Pathologic findings of renal biopsy were a helpful diagnostic clue of stenosis of the iliac segment proximal to the transplant renal artery: a case report.

Common iliac artery stenosis after renal transplantation is a rare complication; it can occur in the course of hypertension and renal dysfunction. We report a case of suspected renal allograft rejection with iliac artery stenosis proximal to a transplanted kidney. A 52-year-old man with a history of cadaveric kidney transplantation 26 years previously underwent a second cadaveric kidney transplantation in the left iliac fossa because of graft failure 3 years before. In June 2012, the patient had progressive renal dysfunction. In July, a percutaneous needle biopsy was taken, and it showed no rejection; however, his renal function continued to get worse through September. A percutaneous allograft renal biopsy was performed under ultrasound guidance and showed hyperplasia of the juxtaglomerular apparatus and renin granules. Magnetic resonance angiography was used to evaluate the arteries in the pelvis and showed left common iliac artery stenosis, and a stent was placed. After percutaneous intervention, the patient's ankle brachial pressure index was within the normal range and the allograft function had improved.

[Respiratory distress due to rapid expansion of intrapericardial bronchogenic cyst].

A 79-year-old female who had been observed for an intrapericardial cyst for 3 years was admitted due to severe dyspnea and back pain. During 3 years observation, there were no symptoms and no growth of the cyst. Computed tomography scans showed rapid expansion of the cyst compared with an magnetic resonance imaging (MRI) taken 9-days before when she visited our hospital for the 1st time. Urgent complete extirpation of the tumor was successfully done and a histological diagnosis found it was an intrapericardial bronchogenic cyst. This is a 1st report of intrapericardial bronchogenic cyst of which rapid expansion is clearly demonstrated by radiology. It is suggested that complete surgical excision of intrapericardial bronchogenic cysts at the time of diagnosis even if asymptomatic.

Analysis of Chinese rabies virus isolates from 2003-2007 based on P and M protein genes.

UNLABELLED: Phylogenetic analysis of nucleotide sequences or deduced amino acid sequences of phosphoprotein (P protein), matrix (M) protein, and glycoprotein (G protein) genes of 18 Chinese isolates of Rabies virus (RABV) from 2003-2007 showed that these isolates formed a separate monophyletic lineage consisting of sub-lineages A and B. Compared with laboratory-fixed strains, recent Chinese isolates of sub-lineage B contained Val or Ala instead of Met69 in P protein, which is involved in generating truncated P proteins. In addition, one of these isolates CHpg3 had Pro instead of Ser63 and Leu instead of Ser64. Importantly, all functional domains of P and M proteins of all recent Chinese isolates were similar to those of laboratory-fixed strains. This study showed that although the recent Chinese RABV isolates belonged to a distinct lineage, their functional domains of P and M proteins were highly conserved. KEYWORDS: rabies virus; glycoprotein; phosphoprotein; matrix protein; China.

Caracterização genética e distribuição geográfica do vírus rábico isolado de bovinos no estado de Mato Grosso, Brasil / Genetic characterization and geographic distribution of rabies virus isolates from cattle in Mato Grosso, Brazil

Foram caracterizados, geneticamente e geograficamente, o sequenciamento parcial da nucleoproteína (gene N) de 53 isolados do vírus da raiva (VR) originários do Estado de Mato Grosso, Brasil. Os isolados de bovinos, que se encontravam no grupo do VR relacionado a morcegos hematófagos, foram posteriormente subdivididos em sete subgrupos genéticos. Estes subgrupos foram distribuídos em regiões de terras planas, com alguns subgrupos separados por formações de pequenas montanhas e hidrografia. Estes resultados indicam que a raiva em bovinos é derivada de diversas variantes regionalmente definidas, o que sugere que sua distribuição geográfica está relacionada as populações de morcegos hematófagos.

A total of 53 rabies virus (RV) isolates originating from cattle in the state of Mato Grosso, Brazil, were genetically characterized. Partial nucleoprotein gene sequences of these isolates were phylogenetically and geographically analyzed. Cattle isolates, which clustered with the vampire bat related RV group, were further subdivided into 7 subgroups. These subgroups were distributed widely in lowland regions, with some subgroups separated from each other by small mountains and hydrographical features. These results indicate that cattle rabies is derived from several regionally-defined variants, which suggests that its geographical distribution is related to that of the vampire bat population.

