Hemagglutination inhibition antibodies in congenital rubella syndrome. A 17-year follow-up in the Ryukyu Islands

We studied long-term rubella hemagglutination inhibition (HI) antibody titers in 381 children born between 1965 and 1966 with congenital rubella syndrome and in 344 of their mothers, who had had postnatally acquired rubella infection. Serum specimens were obtained 12 times during a 17-year period. The initial geometric mean titer of the rubella HI antibody was higher in the children than in their mothers, but the titer declined more rapidly in the children. After 17 years it was 2(5.4) in the children and 2(6.9) in the mothers. In 13 (3.4%) of the children, the rubella HI antibody titer reverted to negativity after three to 17 years. None of the mothers showed a reversion.

Contact sensitivity to unsaponifiable substances in sesame oil

A case of contact sensitivity to the unsaponifiable substances in sesame oil is reported. An ointment composed of 60% sesame oil was used for the treatment of a burn on the forearm. 10 days later, contact dermatitis developed. The allergens were shown to be sasamin and sesamolin, which are unsaponifiable substances in sesame oil.

Enlargement of a cerebral aneurysm associated with ruptured arteriovenous malformation

Enlargement of a small aneurysm during an eleven year period was encountered in a 32-year-old man who had experienced intracranial haemorrhage from a distally located AVM. Clipping of the feeding artery together with the aneurysmal neck was performed. It was very rare to observe the aneurysmal growth associated with the AVM. This case was considered worth reporting as supporting evidence that hemodynamic stress plays an important role in the development of an aneurysm.

Excitability level-setting mechanisms in the pons: their behavioral support in decerebrate, reflex standing and freely moving, intact cats

In the acute precollicular-postmammillary decerebrate cat, stimulation of the mesencephalic locomotor region (MLR) induces "controlled locomotion" on a moving treadmill. Stimulation of the dorsal area and of the ventral area of the pons at its midline elicited a long-lasting decrease and an increase in the tone of the hindlimb extensor muscles, respectively. By selecting the stimulus strength according to the stimulus site, it was possible to set the extensor muscle tone level, that is the "background excitability" of the brain stem and the spinal cord. Locomotor effects induced by MLR stimulation were greatly modified by the set level of background excitability. When the background excitability was high, MLR stimulation evoked "spastic" locomotor movement, while "atonic" locomotor movement was evoked when it was low. Furthermore, stimulation of the ventral area alone also evoked "spastic" locomotor movement. During locomotion in intact cats, stimulation of the dorsal area evoked a series of postural changes. Within a few seconds from the beginning of stimulation, the cat ceased to walk, but maintained a standing posture with or without a locomotor figure. With continuation of this stimulation, it squatted and then lay down on the floor in a sequential manner. Stimulation of the ventral area of the pons evoked an almost opposite series of postural changes. Within a few seconds from the beginning of stimulation, the cat changed from a lying to a squatting posture, and then stood, started to walk and continued to walk during the period of stimulation. All these results demonstrate that an increase in extensor muscle tone and activation of the spinal stepping generator are not separate phenomena, and suggest that integration of neuronal mechanisms involved in the setting of the background excitability and in locomotor movement is a prerequisite for successful expression of locomotor behavior both in decerebrate and intact cats.

Photoprotective adaptation. Some quantitative aspects

The magnitude and time course of UV radiation-induced photoprotection was investigated in fair-skinned volunteers. Resistance to sunburn was evident three days following single exposures to UV-B, reached a maximum by seven days, and declined gradually over a period of 30 to 40 days. Both the magnitude and time course of UV radiation-induced photoprotection were dose related. The maximal mean protection factor following an exposure to 2 minimal erythemal doses was 4.2. The present findings, along with earlier studies, suggest that there are pronounced spectral differences with regard to the induction of photoprotective adaptation and that UV-B wavelengths are the most effective.

Seroepidemiologic studies on rubella in Fukuoka in southern Japan during 1965-1981: rubella epidemic pattern, endemicity and immunity gap

The epidemiology of rubella in most areas of Asia has not been defined. In Fukuoka city in southern Japan, rubella epidemics occurred in 1956-58, in 1966 and in 1976-77. During the first halves of the 1960s and 1970s, neither epidemic nor endemic clinical rubella occurred. Rubella mass vaccination for girls of 14 years of age started in 1978. Rubella seroepidemiologic studies were performed in 1965, 1974, 1978-79 and 1981 in Fukuoka city. Current studies indicated that children of 6-10 years of age during the epidemics of 1956-58, 1966 and 1976-77 were infected with rubella in 72%, 37% and 57% of cases, respectively. Just before the epidemics of 1966 and 1976-77 100% of the children under nine years of age had no antibodies to rubella indicating absence of recent outbreaks. Whereas 95% of the population (young women of 15-18 years of age in 1981) which participated in the rubella mass vaccination programme since 1978 have rubella Hl antibodies, 46% of the nonparticipating population (19-23 years of age in 1981) remains susceptible to rubella. These facts indicate that rubella epidemics occurred in 1956-58, 1966 and 1976-77, that the magnitude of each epidemic was different, and that there were intervals without endemicity in the inter-epidemic periods. However, after the nation wide rubella epidemic in 1975-77, endemic rubella continued, and rubella epidemics again occurred in 1980-82. The unique rubella epidemic pattern in Japan may be changing in the 1980s to that which existed in most areas of the world where rubella was endemic with periodic increased incidence of epidemicity.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of UVA and visible radiation on acute damage by short-wave UVR (lambda less than 320 nm)

