Development of a new measurement system to detect selectively volatile organic compounds derived from the human body.

A new concept expired gas measurement system used double cold-trap method was developed. The system could detect selectively volatile organic compound (VOC) derived from the human body. The gas chromatography (GC) profiles of healthy volunteer's expired gas collected by our system were analyzed. As a result, 60 VOCs were detected from the healthy volunteer's expired gas. We examined 14 VOCs among them further, which could be converted to the concentration from the GC profiles. The concentration of almost VOCs decreased when the subjects inspired purified air compared with the atmosphere. On the other hand, isoprene was almost the same. It was strongly suggested that these VOCs were derived from the human body because the concentration of these VOCs in the atmosphere were nearly zero. Expired gas of two sleep apnea syndrome (SAS) patients were analyzed as preliminary study. As a result of the study, the concentration of some VOCs contained in the expired gas of the SAS patients showed higher value than a healthy controls.

[Clinicopathological study of six cases of primary pulmonary lymphoma diagnosed by gene rearrangement analysis].

We report six cases of primary pulmonary lymphoma in which a gene-rearranged band was shown by Southern blot analysis of transbronchial or surgical biopsy specimens. The cases were 3 mens and 4 women with an average age of 59.6, who had abnormal pulmonary shadows on chest X-ray. Two cases had Sjögren's syndrome and one case had monoclonal gammopathy (IgM-lambda type). Histopathologic and immunologic examination revealed diffuse infiltration of small lymphocytes (B-cell type) in all cases, and histological features of lymphoepithelial lesion or lympho-cytic interstitial pneumonia (LIP) in three cases. CT revealed an ill-defined margin, air-space consolidation, and air-bronchogram in all cases. A CT-angiogram sign was apparent in 2 cases. In all cases, Southern blot analysis of the tissue obtained from transbronchial or surgical biopsy revealed a gene re-arranged band, supporting the diagnosis of primary pulmonary lymphoma. We infer that an ill-defined margin, air-bronchogram and air space consolidation on CT were associated with the histopathological features of primary pulmonary lymphoma.

Severe thrombocytopenia suggesting immunological mechanisms in two cases of vivax malaria.

Case 1: A 27-year-old woman, referred to our hospital because of relapsing fever after travel to Thailand, was given a diagnosis of vivax malaria. Clinical investigation revealed thrombocytopenia, elevated platelet-associated IgG (PAIgG), and negative antibody against Plasmodium vivax antigen. After antimalarial treatment, the levels of both the platelets and PAIgG returned to normal. Case 2: A 28-year-old Sri Lankan man was admitted to our hospital with a complaint of fever. The patient had thrombocytopenia, elevated PAIgG, and positive antibody against Plasmodium vivax antigen. He contracted malaria in Sri Lanka about 6 months prior to this admission. After treatment, the platelet count and PAIgG level returned to normal. In these two cases, high levels of PAIgG may have been involved in the development of the thrombocytopenia. In the first patient, in particular, the thrombocytopenia was thought to be induced by some immunological mechanism prior to the detection of antimaralial antibodies in serum.

Layer-specific differential regulation of transcription factors Zif268 and Jun-D in visual cortex V1 and V2 of macaque monkeys.

To investigate intracellular mechanisms of cortical layer-specific gene regulation, we quantitatively examined the expression of two transcription factors, Zif268 and JunD, and compared their expression levels in each layer of the primary visual cortex (VI) and visual area 2 (V2) of macaque monkeys (Macaca fuscata). The brain sections were immunohistochemically stained for determination of the percentage of Zif268- or JunD-expressing neurons in the total neuronal population. We found area- and layer-specific expression of these transcription factors; Zif268 tended to be expressed at high levels in layers on the parvocellular pathway in V1, whereas JunD did not show such an expression pattern. In V1, many Zif268-immunopositive neurons were observed in layers II/III, IVC beta and VI. The percentage of Zif268-immunopositive neurons was highest in layer IVC beta and lowest in layer IVC alpha. JunD-immunopositive neurons were fewest in layer IVC beta and most abundant in layer VI. In V2, the level of expression of Zif268 was almost the same as that of JunD in layer II/II. However, layer IV of V2 tended to contain more Zif268-immunopositive neurons than JunD-immunopositive neurons, whereas layer VI contained more JunD-immunopositive neurons than Zif268-immunopositive neurons. Although it has been reported that the same extracellular signals induce both Zif268 and JunD, the present results indicate that the expression of these transcription factors is differentially controlled in each layer of the primate visual cortical areas. Furthermore, the present results suggest that these transcription factors contribute to area- and layer-specific gene regulation by mediating transmission of extracellular signals to the nucleus via different intracellular signalling pathways.

[Autopsy case of amyloidosis with marked cardiac and pulmonary lesions associated with myeloma, initially presenting with muscle weakness].

A 69-year-old man presented initially with muscle weakness of the bilateral lower limbs. Chest roentgenogram showed diffuse reticulonodular shadows, bilateral hilar lymphadenopathy, and dullness of bilateral costophrenic angles. Chest CT showed thickening and irregularity of vascular shadows, and thickening of bronchial walls. On the first admission we could not diagnose pulmonary or muscle lesions. He was subsequently admitted for the deterioration of congestive heart failure, but there was no improvement. Myocardial biopsy demonstrated deposition of amyloid in the cardiac muscular tissue. Autopsy revealed amyloid deposition in pulmonary vasculature, alveolar septal walls and pleura. Amyloid deposition was also recognized systemically in skeletal muscles, lymph nodes, liver, kidney, spleen, stomach, and intestines. We recognized about 20% IgA lambda-positive plasma cells with atypia, and myeloma-associated amyloidosis diagnosed. This case was classified as diffuse alveolar septal form and pleural form of pulmonary amyloidosis. We could find only a few reports of pleural form, which exhibits an interesting distribution.

[A case of status asthmaticus complicated by with pneumoperitoneum during mechanical ventilation therapy].

A 46-year-old woman was admitted to our hospital for a severe asthma attack. On admission, systemic cyanosis was observed, and her consciousness state was drowsy. Arterial blood gas showed severe respiratory acidosis, hypoxia, and hypercapnea, with pH, PaO2, and PaCO2 of 7.163, 29.9 torr and 81.3 torr, respectively. Immediately, mechanical ventilation was commerced but on the third hospital day pneumomediastinum and subcutaneous emphysema appeared, and on the sixth day pneumoperitoneum also appeared. The chest CT scan on the sixth day showed free air around bilateral internal mammary vessels. This indicated that air moved from the mediastinum into the peritoneal cavity through an anterior route, via the sternocostal triangle formed by the xiphoid origins of the diaphragm medially and the costal origins laterally.