[Ventricular septal defect with aortic valvular regurgitation complicated with infective endocarditis; report of a case].

We report a case of ventricular septal defect (VSD) associated with infective endocarditis complication of aortic and pulmonary valvular regurgitation. He received treatment for pyelonephritis and after 2 months he was suffering from congestive heart failure. Echocardiography showed vegetation on the aortic valve and the anterior semilunar cusp of the pulmonary valve. He was referred to our department for surgical repair. Aortic valvular replacement, pulmonary valvular repair and direct closure of VSD were performed. The postoperative course was uneventful and the patient discharged at 28 postoperative day.

[Noonan syndrome with atrial septal defect and hypertrophic cardiomyopathy].

Noonan syndrome is one of the most common nonchromosomal syndromes seen in children with congenital heart disease. The major cause of death is congestive heart failure. We report a case of Noonan syndrome with hypertrophic cardiomyopathy and arterial septal defect (ASD). Since 10 years old he had been suffering from congestive heart failure. ASD patch closure with a fenestrated flap valve patch was performed at 12 years of age. After operation, left-to-right shunt flow through the patch gradually decreased and he was discharged at 19 postoperative day in good condition.

[A low birth weight infant (904 g) associated with ventricular septal defect].

Published data has suggested that low body weight is risk factor for surgical intervention in congenital heart disease. We report a case of a low birth weight infant with ventricular septal defect (VSD) and pulmonary hypertension (PH). A female infant was born at 31 weeks' gestation. The birth weight was 904 g. At birth she was suffering from congestive heart failure. We diagnosed VSD and PH. We performed pulmonary artery banding at 23 days of age. She accepted the band at a circumference of 15.5 mm. And we performed VSD patch closure and de-banding at 175 days of age. After operation she was on good course and discharged at 19 postoperative day.

A unique substitution at position 333 on the glycoprotein of rabies virus street strains isolated from non-hematophagous bats in Brazil.

The amino acid R or K at position 333 on the glycoprotein of the rabies virus is considered necessary for virulence in adult mice. Although some exceptions exist, substitution at this position causes expression of a phenotype that is either less pathogenic or non-virulent. To date, such substitutions have only been found in fixed strains of rabies virus. In this study, the authors found 333H, 333N, and 333Q substitutions at this position in rabies virus street strains isolated from non-hematophagous bats in Brazil. These strains showed pathogenicity and lethality on passage using adult mice with the intracerebral route and were confirmed rabies-positive by immunofluorescent assay. This suggests that these strains maintain virulence. Our findings indicate that rabies virus street strains with these substitutions exist in the field and may result in infection cycles.

Interobserver agreement in endoscopic evaluation of reflux esophagitis using a modified Los Angeles classification incorporating grades N and M: a validation study in a cohort of Japanese endoscopists.

The Los Angeles classification system is the most widely employed criteria associated with the greatest interobserver agreement among endoscopists. In Japan, the Los Angeles classification system has been modified (modified LA system) to include minimal changes as a distinct grade of reflux esophagitis, rather than as auxiliary findings. This adds a further grading M defined as minimal changes to the mucosa, such as erythema and/or whitish turbidity. The modified LA system has come to be used widely in Japan. However, there have been few reports to date that have evaluated the interobserver agreement in diagnosis when using the modified LA classification system incorporating these minimal changes as an additional grade. A total of 100 endoscopists from university hospitals and community hospitals, as well as private practices in the Osaka-Kobe area participated in the study. A total of 30 video clips of 30-40 seconds duration, mostly showing the esophagocardiac junction, were created and shown to 100 endoscopists using a video projector. The participating endoscopists completed a questionnaire regarding their clinical experience and rated the reflux esophagitis as shown in the video clips using the modified LA classification system. Agreement was assessed employing kappa (kappa) statistics for multiple raters. The kappa-value for all 91 endoscopists was 0.094, with a standard error of 0.002, indicating poor interobserver agreement. The endoscopists showed the best agreement on diagnosing grade A esophagitis (0.167), and the poorest agreement when diagnosing grade M esophagitis (0.033). The kappa-values for the diagnoses of grades N, M, and A esophagitis on identical video pairs were 0.275-0.315, with a standard error of 0.083-0.091, indicating fair intraobserver reproducibility among the endoscopists. The study results consistently indicate poor agreement regarding diagnoses as well as fair reproducibility of these diagnoses by endoscopists using the modified LA classification system, regardless of age, type of practice, past endoscopic experience, or current workload. However, grade M reflux esophagitis may not necessarily be irrelevant, as it may suggest an early form of reflux disease or an entirely new form of reflux esophagitis. Further research is required to elucidate the pathophysiological basis of minimal change esophagitis.

