bluuebunny/crossref_metadata_2025 huggingface dataset:
Suppression of experimental lupus nephritis by aberrant expression of the soluble E‐selectin gene
Authors: Takahashi Satoru , Araki Kimi , Araki Masatake , Ito Mitsuko R. , Nakatani Kimihiko , Fujii Hiroshi , Izui Shozo , Vassalli Pierre , Nose Masato
Published: March 2003

Circulating leukocytes, particularly neutrophils and monocytes, are important effector cells in the induction of many forms of glomerulonephritis. Adhesion molecules, especially selectins, are also thought to be critical for the development of this disease. We examined the possible suppressive effect of soluble E‐selectin on the development of experimental lupus nephritis induced by the injection of a hybridoma clone (2B11.3) derived from an MRL/MpJ‐lpr/lpr lupus mouse. This clone produces IgG3 antibodies that induce severe proliferative glomerulonephritis resembling lupus nephritis when injected into normal mice. Transgenic mice with a soluble E‐selectin gene were injected intraperitoneally with the hybridoma cells and histopathologically examined on day 15. As a result, the development of glomerulonephritis was significantly suppressed. This suppression was characterized by fewer inflammatory cell infiltrates, compared with non‐transgenic litter mates, despite the fact that there were no remarkable differences in immunoglobulin deposits or expression of E‐selectin between the two groups. These findings suggest that by controlling inflammatory cell infiltration, soluble E‐selectin plays a preventative role in the development of a particular type of lupus nephritis.
Histological study of papillary thyroid carcinoma treated with percutaneous ethanol injection therapy
Authors: Akasu Haruki , Shimizu Kazuo , Kitagawa Wataru , Naito Zenya , Kawanami Oichi , Tanaka Shigeo
Published: March 2003

An 86‐year‐old male patient was treated by percutaneous ethanol injection therapy (PEIT), following tumorectomy of a papillary thyroid carcinoma and a modified radical neck dissection for its metastasis. After seven treatments with PEIT, the patient was admitted to hospital for a tracheotomy to treat progressive severe dyspnea. Seven days later the patient died from acute renal failure caused by diabetic ketoacidosis. At autopsy, tumor masses were found to comprise mostly scar tissue, and the remaining neoplastic cells often showed anaplastic changes. Fresh coagulation necrosis and hemorrhages were scattered throughout the tumor lesions and their microvessels were occasionally occluded by thrombus. These changes were seen prominently, especially at the central areas of PEIT treatment. Given these findings, we believe that PEIT may be useful in providing local control for the progression of thyroid cancer, especially in cases of unresectable malignant thyroid tumors.
Comparative study of non‐functional islet cell tumors and pancreatic solid and papillary neoplasms: Biological behavior and immunohistochemistry
Authors: Choi Yoon‐La , Oh Young Lyun , Kim Seok‐Hyung , Park Cheol Keun , Ahn Geunghwan
Published: March 2003

Although non‐functional islet cell tumor (NFICT) and solid and papillary neoplasm (SPN) share similar clinical and pathological features, the outcome of each is different. Because NFICT often follow a malignant course and SPN are usually benign, the correct differential diagnosis is very important. We investigated the clinical and pathological findings in 10 cases of NFICT and 12 cases of SPN, including immunohistochemical analysis for chromogranin, vimentin, neuron‐specific enolase, somatostatin, alpha‐1‐antitrypsin, estrogen receptor, progesterone receptor, CD99, p21 and Ki‐67. The current study shows that chromogranin is the most valuable marker in differentiating between the tumors (P < 0.01). In contrast to previous reports stating that SPN express the progesterone and/or estrogen receptors, which are absent in other pancreatic tumors, our results show that one‐third of SPN were positive for the progesterone receptor. Downregulation of p21 was found more frequently in NFICT (40%) than SPN (17%). The mean value of the Ki‐67 proliferation index for NFICT (2.77% ± 2.53%) was significantly higher than that for SPN (0.94% ± 0.89%; P = 0.043). These results are consistent with NFICT having more malignant behavior than SPN.
Differential expression of mucosal addressin cell adhesion molecule‐1 (MAdCAM‐1) in ulcerative colitis and Crohn's disease
Authors: Arihiro Seiji , Ohtani Haruo , Suzuki Manabu , Murata Masahiro , Ejima Chieko , Oki Motoji , Kinouchi Yoshitaka , Fukushima Kouhei , Sasaki Iwao , Nakamura Shiro , Matsumoto Takayuki , Torii Akira , Toda Gotaro , Nagura Hiroshi
Published: March 2003

Mucosal addressin cell adhesion molecule‐1 (MAdCAM‐1) is selectively expressed in the endothelial cells of intestinal mucosa and gut‐associated lymphoid tissue (GALT). Engagement of MAdCAM‐1 to its ligand, integrin α4β7, on lymphocytes is associated with the homing of gut‐associated lymphocytes to normal gastrointestinal tract and inflammation sites. The present study was designed to elucidate differences between Crohn's disease (CrD) and ulcerative colitis (UC) from the expression patterns of MAdCAM‐1. Samples were taken from 40 patients with CrD and 24 patients with UC at surgical resection. Using frozen sections, immunohistochemistry was performed for MAdCAM‐1, E‐selectin and CD34. MAdCAM‐1+ venules were abundant in inflamed mucosa in both UC and CrD. In contrast, clear differences were noted between UC and CrD in the inflammatory area in the ulcer base, that is, MAdCAM‐1+ venules were more abundant in CrD than in UC (P < 0.001), while E‐selectin was expressed equally in these venules in both diseases. Furthermore, CrD was characterized by the occurrence of MAdCAM‐1+ venules in deeper layers of the intestinal tissue, mainly in lymphoid aggregates. Our data indicated more extensive expression of MAdCAM‐1 in CrD, which could contribute not only to mucosal inflammation, but also to transmural inflammation in CrD.
Less aggressive features of colorectal cancer with liver metastases showing macroscopic intrabiliary extension
Authors: Kubo Makoto , Sakamoto Michiie , Fukushima Noriyoshi , Yachida Shinichi , Nakanishi Yukihiro , Shimoda Tadakazu , Yamamoto Junji , Moriya Yoshihiro , Hirohashi Setsuo
Published: March 2003

