Brief survey of leprosy situation in Congo: sero-epidemiologic profile in correlation with some emerging viral infections.

The Democratic Republic of Congo (DRC, former Zaire) in central Africa remains the foremost country for leprosy in Africa, with a total of 4877 registered cases, of which 4573 are new cases since 1997. These numbers are well above the regional average. About 94% of these patients are under multidrug therapy (MDT) coverage in the Congo, which ranks 8th in coverage rate among the surrounding nine nations. Available data on anatomo-clinical profile and bacillarity are provided, with reservations on the use of these data drwn due to relatively small sample sizes. The seroprofile of the disease was reviewed with regard to the association of other immunity impairing infections like HBV infection and the recently highly incident retroviral epidemics (HIV-1, HTLV-1, and HTLV-2). The leading role of non-governmental organizations is cited for improving leprosy patient conditions and also for future prospects, where the necessity of coordinated strategies with the government is emphasized. Recommendations for new trends and steps relevant to improving existing and future leprosy control strategies are put into perspective.

[An autopsy case of cardiomyopathy combined with nephrotic syndrome and pulmonary cytomegalic inclusion disease].

A 63-year-old male complained of palpitation and dyspnea. ECG showed paroxysmal supraventricular tachycardia. Echocardiogram revealed asymmetrical thickening of the cardiac septum, and by other clinico-pathological observations, nephrotic syndrome and colon adenoma were detected. For these diseases, steroid therapy and operation were performed, respectively. Ten months later, chest X-ray revealed diffuse abnormal shadow in the bilateral lung fields, and the patient expired due to respiratory distress syndrome. The patient's heart weighted 300g and showed extensive myofibril disarray in bilateral ventricles involving the septal region of the heart. Degeneration and atrophy of the atrioventricular node was seen. In the lungs, organizing pneumonia, old pleuritis, diffuse septal fibrosis and cytomegalovirus infection were demonstrated in the alveolar walls. Kidneys showed slightly sclelotic changes in glomeruli and edema-fibrosis in the interstitium. In this rare case, hypertrophic cardiomyopathy was combined with nephrotic syndrome due to glomerular change, and colon adenoma. The patient died of cytomegalovirus infection in the lungs. The histogenesis of myofibril disarray was discussed in these diseases.

Caroli's disease associated with liver cirrhosis. An autopsy case.

Caroli's disease is one of the rare congenital conditions associated with the cystic dilatation of intrahepatic bile ducts. This is a case report of a 41-year-old Japanese male who complained of jaundice and general fatigue at the age of 34 for the first time. He was clinically diagnosed as having Caroli's disease by physical examination and image analyses study. The patient died after seven years and three months from the onset of the disease on account of renal function impairment. An autopsy was performed, revealing cystic dilatation of the intrahepatic bile duct, associated with a cirrhotic liver and also evidence of portal hypertension, substantiated by esophageal varices and splenomegaly. The liver weighed approximately 2,200 g. A histological investigation revealed typical morphological evidence of cirrhotic glomerulopathy and tubular degeneration with the presence of calcium casts in the dilated tubuli. The lung revealed diffuse alveolar damage with partial organization associated with remarkable polymorphonuclear and macrophagic infiltration. In this paper, the pathogenesis of the cirrhotic change, biliary duct abnormality and potential malignant transformation in the liver are discussed in relation to Caroli's disease.

[A fundamental and clinical investigation of cancer antigen 130 (CA 130) in the field of obstetrics and gynecology].

Two murine monoclonal antibodies designated 130-22 and 145-9 have been recently established by immunizing mice with a pulmonary carcinoma cell line (PC-9). With use of these monoclonal antibodies a sensitive sandwich immunoradiometric assay (IRMA) for cancer antigen 130 (CA130) was developed in Daiichi Radioisotope Laboratories (Tokyo). Applying this IRMA kit CA130 concentrations were measured in various body fluids with special reference to obstetrics and gynecology. The results are as follows; 1) A CA130-IRMA showed excellent sensitivity, specificity, reproducibility and analytical recovery. The standard dose-response curve covered the range from 10 to 500 U/ml. 2) Serum CA130 levels measured by this assay system were closely correlated with serum CA125 levels, demonstrating quite a high correlation coefficient (r = 0.965). 3) In pregnancy maternal CA130 levels increased moderately (less than 300 U/ml) in the first trimester, and thereafter fell rapidly under normal upper limit (less than 35 U/ml). Immediately after deliveries maternal CA130 levels showed a rapid increase, reaching 269 U/ml (mean levels). In amniotic fluids CA130 concentrations were greatly elevated (3,236 U/ml mean levels), while the levels were almost within normal limit in the umbilical arterial and venous blood. Accordingly it is necessary to measure Schwangerschaftsprotein 1 or human chorionic gonadotropin simultaneously with CA130 to rule out possible pregnancy. 4) CA130 was clearly localized in the amniotic epithelium and umbilical sheath and other placental tissue components remained negative for this antigen. Taking the lower CA130 levels in the umbilical sera into consideration, these immunohistochemical results suggest CA130 is not oncofetal but oncoplacental. 5) Serum CA130 levels increased pretherapeutically beyond 35 U/ml in 87% of ovarian malignancies, and in 56% of endometrial carcinoma. The mean levels of serum CA130 reached 931 and 143 U/ml, respectively. These data indicate clinical usefulness of CA130 as a tumor marker for those diseases. By contrast serum CA130 levels were lower, and very few cases showed serum CA130 levels over 35 U/ml in cervical cancer. 6) In endometriosis 88% of the cases demonstrated increased serum CA130 levels, indicating its usefulness for monitoring therapeutic courses, just like CA125. In benign gynecologic diseases over 80% of cases showed increased serum CA130 levels while only slight increase in serum CA130 was found (mean levels less than 84.0 U/ml). This disadvantage could be lessened by a combination assay with CA72-4 and others whose serum levels were very low in the benign diseases.