Epidemic myalgia and myositis associated with human parechovirus type 3 infections occur not only in adults but also in children: findings in Yamagata, Japan, 2014.

We previously reported an association between human parechovirus type 3 (HPeV3) and epidemic myalgia with myositis in adults during summers in which an HPeV3 outbreak occurred in children. However, this disease association has not yet been reported elsewhere. We have since continued our surveillance to accumulate data on this disease association and to confirm whether myalgia occurs in children as well as adults. Between June and August 2014, we collected 380 specimens from children with infectious diseases. We also collected clinical specimens from two adult and three paediatric patients suspected of myalgia. We then performed virus isolation and reverse-transcription-PCR using the collected specimens. We detected HPeV3 in 26 children with infectious diseases, which we regarded as indicating an outbreak. We also confirmed HPeV3 infection in all patients suspected of myalgia. In particular the symptoms in two boys, complaining of myalgia and fever, closely matched the criteria for adult myalgia. Based on our findings from 2008, 2011 and 2014, we again urge that clinical consideration be given to the relationship between myalgia and HPeV3 infections during HPeV3 outbreaks in children. Furthermore, our observations from 2014 suggest that epidemic myalgia and myositis occur not only in adults but also in children.

Disseminated Fusarium infection identified by the immunohistochemical staining in a patient with a refractory leukemia.

The difficulty and uncertainty encountered in diagnosing a systemic mycosis often lead to a delay in starting antifungal therapy. We reported a disseminated infection of multiple fungal isolates including Fusarium species during donor leukocyte transfusion (DLT) after allogeneic bone marrow transplantation in a 20-year-old woman with a refractory leukemia. Skin lesions are the feature of Fusarium and occur in the early period of the infection. In this case, during immunosuppression state after DLT, she presented with the whole body ache and erythematous lesions which appeared rapidly on her trunk and extremities. While administration of amphotericin B was started, her condition was further deteriorated and she died. Autopsy materials revealed that she had multiple fungal infection with different isolates, including Aspergillus and Candida in the brain, lung and liver, but not in the skin. With the immunohistochemical staining with specific antibody, Fusarium or Aspergillus infection was identified from the biopsy skin or autopsy brain, respectively. This rapid and specific immunohistochemical method may be useful for the diagnosis and treatment of invasive fungal infection without delay.

G-CSF induces apoptosis of a human acute promyelocytic leukemia cell line, UF-1: possible involvement of Stat3 activation and altered Bax expression.

Granulocyte colony-stimulating factor (G-CSF) is a cytokine that regulates the proliferation, differentiation and survival of cells in the granulocytic lineage. In this study, however, we found that G-CSF or interleukin-6 (IL-6) induced UF-1, a human acute promyelocytic leukemia cell line, into apoptosis that was confirmed by morphological features and DNA fragmentation. This rare response is demonstrated for the first time with human acute promyelocytic leukemia cell line. The apoptosis induced by G-CSF or IL-6 was not preceded by terminal differentiation characterized by morphological maturation, capability to reduce nitroblue tetrazolium, or surface CD11b expression. Interestingly, Western blot analysis revealed that the stimulation of UF-1 with either G-CSF or IL-6 resulted in excessive activation of both signal transducer and activator of transcription 3alpha (Stat3alpha) and Stat3beta. Furthermore, an additional 18 kDa Bax-related protein was expressed by the stimulation of G-CSF or IL-6, while Bcl-2 and Bcl-X proteins remained unchanged. These findings suggest that UF-1 may be a valuable tool in investigating the aberrant regulation of apoptosis, especially the Stat3 involvement in the mechanism of apoptosis induction.

[A clinical study of intravenous doxycycline in the pediatrics field (author's transl)].

An intravenous preparation of doxycycline (DOTC, Vibramycin 'Pfizer'), a long-lasting tetracycline, was administered mainly by drip infusion for a series of study in the pediatrics field, and the results were as follows: 1) DOTC (100 mg) was dissolved in a 100 ml of glucose solution and 2--3 mg/kg was administered intravenously. When the total infusion time was adjusted between one to two hours, the peak serum level of DOTC was seen at the end of infusion in each case. The serum level in a two-hour infusion time, however, the serum level was delectable for a long period of time: the serum level after 10 hours was 0.82--1.23 micrograms/ml. Above results suggest that DOTC intravenous should be given in a two-hour infusion twice a day for applicable infections in the pediatrics field. 2) Urine excretion of DOTC was about a half (50%) of the administered dosage. 3) DOTC was given mostly at about 3--5 mg/kg per day (twice a day) infusion to 25 children with five infections, viz. acute angina lacunaris, acute bronchitis, bronchopneumonia, Mycoplasma pneumonia and acute urinary tract infections. A clinical improvement seemed attributable to DOTC was clearly observed in 23 out of 25 patients (92%). 4). DOTC infusion was also effective for Mycoplasma meningoencephalitis, severe Mycoplasma pneumonia associated with pleuritis, bronchitis and bronchopneumonia with a lot of Staphylococcus aureus identified in the sputum medium, acute urinary tract infections caused by E. coli. 5) Before and ten days after DOTC infusion, laboratory tests for liver and renal functions and blood were performed. No noticeable abnormalities were found except one case with transient GOT and GPT elevations. Above summary was presented at the 26th annual meeting of Japan Society of Chemotherapy in June 1978.