Mitsuru Osano

Outbreak of herpangina associated with coxsackievirus B3 infection

An outbreak of acute febrile illness was observed in summer, 1987, in a welfare home in which 31 healthy infants were accommodated. Within a 5-day period 25 infants (81%) acquired a febrile illness. Coxsackievirus B3 was isolated from 16 (64%) of 25 throat swabs. In the patients in whom viral culture was negative or not performed, 6 were serologically identified as having a coxsackievirus B3 infection. Among 22 patients identified as having a coxsackievirus B3 infection 7 had typical herpangina and the others had pharyngitis with or without a few small vesicles. Serum alpha-interferon was detected in all but 2 cases (one with proved infection and another with indefinite infection). Herpangina can be associated with coxsackievirus B3 as well as with the more frequently associated coxsackievirus Group A; this explosive type of outbreak might be transmitted by a small particle aerosol.

Coronary risks after high-dose γ-globulin in children with Kawasaki disease

Abstract Objectives: The goals of the present study were to develop a predictive coronary risk scoring system after intravenous γ‐globulin (IVGG) therapy of any dose for the different preparations currently used in the treatment of children with Kawasaki disease and to determine the predictive value of the system. The previously reported scoring systems were based on treatment with high‐dose IVGG therapy at limited doses and were determined using investigative methods.

Interferon production during the course of Mycoplasma pneumoniae infection

In patients infected with Mycoplasma pneumoniae the development of interferon (IFN) was studied in nasopharyngeal secretions and sera. The production of IFN-gamma by lymphocytes was also investigated in response to M. pneumoniae antigen and mumps virus antigen. IFN-alpha was detected in 25 (61.0%) of 41 nasopharyngeal secretion samples and in 25 (59.5%) of 42 serum samples within 6 days after the onset of illness. IFN-alpha was significantly higher in nasopharyngeal secretions than in sera and a significant correlation was observed between the two. In most of the patients lymphocytes produced a larger amount of IFN-gamma in the convalescent stage than in the acute stage, when lymphocytes were stimulated with M. pneumoniae antigen. In some patients, however, lymphocytes did not produce IFN-gamma during the course of illness. Such lymphocytes, negative for IFN-gamma production in response to M. pneumoniae, produced IFN-gamma after the depletion of macrophages, and readdition of macrophages suppressed the production of IFN-gamma by lymphocytes. When lymphocytes were stimulated with heterogeneous antigen (mumps virus), they produced no IFN or a small amount of IFN in the acute stage of M. pneumoniae infection, and IFN production increased in the convalescent stage. Different mechanisms seem to work for homogeneous and heterogeneous antigens in the suppression of IFN production in M. pneumoniae infection.

Vascular Abnormalities in Congenital Cutis Laxa - Report of Two Cases-

Two cases of Japanese girls with congenital cutis laxa associated with cardiovascular abnormalities are described. Case 1: A 12‐year‐old girl has been under our observation from the age of 6 months. Cardioangiogram revealed dilatation of the ascending aorta, meandering of the descending aorta and the coronary arteries, coiling of the carotid and innominate (brachiocephalic) arteries, and hypoplasia of the pulmonary arteries. Case 2: A 2.8/12‐year‐old girl died after our follow‐up from the age of 3 months. The cause of death was congestive heart failure secondary to peripheral stenosis of the pulmonary arteries. In both cases, skin biopsy revealed a decreased number of elastic fibers and an increased amount of acidic mucopolysaccharides. The same histological features were observed in the pulmonary arteries and other arteries as well. Electron microscopic findings were diffuse thinning of elastic fibers and reduced elastic content. The high blood level of elastase (167.8 μg/l) in case 1 may cast a light on the unknown etiology of the disease.

Lack of linkage between height and weight and age at menarche during the secular shift in growth of Japanese children

During the past century, Japanese children have shown a most dramatic secular trend toward earlier menarche and accelerated tempo of growth. In order to assess the inter-relationship between these dual secular trends, we analysed the data on height and weight measurements of Japanese children, collected by the Japanese Ministry of Education in the years from 1900 through 1986, with reference to various retrospective studies on the age of menarche among Japanese. Between 1950 and 1983, both the mean height and weight at menarche varied significantly but percentage of the mean height achieved at menarcheal age, as compared with the mature height, remained relatively stable at approximately 95%. The results indicate that the secular trend toward earlier menarche reflects largely, if not solely, the secular change in tempo of physical growth in Japanese children.

