bluuebunny/crossref_metadata_2025 huggingface dataset:
Phyllodes tumors of the breast: Correlation of nucleolar organizer regions with histopathological malignancy grading, flow cytometric DNA analysis and clinical outcome
Authors: Samaratunga Hemamali , Clarke Belinda , Owen Leigh , Bryson Greg , Swanson Cheryl
Published: March 2003

To examine whether nucleolar organizer regions detected by argyrophilia (Ag‐NOR counts) can be used as a prognostic indicator in phyllodes tumors of the breast, and to compare its usefulness with that of DNA flow cytometric analysis, 28 cases of breast phyllodes tumors (including 15 benign, two borderline and 11 malignant tumors) were subjected to Ag‐NOR staining and counting as well as DNA flow cytometric analysis. S‐phase fraction and DNA ploidy analysis showed useful trends for improving outcome predictions in malignant phyllodes tumors. However, high Ag‐NOR counts were significant in predicting survival status (P= 0.013) and reached near statistical significance in predicting survival times (P= 0.07). In predicting survival status, results for Ag‐NOR counts were significantly better than those for ploidy analysis (P= 0.02) and S‐phase fraction (P< 0.01). Only S‐phase fraction was significantly predictive of survival times (P= 0.025). It is concluded that Ag‐NOR counts and DNA flow cytometric analysis, easily performed using paraffin sections, give information that can improve predictions made by histopathological classification. Ag‐NOR counts are significant in predicting survival in the presence of histopathological features of malignancy.
Cutaneous bronchogenic cyst of the abdominal wall
Authors: Kim Na Rae , Kim Hyun Hak , Suh Yeon‐Lim
Published: March 2003

We report a case of the unusual location of a cutaneous bronchogenic cyst on the abdominal wall. The patient was a 9‐month‐old boy who had presented with a 1.5 cm‐sized polypoid mass, present since birth. Pathological examination of the excised mass revealed multiple small cystic structures surrounded by the fibroadipose tissue. The lining epithelium consisted of either pseudostratified ciliated columnar epithelium with goblet cells or a single layer of ciliated or non‐ciliated cuboidal to columnar cells. The cystic walls contained a well‐developed smooth muscle bundle, mucous glands and hyaline cartilage plate. This lesion was adherent to the peritoneum, but there was no direct communication with the abdominal cavity. Cutaneous bronchogenic cyst located in the abdominal wall has not been described in the English literature. The present case suggests a possible origin from a downward migration, from the sequestered bud of a tracheobronchial tree primordium along the midline of the body surface, during embryonic development.
E‐cadherin, α‐catenin and β‐catenin in biliary atresia: Correlation with apoptosis and cell cycle
Authors: Sasaki Hideyuki , Nio Masaki , Iwami Daiji , Funaki Nobuo , Sano Nobuyuki , Ohi Ryoji , Sasano Hironobu
Published: March 2003

Biliary atresia (BA) is the most common cause of obstructive jaundice in infancy. Although the etiology of BA remains unknown, the ductal plate malformation has been considered to play an important role in the development of BA. Cell–cell adhesion has long been recognized as one of the most important processes in organogenesis. E‐cadherin is involved in cell–cell adhesion, together with the catenins. Abnormalities of E‐cadherin and associated catenins have not been examined in detail in the liver with BA. We therefore examined immunolocalization of E‐cadherin and α‐ and β‐catenins in the BA liver (n= 45) and
compared the findings with those in non‐BA (n= 11) and fetal liver
(n= 21). We semiquantitatively evaluated the findings using H score,
which were generated according to the percentage of immunopositive cells and their
immunointensity. We also examined mRNA localization of E‐cadherin using mRNA in
situ hybridization. We then studied the correlation of E‐cadherin immunoreactivity
with apoptotic cells, and cyclin‐dependent kinase inhibitor p27Kip1 immunolocalization
of bile duct cells in BA liver (n= 10) and fetal liver (n=
10). In fetal liver, H score of E‐cadherin, but not of α‐ and β‐catenins,
was significantly lower in the remodeling stage than in the ductal plate (P= 0.0034) and remodeled stages (P= 0.0024). In addition, the
H score of E‐cadherin, but not α‐ and β‐catenin, in bile duct
cells was significantly lower in BA liver than in non‐BA liver (P= 0.0132). E‐cadherin mRNA hybridization signals were relatively conserved in bile duct cells of BA liver, but decreased in remodeling ductal plate cells of fetal liver. An inverse correlation was detected between the H score of E‐cadherin and the TUNEL labeling index (LI) in both fetal and BA liver. In contrast, a positive correlation was detected between the H score of E‐cadherin and p27 LI in both fetal and BA liver. These findings suggest that impaired expression of E‐cadherin in bile ducts may play an important role in the biological features of BA, possibly associated with cell cycle and apoptosis.
Invasive ductal carcinoma associated with tubular adenoma of the breast
Authors: Domoto Hideharu , Tsuda Hitoshi , Miyakawa Kunihisa , Shinoda Akiko , Nanasawa Takeshi
Published: March 2003

