Suppression of delayed-type hypersensitivity to PPD and PHA in elderly HTLV-I carriers.

In a previous study on immune responsiveness among asymptomatic human T-cell leukemia virus type I (HTLV-I) carriers, we found that carriers had significantly reduced delayed-type hypersensitivity (DTH) response to purified protein derivative (PPD) skin testing. The association was strongest among persons at least 60 years of age. In order to evaluate this finding further, we evaluated the response to both PPD and phytohemagglutinin (PHA) in an elderly population. Fifty-six consecutive hospitalized patients with nonimmunosuppressive diseases were examined. None had a history of tuberculosis nor evidence of the known HTLV-I-associated diseases. The subjects' ages ranged from 62-93 years (median = 75 years); 43 were women and 13 were men. Twenty-two of the subjects were HTLV-I antibody positive. Among the carriers, there was an increased level of nonreactivity to PPD, the relative risk adjusted for age (RR) being 1.9 (95% confidence interval, 0.62-5.8), as well as to PHA of RR = 2.3 (0.60-9.0). When subjects were cross-classified for response to both skin tests, 15 of 17 carriers were nonreactive to either or both antigens compared to 15 of 25 noncarriers [RR = 5.1 (0.99-25.9) (p value, one-sided = 0.026)]. The decline in reactivity to both antigens increased with age, but was consistently lower among the carriers. Among subjects with positive reactions to PPD, the degree of reaction as measured by the size of erythema was reduced among the carriers; however, for PHA responders, the response in carriers appeared to be normal. Among the HTLV-I antibody negative subjects, the size of erythema for both antigens was strongly correlated (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Association of HTLV-I antibody profile of asymptomatic carriers with proviral DNA levels of peripheral blood mononuclear cells.

The human T-lymphotropic virus type I (HTLV-I) antibody profile of 216 asymptomatic carriers in Miyazaki, Japan, was analyzed in conjunction with the HTLV-I proviral DNA levels in their peripheral blood mononuclear cells (PBMC) determined by the semiquantitative polymerase chain reaction (PCR) method. The geometric mean HTLV-I titer by particle agglutination assay (PA) of 58 subjects (27%) with a high DNA level was 1:1, 240; 94 (44%) with a medium DNA level, 1:740; 38 (18%) with a low level, 1:476; and, 26 (12%) with an undetectable level, 1:263. Moreover, when the subjects were divided into four groups according to titer from high to low, the correlation between DNA level and antibody titer level was highly significant (p < 0.0001). HTLV-I antibody subclass by Western blot (WB) was determined for 78 randomly selected samples from these carriers. Immunoglobulin (Ig) M antibody was detected in 35 (45%). The mean PA antibody titer was higher in carriers with IgM antibody than in those without, at each detectable proviral DNA level. These findings suggest that HTLV-I antibody titer is related to proviral DNA level and also to the presence of IgM antibodies among those with proviral DNA of the same level. Seven carriers (9%) were negative for IgG antibody by WB, among whom the proviral DNA level was low or undetectable and the PA titer was also low. Three of these were positive only for IgM antibody.

The distribution of T-cell subsets among HTLV-I carriers in Japan.

Data on T-cell subsets from 89 human T-cell lymphotropic virus-I (HTLV-I) carriers and 25 seronegative people were analyzed to identify differences in T-cell subset values among three subgroups: HTLV-I carriers with abnormal lymphocytes (Ably; n = 24), carriers without Ably (n = 65), and HTLV-I seronegatives (n = 25). Estimates of mean values were adjusted for age, sex, smoking, and alcohol drinking, as appropriate. The percentage of CD25+ T cells was elevated in carriers with Ably (mean, 16.7 +/- 1.0) compared with the seronegatives (11.4 +/- 1.4; p = 0.0002); individuals with CD25 T-cell percentages above the median for the seronegatives had a corresponding 5.4-fold risk for being a carrier with Ably. Similarly, the percentage of CD4 T cells was elevated in carriers with Ably. Conversely, the percentage of CD8 T cells was lower among both groups of HTLV-I carriers than in the seronegatives. There was a corresponding significant increase (p = 0.0004) of the CD4/CD8 ratio among carriers with Ably (1.57 +/- 0.12) compared with the seronegatives (1.22 +/- 0.12). Among subjects with CD4/CD8 ratios above the median for the seronegatives, there were 6.8- and 4.5-fold risks for being carriers with or without Ably, respectively. The percentage of CD7 was lower among carriers with Ably (75.6 +/- 1.6) than among seronegatives (78.9 +/- 1.5; p = 0.13). The percentage of beta-interleukin-2-receptor-positive T cells did not vary among the three subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)