Wigner crystallization in (DI-DCNQI)2Ag detected by synchrotron radiation X-Ray diffraction.

The low-temperature electronic structure of the quarter-filled, quasi-one-dimensional (Q1D) system (DI-DCNQI)2Ag is revealed using synchrotron radiation x-ray diffraction. In spite of the interchain frustration in the twofold superstructure along the 1D chain, the body-centered tetragonal "charge ordering" structure, which consists of 4k_{F} charge ordering columns and 4k_{F} bond order wave columns, is realized. This is the first example of the Q1D system having plural kinds of columns as its ground state. This charge ordered structure is regarded as a Wigner crystal caused by intercolumn Coulomb repulsion.

Molecular epidemiology of rabies from Maranhão and surrounding states in the northeastern region of Brazil.

Although many outbreaks of rabies have been reported in northern Brazil, few epidemiological studies of these outbreaks have been undertaken. In this study, molecular epidemiological analyses were performed using 41 rabies virus samples isolated in the Maranhão (MA), Pará (PA), and Tocantins (TO) states of northeastern Brazil. A 599-bp region of the glycoprotein (G) gene was first amplified from each sample by RT-PCR, then sequenced and subjected to phylogenetic analysis. A phylogenetic tree divided the 41 isolates into two clades: Clade I was associated with terrestrial carnivores and Clade II was associated with vampire bats. The Clade I isolates were further sub-divided into two groups. The first group was closer to carnivore isolates that predominate in central Brazil, whereas the second group more closely resembled wild fox isolates from the northeastern coastal state of Paraíba (PB). MA isolates of Clade II formed an entirely separate group. These results demonstrate that bat- and dog-transmitted rabies occur in northwestern Brazil.

A PPAR agonist improves TNF-alpha-induced insulin resistance of adipose tissue in mice.

Thiazolidinediones (TZDs), agonists for PPARs, have been shown to block the inhibitory effects of TNF-alpha on insulin action using cultured cells. In order to clarify the in vivo effects of TZDs on the inhibition of insulin sensitivity by TNF-alpha, insulin action in muscles and adipose tissues was assessed in the TNF-alpha-overexpression mice model using transplantation of cells secreting the TNF-alpha protein. After the pioglitazone treatment for 4 weeks, glucose uptake, insulin-induced IRS-1 phosphorylation, and lipoprotein lipase mRNA levels were analyzed. Pioglitazone did not ameliorate TNF-alpha-induced hyperinsulinemia in this model, as assessed by the OGTT. Glucose uptake and lipoprotein lipase mRNA levels were decreased by TNF-alpha in adipose tissues from the TNF-alpha-overexpressing mice, and pioglitazone blocked these inhibitions by TNF-alpha. On the other hand, in muscles, pioglitazone did not reverse the effects of TNF-alpha on insulin-induced phosphorylation of IRS-1, glucose uptake, and lipoprotein lipase mRNA levels. Present study revealed the different sensitivities of pioglitazone for the recovery of decreased insulin action in a TNF-alpha-overexpressing model using cell transplantation. These results suggest that the effect of TZDs is dependent on the fat distribution and accumulation in humans.

Alterations of insulin sensitivity by the implantation of 3T3-L1 cells in nude mice. A role for TNF-alpha?