We have previously reported the frequent occurrence of bile duct invasion by liver metastases from colorectal cancer. We found that patients with macroscopic intrabiliary cancer growth survive longer after hepatectomy than those without this feature. In the present study, we analyzed the clinicopathological features of primary colorectal cancer showing macroscopic intrabiliary extension of liver metastases. We reviewed 217 patients who underwent initial hepatic resection for colorectal liver metastasis between 1992 and 1998, and analyzed the corresponding primary colorectal cancers clinicopathologically. Microscopic bile duct invasion was found in 89 of 217 cases (40.6%) and, of these cases, 23 (10.6%) had macroscopic intrabiliary extension. Histological sections of the corresponding primary colorectal cancer were available in eight (group A) of these 23 cases. These were compared with 20 cases, selected randomly, of colorectal cancer that did not show bile duct invasion and were diagnosed as liver metastases. These patients underwent hepatectomy during the same period as group A and were used as a control (group B). The histology of the primary tumors revealed well‐differentiated adenocarcinoma in 100% of group A and in 25% of group B. The average maximum diameter of the primary tumor was 5.32 cm in group A and 3.61 cm in group B. Venous invasion was detected in 25% of group A and in 90% of group B (P < 0.01), while the incidences of lymphatic vessel invasion and lymph node metastases were similar between the groups. These data suggest that macroscopic intrabiliary extension could be a good indicator of a unique subgroup of colorectal cancers showing less aggressive features even though they develop liver metastases. Careful histological evaluation is important even for metastatic tumors.
Minute pancreatic adenocarcinoma presenting with stenosis of the main pancreatic duct
Authors: Yachida Shinichi , Fukushima Noriyoshi , Nakanishi Kazuaki , Shimada Kazuaki , Kosuge Tomoo , Sakamoto Michiie
Published: March 2003

We describe a case of minute pancreatic ductal adenocarcinoma featuring stenosis of the main pancreatic duct (MPD) and associated with histological findings of periductal elastosis and fibroblast proliferation. A 53‐year‐old Japanese man with preoperative radiological evidence of MPD stricture and dilation of the distal MPD, and suspected of having pancreatic cancer, underwent successful resection. Neither radiological nor macroscopic examination directly disclosed any tumorous lesions, and a small focus of carcinoma (8 × 8 mm) was only revealed on microscopic examination. The tumor was a poorly differentiated, invasive ductal adenocarcinoma that had invaded the intrapancreatic nerves and veins. Interestingly, the MPD located at the edges of the tumor had not been destroyed by the carcinoma, but its wall had been thickened by elastic tissue and fibroblast proliferation, resulting in stenosis. The peripheral pancreas exhibited secondary obstructive pancreatitis. To date, the detection of small pancreatic tumor masses using imaging procedures remains difficult, and most patients are diagnosed on the basis of pancreatic ductal changes. However, the published work on small pancreatic cancers contains little information about the histological features of the affected MPD. The present findings suggest that MPD strictures are not always provoked by destruction or filling with cancer cells, and that they can be caused by periductal elastosis and fibroblast proliferation in a minute carcinoma. Such changes in the MPD may therefore be of clinical importance in the detection of early stage cancers.
Case of primary malignant hemangiopericytoma of the heart expressing basement membrane‐degradable enzymes
Authors: Okada Yoshikatsu , Mori Hiroshi , Yoshii Yasuyoshi , Tsuji Motomu , Horimoto Hitoshi , Sasaki Shinjiro
Published: March 2003

An echocardiogram demonstrated a large tumor in the left atrium of a 47‐year‐old woman with sudden heart failure. Emergent cardiotomy showed that the tumor arose from the left atrial wall, and almost entirely occupied the left atrium. Grossly, the tumor had partly undergone necrosis. Histologically, the tumor consisted predominantly of round to polygonal cells with ill‐defined cell borders surrounding ‘stag horn’‐shaped blood vessels. Mitosis was frequently seen with abnormal mitotic figures. Immunohistochemically, the tumor cells diffusely expressed vimentin and focally expressed factor XIIIa and human leukocyte antigen‐DR. A few tumor cells expressed S‐100 protein or α‐smooth muscle actin. Histopathological diagnosis was malignant hemangiopericytoma of the left atrium. Most tumor cells expressed matrix metalloproteinase (MMP)‐2 and MMP‐3, and several cells expressed MMP‐9, all of which are capable of degrading a major component of basement membrane (i.e. type IV collagen). Furthermore, tumor cells expressed membrane type 1 MMP and tissue inhibitor of metalloproteinase‐2, both of which are required for activation of proMMP‐2. Fourteen months after the surgical removal, she died of systemic recurrent tumors.
Analysis of immunoglobulin VH genes in CD10‐positive diffuse large B‐cell lymphoma
Authors: Hojo Hiroshi , Kuze Tetuo , Nakamura Naoya , Hashimoto Yuko , Sasaki Yoshikazu , Sato Michiko , Shirakawa Asumi , Abe Masafumi
Published: March 2003

