Human herpesvirus-6 DNA in cerebrospinal fluid of a child with exanthem subitum and meningoencephalitis

The involvement of human herpesvirus-6 (HHV-6) and herpes simplex virus infections was evaluated virologically and serologically in a 13-month-old girl with meningoencephalitic illness occurring in the pre-eruptive stage of exanthem subitum. An isolation of HHV-6 from blood and seroconversion to the virus confirmed the primary infection with the virus. HHV-6 gene sequences were detected in cerebrospinal fluid of acute stage of the disease by polymerase chain reaction. There was no evidence of herpes simplex virus infection in blood and cerebrospinal fluid. The patient recovered from the disease without any sequelae, although abnormal electroencephalography and cerebral computed tomography findings were observed temporally in the acute stage of the disease. These findings strongly suggest that HHV-6 invades the central nervous system and causes meningoencephalitis.

Percutaneous trigeminal rhizotomy and percutaneous cordotomy under general anesthesia

Most percutaneous procedures for the treatment of pain are done under local anesthesia and considerable pain can be involved. If the patient is elderly or confused because of severe pain, it is difficult or impossible to perform these procedures successfully. We treated 3 elderly patients with trigeminal neuralgia and 1 patient with severe bone pain due to metastatic osteosarcoma in the lumbosacral region by percutaneous trigeminal rhizotomy and percutaneous cordotomy under general anesthesia with intratracheal intubation. We conclude that percutaneous trigeminal rhizotomy and percutaneous cordotomy can be safely done under general anesthesia.

[Effects of mecobalamin on testicular dysfunction induced by X-ray irradiation in mice]

Experimental testicular dysfunction were produced by X-ray irradiation to the testes in mice. Mecobalamin (CH3-B12) was orally administered at a daily dose of 0.01, 0.1 or 1 mg/kg six times a week for 8 weeks from the next day after the irradiation. The control mice received physiological saline in the same manner. On 4th- and 6th-week after the irradiation, the weights of testes and epididymides were decreased, although those of the body and accessory sex glands (seminal vesicle, coagulating gland and prostate) were nearly equal to those of non-irradiated mice. At the same time, the diameter of seminiferous tubules decreased and sperm parameters (sperm count, sperm motility and sperm abnormality) deteriorated. When CH3-B12 (1 mg/kg) was administered, the diameter of seminiferous tubules increased and sperm parameters improved as compared to those of the control. The results indicate that CH3-B12 improved the experimental testicular dysfunction in mice induced by the irradiation. These results suggest that CH3-B12 might accelerate testicular function.

Recombinant human interleukin-1 beta analogue as a regulator of hematopoiesis in patients receiving chemotherapy for urogenital cancers

Ten patients with advanced urologic cancers who were scheduled to receive at least two courses of chemotherapy were enrolled in this trial. Fifty thousand units of recombinant human interleukin-1 (IL-1) beta analogue OCT-43 (Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan) was administered subcutaneously only once or twice when severe neutropenia (less than 500/microliters) continued for 2 consecutive days. In eight patients, OCT-43 was not injected in the first course of chemotherapy as a control, but was injected in the second course. The durations of leukocytopenia (less than 2000/microliters) and neutropenia (less than 1000/microliters) were significantly shortened in the second course compared with those in the first course in those eight patients. Recovery of neutrophil number from the lowest number was also significantly faster in the second course. Thus, OCT-43 was considered to have hematopoietic activities. However, single or double injection of OCT-43 did not affect the numbers of eosinophilic or basophilic granulocytes, monocytes, or platelets. Adverse effects associated with OCT-43 injections were high fever and chills, but they were controlled by indomethacin.

Recombinant human interleukin-1 beta analogue as a regulator of hematopoiesis in patients receiving chemotherapy for urogenital cancers

Ten patients with advanced urologic cancers who were scheduled to receive at least two courses of chemotherapy were enrolled in this trial. Fifty thousand units of recombinant human interleukin-1 (IL-1) beta analogue OCT-43 (Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan) was administered subcutaneously only once or twice when severe neutropenia (less than 500/microliters) continued for 2 consecutive days. In eight patients, OCT-43 was not injected in the first course of chemotherapy as a control, but was injected in the second course. The durations of leukocytopenia (less than 2000/microliters) and neutropenia (less than 1000/microliters) were significantly shortened in the second course compared with those in the first course in those eight patients. Recovery of neutrophil number from the lowest number was also significantly faster in the second course. Thus, OCT-43 was considered to have hematopoietic activities. However, single or double injection of OCT-43 did not affect the numbers of eosinophilic or basophilic granulocytes, monocytes, or platelets. Adverse effects associated with OCT-43 injections were high fever and chills, but they were controlled by indomethacin.

