Background : Epstein-Barr virus (EBV) is a ubiquitous virus in humans and latently infects B cells. In some individuals, however, EBV produces chronic active infection and causes life-threatening complications due probably to cytokinemia induced by EBV-infected T or natural killer (NK) cells. The role of EBV-encoded small RNAs (EBERs), which are commonly expressed in EBV-infected T and NK cells, is still unknown.
Methods : The plasmid coding EBERs was introduced into human T-lymphotropic virus-I-negative human T-cell lines in a site-directed manner, and stable transformants were established. The alteration of cytokine expression in EBERs-expressing transformants and the activation of the downstream signaling cascade from dsRNA were examined.
Results : Among three mother T-cell lines and their transformants, only the transformants from MOLT-14 cells (γδ T cells) expressed EBERs. EBERs-expressing MOLT-14 cells produced a larger amount of interleukin-10 than did the mother cell line. The phosphorylation of dsRNA-dependent protein kinase (PKR) and that of IκBα which act downstream of PKR, increased in EBERs-expressing clones.
Conclusion : The γδ T cell-specific production of IL-10 through EBERs expression might lead to modification of the role of γδ T cells, and might play a role in human immune diseases.

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Background : We administered questionnaires to six institutions in Nagano prefecture that make up the Muscular Dystrophy Medical Network in Nagano. The organization was established in 2011 and aims to improve the effective treatment of Duchenne muscular dystrophy (DMD). Specifically, we examined the validity of the network's activities.
Materials and Methods : Questionnaires were distributed to team members, including 20 physical therapists, 6 occupational therapists, 2 clinical genetic counselors, and 17 doctors. Participants' responses were returned to an unrelated person, who was not directly associated with this research. An unrelated person then provided the responses to the first author of this study.
Results : Significant improvements were seen in all items, such as “the ease of solving patient problems” and “the ease of communication with other occupations and staff at other facilities.”
Conclusion : All team members recognized the activities of the Muscular Dystrophy Medical Network in Nagano as effective. Specifically, the understanding of information about other institutions, treatment methods, and evaluation methods was deepened, and the activities of the Muscular Dystrophy Medical Network in Nagano could contribute to the reduction of disparity in medical treatment for DMD among prefectural facilities.

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A 57-year-old man in whom systemic sclerosis and interstitial pneumonia had been diagnosed 17 and 3 years earlier, respectively, complained of dysphagia. Endoscopy showed an ulcerative tumor (type 3) in the lower thoracic esophagus, and it was diagnosed as squamous cell carcinoma. Pulmonary hypertension was confirmed by echocardiography with preoperative examination. The patient underwent thoracic esophagectomy with thoracic digestive reconstruction using a gastric tube via laparotomy and right thoracotomy. The pathological examination showed moderately differentiated squamous cell carcinoma (pT3 N1 M0 : pStage III). The postoperative course was uneventful. Six months later, intestinal pneumonia worsened gradually, and steroid was administered. Eight months after surgery, home oxygentherapy was indicated. Ten months after surgery a metastatic node was detected in the mediastinum, and radiotherapy was performed. The metastatic node shrank. Fifteen months after surgery, acute exacerbation of interstitial pneumonia led to respiratory failure. The patient died, although steroidpulse therapy and mechanical ventilation were performed. Esophageal squamous cell carcinoma associated with systemic sclerosis is a rare entity. Since there are complications such as interstitial pneumonia and pulmonary hypertension in systemic scleroderma, clinical practice includes evaluation of the tolerance and management of comorbidities, and in addition to the usual systemic management careful response was deemed necessary.

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