CD10, a proteolytic enzyme seen in germinal center cells and in the majority of follicular lymphomas, is occasionally expressed in diffuse large B‐cell lymphomas (DLBCL). To clarify the origin and cellular characteristics of CD10‐positive DLBCL, we analyzed 36 de novo cases of DLBCL for somatic mutations of the immunoglobulin heavy chain variable region (VH) genes and for their immunophenotypes. Expression greater than that of grade 2 Bcl‐6 was observed in 11 of the 30 CD10‐negative cases (37%) and in all six CD10‐positive cases (100%; P < 0.05) without expression of CD5, CD23, cyclin D1, CD30 or CD138. The average mutation frequencies of the six CD10‐positive and 30 CD10‐negative DLBCL were 12.9 and 9.8%, respectively. The range of SM frequencies in CD10‐positive DLBCL (9.52–18.06) was distinctly narrower than that observed for CD10‐negative DLBCL (0.69–26.89). These findings seem to indicate that CD10‐positive DLBCL, originating from germinal center B cells, is a genetically and immunophenotypically more homogeneous group than CD10‐negative DLBCL. Furthermore, three extranodal lymphomas, in five of the six CD10‐positive DLBCL, showed ongoing mutation, indicating that antigen‐driven, high‐affinity somatic mutation may play an important role in clonal expansion in CD10‐positive DLBCL. All four extranodal cases of the six CD10‐positive DLBCL showed ongoing mutation and/or bcl‐2/JH rearrangement. This result suggests that the cell origin of extranodal CD10‐positive DLBCL may be the same as that of follicular lymphomas.
Identification of an aging‐related spherical inclusion in the human brain
Authors: Kimura Takemi , Fujise Noboru , Ono Tsunehiko , Shono Masahiro , Yuzuriha Takefumi , Katsuragi Shoichi , Takamatsu Junichi , Miyakawa Taihei , Kitamura Toshinori
Published: March 2003

Inclusions, such as corpora amylacea, axonal spheroids and ubiquitin‐positive granular structures, are present in aged brains. We found a phosphorylated tau‐positive inclusion in brain tissues obtained from 13 non‐demented subjects and five patients with Alzheimer's disease. This inclusion was spherical and 3–20 µm in size. It was most frequently detected in the hippocampal CA1 region and in the prosubiculum but was not present in the white matter. The density of this inclusion increased significantly with aging and decreased after the occurrence of neurofibrillary tangles. The presence of the inclusion was confirmed using immunoelectron microscopy. These findings show a possibility that the inclusion is a novel aging‐related structure in the human brain.
Chlamydia pneumoniae and multiple infections in the aorta contribute to atherosclerosis
Authors: Shi Yu , Tokunaga Osamu
Published: March 2003

Our previous study on herpesvirus infection including Herpes simplex virus type 1 (HSV‐1), Epstein–Barr virus (EBV), cytomegalovirus (CMV) and atherosclerosis revealed that the prevalence of herpesvirus is higher in atherosclerotic aorta than in non‐atherosclerotic aorta. Infections with two or three forms of the virus have been found only in atherosclerotic aorta. In our current study, we examined both Chlamydia pneumoniae and Chlamydia trachomatis in herpesvirus‐infected aortic tissues, by means of immunohistochemistry, polymerase chain reaction, Southern hybridization, in situ hybridization, electron microscopy and electron‐microscopic immunohistochemistry. In particular, the bacteria were found in atherosclerotic lesions. In atherosclerotic aorta, 40% of tissues examined were positive for C. pneumoniae in contrast to absence of this bacteria in non‐atherosclerotic aorta. Elementary bodies of C. pneumoniae were found in macrophage‐like cells in the intima of atherosclerotic aorta by electron microscopy. Chlamydia trachomatis was not found in both atherosclerotic and non‐atherosclerotic aorta. Our findings suggest that multiple infections in aortic tissue contribute to the development of atherosclerosis. Furthermore, the absence of C. pneumoniae compared to herpesviruses in normal arterial tissue suggests that C. pneumoniae is specific for atherosclerotic lesions. In contrast to ‘abortive infection’ of viruses in arteries, C. pneumoniae infection was demonstrated in macrophages by electron microscopy and electron‐microscopic immunohistochemistry in atherosclerotic lesion.Chlamydia pneumoniae may be the most important pathogen related to the development of atherosclerosis.
Carcinoid tumor in the female urethral orifice: Rare case report and a review of the literature
Authors: Katayama Masaki , Hara Akira , Hirose Yoshinobu , Yamada Yasuhiro , Kuno Toshiya , Sakata Keiko , Morioka Takamitsu , Inamine Morihiko , Shibuya Chiken , Mori Hideki , Yoshimi Naoki
Published: March 2003

We experienced an extremely rare tumor in the female urethral orifice in a 57‐year‐old Japanese woman. To our knowledge, only two cases of primary urethral carcinoid tumor have been reported. The previous reports of urethral carcinoid tumor were recognized in the male middle urethra and penile urethra. The present case was resected, and diagnosed as a carcinoid tumor by histological, immunohistochemical and ultrastructural findings. The tumor cells were stained by chromogranin A, synaptophsin and neuron‐specific enolase, and neurosecretory granules were confirmed with electron microscopy. The patient did not complain of any symptoms until 5 years after the resection of the tumor. Therefore, the case we describe here is the first known report of carcinoid tumor in the Japanese female urethra.
Leiomyomatosis peritonealis disseminata with malignant change in a man
Authors: Yamaguchi Tadanori , Imamura Yoshiaki , Yamamoto Tatsuya , Fukuda Masaru
Published: March 2003