Inflammatory pseudotumor of the liver diagnosed by needle liver biopsy under ultrasonographic tomography guidance.

Inflammatory pseudotumor of the liver is a rare benign lesion, but exploratory laparotomy and a hepatectomy are often performed unnecessarily after various misdiagnoses, including liver abscess, hepatocellular carcinoma, metastatic liver tumor, and cholangiocarcinoma. We present a case of hepatic inflammatory pseudotumor in a 17-year-old man in whom diagnosis was confirmed by liver needle biopsy under ultrasonographic tomography (UST) guidance. He had complained of fever and right hypochondralgia 2 months after being operated for appendicitis. He was admitted to our hospital because of the persistence of these symptoms and the presence of a hepatic mass lesion detected by UST. He had hepatomegaly, with tenderness; leukocytosis and elevated erythrocyte sedimentation rate and C-reactive protein level were noted. UST showed a hypoechoic mass in the liver and pre-contrast computerized tomography (CT) revealed a low-density area with an ill defined margin, which was barely enhanced by the contrast medium. On the basis of the patient's clinical symptoms and the laboratory data and imaging studies, the presence of a liver abscess was suspected and antibiotics were administered. One month after the initiation of the antibiotic therapy, UST demonstrated that the portal vein had dilated serpiginously and penetrated into the mass. As the heterogeneous appearance displayed by post-enhanced CT indicated the need for a differential diagnosis of the hepatic mass lesion to rule out hepatocellular carcinoma, percutaneous needle biopsy was performed, under UST guidance. Histopathological examination demonstrated marked infiltration of plasma cells and fibrosis, findings which were consistent with those of hepatic inflammatory pseudotumor. There was a spontaneous reduction of the hepatic pseudotumor without continuous antibiotics and this reduction was documented on follow-up UST and CT.

Visual persistence of figures defined by relative motion.

In order to measure visual persistence of figures that were solely defined by relative motion (motion-defined figures or motion figures), random-dot kinematograms were used to form stimulus figures in the two-frame, missing element task introduced by Di Lollo, V. (1977 Nature, 257, 241-243). Experiment 1 showed that motion-defined figures persisted for about 130 msec after the termination of the stimulus presentation (i.e. after the dots stopped moving). This was similar to but several tens of milliseconds longer than the visual persistence of figures which were defined by a luminance difference (luminance-defined figures or luminance figures) in the same random-dot pattern. Since motion detectors are not found in the retina or lateral geniculate in primates, our results strongly suggest that visual persistence is not only a retinal phenomenon but also a cortical one. Experiment 2 investigated the possible influence of motion aftereffects on the visual persistence of motion figures. The results showed that coherent movement of the dots over the whole display after the stimulus offset did not reduce the visual persistence of motion figures, suggesting that the source of this persistence is not a motion aftereffect. In Experiment 3, visual persistence for the motion-defined figures was shown to be longer than that for luminance-defined figures independently of the contrast of the stimulus figure as long as the stimuli could be seen clearly enough. This suggests that different mechanisms are involved in the visual persistence of motion-defined and luminance-defined figures.

Saccadic suppression of low-level motion.

