[Pneumothorax and abdominal free air occurred after percutaneous tracheostomy (PCT)].

We report a case of pneumothorax and abdominal free air after percutaneous tracheostomy (PCT). A 80-year-old female was intubation for upper respiratory stenosis. We thought tracheal stenosis recurrence after extubation. PCT was performed. Respiratory insufficiency and subcutaneous emphysema appeared rapidly at face, neck and precordia Subcutaneous emphysema was pushed away. PCT was performed once more. Chest X-ray showed pneumothorax in right thoracic cavity. Thoracostomy tube was intubation. Chest computed tomography (CT) scan showed pneumothorax another thoracic cavity and abdominal free air. Vital signs was not worse, so observation. Postoperative course was uneventful. The patient was recovered. We thought that PCT was effective under bronchofiber.

Hepatitis delta virus genotype IIb predominates in an endemic area, Okinawa, Japan.

Hepatitis delta virus (HDV) infection is relatively common in the Miyako Islands, Okinawa, Japan, where the infection has been reported to be associated with low pathogenicity. HDV RNA extracted from each of 6 patients with HDV-related chronic liver disease living in the islands was amplified by reverse transcription-polymerase chain reaction and examined genetically to determine the HDV genotype. All isolates from the 6 patients were classified as genotype II by the neighbor-joining method. However, these isolates had relatively low homology (75-81%) to the HDV genotype II isolate reported from Japan, and showed relatively high identity (83-95%) to the novel genotype II isolate (HDV genotype IIb) recently reported from Taiwan. Phylogenetic analysis showed that the 6 isolates form a novel group within HDV genotype II. Furthermore, there was notable variation in sequence among the 6 isolates compared with the relatively close clustering of HDV isolates within limited areas (e.g., United States, Archangelos, Turkey, Albania, Peru). HDV genotype II in the Miyako Islands is therefore unique, and HDV infection may have been introduced at a relatively early time in this area.

Antiphospholipid antibody syndrome in childhood strokes.

The significance of antiphospholipid antibodies was examined in patients with childhood strokes. Eight patients, aged 2-13 years, who presented with acute hemiplegia were studied. On the basis of magnetic resonance imaging, magnetic resonance angiography, single photon emission computed tomography, and cerebral angiographic findings, 3 children were diagnosed as having infarctions due to moyamoya disease, and the others as having idiopathic infarctions. Serologic studies revealed elevated anticardiolipin antibody (ACA) IgG in 3 of the 5 patients with idiopathic infarction; no such elevation was revealed in patients with moyamoya disease. Values for all other tests, including ACA IgM and lupus anticoagulant, were within normal limits or negative in all patients. ACA IgG, therefore, may be a more important causative agent of childhood strokes than was previously considered.

Recognition of biovar C of Fusobacterium necrophorum (Flügge) Moore and Holdeman as Fusobacterium pseudonecrophorum sp. nov., nom. rev. (ex Prévot 1940).

The cellular morphology, colonial morphology, biochemical properties, DNA base compositions, and DNA-DNA homolgies of three biovars of Fusobacterium necrophorum were examined. Some differences were found among the three biovars in cellular morphology, colonial morphology, and biochemical properties. The guanine-plus-cytosine contents of DNAs from biovar C strains Fn521T (T = type strain), Fn522, and Fn520 were 30.4, 29.3, and 28.0 mol%, respectively, and the guanine-plus-cytosine contents of DNAs from strains VPI 2891 (biovar A) and VPI 6161 (biovar B) were 31.3 and 32.0 mol%, respectively. Labeled DNA from biovar C strain Fn521T exhibited 96 and 82% relatedness to DNAs from biovar C strains Fn522 and Fn520, respectively; however, it exhibited only about 10% relatedness to DNAs from strains of biovars A and B. Labeled DNAs from strains VPI 2891 and VPI 6161 exhibited more than 70% relatedness to each other, but about 6 to 20% relatedness to DNAs from biovar C strains. Therefore, Fusobacterium pseudonecrophorum sp. nov., nom. rev. (ex Prévot 1940) is proposed for Fusobacterium necrophorum biovar C. The type strain is strain Fn521 (= JCM 3722).

Encephalitis of cattle caused by Iriki isolate, a new strain belonging to Akabane virus.

A disease characterized by nervous signs was found in 10 calves in two districts in Kagoshima Prefecture, Japan, from October to November, 1984. Histopathological changes of nonpurulent encephalitis were found in every case. An agent, named Iriki isolate, was isolated from the cerebellum of a calf in HmLu-1 cell cultures. All of the affected calves possessed neutralizing antibody to the virus. A high seropositive rate to the virus in cohabiting cattle and cattle kept in the epizootic area, and seroconversion to the virus in 1984, were disclosed. Experimental infection of calves with Iriki isolate produced severe nervous signs and histopathological changes similar to those of the natural infection. These seroepidemiological findings and animal experiments established that Iriki isolate is the causative agent of the disease. Iriki isolate was considered as a variant of Akabane virus since the virus showed cross reaction with Akabane virus in virus neutralization tests.

Adherence of Fusobacterium necrophorum biovar A and B strains to erythrocytes and tissue culture cells.

Fusobacterium necrophorum biovar A and biovar B were examined for haemagglutinability and ability to adhere to cells. Six biovar A strains agglutinated tannic-acid-treated chicken erythrocytes (1/32-1/64), as well as untreated chicken erythrocytes (1/16-1/64). They adhered well to MDBK and FL cells. Haemagglutination by them was not inhibited with D-mannose. In six biovar B strains, the haemagglutination titre was low for chicken erythrocytes and showed no increase for tannic-acid-treated chicken erythrocytes. These strains exhibited a weak ability to adhere to MDBK and FL cells.