We report an extremely rare case of the colocalization of a tubular adenoma and an invasive ductal carcinoma occurring in a 55‐year‐old woman. Following radiographical evaluation, fine‐needle aspiration cytology of the left breast tumor was undertaken. Because cytological examination revealed malignancy, a partial mastectomy was performed. Histologically, the tumor (measuring 1.7 × 1.3 cm) comprised two distinct parts: tubular adenoma and invasive ductal carcinoma. The invasive ductal carcinoma showed a solid pattern, high nuclear and structural atypia and frequent mitotic figures, while the tubular adenoma consisted of a proliferation of small ducts lined by single layers of epithelial and myoepithelial cells with bland nuclei and inconspicuous nucleoli. The histological boundary was clearly defined between the tubular adenoma and the invasive ductal carcinoma, and between the tubular adenoma and the surrounding breast tissue. The current case might be a collision between separate tubular adenoma and invasive ductal carcinoma, but the malignant transformation of a tubular adenoma cannot be ruled out. Both the long‐term observation of this case and analysis of more cases may enable us to determine the histological characteristics and clinical significance of invasive ductal carcinoma associated with tubular adenoma.
Adult T‐cell leukemia/lymphoma in Jujuy, north‐west Argentina
Authors: Marin Oscar , Hasui Kazuhisa , Remondegui Carlos , Sato Eiichi , Aye Moe Moe , Takenouchi Norihiro , Izumo Shuji , Tajima Kazuo
Published: March 2003

Human T‐cell leukemia virus type 1 (HTLV‐1) infection is prevalent in native Americans living in the Andes. Some of their malignant lymphomas (ML) show a peculiar histology suggestive of adult T‐cell leukemia/lymphoma (ATLL). To determine whether ML resembling ATLL are indeed ATLL, re‐analysis of 34 cases occurring in Jujuy, a province of Argentina, was conducted, concentrating on immunological phenotype, integration of HTLV‐1 proviral DNA, expression of HTLV‐1 p40Tax and p27Rex, and infection of Epstein–Barr virus (EBV). The ML were 22 cases of mature peripheral T‐cell and natural killer (NK)‐cell neoplasm (mT/NKN), 11 B‐cell malignant neoplasms and one Hodgkin's lymphoma. Polymerase chain reaction against the HTLV‐1 proviral DNA, using DNA extracted from paraffin sections, indicated integration of the HTLV‐1 proviral DNA in three cases of eight mT/NKN. Two other cases of mT/NKN were positive for anti‐HTLV‐1 antibodies. Expression of p40Tax and p27Rex was detected in all five of these mT/NKN cases associated with HTLV‐1. As such, these five mT/NKN were rediagnosed as ATLL. In situ hybridization signals for EBV‐encoded small nuclear early region‐1 were detected in nine cases of mT/NKN, of which five cases of NK‐cell lymphoma were found to have cytoplasmic CD3 expression, a CD56 phenotype and positivity of TIA1. According to the new World Health Organization classification, the mT/NKN class includes five cases of ATLL and five cases of NK‐cell lymphomas. The five cases of ATLL were of native American extraction from an HTLV‐1‐endemic area around Jujuy, north‐west Argentina.
Autoimmune hepatitis associated with bile duct injury resembling chronic non‐suppurative destructive cholangitis
Authors: Sato Yasunori , Harada Kenichi , Sudo Yoshiko , Watanabe Kishichiro , Nakahama Tohru , Morimoto Hideo , Nakanuma Yasuni
Published: March 2003

Autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) are representative autoimmune liver diseases in which hepatocytes and intrahepatic bile ducts, respectively, are selectively damaged by autoimmune mechanisms. Bile duct injury and loss is characteristic of PBC and chronic non‐suppurative destructive cholangitis (CNSDC), in particular, is a histological hallmark of PBC. In this report, we present an unusual case of AIH accompanied by CNSDC‐like bile duct injury in a 46‐year‐old woman. The patient's serum aminotransferase level was abnormally high. The serum levels of alkaline phosphatase, γ‐GTP and IgG were also elevated, but the IgM level was within normal limits. The titer of antismooth muscle antibody (SMA) was 1:80 , while antinuclear autoantibody (ANA) and the M2 fraction of antimitochondrial antibody (AMA) were both negative. Liver biopsy disclosed CNSDC‐like bile duct injuries and severe interface hepatitis and lobular hepatitis with perivenular zonal necrosis were observed. The aggregate score of the International Autoimmune Hepatitis Group corresponded to the category of probable AIH. Immunohistochemically, histocompatibility leukocyte antigen‐DR, which is aberrantly expressed in the damaged bile ducts of PBC, was not found in the injured bile ducts of this case. Laboratory data were much improved by treatment with prednisone, but ursodeoxycholic acid was not effective. Although the possibility of an overlapping syndrome of AIH‐ and AMA‐negative PBC could not be excluded, this case was diagnosed as AIH with CNSDC‐like bile duct lesions.
DNA copy number changes in carcinoma in pleomorphic adenoma of the salivary gland: A comparative genomic hybridization study
Authors: Morio Takashi , Morimitsu Yosuke , Hisaoka Masanori , Makishima Kazumi , Hashimoto Hiroshi
Published: March 2003

Pleomorphic adenoma is the most common benign tumor of the salivary glands and is rarely associated with concurrent epithelial malignancy, which is designated as carcinoma in pleomorphic adenoma (CPA). Genetic abnormalities potentially related to the development of CPA have not been fully investigated. We analyzed DNA copy number changes in each of the adenomatous and carcinomatous components of seven CPA by comparative genomic hybridization using DNA extracted from microdissected tissues of formalin‐fixed, paraffin‐embedded tumor samples. Carcinomatous components of CPA showed multiple DNA copy number changes at 1–18 different genomic sites (mean 13 sites). Adenomatous components displayed less frequent DNA copy number changes (0–13 sites; mean, 5). In both components, the majority of the changes were gains. The most common recurrent gains in carcinomatous components were seen at 6q (four cases in each), whereas gains at 13q1–2 and 15q1 were most frequently detected in adenomatous components (three cases in each). In five CPA, the same chromosomal regions were involved in the DNA copy number changes detected in both components. Our data suggest that an accumulated or increased number of chromosomal changes including 6q abnormalities may be associated with the development of carcinomatous components in a subset of CPA.
Rearrangement of immunoglobulin heavy and light chains and VH family in thyroid and salivary gland lymphomas
Authors: Kato Kei , Ohshima Koichi , Shiokawa Satoshi , Shibata Takao , Suzumiya Junji , Kikuchi Masahiro
Published: March 2003