Leiomyomatosis peritonealis disseminata (LPD) is a rare clinicopathological entity typically observed in women of reproductive age. We report a case of LPD with malignant change in a man. A 77‐year‐old man presented with a mass measuring 10 cm in diameter at the terminal ileum and numerous peritoneal small nodules that were revealed by abdominal computed tomography. Right hemicolectomy with lymph node dissection was performed. Macroscopically, a tumor of the terminal ileum consisted of aggregates of small nodular lesions with calcification and necrosis. The wall of the ileum and colon was intact. Microscopically, some of the nodular lesions consisted of neoplastic growths of atypical spindle cells with cellular atypism and abnormal mitoses. A few of these lesions were completely surrounded by smooth muscle bundles. Hemorrhages and necroses were found within the tumor nodules. Immunohistochemically, the tumor cells were positive for vimentin, desmin, muscle actin, α‐smooth muscle actin, cytokeratin and p53. The remaining nodular lesions, including small peritoneal lesions, were composed of hypocellular hyalinizing nodules. This case was thought to be LPD with malignant change, although the pathogenesis was uncertain because the tumor cells were negative for estrogen and progesterone receptors.
Screening of epiphytic dinoflagellates for radical scavenging and cytotoxic activities
Authors: Nakagawa Hidenori , Murata Michio , Tachibana Kazuo , Shiba Tadayoshi
Published: March 2003

In the search for antioxidant substances/radical scavengers and cytotoxic substances, extracts from four species (10 strains) of epiphytic dinoflagellates in laboratory cultures were subjected to screening for production of bioactive metabolites. Assays for antioxi‐dants were performed using microsomal lipids prepared from rat livers, which were oxidized with Fe3+‐nitrilotriacetic acid complex (Fe3+‐NTA). Generated lipid peroxides were determined using the thiobarbituric acid (TBA) colorimetric method. Screening tests for cytotoxic activity were carried out using P388 leukemic cells of which the survival ratio was assessed using the tetrazolium salt (MTT) method. Extracts from two strains (Gymnodinium sp. and Gambierdiscus toxicus) and those from five strains (two of G. toxicus, two of Coolia monotis, and one of Prorocentrum sp.) were found to contain active constituents for antioxidant activity and for cytotoxic activity, respectively.
Hepatopulmonary syndrome associated with autoimmune liver cirrhosis
Authors: Takada Nobukazu , Abe Tadashi , Takahashi Yoshinori , Shibuya Akitaka , Tomita Tomoyuki
Published: March 2003

A 46‐year‐old woman presented for evaluation of liver dysfunction and dyspnoea. Laboratory examination showed high levels of γ‐globulin, immunoglobulin (Ig)G, and antinuclear antibodies. Laparoscopy demonstrated hepatic cirrhosis. Despite normal spirometry, hypoxaemia (which was worse in standing position) and a low diffusing capacity were present. The shunt ratio calculated using arterial blood gas was 6.4%, but was 40% when measured using 99mTc‐macroaggregated albumin scanning. The discrepancy between the ratios indicated that hypoxaemia was caused by intrapulmonary vascular dilatation. The patient was diagnosed with hepatopulmonary syndrome associated with autoimmune liver cirrhosis.
Is it possible to detect ulcerative colitis‐related respiratory syndrome early?
Authors: KARADAG FISUN , ÖZHAN MUSTAFA HIKMET , AKÇIÇEK EREN , GÜNEL ÖZDEN , ALPER HÜDAVER , VERAL ALI
Published: March 2003

Objective: Obstructive airway disease, bronchiectasis, non‐specific parenchymal infiltration and bronchiolitis obliterans organizing pneumonia are seen occasionally in patients with inflammatory bowel disease. In the present study, we evaluated ulcerative colitis (UC) patients for latent pulmonary involvement.

Methods: Fifteen patients (nine females, six males, mean age 44 years) were admitted into the study. All patients were free of respiratory symptoms. Ulcerative colitis was active in nine patients and all patients were using anti‐inflammatory treatment. Pulmonary function tests (PFT), high resolution computed tomography of thorax (HRCT) and bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy (TBLB) were carried out in all subjects.

Results: Mild airways obstruction was found in 1 of 13 patients. High resolution CT was
abnormal in 4 of 15 patients. Ground glass appearance suggestive of an interstitial
lung disease was present in three patients. Radiolucency and pneumocysts were present
in the fourth patient suggesting obstructive small airway disease. High resolution
CT findings correlated with disease activity (P < 0.05). Fiberoptic bronchoscopy was performed in 10 patients. A mixed type alveolitis was detected in BAL fluid in five patients. In eight patients, TBLB showed alveolar septal thickening by connective tissue, lymphocytic accumulation in the septal area and minimal septal fibrosis, suggesting subclinical pulmonary parenchymal involvement linked to UC.

Conclusions: Our data suggest that latent interstitial pulmonary involvement may occur during the course of UC, despite an absence of symptoms of lung disease.
Interleukin‐1β and tumour necrosis factor‐α increase microvascular leakage in the guinea pig trachea
Authors: REYNOLDS ANN M. , HOLMES MARK D. , SCICCHITANO RAFFAELE
Published: March 2003

Objective: Airway microvascular leakage is considered to be an important component of airway inflammation in asthma. In the present study we examined the effect of interleukin‐1β (IL‐1β) and tumour necrosis factor‐α (TNFα) on airway microvascular leakage in vivo.