Multielement analysis of kidney tissue with renal calculi

Tissue distribution and concentration gradients of macro- and micro-elements in the papilla, medulla, and cortex of human kidney with renal calculi were measured with spectrometer. An uninvolved portion of the hypernephroma kidney was used as control. Cadmium (Cd), cobalt (Co), and molybdenum (Mo) were least in amount in renal papilla as compared with the cortex and medulla in renal stone kidney. Overall there was less Mo in stone kidney tissue, and also significantly less when compared with that of control renal papilla. Considering the reported fact that Mo was found in high concentrations in urinary tract stones and our data that Mo was less in stone kidney, it is speculated that Mo may play some unexplained but significant role in certain stage(s) of the stone formation.

Human herpesvirus-6 infection in bone marrow transplantation

Twenty-five pediatric patients who received bone marrow transplantation (BMT) were studied prospectively to determine the relationship between BMT and human herpesvirus-6 (HHV-6) infection by the virus isolation from peripheral blood and/or bone marrow and by determining neutralizing antibodies to HHV-6 during the 2 months following BMT. All of the 25 donors and the recipients were immune to HHV-6 at the time of BMT and the virus was not isolated from them. HHV-6 was isolated from peripheral blood and/or bone marrow mononuclear cells in ten (40%) of the 25 recipients between day 14 and day 22 of BMT, but not from any other day. Two additional recipients showed a significant increase in the antibody titer. Thus, infection with HHV-6 was confirmed in 12 (48%) of the 25 recipients. Four of the 12 developed skin rashes; three of these four had a febrile episode when the virus was isolated, whereas none of the remaining 13 developed the skin rash. These results suggest a frequent infection with HHV-6 only a few weeks after BMT and a close association between the infection with the virus and the development of skin rashes.

Severity of human herpesvirus-6 viremia and clinical findings in infants with exanthem subitum

The degree of viremia with human herpesvirus-6 was evaluated in 176 blood samples from 89 infants with exanthem subitum and viremia, and compared with the severity of clinical features and complications of the disease. Fever persisted for 3 to 4 days in 73% of infants and for more than 5 days in 22%, followed by a rubella- or measles-like rash. The viremia was observed between the first day of fever (day 0) and day 4 of the disease. The number of infected cells per 10 million mononuclear cells was 3.45 +/- 1.00 (log10, mean +/- SD) on days 0 to 2, 3.30 +/- 1.14 on day 3, and 3.09 +/- 2.05 on day 4 of the disease. The number of infected cells on days 3 to 4 in infants with a febrile period longer than 4 days and free virus in plasma was significantly greater than that in infants with a febrile period of less than 3 days and without free virus in plasma. The amount of virus in blood on days 0 to 2 did not relate to the duration of fever, and that on days 0 to 4 did not relate to the presence or absence of diarrhea, bulging fontanelle, or bronchopneumonia. These findings suggest that the magnitude of the virus replication in infants with exanthem subitum is reflected in the severity of the disease.

[Clinical study of renal cell carcinoma as incidental finding]

