Subglottic airway becomes stable with age in the human infant larynx.

Development of the mucosal defence system and its relationship to the pathogenesis of laryngeal diseases was studied by examining the changes in the laryngeal structures at the level of subglottic larynx of 59 human infants who died within 1 year of birth. By making a transverse section at the level of the cricoid cartilage, the area and diameter of each subglottic structure were examined using an image analysis system. The results were analysed, not only by their age at death, but also based on the total development score. The areas of the whole structure, cricoid ring, subglottic mucosa and inner cavity (available area) increased in close correlation with the total development score. In contrast to the increased diameter of the inner cavity, the thickness of the mucosa was almost the same size. These results indicate the stability of the subglottic airway with advancing age in the human infant larynx.

Anti-glomerular basement membrane nephritis after extracorporeal shock wave lithotripsy.

Rapidly progressive glomerulonephritis was observed in a 37-year-old woman following the administration of extracorporeal shock wave lithotripsy (ESWL) for a single stone in her right kidney. The renal biopsy specimen showed diffuse cellular crescents in all glomeruli, with linear deposits of immunoglobulin G and complement component C3 along the glomerular basement membrane (GBM). Circulating anti-GBM antibodies were detected by enzyme-linked immunosorbent assay. Thus, the patient was diagnosed with anti-GBM nephritis. It is suggested that ESWL produced an alteration in the GBM leading to the production of anti-GBM antibodies.

[Effects of glucose and TGF-beta 1 on the proliferation of cultured human peritoneal mesothelial cells].

The exfoliation and decrease is peritoneal mesothelial cells and the presence of interstitium hyperplasia are often observed in peritoneal membrane dysfunction caused by long-term peritoneal dialysis. The suppression of peritoneal mesothelial cell proliferation may be the cause of these phenomena. The objective of this study is to clarify the mechanism by which highly concentrated glucose of peritoneal dialysis fluid inhibits mesothelial cell proliferation. We examined the effect of highly concentrated glucose in the medium on human peritoneal mesothelial cell proliferation and TGF-beta 1 mRNA expression. The effect of Ham's F12 media containing various levels of glucose concentration was compared with that of normal medium. We investigated human peritoneal mesothelial cell proliferation by [3H] thymidine incorporation assay and TGF-beta 1 mRNA expression on human mesothelial cells by the RT-PCR method. The suppression effect of glucose and TGF-beta 1 on human peritoneal mesothelial cell proliferation was dose-dependent (glucose; 0-5%, TGF-beta 1; 0-1000 pg/ml). TGF-beta 1 mRNA of cells in 4% glucose medium was greater than that in the control medium. The glucose-induced suppression of human peritoneal mesothelial cell proliferation was relieved by LAP and TGF-beta neutralizing antibody. In conclusion, TGF-beta 1 may play a critical role in inhibiting mesothelial cell proliferation in media with highly concentrated glucose.

[An experience of treatment of double positive myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA) and anti-glomerular basement membrane antibodies in Goodpasture's syndrome onset of crescentic glomerulonephritis].

A 68-year-old woman was admitted to Kinki University Hospital because of progressive renal failure. She had been well until two months before admission. Laboratory data were as follows: serum creatinine 4.1 mg/dl, BUN 69 mg/dl, MPO-ANCA 33 EU, anti-glomerular basement membrane antibodies (AGBMA) 118 U. Histological findings showed cellular and fibrocellular crescents in many glomeruli. Therefore, we diagnosed rapidly progressive glomerulonephritis (RPGN) due to MPO-ANCA and anti-GBM associated renal disease. The patient was started on prednisolone and double filtration plasmapheresis (DFPP) therapy. Subsequently, the values of MPO-ANCA and AGBMA decreased. However, the patient's condition suddenly worsened and she died of interstitial pneumonia. Autopsy examination revealed crescentic glomerulonephritis and alveolar hemorrhage with linear deposition of IgG along the glomerular and alveolar capillary walls by immunofluorescence studies. We considered this to be a rare case of Goodpasture's syndrome associated with not only anti-GBM antibodies, but also MPO-ANCA.

[Immunoblastic lymphadenopathy-like T cell lymphoma associated with erythroid hypoplasia and thrombocytopenia].

A 71-year-old female patient was admitted with generalized lymphadenopathy, anemia and thrombocytopenia. On admission a peripheral blood examination showed a red blood cell (RBC) count of 1.95 x 10(6)/microliter, hemoglobin (Hb) 5.0 g/dl, platelet count (Plt) 2.2 x 10(4)/microliter and no reticulocytes. A bone marrow aspiration specimen was hypocellular with a nuclear cell count 1.0 x 10(4)/microliter, erythroblasts less than 0.3% and no megakaryocytes. Serum examination showed polyclonal hypergammaglobulinemia and the results of the direct/indirect Coombs test indicated the existence of auto-antibodies. as immunoblastic lymphadenopathy-like T cell lymphoma was diagnosed based on the lymph node biopsy specimen. Cyclophosphamide, doxorubicin and etoposide obtained improvement of lymphadenopathy, hypergamma globulinemia, hypoplastic bone marrow and thrombocytopenia. On the other hand, the anemia did not improve and the ratio of erythroblasts in total bone marrow cells was remainde 0.5%. The detailed mechanism of this hypoplastic anemia is still unknown, however, our results imply some