Methodology: Tracheal Evans blue extravasation was examined in an isolated tracheal segment, in anaesthetized mechanically ventilated guinea pigs. Baseline tracheal microvascular leakage was measured in five animals. As a control group for aerosol challenge, the isolated tracheal segment (n = 5) underwent saline aerosol challenge. To test whether a combination of IL‐1β (10 ng/mL) and TNFα (100 ng/mL) induced Evans blue extravasation, the trachea was exposed to an aerosol of these cytokines (n = 5). As a positive control the tracheal segment was challenged with histamine aerosol (5 × 10–2 mol) (n = 3). All aerosol challenges were for 1 min.

Results: TNFα and IL‐1β aerosol challenge significantly increased Evans blue extravasation (28.9 ± 1.6 μg/g wet tissue, mean ± SE) compared to saline challenge (13.8 ± 3.0 μg/g; P < 0.05). Tracheal dye extravasation without aerosol challenge, was not significantly different from saline‐challenged animals (17.5 ± 2.9 and 13.8 ± 3.0 μg/g, respectively). Histamine significantly increased Evans blue extravasation (50.1 ± 4.8 μg/g; P < 0.05) compared to saline challenge.

Conclusion: Pro‐inflammatory cytokines, TNFα and IL‐1β are able to induce significant microvascular leakage in the guinea pig trachea.
Decline in FEV1 in patients with PiZ alpha‐1‐antitrypsin deficiency: The Australian experience
Authors: BURDON JONATHAN G. W. , BRENTON SUE , HOCKING VANESSA , KNIGHT KENNETH R. , AYAD MONNA , COOK LUISA , JANS EDWARD D.
Published: March 2003

Objective: Alpha‐1‐antitrypsin (α1antitrypsin) deficiency is a rare hereditary
disorder which characteristically presents with emphysema at an early age. The aim
of the present study was to determine whether the rate of decline of lung function
in α1antitrypsin‐deficient subjects in Australia was similar to that found elsewhere.

Methodology: Patients registered with the Australian Alpha‐1‐Antitrypsin Replacement Program
were studied. All patients (n = 50) had a serum α1antitrypsin
concentration of < 0.3 g/L and had had spirometry measured over at least 2 years.
They were compared with a group of normal volunteers (hospital staff, n =
107) with normal α1antitrypsin levels and phenotypes and with no clinical
history of lung disease. All had spirometry measured for periods ranging from 2 to
6 years. The rate of decline of forced expiratory volume in 1 s (FEV1)
for each subject was calculated by least squares linear regression using FEV1 against the time from entry into the study.

Results: The group mean (± SD) rate of decline in FEV1 was significantly
greater (P < 0.01) in the α1antitrypsin‐deficient patients
(88 ± 71 mL/year) than for the normal controls (–15 ± 48 mL/year).
There was no difference in decline in FEV1 when the data was analysed for gender and for index versus non‐index cases.

Conclusion: The results confirm previous reports of an accelerated rate of decline of FEV1
in patients with α1antitrypsin deficiency. Our results indicate that
the rate of decline of lung function in α1antitrypsin deficient subjects in Australia is similar to that found in reported series from elsewhere.
Sample survey of drug‐resistant tuberculosis in Henan, China, 1996
Authors: WANG GUOBIN , PENG YI LI , ZHANG GUOLONG , ZHANG LI , XING JIN , LI DENGXU , WANG LIN , SONG HUAIZHOU , DING DEHUANG , DUANMU HONG JIN , ZHANG ZHESHU , ZHANG GENGRONG
Published: March 2003

Background: There is little reliable data on the global drug resistance to tuberculosis (TB) as most of the existing data is based upon biased samples, is not standardized or was obtained using poor techniques. For this reason, the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD) developed a global project on anti‐TB drug resistance surveillance (DRS) in 1994. China joined this project in 1995 and the province of Henan was selected as the first site for collection of representative samples to survey the prevalence of drug‐resistant TB.

Methodology: Standard drug susceptibility testing by the proportion method against streptomycin (S), isoniazid (H), rifampicin (R), and ethambutol (E) was performed with Mycobacterium
tuberculosis isolated from 916 new cases and 456 previously treated cases. Treatment outcome of these patients has been evaluated according to the regimens and drug susceptibility patterns.

Results: Drug resistance among new cases to any drug was found to be 43.0% and any resistance: S, 32.5%; H, 31.0%; R, 20.7%; and E, 10.3%. Drug resistance among previously treated cases to any drug was 68.2% and any resistance: S, 52.2%; H, 49.3%; R, 48.3%; and E, 20.4%. The cure rate for new cases was 43.3% and 29.4% for previously treated cases. The poor cure rate resulted mainly from a high defaulter rate.

Conclusion: Drug‐resistant TB was found to be highly prevalent in Henan and the cure rate remained poor. The results strongly indicated that Henan should take immediate action to improve the cure rate of patients through expansion of the introduction of the directly observed treatment short‐course strategy.
The role of Interleukin‐8 in interstitial pneumonia
Authors: FUJIMORI Yoshiaki , KATAOKA Mikio , TADA Shinya , TAKEHARA Hideki , MATSUO Kiyoshi , MIYAKE Toshitsugu , OKAHARA Masayuki , YAMADORI Ichiro , TANIMOTO Mitsune
Published: March 2003

Objective:  A variety of inflammatory cells accumulate in the lungs of patients with interstitial lung disease. The potential for IL‐8 to be released from these cells into the lungs of patients with idiopathic interstitial pneumonia (IIP), interstitial pneumonia with collagen vascular disease (IP‐CVD), sarcoidosis (SAR) and hypersensitivity pneumonitis (HP) was investigated.