It is often difficult to differentiate extranodal marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma) from non‐neoplastic inflammatory conditions. Demonstration of clonal lymphoid proliferation by molecular procedures is important for accurate diagnosis. We examined the clonal population of B‐cell lymphomas in nine cases of thyroid and two cases of salivary gland B‐cell lymphoma using semi‐nested polymerase chain reaction (PCR)‐based assay for IgH gene arrangement and reverse transcription (RT)‐PCR single‐strand conformation polymorphism (SSCP) for the detection of IgL gene rearrangement. Clonality was evident in nine out of 11 cases of B‐cell lymphomas examined by PCR, and in six of eight cases by RT‐PCR SSCP. In addition, analysis of VH families was performed in eight cases. Although VH3 family was frequently used, each case demonstrated the VH4, VH5 or VH6 family. It is possible that the normal counterpart of thyroid or salivary gland lymphoma might be different from peripheral blood B lymphocytes, which usually use VH3 family. Our results indicate that although no clonality was noted in one case by both PCR and SSCP, these molecular methods are useful as supplementary diagnostic tests for both thyroid and salivary gland lymphomas.
Diffuse mucosal carcinoma of intrahepatic and extrahepatic bile ducts including gallbladder
Authors: Haratake Joji , Kasai Takahiko , Makino Hiroshi
Published: March 2003

An autopsy case with a widespread mucosal carcinoma of the biliary tree was reported. A biochemical profile of the bile duct damage was noticed in a woman in her seventies during a gastric examination. Imaging procedures depicted irregular dilatations of intrahepatic bile ducts with a bead‐like appearance. Elevated levels of serum alkaline phosphatase and γ‐glutamyltransferase with a negative antimitochondrial antibody persisted. The patient was diagnosed as primary sclerosing cholangitis, she was followed up for 4 years under preservative therapies, and died of anasarca and heart failure. Post‐mortem examination showed a diffuse mucosal carcinoma of both intrahepatic and extrahepatic biliary passages including the gallbladder with a minimal invasion and scattered foci of adenoma‐like area in part. There was no evidence of gallstones or pre‐existing sclerosing cholangitis. The striking features of the tumor were extensive papillary growth, mucus secretion and irregular dilatation of bile ducts. The tumor may bear biological and morphological homology with intraductal papillary mucinous tumor of the pancreas.
Mixed tumor of deep soft tissue
Authors: Adachi Toshisada , Oda Yoshinao , Sakamoto Akio , Saito Tsuyoshi , Tamiya Sadafumi , Hachitanda Yoichi , Masuda Sachio , Tsuneyoshi Masazumi
Published: March 2003

Mixed tumors of the salivary gland and skin are relatively common but are quite rare in soft tissue. It is believed that, as in the salivary gland form, most of these lesions are benign, but that a small subset behave in an aggressive fashion. We report here a patient with recurrent mixed tumor of soft tissue with infiltrative growth. The primary tumor arose in deep subfascial soft tissue of the right lower leg and was adjacent to the surface of the fibula. An open biopsy and complete resection were performed. Upon histological examination of the resected specimen, neoplastic cell infiltration at the tumor/soft tissue interface was not obvious; local recurrence, however, was observed 1 year later. The patient was treated with wide resection. Histological examination confirmed that the recurrent tumor with an extensive chondroid area invaded the osseous tissue of the fibula. At present, 1 year after the second resection surgery, there is no evidence of disease.
Evolution of DNA ploidy state and DNA index in colorectal adenomas and carcinomas using the crypt isolation technique: New hypothesis in colorectal tumorigenesis
Authors: Sugai Tamotsu , Uesugi Noriyuki , Nakamura Shin‐ichi , Habano Wataru , Jiao Yu‐Fei , Noro Akihiro , Takahashi Hiroshi , Akasaka Iichiro , Higuchi Taro
Published: March 2003

The evolution of DNA diploid, aneuploid and multiploid (diploid and aneuploid) states that represent DNA types that are independent of genetic alterations in colorectal tumors were examined. Changes in the DNA index (DI) accompanying tumor development from adenoma to carcinoma were assessed. In colorectal adenomas and early cancers, the DNA was diploid or multiploid. A pure aneuploid state was observed in advanced carcinomas only, whereas the aneuploid DI values of adenomas were characterized by two distinct peaks. The DI values for the carcinomas were randomly distributed. However, in advanced carcinomas, aneuploid carcinomas tended to have lower DI whereas aneuploid populations within multiploid carcinomas tended to have higher DI. Early cancers were subdivided into two groups: a cancer region associated with an adenomatous region (group A tumors) and a cancer region that exhibited an absence of or a very limited adenomatous region (group B tumors). Group A tumor DI were lower than group B. It is suggested that low DI adenomas might transform into group A tumors, which consequently progress to advanced aneuploid carcinomas. In addition, group B tumors might derive predominantly from high DI adenomas or from group A tumors by high DI evolution, and might progress into advanced multiploid carcinomas. Therefore, the evolution of the DNA index might play an important role in the development of colorectal tumors.
Rocky shore turfs dominated by Corallina (Corallinales, Rhodophyta) in northern Japan†
Authors: Akioka Hidetsugu , Baba Masasuke , Masaki Tomitaro , William Johansen H.
Published: March 2003

