Mycobacterium bovis-induced Aneurysm after Intravesical Bacillus Calmette-Guérin Therapy: A Case Study and Literature Review

Mycobacterium bovis infection after intravesical Bacillus Calmette-Guérin (BCG) therapy is rare. A 65-year-old Japanese man with history of bladder cancer and intravesical BCG therapy, presented with low-grade fever. An aneurysm with perianeurysmal fluid was suspected and endovascular aortic repair was performed. After 160 days, he developed blood-streaked sputum and computed tomography images revealed that the perianeurysmal fluid area was increasing in size. A multiplex polymerase chain reaction using sputum identified M. bovis. Treatment with anti-tuberculosis drugs reduced the size of the perianeurysmal fluid area. After intravesical BCG therapy, the possibility of M. bovis infection should be considered, thus further investigations are required.

Serum concentrations of cortisone and cortisol in premature infants

To determine the relationship between biological active cortisol and its inert metabolite cortisone accurately in premature infants, serum cortisone and cortisol concentrations were measured by reversed-phase high-performance liquid chromatography (HPLC) in a group of 232 premature infants and in a control group of 127 children and 88 adults. In the control group, serum cortisone concentrations were greater than serum cortisol levels during the first 2 months after birth; cortisol levels were higher than cortisone levels after 2 months of age. However, in premature infants, serum cortisone concentrations were greater than serum cortisol levels even after the first 2 months, and total concentrations of cortisone and cortisol were equal to those in controls. Results were then analyzed according to the equivalent gestational age of premature infants. Cortisone was predominant in premature infants older than 32 weeks of equivalent gestational age, but cortisol was higher than cortisone from equivalent gestational age 24 to 31 weeks. These findings suggest that the ability of premature infants to secrete glucocorticoids resembled that of normal controls. Also, the fetal zone of the cortex, which is associated with a predominance of cortisone, remained functional in premature infants for a longer time than in control infants. Our findings that in premature infants cortisone was predominant compared with cortisol and the sum of cortisone and cortisol was equal to that in the controls indicate that cortisone cannot be disregarded whenever the cortisol level is estimated, although cortisone itself is recognized to be biologically inactive. Simultaneous measurement of serum cortisone and cortisol concentrations is important when adrenocortical function is being determined, especially in premature infants.

Rupture of pararenal pseudocyst in a patient with Down's syndrome

A rare case of Down's syndrome with spontaneous rupture of a pararenal pseudocyst has been reported. The rupture of the pararenal pseudocyst was treated nonsurgically. The presence of this cyst in conjunction with Down's syndrome may be due, in part, to muscular hypotonia.

Complete deficiency of adenine phosphoribosyltransferase: a report of three cases and immunologic and phagocytic investigations

The levels of adenine phosphoribosyltransferase (APRT:EC 2.4.2.7) were determined in red blood cells (RBCs), peripheral mononuclear cells (MNCs), and polymorphonuclear leukocytes (PMNLs) from normal controls and from two families with APRT deficiency. No APRT activity was demonstrated in MNCs and PMNLs of patients with complete deficiency of RBC-APRT. APRT deficiency occurs not only in RBCs but also in MNCs and PMNLs. Immunologic and phagocytic examinations showed normal hemogram and serum immunoglobulin levels, and normal E-rosette forming cells and surface immunoglobulin-bearing cells. Lymphocyte blastogenesis in response to phytohemagglutinin and lymphocyte differentiation to cytoplasmic immunoglobulin-producing cells induced by pokeweed mitogen were normal. No major defects were apparent in natural killer activity. Phagocytic functions were normal as tested by bactericidal activity, O2-consumption, chemotaxis, and chemiluminescence response.