We measured the detection of motion before, during and after a saccade to explore the effects of a saccade on motion perception. To isolate the low-level motion mechanism, the stimulus was a random-dot field displaced by small distance (0.3 deg) within a stationary frame. The displacement signaled motion clearly if eyes were fixated, but for the displacement during a saccade, motion was not detected whether the displacement was defined in spatial coordinates (expt 1) or in retinal coordinates (expt 2). Since motion could be seen with ISIs longer than the duration of a saccade (expt 3), the suppression cannot be attributed to visual loss during the saccade. Experiment 3 also showed that motion was never seen for a displacement that occurred during a saccade, even though the random dots were replaced by a uniform field during the eye movement thereby eliminating any masking effect of the sweep of the image across the retina. The purpose of the saccadic suppression of motion may be to block out unreliable motion signals that would be produced by a saccade. Since saccade distances are very often greater than the maximum distance over which the low-level motion mechanism can produce accurate direction discrimination for fine textures, motion signals would generally indicate false directions if they were not suppressed.

ISI produces reverse apparent motion.

A moving random-dot stimulus was presented in two sequential frames separated by an interstimulus interval (ISI) during which the field was spatially uniform with luminance equal to either the average luminance of the stimulus field (grey) or that of the black dots (black). In Experiment 1, black ISIs did not affect perception of motion direction but grey ISIs produced motion in the direction opposite to the physical displacement (reverse motion). In Experiment 2, the contrast of the stimulus was reversed simultaneously with the displacement of the random-dot fields so that reverse motion would be seen with no ISI [Anstis & Rogers, Vision Research, 15, 957, 1975]. In this condition, grey ISIs reversed the reverse motion to produce a veridical perception. Finally, in Experiment 3, we examined whether the negative image that follows the stimulus offset was the source of the reversal in motion direction. A gradual offset of the stimulus necessarily reduces the amplitude of the negative response at stimulus offset and also reduced the frequency of seeing reverse motion, suggesting that the apparent reversal of motion direction with ISI can be attributed to the negative phase of a biphasic impulse response function. A simulation of the temporal response to the displacements of random-dot fields demonstrated that the negative phase of a biphasic impulse response function is sufficient to produce the reverse motion. We therefore claim that there is a significant biphasic temporal response function that precedes the analysis of motion in the visual system. This indicates that the overall temporal response function of the visual system is the result of a cascade of functions from early through late stages and that only a portion of the overall temporal response function can be attributed to stages involved in motion analysis.

Motion in depth based on inter-ocular velocity differences.

Two different binocular cues are known for detecting motion in depth. One is disparity change in time and the other is inter-ocular velocity difference. In contrast to the well known fact of the use of the disparity cues, no evidence of contribution of inter-ocular velocity differences for detecting motion in depth has been reported. We demonstrate that motion in depth can be seen based solely on inter-ocular velocity differences using binocularly uncorrelated random-dot kinematograms. This indicates that the visual system uses monocular velocity signals for processing motion in depth in addition to disparity change in time.

Tracking the apparent location of targets in interpolated motion.

Under appropriate conditions, a target moving in discrete steps can appear to move smoothly and continuously even within the portions of the path where no physical stimulus is present. We investigated the nature of this interpolated motion in attentive tracking displays as well as apparent motion. The results showed that the apparent location of the target moved smoothly through space between the two discrete locations and the judgements of interpolated motion for attentive tracking and apparent motion were comparable to those for continuous motion in both the perceived path and the precision of the judgements. There were few, if any, differences between judgements for real and interpolated motion. An alignment procedure showed that the smooth change in location judgements was real and not a consequence of averaging across discrete locations actually seen on each trial. We also found that the slowest alternation rate which supported accurate location judgements corresponded to a critical SOA of about 500 ms, similar to the longest SOA which supported a subjective impression of motion in the display. Deviations from a constant velocity which were shorter than 200 ms did not register in the judged motion path, suggesting a fairly long time constant for the integration of velocity information into the perceived motion. These results suggest a specialized motion analysis which provides an accurate, explicit model of the interpolated motion path.

