MEFV gene mutations in neuro-Behçet's disease and neuro-Sweet disease

ArticleAnnals of clinical and translational neurology. 6(12): 2595-2600 (2019)journal articl

Identifying and characterizing people with dementia not accessing Japanese Community-Based Integrated Care System using health insurance claims data

application/pdf要約/三重大学大学院医学系研究科 生命医科学専攻 臨床医学系講座 神経病態内科学分野氏名欄の表記は海野(水谷)あか

Uterine cervical mesonephric hyperplasia with focal cystic change masquerading clinicopathologically as lobular endocervical glandular hyperplasia to malignancy

Introduction: Although uterine cervical mesonephric hyperplasia (MH) arising from mesonephric remnants is a well-known but uncommon entity, it might pose a clinicopathological diagnostic challenge to distinguish from lobular endocervical glandular hyperplasia (LEGH) or adenocarcinoma, if MH rarely presents as a lobular and/or cystic mass with expansion of the cervical wall. However, few papers have described the detailed clinicopathological characteristics of MH compared to those benign to malignant lesions. Case presentation: An early forties Japanese female presented with a history of increased vaginal watery discharge. Multiple cystic lesions measuring less than 3 mm in diameter generated a high signal intensity on T2-weighted MRI, in the bilateral aspects of the variably enlarged uterine cervix. A gross examination of a hysterectomy specimen revealed bilateral small multicystic lesions, filled partly with secreted fluids, measuring approximately 25 × 7 × 5 mm, respectively, located in the superficial to relatively deep cervical wall. A microscopic examination showed that these lesions predominantly consisted of a lobular proliferation of small to medium-sized tubules and cysts containing occasionally periodic acid-Schiff-positive eosinophilic/pink secreted materials, lined by bland-looking cuboidal to flattened epithelium. Immunohistochemically, these lining cells were specifically positive for CD10 in a characteristic luminal staining pattern, whereas negative for MUC6, and had a low MIB-1 labeling index. We ultimately made a diagnosis of cervical MH, lobular type, with focal cystic change. Conclusion: We should be aware that, since gynecologists/pathologists might misinterpret MH as LEGH to malignancy, including the malignant counterpart of MH, a wide panel of immunohistochemical antibodies can be helpful supplemental tools

An autopsy case of peripheral T cell lymphoma occurring in a postpartum woman: a unique case suggesting changes in the immunocharacteristics of lymphoma cells before and after delivery

Abstract Background The occurrence of malignant lymphoma after delivery is an extremely rare event. Although several cases of Hodgkin lymphoma and B cell lymphoma and a few cases of peripheral T cell lymphoma (PTCL) after delivery have been reported, there are no report of autopsy cases of PTCL in the puerperal period. Case presentation A 32-year-old Japanese woman with a past medical history of atopic dermatitis and bronchial asthma presented with generalized eruptions four days after the delivery of her first child; generalized skin induration and lymphadenopathy subsequently emerged. A skin biopsy specimen showed the diffuse proliferation of atypical lymphoid cells that were immunohistochemically-positive for CD4 but negative for CD8. She was diagnosed as PTCL, not otherwise specified (PTCL, NOS). She died one year and three months after the onset of symptoms. At autopsy, the systemic infiltration of lymphoma cells into the whole body was observed. Unexpectedly, these lymphoma cells were immuno-reactive with CD8 but not with CD4. Conclusion The occurrence and development of PTCL after delivery with the shift from CD4 positivity to CD8 positivity may be associated with not only the selection of resistant subclone as a result of chemotherapy but also the changes of immune status before and after delivery

Prognostic factors affecting periodontal regenerative therapy using recombinant human fibroblast growth factor-2: A 3-year cohort study