The head circumference growth curve for Japanese children between 0-4 years of age: comparison with Caucasian children and correlation with stature

Controversy exists regarding possible international and interracial differences in head circumferences of children. We undertook the present study in order to see if there was a difference in head circumference between Japanese and Caucasian children. The subjects consisted of a total of 42,392 Japanese children between 0 and 4 years of age surveyed from 1940 to 1980, and these data were compared with those of American and British children. We conclude that there is a significant ethnic difference in head circumference, as large as one channel of usual percentiles, between Japanese and Caucasian children. The results indicate that smaller head circumference in Japanese children primarily reflects smaller stature of the Japanese.

Evaluation of Live Trivalent Vaccine of Measles AIK-C Strain, Mumps Hoshino Strain and Rubella Takahashi Strain, by Virus-Specific Interferon-γ Production and Antibody Response

A trivalent measles‐mumps‐rubella live virus vaccine, containing measles AIK‐C strain, mumps Hoshino strain, and rubella Takahashi strain, was evaluated in 229 children, aged 1 to 5 years. The vaccine induced a high seroconversion rate: 221 (98.7%) out of 224 subjects initially seronegative for measles virus, 167 (93.3%) out of 179 initially seronegative for mumps virus, and 212 (99.1%) out of 214 initially seronegative for rubella virus. It also induced a sufficient cellular immunity against each of the three viruses in over 90% of the subjects, as judged by virus‐specific interferon‐γ (IFN‐γ) production. Virus‐specific IFN‐γ production was observed 10 days after vaccination by stimulation with measles virus and rubella virus and 14 days after vaccination by stimulation with mumps virus. Mumps‐virus‐specific IFN‐γ production was observed in 7 out of 12 recipients without seroconversion for mumps virus. And measles‐virus‐specific IFN‐γ production was demonstrated in one out of three recipients without seroconversion for measles virus. A significant correlation was observed between the serum antibody and IFN‐γ production six weeks after vaccination for measles virus (r = 0.201, P<0.01) and for mumps virus (r‐0.174, P<0.05) but not for rubella virus (r= ‐0.045, P>0.05). The incidence of febrile reactions of ≧37.5 C was quite low, 14.4%, and that of ≧39 C occurred in only 1.3% of the recipients. These results suggested that the trivalent vaccine induced sufficient humoral and cellular immunity and yet resulted in no more untoward reaction than observed from the measles vaccine alone.

Effects of Pentoxifylline on Polymorphonuclear Leukocyte Function

Capillary vessels form a network through which red and white blood cells are carried to all sites in the body. Pentoxifylline is a drug which increases the permeability of erythrocytes for glucose, increases adenosine triphosphate (ATP) in erythrocytes and changes cell deformability [ 1 I . Thus pentoxifylline improves the microcirculation of red blood cells [21. Pol y morphonuclear leukocytes (PMNs) play an important role in host defense mechanisms. We studied the in vitro effect of pentoxifylline on PMN shape and function, investigating whether this drug is useful in PMN disorders or not.

Bone marrow necrosis associated with medulloblastoma.

A 9‐year‐old Japanese boy with bone marrow necrosis associated with metastatic medulloblastoma is reported. The diagnosis of bone marrow necrosis was obtained nine months after operative removal of the medulloblastoma. Bone marrow necrosis was treated with a combination chemotherapy, but unfortunately he died of disseminated metastasis of medulloblastoma. This case suggests that the prognosis of bone marrow necrosis would be attributable to the behavior of the original tumor.

Suppressive Effect of Macrophages on Interferon-γ Production by Human Peripheral Lymphocytes Stimulated with Mycoplasma pneumoniae

Production of interferon (IFN)‐γ was investigated in human peripheral lymphocytes stimulated with Mycoplasma pneumoniae. Lymphocytes obtained from non‐immune individuals produced no IFN. IFN‐γ was produced by T cells obtained from immune individuals, and the helper/inducer T cells produced two‐ to sixfold higher titer of IFN‐γ than the suppressor/cytotoxic T cells. The addition of macrophages in T cell cultures suppressed the production of IFN‐γ; this differs from the previous result wherein the addition of macrophages enhanced the production of IFN‐γ, when stimulated with mumps virus or measles virus.