Methodology:  IL‐8 levels were assessed by enzyme‐linked immunosorbent assay in BAL fluid and serum, and the expression of IL‐8 in the lungs of these patients was evaluated by immunohistochemistry.

Results:  Serum IL‐8 levels were significantly elevated in patients with IIP (P < 0.05) and SAR (P < 0.01). In BAL fluid, the IL‐8 level was significantly higher in patients with IIP (P < 0.05), IP‐CVD (P < 0.01), SAR (P < 0.01) and HP (P < 0.01). In several cases, IL‐8 level correlated with neutrophil density. The IL‐8 immunopositive cells were type II pulmonary epithelial cells and alveolar and interstitial macrophages in patients with IIP and IP‐CVD.

Conclusions:  IL‐8 is likely to be a key factor in the pathogenesis of fibrosis of the lung and in lung injury.
Variations in size structure, growth and reproduction in Japanese plantain (Plantago asiatica L.) between exposed and shaded populations
Authors: Kobayashi Tsuyoshi , Okamoto Kazuyasu , Hori Yoshimichi
Published: March 2003

Plantago asiatica is a perennial herb that is distributed over a wide range of east Eurasia. The population structure, growth and reproduction in exposed (E‐) and shaded (S‐) populations of P. asiatica were examined in the Kanto District of eastern Japan. In both populations, the plant size structure showed a bimodal distribution during spring to early summer, in which the two modes corresponded to smaller seedlings and larger overwintered plants, respectively. In autumn, this distribution became unimodal due to seedling growth. However, this change occurred later in the S‐population because of suppressed growth in the seedlings. In the S‐population, flowering also began later in the growing season and the threshold plant size for flowering was larger than that of the E‐population. Biomass allocation to the rhizomes was greater in autumn in the reproductive plants of the S‐population. Growth and biomass allocation in plants grown from seeds collected from each population were compared under phytotron conditions. Near a saturated photon flux density, E‐population plants had a higher relative growth rate than S‐population plants. Therefore, E‐population plants should allocate resources to reproductive organs sooner. Shaded population plants were not vigorous in their growth and reproduction. Seed size (dry weight per grain) was significantly greater in the S‐population than in the E‐population, both in the field and under phytotron conditions. These results suggest that ecotypic differentiation in life‐history strategies, which is mainly due to light availability, occurs among local P. asiatica populations. The effects of severe trampling on early reproduction in the E‐population are also discussed.
Demographic genetics of the American beech, Fagus grandifolia. II. Genet substructure of populations for the Blue Ridge, Piedmont and the Great Smoky Mountains
Authors: KITAMURA KEIKO , HOMMA KOSUKE , TAKASU HIDEKI , HAGIWARA SHINSUKE , UTECH FREDERICK H. , WHIGHAM DENIS F. , KAWANO SHOICHI
Published: March 2003

Populations of American beech in Virginia and the Great Smoky Mountain National Park in Tennessee and North Carolina were investigated for demographic genetic substructurings. Two Virginia populations, one on the Blue Ridge (WG1) and the other on the Piedmont (WG2) occur over an elevational gradient of several hundreds meters. One of the Great Smoky Mountain populations (GS1) was in a ‘beech gap’ and the other (GS2) in a ‘cove forest’ along a creek. The populations in the Great Smoky Mountain National Park were only separated by a few hundred meters in elevation, but both on the same physiographic province. The populations had two growth forms. Trees produced extensive root suckers at WG1, GS1 and GS2, but WG2 had no root suckers and all individuals had obviously been established from seeds. A total of 1335 shoots were mapped at the four sites, their size measured [diameter at breast height (DBH) or diameter at ground height (DGH)], and genotypes were determined for each locus using allozyme analysis. FIS among five different size‐classes revealed an excess of homozygotes in WG1, GS1 and GS2, and an excess of heterozygotes in WG2. The offshoot formation from root suckers obviously contributed to the abundance of intermediate size‐classes in WG1, GS1 and GS2. Exceedingly localized patchiness of different multilocus genotypes reveals genetic clustering of shoots that have obviously originated from root suckers in WG1, GS1 and GS2. The Piedmont population (WG2), on the other hand, showed loose localization of genetically related trees at a scale of 35–40 m in area, suggesting broader ranges of pollen and seed dispersal. The data are discussed in the light of the differences in growth form and mode of reproduction, and also in relation to the post‐glacial migration and the current geographic distribution of the species.
Unfavorable lipid profiles in mild obesity with excess body fat percentage
Authors: Tamura Akiho , Mori Tetsuo , Komiyama Atsushi
Published: March 2003

Abstract Background: The aim of the present study was to investigate the usefulness of subclassifications of overweight children using the body fat percentage (Fat%) to predict the serum lipid profile.

Methods
: School children (431, 236 boys and 195 girls) aged 9–12 years were divided into three obesity groups (non‐, mild and advanced obesity) and were further divided into two subgroups according to the Fat% measured by bioelectrical impedance analysis. The mean fasting serum lipid levels were also evaluated.

Results
: In the non‐obesity and the advanced obesity groups, the Fat%‐based subclassification demonstrated no essential differences in lipid profiles or in the prevalence of hyperlipidemia between the two subgroups. However, in the mild obesity group, the levels of low‐density lipoprotein cholesterol and triglyceride and the atherogenic index were significantly higher and the high‐density lipoprotein cholesterol level was significantly lower in the adipositic subgroup (Fat%≥ age/sex‐specific cut‐off value) than in the non‐adipositic subgroup. Multiple comparison of lipid levels among all six categories of children indicated that the adipositic subgroup of mild obesity had no advantage over the advanced obesity group with respect to the atherogenic potential and that the non‐adipositic subgroup of mild obesity showed no additional risks compared to the non‐obesity group. Moreover, the prevalence of hyperlipidemia in the adipositic subgroup of mild obesity (50.0%) was significantly different from that in its non‐adipositic counterpart (13.3%) and was equivalent to that in the advanced obesity group.

