Combination of anti-glycopeptidolipid-core IgA antibody and clinical features for diagnosing potential nontuberculous mycobacterium pulmonary disease in routine practice.

BACKGROUND: The anti-Mycobacterium avium complex (MAC) antibody test measures levels of IgA antibody against the glycopeptidolipid (GPL) core in the bacterial cell walls and is a useful clinical indicator of nontuberculous mycobacterium pulmonary disease (NTM-PD). However, it is not currently possible to diagnose the disease using anti-MAC antibodies alone. OBJECTIVES: The study aim was to assess the efficacy of the combination of anti-MAC antibodies and clinical findings for diagnosing potential NTM-PD. METHODS: This cross-sectional study included 938 patients tested using the anti-MAC antibody. NTM-PD was diagnosed by multiple positive cultures of the same species in sputum samples. Multivariate logistic regression models were used to identify the clinical factors related to NTM-PD. RESULTS: Overall, 19.6% (184/938) of participants were diagnosed with NTM-PD. In multivariate analysis, positive anti-MAC antibodies, low body mass index, absence of malignancy, and cavity-forming lung lesions were significantly associated with NTM-PD at diagnosis. The positive rates of the anti-MAC antibody test were 79.4% (135/170) for MAC and 55.6% (5/9) for Mycobacterium abscessus complex, respectively. CONCLUSIONS: Bronchoscopic examinations should be performed especially in certain types of individuals from whom sputum samples cannot be obtained. Anti-MAC antibodies are also positive in patients other than those harboring MAC, but the rate may be low because of the different components in GPLs.

[Objective evaluation of the visual field defects in a patient with cerebral infarction using multifocal VEPs].

PURPOSE: We investigated whether visual field defects can be objectively evaluated using multifocal visual evoked potentials (mVEP) in a patient with cerebral infarction in whom it is difficult to measure the visual field. METHODS: To determine normal waves in mVEP recording was performed using a VERIS Junior Science (Mayo, Aichi, Japan) in 20 healthy subjects (20 eyes), peak latency and amplitude were used for assessment. In a patient with cerebral infarction, mVEP were recorded, and compared with the lesion observed by computed tomography. RESULTS: In 20 healthy subjects, the waveforms in the nasal and temporal quadrants were very similar but the waveforms in the superior and inferior quadrants were mirror images. The mVEP in patient with cerebral infarction showed abnormal waves, corresponding to the visual field defects in the lesion observed by computed tomography. CONCLUSIONS: Objective evaluation of visual field defects using mVEP may be useful in patients with cerebral infarction in whom kinetic/static perimetry as a subjective examination is difficult.

Dioptric changes in eyes with reversed intraocular lenses.

PURPOSE: To theoretically calculate refractive changes in eyes with reversed intraocular lenses (IOLs). SETTING: Nara Medical University, Nara, Japan. METHODS: With the ray-tracing method, the refractive changes in a theoretical eye model with a reversed IOL in the capsular bag were calculated. Data for 3 models, anterior biconvex (MA60AC, Alcon), posterior biconvex (MA60BM, Alcon), and convex plano (UV2565T, Menicon), were provided by the manufacturer and used in the analysis. RESULTS: Using the assumption that the axial length varied from 22 to 27 mm, the anterior-biconvex IOLs elicited small refractive changes when reversed. The posterior-biconvex IOLs elicited a significant myopic shift (up to 0.90 diopter [D]) when reversed. The convex-plano IOLs elicited a significant hyperopic shift (up to 2.01 D) when reversed. CONCLUSIONS: Anterior-biconvex IOLs with similar anterior and posterior radii of curvature will not cause large diopter surprises when reversed. High-power posterior-convex IOLs will cause significant myopic diopter surprises when reversed. Both these changes shift toward myopic if the postoperative anterior chamber depth (ACD) becomes shallow. Medium- to high-power convex-plano IOLs will cause a large hyperopic shift when reversed. This hyperopic shift decreases if the postoperative ACD becomes shallower.

Placental extracts induce the expression of antioxidant enzyme genes and suppress melanogenesis in B16 melanoma cells.

One of the activities of placental extracts (PEs) is skin-whitening effect, but the physiological and genetic mechanism for this effect has not yet been clarified. Here, we focus on PE as a regulator of antioxidant enzyme genes. Porcine PE was prepared, and its activity was investigated in B16 melanoma cells. PE treatment decreased the melanin content of UV-irradiated B16 cells in a dose-dependent manner. PE directly reduced the enzyme activity of tyrosinase in a cell-free assay. In addition, PE treatment increased the gene expression of cytosolic superoxide dismutase (SOD-1), extracellular SOD (SOD-3) and catalase but did not affect the expression of tyrosinase. Moreover, PE protected the B16 cells from H2O2-induced cell death. Taken together, our data suggest that PEs could play a role not only as a suppressor of melanin synthesis but also as a regulator of antioxidant genes and might protect the skin against oxidative stress.