IntroductionFibroblast growth factor-2 (FGF-2) has been reported to promote periodontal tissue regeneration. However, no study has investigated the long-term prognosis of periodontal regenerative therapy using FGF-2 to date. The aim of this study was to observe the long-term outcomes as well as to investigate the factors affecting the prognosis of periodontal regenerative therapy using FGF-2.MethodsSixty intrabony defects were prospectively investigated for three years after periodontal regenerative therapy with recombinant human FGF-2 (rhFGF-2) by evaluating probing pocket depth (PPD) and radiographic bone defect depth (RBD). The factors influencing RBD were assessed by conducting a multivariate linear regression analysis after adjusting for confounders.ResultsThe mean age of the participants was 62.4 ± 13.4 years, and baseline PPD and RBD were 6.1 ± 1.9 mm and 4.5 ± 1.8 mm, respectively. At six months, one year, and three years after surgery, PPD and RBD had significantly improved to 4.2 ± 1.7, 3.7 ± 1.4, 4.0 ± 1.9 mm and to 3.08 ± 2.05, 2.73 ± 1.90, 2.51 ± 2.15 mm, respectively. At the three-year examination, a significant positive association was deteced between RBD reduction and RBD at baseline, while the association was not significant between RBD reduction and the radiographic bony angle, number of bony walls of the defect, or the furcation involvement at baseline.ConclusionsrhFGF-2 was effective for alveolar bone regeneration in patients with periodontitis and maintained the improved parameters over the three-year observation period. The radiographic bone defect depth at baseline was found to be the factor affecting the periodontal regenerative therapy using rhFGF-2 in the intrabony defects.Trial registration numberUMIN000027979

Erythrocyte-Rich Thrombus Is Associated with Reduced Number of Maneuvers and Procedure Time in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Background: Only few studies have investigated the relationship between the histopathology of retrieved thrombi and clinical outcomes. This study aimed to evaluate thrombus composition and its association with clinical, laboratory, and neurointerventional findings in patients treated by mechanical thrombectomy due to acute large vessel occlusion. Methods: At our institution, 79 patients were treated by mechanical thrombectomy using a stent retriever and/or aspiration catheter between August 2015 and August 2016. The retrieved thrombi were quantitatively analyzed to quantify red blood cells, white blood cells, and fibrin by area. We divided the patients into two groups – a fibrin-rich group and an erythrocyte-rich group – based on the predominant composition in the thrombus. The groups were compared for imaging, clinical, and neurointerventional data. Results: The retrieved thrombi from 43 patients with acute stroke from internal carotid artery, middle cerebral artery, or basilar artery occlusion were histologically analyzed. Erythrocyte-rich thrombi were present in 18 cases, while fibrin-rich thrombi were present in 25 cases. A cardioembolic etiology was significantly more prevalent among the patients with fibrin-rich thrombi than among those with erythrocyte-rich thrombi. Attenuation of thrombus density as shown on computed tomography images was greater in patients with erythrocyte-rich thrombi than in those with fibrin-rich thrombi. All other clinical and laboratory characteristics remained the same. Patients with erythrocyte-rich thrombi had a smaller number of recanalization maneuvers, shorter procedure times, a shorter time interval between arrival and recanalization, and a higher percentage of stent retrievers in the final recanalization procedure. The occluded vessels did not differ significantly. Conclusions: In this study, erythrocyte-rich thrombus was associated with noncardioembolic etiology, higher thrombus density, and reduced procedure time

MEFV

ArticleAnnals of clinical and translational neurology. 6(12): 2595-2600 (2019)journal articl

Community Clinical Psychological Support of an Evening High School (XI)

大学院生による定時制高校への支援活動は11年目を迎えた。今年度は感染症対策として感染防止策を作成し、高校側と同意の上でその防止策に則り支援活動を行った。活動内容として校内巡回、ほっとステーションにおける相談活動、教室内支援、先生方との情報共有、広報活動を行った。感染症防止策に伴い情報共有の実施が困難になったが、情報共有シート（気になるメモ）、オンライン、ほっとステーション通信の活用により、十分な情報共有が成されるよう努めた。また、感染症拡大により人間関係が限局された中では、生徒にとって支援員という第三者との関わりが肯定的な意義を持つことが示唆された。This is the 11th year during which some of the graduate students in our department engaged in psychological support activities at an evening high school. In addition to continuing the usual support activities, the authors devised prevention measures for infectious diseases such as (COVID-19) in collaboration with school teachers. What the authors have done is making rounds in the school: counseling students in a room called "Hot Station," providing psychological support regarding studies in classrooms, sharing student information with the teachers, and informing them of the authors\u27 activities. Although it was not easy to share information with the teachers because of reduced contacts associated with the infectious disease, the authors tried as much as possible by sharing notes, talking online, and issuing the "Hot Station leaflet." The positive meaning of students establishing contacts with third party members such as the authors during times of curtailed human relationships related to infectious diseases was discussed