofibers and hollow carbon nanofibers were grown by MW ECR-CVD method using methane and argon mixture gas at the temperature of 550••. Carbon nanofibers and hollow carbon nanofibers were deposited perpendicularly on Si substrate and on Si substrate coated with Ni catalyst, respectively. Raman spectra of aligned carbon nanofibers and hollow carbon nanofibers showed new bands of 1340 and 1612 cm-1 of the first-order Raman scattering and 2660, 2940 and 3220 cm-1 of the second-order Raman scattering. The second-order Raman scattering bands were assigned to two overtone and one combination bands on the basis of a similar assignment of micro crystal graphite. Combination bands are intense unusually. Field emitter characteristics of the well-aligned carbon nanofibers and hollow carbon nanofiberswere investigated and the current densities were 7.25 mA/cm2 and 0.69 mA/cm2at 12.5 V/μm, respectively.

We report a case of early congenital syphilis in which the placenta showed diffuse proliferative villitis and Treponema pallidum was identified by indirect immunoperoxidase stain in formalin-fixed paraffin-embedded placental tissue. This is the first report demonstrating T. pallidum in placental tissue using an immunohistochemical method.

Purpose: Few reports have been made on the therapeutic effects as well as pathological features of an antithrombin preparation in patients diagnosed with septic disseminated intravascular coagulation (DIC) by the diagnostic criteria for acute DIC. Materials and Methods: A total of 88 sepsis patients who had received inpatient hospital care during the period from January 2000 through December 2008 were divided into two groups, an antithrombin group and a non-antithrombin group, to study the outcomes. Furthermore, the relationship between sepsis-related factors and DIC in 44 patients was studied. Results: The antithrombin group contained 34 patients, and the non-antithrombin group contained 54 patients. The outcomes were significantly better in the antithrombin group. The levels of protein C were low in DIC patients. Conclusion: Our results suggest that early administration of antithrombin might improve outcomes of septic DIC patients in the diagnostic criteria for Japanese Association for Acute Medicine acute DIC.

A case of cloverleaf skull (CLS) syndrome with Chiari malformation was reported. The patient developed congenital hydrocephalus, upper airway obstruction and breath holding spells. Ventriculo-peritoneal shunt improved the hydrocephalus, but the patient progressively developed apneic episodes in spite of intubation. Brain magnetic resonance imaging (MRI) disclosed severe Chiari malformation. Laminectomy of the cervical vertebrae and craniectomy at the occipital bone were performed to relieve the brain stem compression. Postoperatively, the respiratory symptoms improved slightly, but 8 weeks later the patient suddenly died. Literature survey revealed that this is the second case report of CLS associated with Chiari malformation. It was assumed that the respiratory problems in our patient are ascribable to the Chiari malformation as well as the upper airway obstruction. The patient here reported seems to be a case of Beare-Stevenson cutis gyrata syndrome, in view of an association of multiple characteristic dysmorphic features, in addition to CLS.

We report on a 3-month-old girl with Miller-Dieker syndrome resulting from a maternal full-cryptic translocation t(10;17)(q26.3;p13.3) detectable only by using fluorescence in situ hybridization (FISH). Parental studies using FISH are crucial for genetic counselling in cases of Miller-Dieker syndrome with submicroscopic deletion at 17p13.3. In a family with a parental cryptic translocation and high recurrence risk, prenatal diagnosis using FISH is feasible. © 1995 Wiley-Liss, Inc.

Neonatal alloimmune thrombocytopenic purpura (NAITP) is one of the causes of thrombocytopenia in the newborn period. The thrombocytopenia is caused by maternal transplacental antiplatelet alloantibodies. We report a case of NAITP in a newborn infant having subarachnoid hemorrhage. Examination of platelet antibodies revealed anti-Yukb, that is, human platelet antigen (HPA)-4a incompatibility. Cranial ultrasound and brain magnetic resonance imaging revealed subarachnoid hemorrhage in the temporal region inferior to the cephalohematoma. The lesion seemed to have been sustained during delivery. The patient was treated with high-dose gamma-globulin and several transfusions of random donor platelets and showed a good clinical course. This is the second reported case of NAITP associated with the Yuk antigen system having intracranial hemorrhage.

A nationwide survey on the epidemiology of chronic lung disease (CLD) of the newborn was conducted. Questionnaires were sent to 391 level II and III neonatal centers in Japan and the registration of infants born in 1990 with chronic lung disease was requested. CLD was defined as an oxygen requirement greater than that obtainable in room air at 28 days after birth, with symptoms of persistent respiratory distress and a hazy or emphysematous and fibrous appearance on chest X-ray. A total of 301 neonatal centers (77.0%) responded and 50,290 infants at these centers were registered. Of these, 97% survived the first month and 1,135 of 48,762 neonatal survivors developed CLD. The mortality of infants with CLD was 6.2%. Survival rates at 28 days of age increased consistently with birthweight. Survival at 28 days of age in infants below 1,000 g at birth was 73.7%, but the rate was 93.9% in infants weighing 1,000-1,499 g. The incidence of CLD was inversely proportional to birthweight. Approximately one quarter of neonatal survivors with a birthweight below 1,500 g and approximately half of extremely small infants ( < 1,000 g) developed CLD. The analysis of CLD infants showed that 28.2% of them had a history of respiratory distress syndrome (RDS) and a typical fibrous appearance on chest X-ray (Type I), while 29.3% also had a history of RDS but had an atypical X-ray appearance (Type II).(ABSTRACT TRUNCATED AT 250 WORDS)