Conclusions
: These results suggest that Fat% evaluation is useful to divide mildly obese children into two distinct subtypes based on serum lipid profiles and that the excess Fat% in mildly obese school children is a predictor of atherogenesis.
Short‐term developmental outcome of iron prophylaxis in infants
Authors: Yalçin S Songül , Yurdakök Kadriye , Açikgöz Demet , Özmert Elif
Published: March 2003

Background
: Previous studies on the cognitive effects of iron treatment have focused on anemic or non‐anemic iron‐deficient infants. The effect of iron supplementation on cognitive development among iron‐sufficient infants has not been studied. The aim of the present study was to examine the effect of iron supplementation on performance in the Bayley Scales of Infant Development (BSID) and anthropometric measurement in 6‐month‐old iron‐sufficient healthy infants.

Methods
: Healthy, iron‐sufficient infants who were 6 months of age and were attending the Well Baby Clinic were considered for enrollment. Infants were randomly assigned to take ferrous sulfate supplementation (1 mg/kg per day) or no supplementation and were followed for 3 months. Anthropometric measurement, hematologic status and BSID were evaluated on admission and after 3 months.

Results
: Seven infants in the intervention group and nine in the control group completed the study. No significant differences were observed in anthropometric measurements and complete blood counts between the two groups after the 3 month study period. The mean transferrin saturation (TS) level decreased significantly in the control group during the study period (from 15.3~2.6 to 7.8~5.1%; P=0.0117), but no such reduction was seen in the intervention group. At the end of the study, the TS of the control group was found to be significantly lower than that of the intervention group (7.8~5.1 vs 19.9~7.9%, respectively; P=0.0033). The BSID scores of infants in both groups were within the normal range on admission and at the end of the study period.

Conclusions
: Short‐term iron supplementation did not change developmental test scores despite the hematologic response in iron‐sufficient healthy infants. The high prevelance of iron‐deficiency anemia and its relationship with adverse developmental outcome suggests that prevention of iron‐deficiency anemia with prophylaxis needs to be emphasized, rather than treatment.
Pattern of human leukocyte antigens in Turkish children with celiac disease
Authors: Tümer Leyla , Altuntaş Buket , Hasanoğlu Alev , Söylemezoğlu Oğuz , Arinsoy Turgay
Published: March 2003

Abstract

Background
: Regional variations in the human leukocyte antigen (HLA) distribution patterns of celiac disease (CD) have been reported. The aim of the present study was to assess the distribution of HLA class I and class II in Turkish children with CD and to compare the findings with a control group.

Methods
: Human leukocyte antigen typing was performed in 33 children with CD and in 77 healthy individuals, who served as controls, by using standard National Institutes of Health lymphocytotoxicity techniques.

Results
: A positive association was found between HLA A2 (42 vs 19% for sick subjects compared with healthy controls, respectively), B8 (39 vs 9% for sick subjects compared with healthy controls, respectively), CW7 (45 vs 25% for sick subjects compared with healthy controls, respectively), DR3 (70 vs 17% for sick subjects compared with healthy controls, respectively), DR7 (30 vs 13% for sick subjects compared with healthy controls, respectively) and DQ2 (52 vs 34% for sick subjects compared with healthy controls, respectively). The combinations of DR3–DQ2 (30 vs 12% for sick subjects compared with healthy controls, respectively), DR3–DR4 (21 vs 1% for sick subjects compared with healthy controls, respectively) and DR7–DQ2 (21 vs 6% for sick subjects compared with healthy controls, respectively) were also found to be significantly important in children with CD. The highest relative risk (RR) was for HLA B8 in class I (RR 6.50), for DR3 (RR 11.30) in class II and for combination of DR3–DR4 (RR 20.46). The highest etiologic fraction (EF) was for the DR3 antigen (EF 0.55).

Conclusions
: The present study emphasizes that HLA genotypes are an important background to CD development, but some additional susceptibility factors remain to be identified.
Pulmonary sequelae in long‐term survivors of bronchopulmonary dysplasia
Authors: Ng Daniel Kwok‐Keung , Lau Winnie Yuen‐Wah , Lee So‐Lun
Published: March 2003

Abstract

Background
: Bronchopulmonary dysplasia (BPD) is a common problem in premature babies. Long‐term sequelae are the main concerns.

Methods
: A retrospective review of all BPD children born in Queen Mary Hospital, a teaching hospital of the University of Hong Kong, from January 1987 to December 1995 was conducted. Children with cerebral palsy, immunodeficiency, congenital heart disorders, renal or liver failure were excluded from analysis. Chest radiography (CXR), electrocardiogram (ECG) and pulse oximetry were routinely performed.

Results
: Fifty‐five children completed the study. The female to male ratio was 1 : 1.1. The mean gestational age was 28 weeks. Twenty‐five children were born with a birthweight of less than 1001 g. Mean age at assessment was 5.4 years. Twenty‐four children (44%) demonstrated signs or symptoms of current asthma. Only seven children managed to perform the spirometry satisfactorily. One child had low forced vital capacity and one had hyperresponsive airway. The only risk factor found to be associated with current asthma was the birth month, with those children born early in the year at higher risk of developing current asthma. Seventeen of 48 children (35%) had a bodyweight below the third percentile at the corrected age of 1 year. Eleven of these seventeen children (65%) demonstrated catch‐up growth at assessment. Abnormal CXR was found in 25 of 40 children (63%). All had normal pulse oximetry and ECG.

