A case of biopsy-confirmed chronic leptomeningitis complicating rheumatoid arthritis in a 53-year old female is reported. Her symptoms included weight loss, severe depression, and pyrexia. Magnetic resonance imaging was useful in diagnosis. Intravenous methylprednisolone was prescribed (1 g/day for 3 days), followed by prednisolone (initial dose of 30 mg daily), and this treatment was effective. Her IgG-index, serum levels of soluble interleukin-2 receptor and ferritin, and cerebrospinal level of interleukin-6 paralleled her clinical course.

No abstract

Lightning activity in Indonesia is very high, and the ratio of lightning tripouts of the transmission line is also very high, reaching 66%. The results of our investigation show that a positive correlation exists between the number of lightning tripouts on a 150-kV transmission line and the tower-footing resistance and that the main cause of the tripouts is the back-flashover. Moreover, it turns out that the flashover at the lower arm increases in case of high tower-footing resistance.

T cell lymphopenia results in peripheral homeostatic expansion to maintain the T cell immune system, which is termed lymphopenia-induced proliferation (LIP). LIP is a potential risk for expanding autoreactive clones to become pathogenic in human and murine autoimmune diseases. However, the ontogeny of T cells that induce autoantibody production by autoreactive B cells in LIP remains unclear. Transfer of CD4+CD25− conventional T (Tc) cells into T-cell-deficient athymic nude mice has been previously reported as a LIP-induced autoimmune model which develops organ-specific autoimmune diseases and systemic antinuclear antibodies (ANAs). We show here that via LIP in this model, Tc cells proliferated and differentiated into PD-1+CXCR5−/dim B-helper T cells, which promoted splenic germinal center (GC) formation, provided help for autoantibody-producing B cells, and had distinctive features of follicular helper T (Tfh) cells except that they do not express high CXCR5. Intestinal microbiota were essential for their generation, since depletion of them in recipient mice by antibiotics resulted in a reduction of LIP-induced PD-1+CXCR5−/dim B-helper T cells and an amelioration of autoimmune responses. Our findings will contribute to the elucidation of the mechanism of lymphopenia-induced autoimmunity and autoantibody production, and will pave the way for microbiota-targeted novel therapeutic approaches to systemic autoimmune diseases.

The trip-out rates calculated by taking account of the reduction in the tower-footing resistance due to the ionizing effect agree well with the observed ones. This indicates the importance of the impulse resistance in the analysis of the lightning performance of the line. The trip-out rate at the lower arm is high for the cases of the average grounding resistance of 33.3 ohms, and the rates at the upper arm are high for the cases of the average grounding resistance of 5.6 ohms. Such à trend can be simulated by the IEEE method using the impulse resistance. The trend for the trip-out ratio to become high with the increase in the span length is significant after improvement of the tower-footing resistance. However, the trend is weak before improvement of the tower-footing resistance. This is because in the case of the high tower-footing resistance the flashover occurs before the arrival of the wave reflected from the adjacent towers due to the high potential rise of the tower. Therefore, the degree of the influence of the span length on the trip-out ratio is dependent on the tower-footing resistance. The local lightning activity significantly affects the trip-out rate.