Three intertidal sites dominated by Corallina turfs were investigated in Hokkaido, Japan. The sites (A, B and C) differed in slope, wave exposure and length of time exposed to air during tidal cycles. Monthly samples were analyzed for frond morphology and other features. Site A, the most wave‐exposed site, was dominated by Corallina sp. X, an unknown species, and sites B and C by Corallina pilulifera Postels et Ruprecht. At the different sites the populations differed in conceptacle abundance, coverage by epiphytic Titanoderma corallinae (P. Crouan et H. Crouan) Woelkerling, Chamberlain et Silva, amount of contained sediment, numbers of axes per quadrat, numbers of branch fusions, branch entanglement, frond dryweight, frond length, amount of adventitious branching, numbers of epiphytes (exclusive of T. corallinae), and numbers of animal species. Ninety‐one animal species were recorded from the turfs. Corallina is affected morphologically by conditions inherent in its microhabitat, including desiccation, epiphyte loading and the abundance of herbivores.
pEffects of UV radiation on the ultrastructure of several red algae
Authors: Poppe Frank , Schmidt Ralf A. M. , Hanelt Dieter , Wiencke Christian
Published: March 2003

The effect of ultraviolet (UV) radiation on the ultrastructure of four red algae, the endemic Antarctic Palmaria decipiens (Reinsch) Ricker and Phycodrys austrogeorgica Skottsberg, the Arctic‐cold temperate Palmaria palmata (Linnaeus) O. Kuntze and the cosmopolitan Bangia atropurpurea (Roth) C. Agardh was studied. All four species showed a formation of ‘inside‐out’ vesicles from the chloroplast thylakoids upon exposure to artificial UV‐radiation. In P. decipiens, most vesicles were developed after 8 h and in P. palmata, after 48 h of UV exposure. In B. atropurpurea, vesi‐culation of thylakoids was observed after 72 h of UV irradiation. In Ph. austrogeorgica, the chloroplast envelope and thylakoid membranes were damaged and the phycobilisomes became detached from the thylakoids after 12 h of UV exposure. Ultraviolet‐induced changes in the membrane structure of mitochondria were observed in P. decipiens and P. palmata. However, in P. decipiens they were reversible as was the damage in chloroplast fine structure after 12 h of UV treatment. Protein crystals in Ph. austrogeorgica showed degradation after exposure to UV radiation. Different methods of fixation and embedding macroalgal material are discussed. These findings give insight into the fine structural changes which occur during and after UV exposure and indicate a relationship between the species dependent sensitivity to UV‐exposure and the depth distribution of the different species.
An increase in hyaluronan by lung fibroblasts: A biomarker for intensity and activity of interstitial pulmonary fibrosis?
Authors: Zhao Hong‐Wen , Lü Chang‐Jun , Yu Run‐Jang , Hou Xian‐Ming
Published: March 2003

The purpose of the present study was to clarify the roles of hyaluronan (HA) production of lung fibroblasts in the pathogenesis of pulmonary fibrosis. Quantitative and comparative assessments of the HA levels in bronchoalveolar lavage fluid (BALF) and lung fibroblast‐conditioned media (F‐CM) were made at various stages during the development of bleomycin‐induced pulmonary fibrosis in rats. In bleomycin‐treated animals,the HA levels in F‐CM increased significantly (P < 0.01) on day 1 after bleomycin treatment, peaked on day 3, and then gradually declined and returned to control values on days 14–28. The HA concentrations of BALF in the bleomycin group were significantly increased (P < 0.01) on day 3, were maximal on day 7, and thereafter gradually decreased, remaining significantly above normal values (P < 0.01) on day 14, but returning to control values by day 28. In the bleomycin group, the HA levels both in BALF and in F‐CM were significantly correlated with the cell components in BALF and there was a significant correlation between the HA concentration in BALF and in the F‐CM. Lung fibroblasts were activated and produced increased HA which resulted in excessive accumulation of HA in the lung in the early stage of pulmonary fibrosis; the increased HA synthesis of lung fibroblasts and enhanced HA concentrations of BALF might reflect the intensity of alveolitis and the disease activity.
Lymphoma of bronchus‐associated lymphoid tissue resembling middle lobe syndrome
Authors: Chida Kingo , Sato Atsuhiko , Sato Jun , Ide Kyohtaro , Shirai Masahiro , Iwata Masatoshi , Nakamura Hirotoshi
Published: March 2003

We describe three cases of lymphoma of bronchus‐associated lymphoid tissue (BALT). All three patients had long histories of right middle lobe and/or lingula infiltrates on chest radiographs that were compatible with chronic respiratory tract infection. On histological and immunological examination of lung biopsy specimens in the three cases, a lymphoepithelial lesion was identifiable. Phenotyping of the infiltrating lymphocytes showed predominantly B cells, but the lymphocytes were negative for CD10. In two of the cases, rearrangement of the immunoglobulin heavy chain genes was positive, while rearrangements of the bcl‐2 and T cell receptor genes were negative. Each patient had a long history of a productive cough, ranging from 5 to 7 years. Thus, the differential diagnosis of BALToma must be considered when serial chest radiographs show progression over years in the right middle lobe and/or lingula. Furthermore, because BALToma arises from BALT itself and hyperplasia of BALT is dependent on prolonged antigenic stimulation, the onset of these BALTomas may have been related to chronic respiratory tract infections.
A dynamic analysis of chest wall motions with MRI in healthy young subjects *
Authors: Kondo Tetsuri , Kobayashi Ichiro , Taguchi Yasushi , Ohta Yasuyo , Yanagimachi Noriharu
Published: March 2003

Objective:

The objective of this study was to analyse respiratory‐related motion of the chest wall with non‐invasive method.

