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Human T-cell leukemia/lymphoma virus type 1 (HTLV-1) infection can lead to the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), concomitantly with or without other inflammatory disorders such as myositis. These pathologies are considered immune-mediated diseases, and it is assumed that migration within tissues of both HTLV-1-infected CD4؉ T cells and anti-HTLV-1 cytotoxic T cells represents a pivotal event. However, although HTLV-1-infected T cells were found in inflamed lesions, the antigenic specificity of coinfiltrated CD8؉ T cells remains to be determined. In this study, we performed both ex vivo and in situ analyses using muscle biopsies obtained from an HTLV-1-infected patient with HAM/TSP and sporadic inclusion body myositis. We found that both HTLV-1-infected CD4؉ T cells and CD8 ؉ T cells directed to the dominant Tax antigen can be amplified from muscle cell cultures. Moreover, we were able to detect in two successive muscle biopsies both tax mRNA-positive mononuclear cells and T cells recognized by the Tax11-19/HLA-A‫20ء‬ tetramer and positive for perforin. These findings provide the first direct demonstration that anti-Tax cytotoxic T cells are chronically recruited within inflamed tissues of an HTLV-1 infected patient, which validates the cytotoxic immune reaction model for the pathogenesis of HTLV-1-associated inflammatory disease.

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Best-corrected visual acuity improved up to 4 months in around half of the eyes. Eyes that benefited the most were pseudophakic, steroid nonresponsive, with large initial central macular thickness, and profuse fluorescein dye leakage.

Twenty-three-gauge single- and two-step sclerotomies showed no statistical difference in site diameter at UBM. Postoperative UBM examination allowed the evaluation of the wound architecture. A large sample size comparing both surgical techniques should provide a statistical difference.

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. In general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal, hepatic and hematologic, in some cases. Presented here is a case report of a 63-year-old male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate. After 6 wk of prolonged use of the drug, he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia (total bilirubin > 300 mg/L). Diagnostic investigation was conducted by ultrasonography of the upper abdomen, serum tests for infection history, laboratory screening of autoimmune diseases, nuclear magnetic resonance (NMR) of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound. The duration of disease was approximately 4 mo, with complete resolution of symptoms and laboratory changes at the end of that time period. Specific treatment was not instituted, only a combination of anti-emetic (metoclopramide) and cholestyramine for pruritus.

Background: Dual pneumatic systems use two separate air line tubes to open and close the cutter and can achieve high cut rates. The purpose of this study is to evaluate the influence of gauge size, cut rate and aspiration on the flow rate performance of ultra high-speed cutters operated with a commercially available dual pneumatic vitrectomy system. Methods: Analysis of a high-speed video was used to determine duty cycle. Flow rates from 20-, 23- and 25-gauge cutters were calculated in predetermined conditions of aspiration levels and cut rates; water and fresh porcine vitreous samples were studied. Results: For all three gauges of cutters, the duty cycle and water flow showed an inverse correlation with increasing cut rates and a direct correlation with increasing aspiration levels (p < 0.05). Vitreous flow rates from all gauges increased with increasing aspiration and cut rates (p < 0.05). Conclusion: Larger gauges of the cutters as well as higher aspiration and cut rate levels resulted in improvement of the vitreous flow rates. A good understanding of the different flow rate settings is essential for the surgeon and optimizes the safety of surgical procedures.

Purpose Determine the performance of dual pneumatic ultra high-speed 23-gauge cutters operated with variable duty cycle (DC) settings. Methods Frame-by-frame analysis of high-speed video was used to determine the DC in core, 50-50 and shave modes. Using three cutters at various cycles per minute (CPM) and aspiration levels, mass of water or vitreous removed from a vial was measured within a specified time period. Average flow rates were calculated for each aspiration level and cut-rate with the different DC options. Results The DC increased with increasing cut rate in shave mode, was relatively stable in the 50-50 mode and decreased for the core mode. The DC converged at 5000 CPM for the three different modes. Water flow curves followed the DC variation. Vitreous flow rates for all the DC modes increased with increasing cut rates and peaked at 5000 CPM (P<0.05). The results of the 50-50 mode, that had isolated the DC influence, showed that increasing aspiration and/or cut rate, independently increased the vitreous flow rate. Conclusion Progressive values of aspiration and/or cut rate, increases the vitreous flow rate, independently of the DC. DC control also has an important effect on the vitreous flow; but this effect was reduced at high cut rates due to convergence of the DC modes.