Reports on renal cell carcinoma (RCC) as an incidental finding have been increasing in recent years as the imaging modalities including ultrasonography (US) and computerized tomography (CT) scan have gained popularity in clinical medicine. Because effective treatment in RCC is only surgical removal of the involved kidney even at present, it is imperative for urologists to find and to diagnose the RCC in early stage. Whether RCC found incidentally is in early stage cancer is not determined at present. To determine if the RCC found incidentally is in early stage cancer and if the survival rate is better than that of the RCC found with symptoms, we undertook the following study. Between December 1972 and March 1990, 65 patients with RCC were registered at the Department of Urology, Teikyo University Hospital. Of 65 patients 20 with RCC as an incidental finding were subjected to this study. 34 patients with RCC found with symptoms including hematuria were subjected to control group. Causes of the diagnosis in 20 patients included workup for non-urological diseases in 11 patients (55.0%), workup for urological disease other than RCC in 5 patients (25.0%) and routine medical checkup in 4 patients (20.0%). First-line imaging modalities for the diagnosis was US in 9 patients (45.0%), DIP in 6 patients (30.0%) and CT in 5 patients (25.0%). Size of the tumor, pathological stage (pT) and grade in these 20 patients were tended to be smaller and lower, respectively, but these results were not significant as compared to those of the control group. Incidence of the remote metastasis, at the time of diagnosis, however, was significantly lesser than that of the control group (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

The classification of the low birth-weight infants from the viewpoint of mental development

Periodical checkups on 206 infants were carried out in order to elucidate which of various factors would pose decisive influence upon the retardation of mental development after birth with the AIKEN method. Correlations between average DQ (development quotient) and figures of physical measurements at birth were sought after. Consequently, weeks of gestation, body weight, cephalic circumference and body length at birth revealed certain correlation with the retardation of mental development. Multiple regression analysis disclosed highly significant correlations of body length and cephalic circumference toward the birth weight. Therefore, both weeks of gestation and birth weight are the direct contributory factors to average development quotient. Based on this result, a prediction equation for the mental development after birth has been proposed. Low average DQ was found in high percentages among infants born with toxemia of pregnancy or premature rupture of membranes. However, it is suggested that they are not the direct causes of such retardation, but are rather provoking short weeks of gestation and low birth weight. In summary, the newborn with less than 37 weeks of gestation and below 2,000 grams of birth weight would be named and classified as a SFD (small for dates) with the problem for mental development (MD-SFD).

[Urothelial tumor in dialysis patients; report of four cases]

Four cases of urothelial tumors diagnosed during hemodialysis were reported. Patients' ages ranged from 43 to 74 years old. One case was female and others were male. Durations of dialysis at the time of diagnosis were 13 to 24 months. Chief complaints of these four cases were gross hematuria. One case with bladder tumor underwent emergency operation because of repeated bladder tamponade. Partial cystectomy was performed on this case. Other two cases with bladder tumor were treated with endoscopic method. Simple nephrectomy was done in the case with renal pelvic tumor. Post operative course in all four cases were uneventful without major complications.

Enzyme-linked immunosorbent assay for detection of IgG antibody to human herpesvirus 6

A lysate of human herpesvirus 6 (HHV-6)-infected cord blood mononuclear cells was used as antigen for enzyme-linked immunosorbent assay for the detection of IgG antibody to HHV-6. Antibody responses after exanthem subitum were well correlated with clinical recovery from the disease and the level of antibody activities was well correlated with indirect immunofluorescence assay and the neutralization test. Seroconversion to other human herpesvirus, including cytomegalovirus, was not observed in infants with exanthem subitum. All of the infants had by the age of 1 month antibodies to HHV-6, which decreased with age to the lowest level at the age of 3 to 6 months and then increased and reached the maximum level by 1 to 2 years of age. After 3 years of age, the prevalence was almost stable.

[Inhibitory action amlexanox on interleukin-3-induced enhancement of histamine releasability of human leukocytes]

Amlexanox, an anti-allergic drug, showed a concentration-dependent inhibition against hrIL-3-induced enhancement of in vitro histamine release from human leukocytes by anti-IgE. The significant inhibitory action of amlexanox was observed in one out of nine and six out of nine allergic subjects at concentrations of 10(-5) M and 10(-4) M, respectively. This means that the inhibitory effect of amlexanox varied from patient to patient. Post-treatment as well as simultaneous treatment with amlexanox produced an inhibitory action on the enhancing effect of hrIL-3, suggesting that hrIL-3-induced enhancement of releasability is a reversible reaction. AA-861, OKY-046, superoxide dismutase and prostaglandin E2 showed no effects on the hrIL-3-induced enhancement of histamine releasability. The inhibitory action of amlexamox to the hrIL-3-induced enhancement of histamine releasability may be a new anti-allergic mechanism, details of which remains unclear.