The influence of UVA and visible radiation on the acute damage by short-wave ultraviolet radiation (UVR) (lambda less than 320 nm) was investigated in human volunteers, using delayed erythema and sunburn cell production as markers of injury. It was found that subsequent exposure to UVA + visible radiation produced a significant reduction of the threshold erythema dose by short-wave UVR, in a dose-dependent manner. Subsequent exposures to varying doses of UVA + visible radiation, as well as to visible light alone failed to influence sunburn cell production. It is concluded that there is a positive interaction between short-wave UVR and UVA in the induction of delayed erythema, but this may not apply to epidermal cell injury. Photorecovery was not observed.

Dermatological survey of onchocerciasis in Guatemala

A comprehensive survey of onchocerciasis was performed on 1259 inhabitants in San Vicente Pacaya and the surrounding area. The total number of inhabitants examined was 1259, 763 males and 496 females. An examination of microfilarial density was carried out by the skin snip method. There were 610 microfilarial positives (50.4%) out of 1211 persons, 448 males (60.9%), and 162 females (34.1%). Nodules were examined by palpation, and there were 404 (32.8%) positives for nodule out of 1232 persons, 299 males (40.3%), and 105 females (21.4%). Eczematous dermatitis was seen in 149 persons, the generalized type in 13, and other types in 136. Depigmentation on the lower extremities was seen in 290 persons, the severity was graded from 0 to 4, and grade 1 depigmentation was seen in 91; grade 2, in 143; grade 3, in 52 and grade 4 in 4 persons out of 1159 individuals examined. The positives for lymphadenopathy (above grade 2) were 464 (41.2%) out of 1127 individuals. Itching was seen in 129 (18.3%) of 705 individuals examined by the inquiry card method. The correlation between skin changes and onchocerciasis was also analyzed. Those individuals who were microfilarial positive in the skin snip and eyes, and who had palpable nodules were defined as being onchocerciasis patients. There was a high frequency of eczematous dermatitis, depigmentation on the lower extremities and lymphadenopathy in the onchocerciasis infected group, compared with the non-infected group, but there was no difference in the rate of itching between them. Hanging groin, elephantiasis and "erisipela de la costa" were not seen in this endemic area, and the degree of skin changes was slight, compared with that reported in Africa thus far.

An explanation for the high incidence of congenital rubella syndrome in Ryukyu

An exceptionally high incidence of congenital rubella syndrome (CRS) has been noted in Ryukan children who were infants in utero during an extensive rubella epidemic in the Ryukyu Islands in 1964 through the spring of 1965. In 1965, the Congenital Rubella Study Group of Kyushu University registered in the Ryukyus 408 cases of CRS and an incidence of 20 cases of CRS per 1000 births. The nearby Amami Islands, on the other hand, had a low incidence of CRS. Seroepidemiologic studies indicated a high prevalence of antibodies in the Ryukyus but a low prevalence in the Amamis. Since CRS is uncommon throughout Japan, some investigators have hypothesized that Japanese strains of the virus are avirulent and that a virulent American strain caused the epidemic in the Ryukyus. However, retrospective seroepidemiologic studies reported here indicate that the high incidence of CRS in the Ryukyus was more probably due to low seropositivity and a resultant high attack rate of rubella among pregnant women, rather than to a hypothetical virulent teratogenic strain of rubella virus. Conversely, the data suggest that the low incidence of CRS in Japan may reflect the infrequency of rubella nonimmunes in women of childbearing age.

A case of lichen myxedematosus associated with immunological abnormalities

A 33-year-old male consulted us with symptoms of band-like infiltration, thickenning and subcutaneous induration occurring in the face, chest, back, shoulder and upper extremities. In the following time he developed arthralgia, fever and ocular symptoms. Laboratory tests revealed normal thyroid functions and a normal bone marrow picture, but there were immunological abnormalities such as reduced cellular immunity, decrease in C 3 (beta 1c/la) and positive antinuclear antibody. Histologically, there was an increase in fibroblasts and deposits of hyaluronic acid were revealed histochemically. A diagnosis of lichen myxedematosus was established. At present, all symptoms and signs including skin rash have disappeared following corticosteroid therapy and the patient is being followed up. So far as we have been able to trace, reports on lichen myxedematosus associated with immunological abnormalities as described here have not been found. The relationship between this pathology and immunological abnormalities are discussed.