Technique to investigate the temporal phase shift between L- and M-cone inputs to the luminance mechanism

We describe a technique to estimate the intrinsic phase shift between long-wavelength-cone (L-cone) and middle-wavelength-cone (M-cone) signals in the luminance mechanism with minimal contamination by chromatic mechanism(s). The technique can also estimate, simultaneously with the phase shift, the weight ratio of L and M cones for the luminance mechanism. We measured motion identification thresholds for a 1.0 cycle/deg, 12.0-Hz sinusoidal grating representing different vector directions in L- and M-cone contrast space. The physical phase of the L- and M-cone signals was varied over a broad range between -150 deg and +150 deg to investigate the effect on the threshold contours. The slope of the threshold contour in cone contrast space varied as a function of the physical phase. Estimates of the intrinsic phase shift between L and M cones are based on the change in slope of the threshold contour. The estimates are consistent with previous reports and show that whereas the L-cone signal lags behind the M-cone signal by approximately 35 deg for an orange background, the M-cone signal lags behind the L-cone signal by approximately 8 deg for a green background.

Functional visual field of patients with visual field loss.

To assess the capability of perceiving forms in patients with visual field loss, a concept of functional visual field was introduced based on determinations of the time required for pattern recognition. Two series of stimulus patterns were made of Japanese syllabic hiragana characters drawn with black dots in the background of open circles of various sizes: the clear stimulus had only open circles in the background and the noisy stimulus had black dots scattered in the background. The stimuli were presented for various durations to 15 normal subjects and 25 patients with narrowed visual field; a correlation of the percentages of correct pattern recognition with the stimulus durations permitted calculations of the 50% recognition time. The recognition time was longer with the noisy than with the clear stimuli. The recognition time with a given stimulus size was longer in patients than in normal subjects. In 3 normal subjects the visual field was artificially narrowed and the recognition time was determined. The recognition time could be expressed by a power function of the ratio of the effective visual field diameter to the diameter of the stimulus pattern. On this basis the functional visual field size of a patient was defined as the size of the artificially narrowed visual field of the normal subject that required the same recognition time as that of the patient. The functional visual field of patients could be correlated with the area of the perimetric field with the V/4 target of Goldmann's projection perimeter. The concept of the functional visual field was found to be useful to express the patients' capability for pattern perception.

[Seroepidemiological analysis of the age specific prevalence of anti HTLV-I in Miyazaki Prefecture].

Antibody for HTLV-I in sera from 11,224 residents in Miyazaki Prefecture, Japan, was determined by indirect immunofluorescent antibody method to compare age- and sex-specific antibody prevalence among three geographically divided areas of the prefecture. There was a significant difference in the positive rate of older age groups among three areas, 9.0% for the northern part, 14.5% for the southern part and 8.4% for Miyazaki City, in spite of little variation in younger age groups. A marked rise of positive rate in the southern part at the age of 40th was observed, which suggests that changes of some conditions for mother-to-child transmission happened in the time of their birth. Six seroconversions were observed by the follow-up study for five years of the 971 residents. They were between 28 and 38 years of age, four men and two women. This may provide another reason for the increase in antibody positive rate by age in the adult. However, it could not be investigated if the seroconversion was caused by a horizontal transmission from their spouse. The possibility of the long latency of the virus in man as in the experimental animal may also have to be considered.

[Infections in hematological malignancies--clinical analysis of septic patients admitted to the Second Department of Miyazaki Medical College Hospital in the past ten years].