硬癌ならびに小葉癌における細胞学的特徴を明確にすることを目的に, 狭義の硬癌15例, 混合型硬癌20例, 浸潤性小葉癌3例, および対照として良性腫瘍20例 (線維腺腫5例, 乳管内乳頭腫15例) の捺印細胞標本を用いて, 核長径の計測, 核小体所見の比較, 核DNA量の測定を行った.1. 核長径の平均値は狭義の硬癌で9.7μ, 混合型硬癌で10.0μ, 小葉癌で9.0μ, 良性腫瘍で9.4μであった. 15μ以上の大型核は良性腫瘍や小葉癌ではほとんどみられなかったが, 硬癌, 特に混合型硬癌でいくらか目立つ傾向にあった.2. 2.5μ以上ないし5個以上の核小体を有する細胞の出現率はそれぞれ, 狭義の硬癌で0.8, 0.1%, 混合型硬癌で1.0, 0.2%, 小葉癌で0.1, 0.03%, 良性腫瘍では0.3, 0.1%であった.3. 核DNA量については, 混合型硬癌ではモードの4倍体方向への移動, polyploid, aneuploidの細胞増加を示す症例が多数を占めた. 狭義の硬癌ではそのような症例が減少し, 小葉癌ではむしろ分散傾向に乏しく, 4倍体を越える細胞もわずかで, 良性例と類似したヒストグラムを呈した.

乳房検診のため過去2年間に東京都がん検診センター乳房科を訪れた3,719名の受診者中, 494名 (13.3%) に触診時乳頭分泌物が認められた.このうち通常の乳頭分泌物細胞診の結果再検の必要性を考えた120名 (3.2%) に対し, 蓄痰用固定液 (YM液) を応用して患者自身に3～5日分の乳頭分泌物を貯めさせる蓄乳法を行った。120症例の成績の内訳は, 陽性9.2%(11/120), 疑陽性2.5%(3/120), 陰性81.6%(98/120), 検体不良6.7%(8/120) であった.このうち, 病理組織診にて診断の確定している乳癌例は13例あり, この13例について従来よりの直接塗抹法と蓄乳法による細胞診成績を比較した. 直接塗抹法では, 陽性3例 (23.1%), 疑陽性3例 (23.1%), 陰性7例 (53.8%) であったのに対し, 蓄乳法では陽性8例 (61.5%), 疑陽性1例 (7.7%), 陰性4例 (30.8%) であった. また, 13例中TO乳癌が5例みられたが, 直接塗抹法では3例を, 蓄乳法では5例全例を陽性と判定できた。乳頭分泌物細胞診の手法に本法を取り入れることにより, 細胞の乾燥を防ぐとともに十分な細胞量を得ることができ, したがって従来の方法では誤陰性または疑陽性と判定の困難であった症例が減少するものと考えた.

Congenital polyvalvular disease (CPVD) is seen in trisomy 18 and other aneuploidy syndromes. However, its extent and nature have not been studied. Gross pathologic and histologic aspects of the heart were studied in 15 autopsied cases of trisomy 18. All had CPVD; other congenital defects included membranous ventricular septal defect (87%), patent ductus arteriosus (73%), and high takeoff of the right coronary ostium (80%). With a scoring system, histologic findings of the valves of all trisomy 18 cases were compared with those of 30 normal hearts of comparable age in order to determine the degree of morphologic abnormality. This included the presence of blood cysts, derangement of the spongiosa and fibrosa, vascular degeneration of the spongiosa, and defective elastic fibers. There were distinct differences between the changes seen in CPVD with trisomy 18 syndrome and those seen in the normal individuals. The most severe changes were present in the tricuspid and mitral valves with derangement of the spongiosa and fibrosa and defective elastic fibers. The valve tissue had a similar histologic appearance and structure to that of low birth weight infants (gestational age, 25 weeks). The valvular changes observed therefore are of fetal type and represent errors in tissue differentiation occurring as last as the third trimester.

We have considered the applicability of strontium isotope analysis, using Laser Ablation-assisted Resonance Ionization Mass Spectrometry (LA-RIMS), to the determination of bone origin. We separated the uncertainty into two categories: ion counting statistics, and short-term or uncontrollable shifts of experimental conditions; only the former decreases with increasing signal intensity. Additionally, we confirmed that long-term shifts of isotope ratio in LA-RIMS can be cancelled by an internal correction method. We preliminarily estimated the precision of our technique to be 0.7% (1σ) for 105 laser shots; the accuracy is also confirmed within the present uncertainty through the comparison with a reference value.

Recently, serum lactate level rather than systolic blood pressure (sBP) has been widely used to diagnose peripheral circulatory insufficiency, which often leads to coagulopathy with systemic inflammation. However, most of the reported disorders were examined by plasma samples. The aim of this study was to evaluate the utility of serum lactate for detecting coagulopathy with circulatory failure by using thromboelastometry as well as standard coagulation test. 192 adult patients transported to our hospital between January 2013 and September 2014 were enrolled in this retrospective study. The sBP, serum lactate and thromboelastometry (ROTEM(®)) were measured in these patients in the emergency department. All patients were divided into three groups based on serum lactate levels: (1) the severe group (≥4 mmol/L, n=41); (2) the mild group (