AIMS/HYPOTHESIS: Visceral adipocytes have different functions than those from the subcutaneous fat area. These differences could contribute to the pathological significance of excessive visceral fat accumulation for accompanying insulin resistance and hyperinsulinaemia. This study addresses this hypothesis and describes a unique method to clarify whether the functional differences between visceral and subcutaneous adipocytes depend on their anatomical location. METHODS: 3T3-L1 cells or TNF-alpha overexpressing CHO cells were implanted into subcutaneous fat area or mesenteric area as visceral fat area in athymic mice of BALB/C strain. Then, serum insulin, glucose, TNF-alpha, and several markers of lipid metabolism were measured in the fasting condition. OGTT was also analysed. RESULTS: During the course of glucose loading, the mice which had 3T3-L1 cells implanted into mesenteric area but not into subcutaneous fat area showed remarkably increased serum insulin and TMF-alpha concentrations, compared to the control mice. Moreover, serum insulin concentrations of the mice, implanted with TNF-alpha overexpressing cells into subcutaneous fat area, were apparently higher than that of control mice. CONCLUSION/INTERPRETATION: This method of implanting adipose cells into subcutaneous or visceral fat area showed high TNF-alpha concentration and insulin resistance by the adipose cells in visceral area of nude mice. Furthermore, we found that the functional significance of visceral fat accumulation for TNF-alpha-induced insulin resistance is partly caused by the interaction of adipocytes with surrounding conditions in mesenteric area.

Molecular cloning and functional characterization of bottlenose dolphin (Tursiops truncatus) tumor necrosis factor alpha.

Bottlenose dolphin tumor necrosis factor alpha (doTNF-alpha) cDNA was cloned by reverse transcription polymerase chain reaction (RT-PCR) and the nucleic and deduced amino acid sequences were determined. The sequence of the cDNA clones shows that doTNF-alpha has an open reading frame of 699bp encoding 233 amino acids. The nucleic acid sequence of doTNF-alpha indicates 90, 88, 87, and 79% similarity with the cattle, pig, human, and mouse TNF-alpha gene, respectively. Based on the analysis of human and mouse TNF-alpha molecules, doTNF-alpha is processed to a mature protein with 157 amino acids. The 233 amino acids precursor has a hydrophobic region that could serve as a transmembrane domain. The recombinant doTNF-alpha expressed in Escherichia coli as a glutathione S-transferase fusion protein reacted with anti-human TNF-alpha antibody and exerted cytotoxity to the TNF-alpha sensitive murine cell line L929.

A craniocervical injury-induced syringomyelia caused by central canal dilation secondary to acquired tonsillar herniation. Case report.

The authors report on a 19-year-old man with an acquired tonsillar herniation caused by a craniocervical junction injury in which serial magnetic resonance (MR) images demonstrated patent and isolated segments of the central canal participating in the dilation and then formation of a cervical syrinx. The patient was involved in a motor vehicle accident; he developed tonsillar herniation as a complication of subarachnoid and epidural hemorrhage, predominantly observed around the cisterna magna and upper cervical canal. Repeated MR images obtained over an 11-month period indicated the for mation and acute enlargement of the syrinx. Ten months after the accident, the patient presented with sensory disturbance in both upper extremities and spasticity due to syringomyelia. He underwent craniocervical decompressive surgery and doraplasty, which reduced the size of syringomyelia. The authors postulate that the patent central canal may play a role in determining the location of a syrinx remote from a focus of cerebrospinal fluid obstruction.

[Adenocarcinoma of the renal pelvis and transitional cell carcinoma of the ureter occurring 11 years after radical cystectomy for bladder cancer: a case report].

We report a case of upper urinary tract carcinoma which recurred 11 years after total cystectomy. A 52-year-old man presented with complaints of a sense of residual urine and terminal miction pain. Urinary cytology, cystoscopic examination and intravenous pyelography revealed normal findings. Twenty months later, because class V urinary cytologic findings were detected, transurethral biopsy was performed. Carcinoma in situ was diagnosed pathologically. Therefore, total cystectomy and ileal conduit urinary diversion were performed. The pathological diagnosis was transitional cell carcinoma, grade 3, pTis. At 127 months postoperatively, laboratory examination revealed an extremely high serum level of LDH (3,084 U/l). The right kidney was not visualized on IVP and computed tomography revealed a right renal irregular mass. On the suspicion of a renal pelvic tumor, right total nephroureterectomy was done. The pathologic diagnosis was renal pelvic adenocarcinoma and ureteral transitional cell carcinoma. The patient was treated postoperatively with 3 cycles of systemic chemotherapy and radiotherapy. The serum level of LDH returned to normal. However, one year later, the serum level of LDH elevated to 1,118 U/l. He died of retroperitoneal lymph node, left adrenal gland and pulmonary metastases.