Methodology: Using magnetic resonance image (MRI), 30 sequential images (scanning time, 0.4 s per image) on sagittal, axial and coronal planes were obtained in nine healthy young subjects during quiet breathing (QB) and maximal deep breathing (MDB). The coronal planes were obtained in five of nine subjects during MDB. Ventilation was simultaneously measured with pneumotachometer. Results: There was a linear correlation between instantaneous lung volume and lung cross‐sectional area. Motion of the diaphragm and rib cage was also linearly related to instantaneous lung volume. The exception was lower anteroposterior (AP) diameter of the rib cage. The contribution of individual part of the chest wall motion to a unit lung volume change was assessed by slope (S) of the linear regression line. The S at the anterior diaphragm was significantly smaller than those at middle and posterior parts during MDB. The S of middle and posterior diaphragmatic motion was approximately five times that of AP motion of upper rib cage. The S of AP motion of upper rib cage was twice that of transverse motion during either QB or MDB.

Conclusion: We concluded that dynamic MRI study with concurrent ventilation measurement is a simple and reliable method for evaluation of local chest wall motion, and that neither diaphragm nor rib cage works as a single functional unit during active ventilation.
Pleural amyloidosis in a patient with intractable pleural effusion and multiple myeloma
Authors: Maeno Toshitaka , Sando Yoshichika , Tsukagoshi Masaaki , Suga Tatsuo , Endo Michiko , Seki Ryotaro , Ooyama Yuko , Yamagishi Takahiro , Kaneko Yoshiaki , Kanda Tsugiyasu , Iwasaki Tsutomu , Kurabayashi Masahiko , Nagai Ryozo
Published: March 2003

Abstract:

Pleural involvement of systemic amyloidosis has been rarely reported. We report a case with multiple myeloma presenting an intractable right pleural effusion, in which pleural amyloidosis was diagnosed through pleural biopsy using a Cope needle. The diagnosis of pleural amyloidosis is important, because its refractory pleural effusion should be treated with pleurodesis. Since closed pleural biopsy using a Cope needle is much less invasive than thoracoscopy, the former should be attempted first whenever pleural amyloidosis is suspected.
A comparative study of pleurodesis using talc slurry and bleomycin in the management of malignant pleural effusions
Authors: Ong Kian Chung , Indumathi Venkathesan , Raghuram Jagadesan , Ong Yong Yau
Published: March 2003

Objective:

Differing success rates of various pleurodesis agents have been reported in the management of malignant pleural effusions. A randomized clinical trial was conducted to compare the efficacy of two commonly used agents, talc and bleomycin, for the pleurodesis of malignant pleural effusions.

Methodology: Inclusion in the study required proof of a malignant pleural effusion by fluid cytology or pleural biopsy. Exclusion criteria included trapped lung, loculated effusions, recurrent effusions and life expectancy < 1 month. Five grams of talc or 1 unit per kilogram bodyweight of bleomycin mixed in 150 mL of normal saline was administered via tube thoracostomy after complete drainage of the pleural effusion in each patient. Treatment success was defined as the absence of recurrent pleural effusion on the chest radiograph 1 month after pleurodesis.

Results: Treatment success was achieved in 16 out of 18 patients (89%) in the talc slurry group versus 14 out of 20 patients (70%) in the bleomycin group (P = 0.168). Fever and pain were the only side‐effects of pleurodesis in both groups.

Conclusion: These results indicate that talc slurry is as effective as bleomycin in preventing early recurrence of malignant pleural effusions. Pleurodesis with talc instead of bleomycin can result in significant cost savings.
Cell type accuracy of transthoracic fine needle aspiration material in primary lung cancer
Authors: Yilmaz Adnan , Üskül Taha Bahad´yr , Bayramgürler Birol , Baran Reha
Published: March 2003

Objective:The aim of this study was to evaluate the diagnostic accuracy of transthoracic fine needle aspiration (TFNA) materials in establishing the specific cell type in primary lung cancer, and to study the influence of several factors on this accuracy.

Methodology:The present study included 129 patients [(12 females, 117 males; mean age 54.6 years (range 25–75)] who underwent thoracotomy. The initial diagnosis was obtained by means of TFNA biopsy in all patients. Transthoracic fine needle aspiration was performed by 22‐gauge Chiba needle with fluoroscopy guide in 93 patients and with computed tomography guide in 36 cases.

Results:The overall concordance was 73.6% (Kappa = 0.52). The worst agreement was obtained for the large cell carcinoma (40%; Kappa = 0.48). The likelihood of a correct diagnosis using the TFNA specimens was 6.2‐fold higher for well‐differentiated tumours than for poorly differentiated tumours (P< 0.005). The stage of tumour and diameter of the lesion had no effect on cell agreement. Cell agreement was higher in central lesions than peripheral lesions, but the difference was not statistically significant (P= 0.097). This difference was more significant between patients with central and peripheral epidermoid carcinoma (P= 0.057).