Simultaneous infection with human herpesvirus-6 and measles virus in infants

Two infants (4 and 5 months of age) with a febrile episode for 3 and 5 days, respectively, developed skin rashes after the fever subsided and were diagnosed as exanthem subitum. The rash continued for 5 days followed by mild-to-moderate pigmentation. Human herpesvirus-6 and measles virus, which were confirmed by a specific immunofluorescence assay and by electron microscopy, were isolated simultaneously from blood in the acute stage of the disease but not from the convalescent stage. The titer of the herpesvirus-6 in blood was greater than that of measles. Specific serologic assays showed marked seroconversion against human herpesvirus-6 but not to measles virus. The results suggest that dual infection with human herpesvirus-6 and measles virus results in atypical exanthem subitum or modified measles with unique immunologic responses.

Severity of viremia and clinical findings in children with varicella

The number of varicella zoster virus-infected mononuclear cells in blood samples obtained during 3 days before appearance of vesicular skin rashes could be estimated in 13 of 21 immunocompetent children with varicella and viremia (range, 1-83 per 10(7) mononuclear cells). The virus was isolated from 5% of adherent cells (1/21), 71% of nonadherent cells (12/17), 43% of T lymphocytes (9/21), and 33% of B lymphocytes (7/21). The number of vesicles on the body correlated with the maximum body temperature, duration of fever, and number of infected cells in the blood. These results indicate that varicella zoster virus infection in immunocompetent children is disseminated by circulating T and B lymphocytes and the severity of the viremia is reflected in the severity of the disease.

[Histamine release from human leukocytes by human recombinant interleukin-3]

Human recombinant interleukin-3 (hrIL-3) released histamine from human leukocytes in vitro. The histamine release by hrIL-3 significantly correlated with those by anti-IgE, thrombin, and f-met. peptide, but not by A23187. Histamine release by hrIL-3 was a Ca2(+)-dependent reaction, as was that by anti-IgE, although the time course of histamine release by hrIL-3 was slower than that by anti-IgE. Pre-treatment of leukocytes with hrIL-3 decreased the histamine release by hrIL-3 itself, but enhanced the histamine releases by anti-IgE, f-met. peptide, thrombin and A23187. These results suggested that the mechanism of hrIL-3-induced histamine release was different from those of anti-IgE, f-met. peptide, thrombin, and A23187. There was no significant difference between hrIL-3-induced histamine release of leukocytes from asthmatics and healthy controls.

Spermicidal activity of menfegol-coated condom

The spermicidal activity of menfegol-coated condoms was investigated. Menfegol (P-menthanyl-phenyl-polyxyethylene [8,8] ether) showed strong spermicidal activity at 0.5 mg/ml and higher concentrations. Semen was ejaculated directly into menfegol-coated condoms (20 mg/condom) or uncoated condoms. Immediately after ejaculation, sperm motility and viability were examined. In the menfegol-coated condoms, sperm motility was completely suppressed and no viable sperm were observed. In the uncoated condoms, most of the sperm were alive, although their motility was almost suppressed. These results indicate that the menfegol-coated condom represents a new birth control method in which the contraceptive efficacy of the condom is enhanced by the spermicidal activity of menfegol.

Damaging effects of cisplatin on mouse spermatozoa

The effect of cis-diamminedichloroplatinum (cisplatin: CDDP) on mouse spermatozoa was evaluated quantitatively by means of equilibrium sedimentation in Percoll. CDDP was administered subcutaneously at doses of 1, 3, and 10 mg/kg/week for 5 weeks. After different periods (1, 3, and 10 weeks) without CDDP, the quality of epididymal sperm was evaluated by sperm count, motility, morphology of sperm, and the apparent density of sperm. At 10 mg/kg dose, about 80% mortality occurred during the administration period. There were no sperm even 10 weeks after discontinuing CDDP. With the 3 mg/kg dose, sperm count, motility, and normal morphology of sperm declined after 1 and 5 weeks, but recovered to the control level after 10 weeks. The sperm distribution profiles in the Percoll gradient were quite different among the groups. The control sperm showed two separated peaks in the gradient, whereas the peak of sperm at 1 and 3 mg/kg were shifted forward to lighter apparent density. CDDP causes a reduction in sperm apparent density and impairs semen quality in mice.