Molecular cloning and identification of bottle-nosed dolphin p40(phox), p47(phox) and p67(phox).

The bottle-nosed dolphin NADPH oxidase cytosolic components, p40(phox), p47(phox) and p67(phox) cDNA's were cloned from mitogen stimulated peripheral white blood cell mRNA utilizing the reverse transcription-polymerase chain reaction. The sequences of these cDNAs showed that dolphin p40(phox), p47(phox) and p67(phox) clones contained open reading frames encoding predicted polypeptides of 339, 391 and 526 amino acids, respectively. Analysis of the p47(phox) and p67(phox) amino acid sequences showed two potential Src homology three domains and p40(phox) one. Comparison of the deduced amino acids showed that dolphin p40(phox) sequence shared 88.8% similarity with the human p40(phox), that dolphin p47(phox) sequence shared 87.7% similarity with the bovine p47(phox), and that dolphin p67(phox) shared 88.1% similarity with the bovine p67(phox). Western blot analysis using anti-human p40(phox), p47(phox) and p67(phox) antibodies demonstrated that dolphin neutrophil possesses p40(phox), p47(phox) and p67(phox) with similar molecular masses and structures, to each counterpart in human neutrophils, except for the p67(phox) COOH-terminus. These results suggest that dolphin NADPH oxidase cytosolic components have functional activities equivalent to those of human.

Molecular cloning and functional expression of bottle-nosed dolphin (Tursiops truncatus) interleukin-1 receptor antagonist.

The bottle-nosed dolphin (Tursiops truncatus) interleukin-1 receptor antagonist IL-1ra cDNA was cloned from mitogen-stimulated peripheral blood mononuclear cells (PBMC) RNA utilizing the reverse transcription-polymerase chain reaction (RT-PCR). The sequence of this cDNA showed that dolphin IL-1ra clones contained open reading frames encoding 177 amino acids. Comparison of the deduced amino acids showed that dolphin IL-1ra sequence shared 87.6, 77.9, 77.4, 77.4, 76.4, and 75.8% similarity with the bovine, rabbit, equine, human, mouse, and rat IL-1ra sequences, respectively. Recombinant glutathione S-transferase (GST) dolphin IL-1ra produced in Escherichia coli (E. coli) was purified. This protein suppressed the cytostatic activity of dolphin IL-1beta on A375S2 cells, indicating that the dolphin IL-1ra cDNA obtained in the present study encodes biologically active dolphin IL-1ra.

Molecular cloning and identification of bottle-nosed dolphin flavocytochrome b gp91(phox) and p22(phox) subunits.

The bottle-nosed dolphin (Tursiops truncatus) gp91(phox) and p22(phox) cDNA were cloned from mitogen stimulated leukocytes RNA utilizing the reverse transcription-polymerase chain reaction. The sequences of these cDNAs showed that dolphin gp91(phox) and p22(phox) clones contained open reading frames encoding 569 and 192 amino acids, respectively. Analysis of the gp91(phox) amino acids sequence showed three potential N-linked glycosylation sites. Comparison of the deduced amino acid showed that dolphin gp91(phox) sequence shared 95.4, 93.8, 91.4 and 89.5% similarity with the bovine, porcine, human and mouse gp91(phox) sequences, respectively. Similarly, the amino acid sequence showed that dolphin p22(phox) shared 89.7, 84.6, 84.1, 83.6 and 83.6% similarity with the bovine, mouse, porcine, human and rattus p22(phox) sequences, respectively. Western blotting analysis with anti-peptide antibodies supported the molecular weights of the dolphin gp91(phox) and p22(phox) homologous proteins predicted from the cDNAs and amino acids sequence data.