Conclusion:In our opinion, cell typing by TFNA may lead to incorrect results in the presence of poor differentiation, mixed tumours and peripheral epidermoid carcinomas.
Effect of the long‐term use of inhaled corticosteroids on bone mineral density in asthmatic women
Authors: Sivri Ayşen , Çöplü Lütfi
Published: March 2003

Objective: Inhaled corticosteroids have become a key element in the maintenance treatment of bronchial asthma. Recent studies have shown that administration of inhaled corticosteroids is associated with evidence of derangement in bone turnover. Therefore, we studied the bone mineral density (BMD) of asthmatic women receiving long‐term inhaled corticosteroids and compared them with healthy individuals matched for age, sex, menopausal status and body mass index.

Methodology: Thirty‐two female patients with bronchial asthma, who had been using inhaled corticosteroids (beclomethasone dipropionate 750–1500 μg/day) regularly for at least 3 months, were included in the study. Bone mineral density measurements were done with dual X‐ray absorptiometry in the lumbar area of the spine and the hip. Detailed laboratory examation was also done for the patients and 26 controls.

Results: There was a significant decrease in BMD of the patient group at the lumbar region and femur as compared with normal controls. In the patients there was a significant negative correlation between the duration of therapy, daily and cumulative doses, and BMD at the lumbar region but not BMD at the femur.

Conclusions: These results indicate that long‐term use of inhaled corticosteroids is associated with significant bone loss in asthmatic women and is especially related to the duration of therapy. Therefore, it is necessary to appropriately screen and give prophylactic treatment to those who are likely to develop osteoporosis from inhaled corticosteroid treatment.
Pulmonary diffusion capacity in patients with systemic lupus erythematosus
Authors: NAKANO MASAAKI , HASEGAWA HISASHI , TAKADA TOSHINORI , ITO SATOSHI , MURAMATSU YOSHIYUKI , SATOH MAKOTO , SUZUKI EIICHI , GEJYO FUMITAKE
Published: March 2003

Objective: The aim of this study was to clarify the characteristics of pulmonary function tests (PFT), especially carbon monoxide diffusion capacity (DLCO), and their correlation with clinical features and immunological findings in patients with systemic lupus erythematosus (SLE).

Methodology: Vital capacity (VC) and DLCO were analysed retrospectively in 110 sequential Japanese SLE patients with active disease between 1985 and 1999. In 38 patients, serial measurements of PFT were also assessed during high‐dose corticosteroid therapy.

Results: DLCO was reduced in 52 patients (47%) and a restrictive impairment of PFT was observed in nine patients (8%). The prevalence of pulmonary fibrosis was 13%. Reduced DLCO was frequently observed, even in patients with neither pulmonary fibrosis nor a restrictive pattern. No correlation between immunological data and reduced DLCO was found, except for the presence of anti‐RNP. Patients with Raynaud’s phenomenon showed a higher prevalence of DLCO impairment than those without this phenomenon. Although immunological parameters improved significantly after the corticosteroid therapy, no significant change in the level of DLCO was observed.

Conclusions: Impairment of DLCO was frequently observed in patients with SLE who had no clinical respiratory abnormalities. DLCO impairments were correlated with Raynaud’s phenomenon clinically, and the presence of anti‐RNP immunologically. No significant correlation was found between impairment of DLCO and disease activity of SLE.
Chronic cough at a non‐teaching hospital: Are extrapulmonary causes overlooked?
Authors: AL‐MOBEIREEK ABDULLAH F. , AL‐SARHANI AWADH , AL‐AMRI SALEH , BAMGBOYE ELIJAH , AHMED SYED
Published: March 2003

Objective: To estimate the prevalence, assess the diagnostic approach and to identify specific causes and treatment response of chronic persistent cough (CPC) in consecutive adult patients attending the chest clinic at a non‐teaching hospital in Riyadh, Saudi Arabia.

Methodology: Chronic persistent cough was defined as cough persisting for more than 3 weeks. Patients were assessed clinically and investigated according to the suspected diagnosis. The specific causes were confirmed by appropriate investigations, as well as response to specific therapy. Improvement in cough following therapy was assessed subjectively by patients on a scale from 0 to 100%.

Results: Of 1332 patients seen in the chest clinic, 136 (10.2%; 95% confidence interval 8.6–11.8%) presented with CPC as the main complaint. One hundred patients (55% males) were assessed, after excluding 36 patients who were lost to follow up. The common presenting diagnoses (for the 81 patients who had previously consulted a physician) were upper respiratory tract infection (17.1%), asthma (15.9%), bronchitis (9.8%) and unknown in 30.8% of patients. Final diagnoses (as a sole or contributory cause) were established in 96% of patients and included rhinosinusitis (RS; 60%), asthma (26%), gastro‐oesophageal reflux (GERD; 9%), postinfectious cough (8%) and bronchiectasis (5%). The agreement between the presenting and final diagnoses was generally poor, especially for extrapulmonary causes, which was as low as 5.3%. All patients, except for one, had complete or substantial improvement in the severity of cough.

Conclusions: In a non‐teaching hospital setting, CPC is a common benign disorder that rarely requires specialized investigations and is easily treated once the causes are identified. The multiplicity of causes and extrapulmonary triggers of CPC, particularly RS, are often overlooked. The principal causes in our series remain the same as in studies elsewhere, namely RS, asthma and GERD.
Comparison between specified percentage and fifth percentile criteria for spirometry interpretation in Thai patients
Authors: DEJSOMRITRUTAI WANCHAI , WONGSURAKIAT PHUNSUP , CHIERAKUL NITIPATANA , CHAROENRATANAKUL SUCHAI , NANA ARTH , MARANETRA KHUN NANTA
Published: March 2003

Objectives: The present study was conducted to determine the degree of agreement between the interpretation of spirometry using a specified percentage of predicted value (SPC) and the fifth percentile (FPC) as the cut off between normal and abnormal.

