Production of T-type Specific Agglutinin and Antistreptolysin-O in the Sera of Pharyngeal Streptococcal Carriers in Relation to T-types of Carrying Streptococci and Persistency of the Carrier State

In the course of monthly examinations of the pharyngeal swab cultures of 124 elementary school children in the City of Sapporo over a period of 2 years and 5 months (from August 1977 to December 1979), a small quantity of each of 99 serum samples collected from the same group of children by some other investigators in the middle of the course of our investigation for other purposes were kindly given to the present authors. The serum specimens were tested for agglutinins against the following T-type specific antigens ; T1, T4, T12, T28 and B3264, these being the main types of streptococci isolated from the carrier children of our examinations. The relation between the types and titers of agglutinins contained in the sera and the types and groups of streptococci isolated from the streptococcal carriers was investigated. When more than one type of agglutinin was contained in a single serum sample, absorption tests were performed employing agglutinogens homologous to the main type of agglutinin contained. In most cases, streptococcal carrier children contained serum agglutinins homologous to the types of carrying streptococci. The ratios of the homologous type of agglutinin-containing carrier in the cases of T1, T4, T12 and B3264 were 83%, 83%, 67% or 83%, respectively. The tendency of existing positive correlation between the titers of agglutinins contained in the sera and the persistency of the carrier state with the cocci was observed. Some of the non-carriers and carriers of streptococci of other T-types or other groups than A also contained agglutinins of some T-types. However, the mean values of the titers of agglutinins contained in these samples were generally lower than those contained in the sera of carriers carrying streptococci of the homologous types. In addition to T-type specific agglutinin,. the antistreptolysin-O (ASO) titers in these serum samples were also measured and comparisons of the mean value of ASO-titers in the sera of Group A streptococcal carriers with that in the sera of non-Group A streptococcal carriers or non-streptococcal carriers were made. From the whole results of our experiments it is inferred that the T-type-specific antibodies contained in the sera of streptococcal carriers were produced by the antigenic stimulation of T-protein at the surface of streptococci inhabited at their pharyngeal regions. The results of some other investigations, which showed a rather higher rate of streptococcal carriers possessing antibodies against double or triple T-type-specific antigens, probably come from the misreading of cross-reactive antigen-antibody reactions owing to the incompleteness of the test method without taking the cross-absorption procedure. Since the antibodies to the T-type-specific protein did not act as protective antibodies, elimination of the inhabited cocci could not be identified by any increase in those antibodies in our observation

Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System

Dense breasts are a risk factor for breast cancer. Assessment of breast density is important and radiologist-dependent. We objectively measured mammographic density using the three-dimensional automatic mammographic density measurement device Volpara™ and examined the criteria for combined use of ultrasonography (US). Of 1227 patients who underwent primary breast cancer surgery between January 2019 and April 2021 at our hospital, 441 were included. A case series study was conducted based on patient age, diagnostic accuracy, effects of mammography (MMG) combined with US, size of invasion, and calcifications. The mean density of both breasts according to the Volpara Density Grade (VDG) was 0–3.4% in 2 patients, 3.5–7.4% in 55 patients, 7.5–15.4% in 173 patients, and ≥15.5% in 211 patients. Breast density tended to be higher in younger patients. Diagnostic accuracy of MMG tended to decrease with increasing breast density. US detection rates were not associated with VDG on MMG and were favorable at all densities. The risk of a non-detected result was high in patients without malignant suspicious calcifications. Supplementary use of US for patients without suspicious calcifications on MMG and high breast density, particularly ≥25.5%, could improve the breast cancer detection rate

Serum Uric Acid Level Predicts Progression of IgA Nephropathy in Females but Not in Males.

BACKGROUND:Immunoglobulin A nephropathy (IgAN) is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN. STUDY DESIGN:Multicenter retrospective cohort study. SETTING & PARTICIPANTS:935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital. were included in this study. PREDICTOR:Uric acid levels at renal biopsy. OUTCOMES:The outcome of interest was the time from the kidney biopsy to the time when a 50% increase in the baseline serum creatinine level was observed, which was defined as "progression". MEASUREMENTS:The baseline characteristics according to the kidney biopsy at the time of diagnosis were collected from the medical records, and included age, gender, body mass index, hypertension, diabetes (use of antidiabetic drugs), serum levels of creatinine, urinary protein, smoking status, RAAS blockers and steroid therapy. RESULTS:An elevated serum uric acid level was an independent risk factor for progression in female patients (per 1.0 mg/dL, multivariate-adjusted incident rate ratio 1.33 [95% confidence interval 1.07, 1.64], P = 0.008) but not in male patients (1.02 [0.81, 1.29], P = 0.855). To control a confounding effect of renal function on an association between serum uric acid level and progression in female patients, age- and serum creatinine-matched and propensity score-matched analyses were performed, and these results also supported the effect by uric acid on kidney disease progression independent of basal kidney function. LIMITATIONS:A cohort analyzed retorospectively. CONCLUSIONS:This study revealed that an elevated uric acid level was an independent risk factor for ESKD in female IgAN patients. Therefore, uric acid might be a treatable target in female IgAN patients