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Ulnar nerve palsy associated with closed midshaft forearm fractures

Ulnar nerve palsy is a rare complication of closed midshaft forearm fractures; only 8 cases have been reported. This article describes a case of ulnar nerve palsy associated with a midshaft forearm fracture. A 12-year-old girl sustained a right midshaft forearm fracture. Whether she had a peripheral nerve injury was unknown due to strong pain. She underwent emergency manual reduction and intramedullary pinning. However, ulnar nerve palsy was remarkable postoperatively and gradually worsened. Therefore, neurolysis was performed 9 weeks later. The nerve had adhered to surrounding scar tissue. Six months after a second surgery, she had no motor dysfunction. The pathogenesis of ulnar nerve palsy complicated with midshaft forearm fractures varies and may be the result of direct contusion, direct damage by a bony spike, bony entrapment after closed reduction, and entrapment by a scar. In the current case, the patient was uncooperative at initial examination. Therefore, it is unknown whether she presented with immediate ulnar nerve palsy after the fracture. However, the ulnar nerve was not entrapped at the fracture site, and the surrounding muscle was intact but adhered to the surrounding scar tissue. The etiology of this case was considered to be entrapment by scar formation. According to a literature search, the authors recommend exploring the nerve approximately 8 to 10 weeks after primary surgery, after which neurological symptoms do not tend to improve

ステロイド依存性重症難治性喘息に対する温泉療法の遠隔効果

The immediate effects (IEs) and distant effects (DEs) of spa therapy were observed in 67 patients with steroid- dependent intractable asthma (SDIA). (1) The IEs of spa therapy evaluated one week after spa therapy were considerably high, and the efficacy rate was 61.5% in type Ⅰa, 82.7% in type Ⅰb, and 83.4% in type Ⅱ asthmatics. (2) The DEs of spa therapy on SDIA were also observed. The efficacy rate was 50.2% in type Ⅰa, 54.3% in type Ⅰb and 63.7% in type Ⅱ asthmatics. (3) The DEs　of spa therapy were different between cases with and without maintenance therapy (MT).　The efficacy rate of DEs was generally high (72.8～91.7%) in cases with MT, and low (16.7～40.0%) in cases without MT. These results show that MT is very important to keep the IEs of spa therapy high for a long time.67例のステロイド依存性重症難治性喘息を対象に，温泉療法を行い，その即時的効果（1週間後）および遠隔効果（1年後），さらには，温泉療法後の継続療法の影響などについて検討を加えた。1．温泉療法1週間後の即時的効果は比較的高く，その有効率は，Ⅰa．気管支攣縮型で61.5％，Ⅰb．気管支攣縮＋過分泌型で82.7％，Ⅱ．細気管支閉塞型で83.4％であった。2．温泉療法の遠隔効果では，その有効率は，Ⅰa型で50.2％，Ⅰb型で54.1％，Ⅱ型で63.7％であった。3．温泉療法の遠隔効果は，その後の継続療法の有無によりかなり異なった結果であった。すなわち，継続療法を行った症例の有効率は，72.8～91.7％と高く，一方，継続療法を行わなかった症例の有効率は，16.7～40.0％の間にあった。これらの結果から，温泉療法の即時的効果を保つためには，その後の継続療法が極めて重要であることが示唆された

Essential roles of DC-derived IL-15 as a mediator of inflammatory responses in vivo

Interleukin (IL)-15 is expressed in a variety of inflammatory diseases. However, the contribution of dendritic cell (DC)–derived IL-15 to the development of diseases is uncertain. Using established models of Propionibacterium acnes (P. acnes)– and zymosan-induced liver inflammation, we observed granuloma formation in the livers of wild-type (WT) and RAG-2−/− mice but not in those of IL-15−/− mice. We demonstrate that this is likely caused by an impaired sequential induction of IL-12, IFN-γ, and chemokines necessary for monocyte migration. Likewise, lethal endotoxin shock was not induced in P. acnes– and zymosan-primed IL-15−/− mice or in WT mice treated with a new IL-15–neutralizing antibody. In both systems, proinflammatory cytokine production was impaired. Surprisingly, neither granuloma formation, lethal endotoxin shock, nor IL-15 production was induced in mice deficient for DCs, and adoptive transfer of WT but not IL-15−/− DCs restored the disease development in IL-15−/− mice. Collectively, these data indicate the importance of DC-derived IL-15 as a mediator of inflammatory responses in vivo

気管支喘息患者末梢血好塩基球の抗ヒトIgEおよびカルシウムイオノフォァA23187に対する反応性について

The release of histamine from basophils induced by anti-lgE and calcium ionophore A 23187 ( Cal) was examined in 27 patients with bronchial asthma and 7 healthy subjects, using a whole blood method. (1)The release of histamine induced by anti-IgE and CaI was significantly higher in atopic asthmatics than in non-atopic cases. (2) The histamine release with anti-lgE and CaI was significantly lower in cases with long-term steroid therapy compared to the release in cases without steroid therapy. (3) The release with anti-lgE and CaI was increased in cases with age of 0-39 years and in cases wpth age at onset of 0-39 years. (4) Anti-IgE induced release correlated to a certain extent with the release induced by CaI. These results show that basophil reactivity as expressed by histamine release changes under different conditions.気管支喘息27例および健康人7名を対象に，抗ヒトIgEおよびカルシウムイオノフォァA23187（CaI)刺激時の末梢血好塩基球からのヒスタミン遊離について検討を加えた。(1)抗ヒトIgEおよびCaI刺激時の好塩基球からのヒスタミン遊離は，非アトピー型喘息に比べ，アトピー型喘息において有意に高い値を示した。(2)これらの刺激物質によるヒスタミン遊離は，非使用例に比べ，ステロイド依存性喘息において低い傾向がみられた。また，年齢では39才以下，発症年齢では39才以下でヒズタミン遊離がより高い傾向がみられた。(3)血清IgE値の高い症例の好塩基球は，低い症例に比べより多くのヒスタミンを遊離する傾向がみられた。(4)全般的には，抗ヒトIgE刺激によるヒスタミン遊離とCaI刺激時の遊離との間にはある程度の相関がみられた。以上の結果より，好塩基球の反応性はいろいろの条件下でかなり異なることが示唆された