Methodology: Spirometric values were collected for 1754 subjects attending the respiratory service at Siriraj Hospital between February 2000 and April 2001. These values included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, maximal mid‐expiratory flow (FEF25–75%) and peak expiratory flow (PEF). A comparison of results between SPC and FPC was performed. The SPC cut‐off values for FVC, FEV1, FEV1/FVC, FEF25‐75% and PEF were 80% predicted, 80% predicted, 70%, 65% predicted and 80% predicted, respectively. The FPC cut‐off values were calculated from reference equations for the Thai population. Inter‐rater agreement was calculated as the kappa score.

Results: High kappa scores were obtained for FVC (0.84), FEV1 (0.88) and FEF25–75% (0.80). However, poor agreement was found for FEV1/FVC (0.72) and PEF (0.61). When the cut‐off values for SPC were modified to 90% of predicted values for FEV1/FVC and to 65% of predicted values for PEF, agreement was substantially improved to 0.92 and 0.89, respectively.

Conclusions: Interpretation by SPC using cut‐off values of 80% predicted for FVC and FEV1 and 65% predicted for FEF25–75% resulted in good agreement with FPC. However, the SPC cut‐off values for FEV1/FVC and PEF should be modified to 90% predicted and 65% predicted, respectively.
Pulmonary glomus tumour: A case initially diagnosed as carcinoid tumour
Authors: YILMAZ ADNAN , BAYRAMGURLER BIROL , AKSOY FERDA , TUNCER LEYLA YAGCI , SELVI AHMET
Published: March 2003

Pulmonary glomus tumours are rare lesions, with few cases reported previously. Herein, we present the clinical and pathological features of a case of pulmonary glomus tumour. A 29‐year‐old female patient presented to our clinic complaining of cough, dyspnoea and left‐sided chest pain. Computed tomography (CT) of the thorax revealed a nodular lesion causing obstruction of the left main bronchus. Fibreoptic bronchoscopy demonstrated a polypoid mass occluding the left main bronchus 10 mm distal to the main carina. Bronchoscopic biopsy was interpreted histologically as carcinoid tumour. Bronchotomy plus mass extirpation was performed with left thoracotomy. Microscopically, a tumoral structure composed of uniform cells with a round centrally located nucleolus and narrow eosinophilic cytoplasm was seen. Thin‐walled vessels lined with endothelium were interspersed between tumoral structures. The cells were stained chromogranin and cytokeratin negative and strongly vimentin positive. The pathological diagnosis for the thoracotomy specimen was pulmonary glomus tumour. Follow‐up chest CT was negative for recurrent tumour and the patient remains free of disease 17 months after surgery.
Pollination system and evolution of dioecy from distyly in Mussaenda parviflora (Rubiaceae)
Authors: Naiki Akiyo , Kato Makoto
Published: March 2003

The floral morphology and reproductive ecology of a scandent shrub species, Mussaenda parviflora Miq. (Rubiaceae), were studied on Iriomote and Amami Ohshima Islands, Japan. The morphological study demonstrated that M. parviflora was gynodioecious. Crossing experiments, however, revealed that it was functionally dioecious. The flowers were visited mainly by butterflies in the daytime and mainly by crepuscular hawkmoths in the evening. Dioecy in this species is thought to have evolved from distyly. Dioecy of this species, which is pollinated by long‐tongued Lepidoptera, is unusual as the evolution of dioecy from distyly in plants with long corolla tubes is thought to have been triggered by a pollinator shift from long‐ to short‐tongued insects. In this species, however, two floral morphological features may have caused the evolution. The first feature is the presence of many upward‐facing hairs covering the inner surface of the upper part of the corolla tube; these hairs appear to have impeded pollen flow from long‐ to short‐styled flowers. The second feature is the overlap in anther height between the two types of flowers, which may have reduced seed set by clogging stigma with incompatible pollen grains. Accordingly, male sterility in long‐styled plants may have evolved.
Ecological and evolutionary trends in wetlands: Evidence from seeds and seed banks in New South Wales, Australia and New Jersey, USA
Authors: Leck Mary A. , Brock Margaret A.
Published: March 2003

Aquatic plants include a variety of life forms and functional groups that are adapted to diverse wetland habitats. Both similarities and differences in seed and seed‐bank characteristics were discovered in comparisons of Australian (New South Wales) temporary upland wetlands with a North American (New Jersey) tidal freshwater marsh having both natural and constructed wetlands. In the former, flooding and drying are unpredictable and in the latter water levels vary diurnally and substrate is constantly moist. The hydrologic regimen provides the overriding selective force, with climate an important second factor. Other factors related to water level, such as oxygen availability, temperature and light, vary spatially and temporally, influencing germination processes, germination rates and seedling establishment. Seed and seed‐bank characteristics (size, desiccation and inundation tolerance, germination cues and seed‐bank longevity and depletion) differ, with the Australian temporary wetland being more similar to the small‐seeded persistent seed bank of the constructed wetland site than to the natural tidal freshwater site with its larger seeds, transient seed bank and seasonal spring germination. Some non‐spring germination can occur in the tidal constructed wetland if the soil is disturbed. In contrast, seeds in the temporary Australian wetlands germinated in response to wet/dry cycles rather than to season. Functional groups (e.g. submerged, amphibious) are more diverse in the Australian temporary wetlands, where all species tolerate drying. We suggest that the amphibious zone, with its hydrologic gradient, is the site of selection pressure determining establishment of wetland plants from seed. In this zone, multiple selective factors vary spatially and temporally.
Adaptive advantages of aerial seed banks
Authors: Lamont Byron B. , Enright N. J.
Published: March 2003