Two hundred and sixty-two patients (actual number 162) of hematological malignancies were admitted to our department from November 1977 to December 1986. Fourty-three of them (16.4%) were demonstrated to be accompanied with sepsis by blood culture. In acute non-lymphocytic leukemias (AML, APL, AMoL) the rate of sepsis was 33.8% (27 patients), while in lymphocytic malignancies (ML, HD, ATL) it was 11.7% (16 patients), particularly being 3.0% in ATL. Among the detected pathogenic microorganisms, gram-negative bacilli were 86.2% in the former and 50.0% in the latter. Especially, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli occupied 58.6% of the total in the former. Laboratory examination, when sepsis occurred, revealed peripheral neutropenia in acute non-lymphocytic leukemias (mean 831/cmm) but not in lymphocytic malignancy (mean 4,420/cmm). And 20 of the 27 cases showed remarkable neutropenia of below 500/cmm in the former. On the other hand in the latter, out of 16 only one with ATL was the case. Hypogammaglobulinemia was one of the characteristic features in lymphocytic malignancies but not in acute non-lymphocytic leukemias. Hypogammaglobulinemia in lymphocytic malignancies might be affected by long-term immunodepressant therapy. Immunologic skin reaction was demonstrated to be decreased in lymphocytic malignancies on admission. From the findings mentioned above, affecting factors to infections may be mainly neutropenia in acute non-lymphocytic leukemias and immunodeficiency in lymphocytic malignancies. And sepsis can occur frequently under neutropenic condition. In ATL both of humoral- and cellular-immunologic disturbance were detected before therapy. But peripheral neutrophil count was maintained to be normal and this could be the reason for the low septic incidence in ATL despite of total immunodepression.

[A case of EEC (ectrodactyly, ectodermal dysplasia, and cleft lip) syndrome].

EEC syndrome is a rare congenital malformation characterized by ectrodactyly, ectodermal dysplasia, cleft lip and/or palate. We reported a case of EEC syndrome with cleft palate. The patient was a 15-month-old girl. She had split hands of the upper extremities, syndactyly and polydactyly of the right lower extremity, ectodermal dysplasia including sparse hair, enamel hypoplasia and cleft palate. The patient underwent palatoplasty at the age of 18 months.

A new method for assessing motion-in-depth perception in strabismic patients.

AIM: In strabismus clinics, stereoscopic depth perception is usually examined using static stimuli, but these stimuli do not necessarily allow assessment of the ability to perceive motion in depth. We assessed the ability to perceive motion-in-depth perception using a novel stereo motion test that we developed and compared with that to perceive static depth perception using a conventional stereo test in strabismic patients. METHODS: To investigate motion-in-depth perception in patients with strabismus, we developed a stereo motion test using four types of computer-generated dynamic visual stimuli. Three of them are random dot stereograms of two parallel planes moving in depth. The patient is asked to indicate the planes' direction of rotation in depth (in the first and second types) or the presence/absence of motion-in-depth signal (in the third type). The fourth type of stimulus was a random dot stereogram of a rotating cylinder. The upper and lower parts of the cylinder rotate in opposite directions, and the patient is asked to indicate the position of the border between the two parts. Threshold disparity was defined as the disparity (relative disparity between the nearest and farthest points of the planes or the cylinder) that gives a critical level of performance with the method of limit. The conventional Titmus stereo test using static visual stimuli was used to assess static depth perception. The measurements were performed in 52 strabismic patients, aged between 4 and 38 years old, who visited Tokyo Medical University Hospital between January 2003 and July 2004. RESULTS: The results showed a poor correlation in the threshold of individual patients between the stereo motion test and conventional Titmus stereo test. For example, the ability to perceive motion in depth (disparity threshold <500 sec of arc) was demonstrated in three of seven patients who were not able to perceive depth using static stimuli (0/9 for Titmus circle). These results suggest that the process of the dynamic element of binocular depth perception is preserved in some of the strabismic patients who lack static stereopsis. CONCLUSION: This study indicates the importance of testing motion-in-depth perception as well as static depth perception in assessing stereopsis in strabismic patients.

Postsaccadic processing of the retinal image during picture scanning.

Eye movements were monitored while observers inspected photographs of natural scenes. At the end of each saccade (i.e., at the beginning of each period of steady fixation), the stimulus was replaced for a certain period of time by a uniform field (Experiment 1) or a blurred version of the stimulus scene (Experiment 2). Total fixation duration was measured as a function of the duration of the initial uniform field or the blurred image that followed the saccade. It was found that fixation duration increased proportionally with the duration of the initial replacement field, even for durations as short as 25 msec. These results suggest that the visual system uses information on the retina right after each saccade is completed and that the blurred, low-resolution information used in Experiment 2 (cutoff frequency of 0.8 cpd) is not sufficient for the requirements of picture processing in this task.