Extrinsic allergic alveolitis induced by the yeast Debaryomyces hansenii.

A 65-yr-old female developed cough, fever and dyspnoea following repeated exposure to a home ultrasonic humidifier. High-resolution computed tomography showed ground-glass opacity in both lung fields. Arterial blood gas analysis gave an oxygen tension of 8.38 kPa (63 Torr). Pulmonary function testing revealed restrictive ventilatory impairment with a reduction in the diffusing capacity. The diagnosis of extrinsic allergic alveolitis (EAA) was confirmed by radiographic findings, pathological evidence of alveolitis and reproductive development by a provocation test to the humidifier water. The yeast Debaryomyces Hansenii was the only microorganism cultured from the water of the humidifier. The double diffusion precipitating test and lymphocyte proliferative response was positive for an extract of D. Hansenii, providing evidence to incriminate this fungus. This is the first described case of EAA caused by D. Hansenii.

Bacterial heat shock proteins directly induce cytokine mRNA and interleukin-1 secretion in macrophage cultures.

Bacterial heat shock proteins (hsp) have been shown to be important immunogens stimulating both T cells and B cells. However, little is known concerning the direct interactions between hsp and macrophages. In this study, we demonstrated that treatment of macrophage cultures with purified bacterial hsp, including Legionella pneumophila hsp60, Escherichia coli GroEL, Mycobacterium tuberculosis hsp70, Mycobacterium leprae hsp65, and Mycobacterium bovis BCG hsp65, increased the steady-state levels of cytokine mRNA for interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-6, tumor necrosis factor alpha, and granulocyte-macrophage colony-stimulating factor as well as supernatant IL-1 secretion. This effect was shown not to be due to contamination of the hsp preparations with bacterial lipopolysaccharide. However, not all hsp induced cytokines; M. tuberculosis hsp10 showed minimal activity in our study. These results suggest that bacterial hsp might modulate immunity by rapidly and directly increasing cytokine production in macrophages.

[Abortion in Japan]. / Schwangerschaftsabbruch in Japan.

In Japan, the artificial abortion is a penal offence; only in the presence of certain conditions it is authorized under the provision of the Eugenic Protection Law which was promulgated in 1948. According to the law, the artificial abortion is restricted to the period, in which the fetus is not viable outside of the uterus. This period is prescribed by notification from the Ministry of Public Welfare; up to now it has been shortened twice (1976, 1991). Due to the introduction of economic reasons in the list of conditions and the simplification of the procedure the artificial abortion in Japan was virtually liberalized. Prosecution for illegal abortion is very rare in recent years. The number of reported artificial abortions decreases; in the about last 30 years it reduced by half. However, the increase in the number of abortions in women younger than 20 years of age is a problem. The abortion in teenagers is late compared with that in other age groups. Although the number of neonaticides does not seem to increase, the increase in the number of abortions in teenagers remains a serious problem in Japan.

PIP: In Japan abortion is essentially a crime except for certain indications. These indications have to do with mental illness, hereditary disease, leprosy, threat to the health of the mother, and pregnancy resulting from rape or threat. These indications entered into force under the eugenic protection law of 1948. On January 1, 1991, a new regulation became effective that shortened the duration of pregnancy termination from 23 weeks of gestation to 21 weeks in view of the advancement of medicine that made it possible for prematurely born children to survive outside the uterus. In one case in 1988, when the fetus of a 16-year old girl was aborted in the 25th week of pregnancy and left unattended although alive, the doctor was indicted and punished, although the probability of survival of the child was estimated at about 50%. Under law the doctor who has performed a legal abortion is obligated to report it to the authorities who compile annual statistics. Since 1955, when the abortion rate was the highest (about 1,150,000 abortions), the number has been decreasing steadily. In 1991 the abortion rate was 13.9/1000 women of reproductive age (15-50 years); however, great differences existed between prefectures (6.4-26.0/1000). The decline of the incidence of abortion can be attributed to the increase of contraceptive usage. It is alarming that the rate of abortions has increased among women under 20 years of age and at later phases of gestation. In 1990, out of a total of 33,286 abortions, 1015 were for women under 20 years old at 20 to 23 weeks of pregnancy, and this rate was higher than the rate in older age groups. Unquestionably, the abolition of the requirement in 1952 mandating that the abortion seeker undergo an examination by two doctors has liberalized the abortion law. However, many young pregnant women who need help do not get adequate support and counseling and may end up in prostitution.

Electron microscopy of Mycobacterium leprae murium in ultra-thin sections of murine leprosy lesions

1- Lepromas of murine leprosy were studied in ultra-thin sections with the electron microscope. 2- The cell wall, cytoplasm and nuclear elements of M. leprae murium are described. 3- Around each bacillus there is a distinct electron-transparent zone which distinguishes them from other cytoplasmic components of the leproma cells. 4- Foamy structures as are seen in human lepra cells were not observed.

Electron microscopy of ultra-thin sections od lepra cells and Mycobacterium leprae

1- Ultra-thin sections of lepromas taken from six cases of lepromatous leprosy were examined with the electron microscope. 2- Leprosy bacilli which exhibited a nuclear apparatus were found. The nuclear apparatus of M. leprae is composed of moderately electron-dense threads, about 9 mµ wide, which show a coil-like arrangement in the bacillary bodies. 3- The nuclear apparatus was not found in the bacilli of the retrogressive lesions of well-treated cases. 4- A hypothesis of the mechanism of the growth of foamy structures in the cytoplasm of lepra cells is offered.