Prolonged storage of seeds on the plant is called serotiny. It is well represented in fire‐prone, nutrient‐poor and seasonally dry, woody vegetation in Australia, South Africa and North America. Serotiny maximizes the number of seeds available for the next generation by storing successive seed crops and protecting them from granivores, agents of decay and fire heat. It is an advantage when annual seed production is insufficient for self‐replacement in any single year and greatly increases the range of fire frequencies tolerated. While serotiny is a form of environmentally enforced dormancy, it has little in common with soil storage of seeds in terms of its ecology and trade‐offs. Our models have shown that optimal levels of serotiny depend on fire frequency in relation to lifespan of the species, probability of interfire recruitment and the extent of fluctuations in fire intervals. Serotiny is adaptive when the cue for seed release, usually fire, also creates superior conditions for seedling establishment. For serotiny to be an advantage over soil storage, it is essential that any fire is followed by reliable recruitment conditions. Intermediate levels of serotiny are favored as fire intervals approach the lifespan of the species, or if there is a substantial resource cost at short intervals. As the probability of interfire recruitment increases, maximum population growth shifts from strong serotiny under short fire intervals to no serotiny at long fire intervals. As variation about the mean fire interval increases, the optimal level of serotiny declines slightly.
Pollinator limitaton in a deceptive orchid, Pogonia japonica, on a floating peat mat
Authors: MATSUI KIYOSHI , USHIMARU TSUSHI , FUJITA NOBORU
Published: March 2003

Deceptive orchid species that offer no floral rewards to pollinators often experience pollinator limitation because they. The breeding system and fruit set were investigated in order to examine pollinator limitation for a population of a deceptive orchid, Pogonia japonica, on a floating peat mat in Mizorogaike Pond, western Japan.

Fruit sets for outcross‐pollinated, self‐pollinated and pollinator‐excluded flowers

were 75%, 80%, and 0%, respectively. Thus, this species was

self‐compatible but neither autogamous nor apogamous. The fruit set for open‐pollinated

flowers was 22.9% and 17.4% in 1994 and 1995, suggesting that pollinator

limitation did occur in the field. Larger flowers were more likely to develop into

fruit than smaller ones in open pollination (36%vs 8%). Thus,

flower size seems to affect fruiting of this species. No effective visits by major

pollinators such as bees, which could carry pollinia, were observed during 16.5 h

of observation during daytime. Instead, thrips were often found moving on gynostemium

or pollinia and circumstantial evidence that suggests thrips may partly transfer

pollen in pieces out of a granular pollinium of P. japonica was obtained.

Pogonia japonica should come to use thrips as a pollinator to supplement low fruit set under limited flower visitation by major pollinators.
Importance of genetic characterization and conservation of plant genetic resources: The breeding system and genetic diversity of wild soybean (Glycine soja)
Authors: Ohara Masashi , Shimamoto Yoshiya
Published: March 2003

Abstract Plant genetic resources play an important role in the improvement of cultivated plants. To characterize and evaluate the ecological and reproductive features of wild soybean (Glycine soja Sieb. et Zucc.), which is the most probable ancestor of cultivated soybean (G. max (L) Merr.), the breeding system and genetic diversity of G. soja were investigated. The extent of natural cross‐pollination of G. soja was estimated in four populations along the Omono River in Akita Prefecture, Japan by examining allozyme variation. Although it has been previously believed that G. soja is autogamous, as is cultivated soybean, the mean multilocus outcrossing rate (tm) estimate was 13%. These values are much higher than the outcrossing rate previously reported for both G. soja and G. max. Frequent visits by honeybees and carpenter bees to flowers were also observed, which supported this conjecture. Furthermore, to evaluate the genetic variation of G. soja as a genetic resource, the genetic structure of 447 populations over Japan were analyzed. Wild soybean populations had a higher degree of variation of isozyme loci. The GST coefficient of gene differentian values among the sites within the district were particularly high, revealing that the isozyme genotype was greatly different among site populations and homogeneous within the sites. The genetic differentiation among nine districts was observed in the allele frequencies of a few loci, indicating that geographic isolation in the wild soybean population was effectively created through the distance between the districts. The difference in the allele frequency among the districts may be produced under genetic drift. Finally, the importance of the preservation of natural plant populations and the habitats of wild progenitors (i.e. the in situ conservation of plant genetic resources) was emphasized.
Delay of liver maturation as a cause of transient neonatal galactosemia
Authors: Ono Hiroaki , Mawatari Hideo , Mizoguchi Nobuyuki , Eguchi Takaatsu , Sakura Nobuo , Hamakawa Mochiyuki
Published: March 2003

Abstract Background: Because a large amount of serum α‐fetoprotein (α‐FP) is synthesized in the liver of the fetus or premature newborn, high concentrations or delayed degradation of serum α‐FP during the neonatal period may reflect hepatic immaturity.

Methods
: In order to evaluate the relationship between transient neonatal galactosemia and delay of liver maturation, the concentration and half‐life of serum α‐FP during the neonatal period were measured in patients with transient galactosemia and in normal neonates.

Results
: No significant differences were observed in the serum concentration of α‐FP between normal and galactosemic patients less than 1 month of age. However, the half‐life of serum α‐FP was significantly longer in galactosemic patients between 15 and 60 days of age compared with age‐matched normal neonates.

Conclusion
: Based on these results, we hypothesize that delay of liver maturation during the neonatal period, especially during the first 2 months after birth, can be a cause of transient neonatal galactosemia.