The patient was infected with HEV via transfused blood from a volunteer donor. A potential risk of posttransfusion hepatitis E should be considered even in nonendemic countries.

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We report a case of severe gastro-intestinal (G-I) graft-vs.-host disease (GVHD) successfully treated with intra-mesenteric artery steroid administration. A 29-year-old man with severe aplastic anemia (SAA) was submitted to HLA-identical unrelated allogeneic bone marrow transplantation (BMT) and was found to be suffering from grade IV G-I GVHD. Although cyclosporine, steroid pulse therapy, and FK506 proved ineffective, 30 mg of water-soluble prednisolone as administered into each the superior and inferior mesenteric artery with remarkable effects. This treatment was repeated two times, and the symptoms of G-I GVHD disappeared completely.

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SUMMARY:The antitoxin levels for diphtheria and tetanus were measured with samples of a young group immunized with diphtheria-tetanus-acellular pertussis combined vaccine and those of an aged group, members of which had not received vaccination in their youth. In the young group members of which had already received basic immunization with diphtheria-tetanus-acellular pertussis combined vaccine, the levels of both antitoxins rose well after injection at 11 to 12 years old with diphtheria-tetanus combined toxoids and remained high until 20 years of age. In the aged group, more than 80% showed antitoxin levels above 0.01 u/ml for diphtheria, while all had levels below that for tetanus , except three persons with confirmed tetanus immunization history. Maintenance of the protective antitoxin levels in the population by vaccination is necessary to prevent outbreaks of infection among unvaccinated or only partially immunized persons.87

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