Conclusions
: Bronchopulmonary dysplasia children had a significantly higher risk than the general population of developing current asthma (odds ratio 4.7; 95% confidence interval 3.4–6.5; P<0.0001). The importance of birth month suggests that early life experience is important in the pathogenesis of asthma, even in BPD children. The long‐term growth of BPD children was much better than previously reported.
Idiopathic sustained left ventricular tachycardia in pediatric patients
Authors: Yasui Kiyoshi , Shibata Toshimitsu , Yokoyama Utako , Nishizawa Takashi , Takigiku Kiyohiro , Sakon Takuma , Kobayashi Hirohide , Iwamoto Mari , Nimura Ichiro
Published: March 2003

Background
: Idiopathic sustained ventricular tachycardia originating from the left ventricle (ILVT) has been an indication for catheter ablation. The present study evaluated the clinical features, long‐term prognosis and indications for treatment in pediatric patients with ILVT.

Methods
: The subjects of the present study were eight patients (four males and four females) with a mean age at onset of 11.0 years (range 3–15 years). The mean follow‐up period was 7.7 years (range 2.1–11.3 years).

Results
: In electrophysiologic studies, intravenously administered verapamil was effective for the termination of tachycardia in all six patients who received this treatment and for the prevention of tachycardia in four of five patients. Oral administration of verapamil was effective in five of seven patients. Propranolol or flecainide was added to the treatment protocol for two patients who did not respond to verapamil alone. Tachycardia disappeared without drugs in four patients during the follow‐up period and became non‐sustained in another patient. Two of three patients with persistent tachycardia underwent catheter ablation. Pharmacologic treatment was very effective for ILVT among these patients.

Conclusions
: Pharmacologic therapy, such as with verapamil, is still the treatment of choice for ILVT because of a good long‐term prognosis and potential risks and complications by manipulation of catheter ablation.
Endomysium antibodies in the diagnosis of celiac disease in short‐statured children with no gastrointestinal symptoms
Authors: Tümer Leyla , Hasanoglu Alev , Aybay Cemalettin
Published: March 2003

Background
: Endomysium antibodies (EmAb) are strongly associated with untreated celiac disease and are suggested to be diagnostic. The aim of the present study was to assess the value of anti‐EmAb for celiac disease screening in children with short stature.

Methods
: In 84 children with height less than the third percentile for age, preliminary work‐ups were made to find a cause for their short stature and then their serum was assayed for anti‐EmAb by indirect immunofluorescence tests using monkey esophagus.

Results
: Seven children were strongly positive for EmAb and all had positive histologic findings for celiac disease.

Conclusions
: Our results show that there is an association with occult celiac disease and idiopathic short stature and that the serum anti‐EmAb test is useful in identifying such cases.
Effect of gestational age on plasma fibronectin concentrations in the neonate
Authors: Topaloglu A Kemal , Hallioglu Olgu , Duzovali Oznur , Amac Aysel , Yilgor Esat
Published: March 2003

Background
: Fibronectin (FN) is known to have important roles in host defense against infection. The risk for neonatal sepsis increases with the degree of immaturity of the host. Conflicting results have been reported on the relationship between plasma FN levels and gestational age (GA) in the preterm neonate.

Methods
: In the present study, we determined plasma FN concentrations with an immunodiffusion method in 40 newborns of various gestational ages, ranging from 30 to 42 weeks.

Results
: We found a strong direct correlation between plasma FN levels and GA (r=0.86; P<0.001).

Conclusions
: We speculate that the increased risk for neonatal sepsis with degree of prematurity may, in part, be explained by impaired defense with decreasing plasma FN levels seen with lessening GA.
Catheter closure of moderate to large sized patent ductus arteriosus using the simultaneous double or triple coil technique
Authors: Akagi Teiji , Mizumoto Yoshie , Iemura Motofumi , Tananari Yoshifumi , Ishii Masahiro , Maeno Yasuki , Kato Hirohisa
Published: March 2003

Abstract

Background
: Although the clinical experience with transcatheter closure of the patent ductus arteriosus using the coils has grown rapidly, one important complication of this procedure using the conventional Gianturco coil was the migration of coils into peripheral vessels. This is especially for patients with a relatively larger size ductus and the risk for such complications could be increased. In this situation, the detachable coil may have some technical benefits to perform coil occlusion and reduce the incidence of complications.

Methods
: We describe the clinical efficacy of a simultaneous double or triple coil occlusion technique using the Cook detachable coil or bioptome delivered 0.052 inch Gianturco coil to close the ductus arteriosus. This was performed in patients whose ductus diameter was greater than 3.0 mm.

Results
: From February 1995 to December 2000, 118 patients with patent ductus arteriosus were treated by coil occlusion using Cook detachable coils, of whom 58 patients whose minimum diameter of ductus ≥ 3.0 mm were reviewed. All patients had successful placement of coils. According to the evaluation by color flow mapping, a trivial shunt was observed in 17 patients (29%) within 24 h after the procedure. In 11 out of 17 patients, a residual shunt was not detected 1 month after the procedure. At 6 months after the procedure, the residual shunt was detected only in three patients.

Conclusions
: Although this study did not calculate the statistical significance between detachable and non‐detachable coils in term of occlusion rate, our institutional experience suggests that the simultaneous double or triple coil technique using the detachable or 0.052 inch Gianturco coils can reduce the prevalence of coil migration or complications.