ABSTRACT
A 25-year-old Japanese man presented with high spiking fever, arthralgia and a skin rash. A pruritic edematous erythema with persistent plaques was found mainly on the trunk; these lesions persisted even when the fever subsided, with prominent linear pigmentation. As marked neutrophilia and a high level of serum ferritin were detected, a diagnosis of adult-onset Still's disease (AOSD) was made, even though the persistent eruption was not characteristic of the disease. Oral prednisolone, together with low-dose methotrexate, was given with good results. In the literature, a similar atypical rash has been reported in 11 cases in Japan. All of them required high-dose administration of corticosteroids or other immunosuppressive agents. Severe systemic complications were seen in 3 patients, and 2 cases died of the disease. Persistent plaques and linear pigmentation are some of the manifestations of AOSD, which cannot be overlooked. This appearance could be an indication that suggests an increased risk of systemic complications and a prolonged time to clinical remission.
Subject(s)
Still's Disease, Adult-Onset/diagnosis , Administration, Oral , Adult , Antirheumatic Agents/therapeutic use , Diagnosis, Differential , Humans , Male , Methotrexate/therapeutic use , Prednisolone/therapeutic use , Still's Disease, Adult-Onset/drug therapy , Still's Disease, Adult-Onset/pathologyABSTRACT
Infective endocarditis is extremely rare in early pregnancy. We report an emergency mitral valve replacement performed successfully on a 16 week pregnant woman for infective endocarditis without preexisting heart disease. On admission, the patient was in acute heart failure, and the fetus had been already dead. Induced abortion was performed uneventfully 6 days after the cardiac operation.
Subject(s)
Endocarditis, Bacterial/surgery , Heart Valve Prosthesis Implantation , Mitral Valve/surgery , Pregnancy Complications, Cardiovascular/surgery , Pregnancy Complications, Infectious/surgery , Streptococcal Infections/surgery , Adult , Bioprosthesis , Emergencies , Female , Heart Valve Prosthesis , Humans , Mitral Valve Insufficiency/surgery , Pregnancy , Pregnancy Trimester, SecondABSTRACT
The expression of PCNA in brain tumor cells was measured in vitro and in situ by using an electrophoretical immunoblotting method and an immunohistochemical staining method. In synchronized C6 rat glioma cells, PCNA were almost parallel to the S phase, although the small amounts of PCNA were expressed in G1 and G2 x M phases. In astrocytic tumors from operative tissues, immunohistochemical PCNA positive rate increased significantly with increasing tumor grade. PCNA positive rate of recurrent meningiomas was also significantly higher than that in nonrecurrent meningiomas. These findings suggest that the PCNA is associated with the cell cycle, especially the S phase and immunohistochemical staining of PCNA is useful to evaluate the proliferating activity of a brain tumor. Immunoblotting method would also be helpful for the exact analysis of proliferating activity in brain tumor cells.
Subject(s)
Brain Neoplasms/chemistry , Glioma/chemistry , Proliferating Cell Nuclear Antigen/analysis , Animals , Immunoblotting , Immunohistochemistry , Meningioma/chemistry , Rats , Tumor Cells, CulturedABSTRACT
Ability to drive an automobile was evaluated in 16 patients with well compensated liver cirrhosis. Four tests were performed, namely the emergency reaction test, the continuous emergency reaction test, the signal confirmation test and the accelerator reaction test. Test scores were compared to those of a group of age-matched healthy volunteers. 31% of patients were found to be unfit to drive. Alcoholic cirrhotics fared as poorly as non-alcoholic cirrhotics. In patients with subclinical hepatic encephalopathy (defined by neuropsychologic testing), 44% were unfit to drive. Routine testing of cirrhotic patients for ability to drive could have a major impact on motor vehicle accident rates.
Subject(s)
Automobile Driving , Liver Cirrhosis/physiopathology , Liver Cirrhosis/psychology , Mental Health , Nervous System/physiopathology , Adult , Aged , Automobile Driver Examination , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Psychometrics , Reaction Time , Reference ValuesABSTRACT
A 49-year-old housewife had suffered from classical seropositive rheumatoid arthritis for 24 years. The shoulders and hands were involved but the most severs pain and deformity were in both elbows and knees. Consequently, she was unable to sit on wheel chair and was confined to a bed. And then, she was admitted to the Chiba Rehabilitation Center in September, 1986 for bilateral total knee replacement. In April 1987, she had an operation upon the right knee and in June, she had an operation upon the left knee. About 6 weeks after surgery, she felt numbness in bilateral hands. The diagnosis was cubital tunnel syndrome. This was confirmed by electromyographic studies. Surgical release was undertaken without delay. The day following operation the patient remarked on the absence of numbness in bilateral hands.
