bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of bone morphogenetic proteins in colon carcinoma with heterotopic ossification
Authors: Imai Nobuhiro , Iwai Atsuhiro , Hatakeyama Setsuko , Matsuzaki Koji , Kitagawa Yoshitake , Kato Shingo , Hokari Ryota , Kawaguchi Atsushi , Nagao Shigeaki , Miyahara Toru , Itoh Kazuro , Miura Soichiro
Published: March 2003

Here we report the case of a 50‐year‐old woman with adenocarcinoma of the colon, showing heterotopic ossification. The patient was referred to our hospital for investigation of anemia secondary to occult gastrointestinal blood loss. By colonoscopy, an irregular polypoid mass was found in the ascending colon. A biopsy of the lesion revealed moderately to poorly differentiated adenocarcinoma with heterotopic ossification. A right hemicolectomy was done and revealed areas of heterotopic bone within the tumor, but no ossification was evident in the metastatic lesions within the mesenteric lymph nodes. The formation of heterotopic bone in gastrointestinal tumors is rare and its exact mechanism is unknown. Immunohistochemical localization of bone morphogenetic proteins (BMP), known to be primary inducers of new bone formation, was determined. BMP‐5 and ‐6 were prominent in the cytoplasm of tumor cells, and they stained weakly in osteoblast‐like cells adjacent to newly formed bone. Cytoplasmic staining for BMP‐2 and ‐4 was weak in tumor cells, osteoblast‐like cells, and stromal fibroblast cells. BMP may play an important role in heterotopic ossification in colon adenocarcinoma.
Co‐expression of N‐cadherin and α‐fetoprotein in stomach cancer
Authors: Yanagimoto Kunio , Sato Yuichi , Shimoyama Yutaka , Tsuchiya Benio , Kuwao Sadahito , Kameya Toru
Published: March 2003

Although N‐cadherin is necessary for organ formation originating in the endoderm, the expression of N‐cadherin in gastric carcinoma and its role has not yet been reported. The present study was conducted to determine the pattern of immunohistochemical expression of E‐cadherin and N‐cadherin, using formalin‐fixed, paraffin‐embedded tissues from 97 primary gastric carcinomas, including 17 which were producing α‐fetoprotein (AFP). Samples were subdivided into 50 tubular adenocarcinomas and 47 poorly differentiated adenocarcinomas. Results showed that E‐cadherin was expressed in varying degrees in areas of cell adhesion between tumor cells, in 94 out of 97 cases studied. Three cases which showed no expression of E‐cadherin were diagnosed as AFP‐producing tumors by immunohistochemistry. Expression of N‐cadherin was observed in varying degrees in the intercellular spaces between tumor cells in 11 tubular adenocarcinomas and in six poorly differentiated adenocarcinomas, including E‐cadherin‐negative cases, all of which were AFP positive. The present findings suggest a possible role for N‐cadherin in gastric carcinoma.
Gastrointestinal stromal tumors: Clinicopathological study of Chinese cases
Authors: Wang Xiaojuan , Mori Ichiro , Tang Weihua , Utsunomiya Hirotoshi , Nakamura Misa , Nakamura Yasushi , Zhou Genying , Kakudo Kennichi
Published: March 2003

In the present study, we reviewed 73 Chinese cases of gastrointestinal stromal tumor (GIST), and analyzed factors in evaluating malignant potential, in particular focusing on Ki‐67 index and p53 expression to determine whether these can be used as prognostic indicators in GIST. The p53 positive rate was 50.7% and it was significantly higher in malignant (25/35; 71.43%) than in benign cases (13/38; 34.21%). A Ki‐67 labeling index of >10% was also significantly different between malignant (23/35; 65.71%) and benign cases (14/38; 36.84%). In the cases in which the patient died, 15/21 and 14/21 cases showed expression of p53 and Ki‐67, respectively; both had a higher expression than in surviving cases. Comparing the cases positive for both Ki‐67 and p53 with those positive for Ki‐67 or p53 alone, and those negative for both Ki‐67 and p53, the latter demonstrated the best prognosis. The study also indicated that the malignant potential of GIST is correlated with the mitotic index (≥1/10 high‐power fields; HPF), tumor size (≥5 cm), high cellularity, tumor invasive growth, tumor location, tumor hemorrhage and tumor necrosis.
Classic type of Kaposi's sarcoma and human herpesvirus 8 infection in Xinjiang, China
Authors: Dilnur Payzula , Katano Harutaka , Wang Zhen Hau , Osakabe Yasuhiro , Kudo Motoshige , Sata Tetsutaro , Ebihara Yoshiro
Published: March 2003

We report 17 cases of the classic type of Kaposi's sarcoma in Xinjiang, which is located in the north‐western area of China surrounded by Mongolia in the east, Russia in the north and Kazakhstan in the west. Fifteen of the patients were of the Uygur people. All patients were male and did not have acquired immunodeficiency syndrome. Most of the lesions were found in the lower and/or upper extremities, with 16 patients showing multiple lesions. Immunohistochemical examination of the lesions revealed that human herpesvirus 8 (HHV‐8)‐encoded latency‐associated nuclear antigen was expressed in the nuclei of spindle‐shaped tumor cells. HHV‐8 DNA was detected by polymerase chain reaction in all seven cases examined. Phylogenetic tree analysis revealed that DNA sequences of the HHV‐8‐encoded K1 gene in the seven Kaposi's sarcoma cases were classified as subtype C that was common in the Mediterranean, the Middle East and East Asian countries. In addition, using immunofluorescence we investigated the seroprevalence of HHV‐8 in 73 Uygur patients with diseases other than Kaposi's sarcoma. Surprisingly, the serological study revealed that 34 of the patients (46.6%) were positive for antibodies against HHV‐8, suggesting that HHV‐8 infection is widespread in Xinjiang area. The occurrence of the classic type of Kaposi's sarcoma with a high seropositivity rate implies that Xinjiang is the most endemic area for HHV‐8 infection in the world known to date. Considering that Xinjiang is located at the middle point of the Silk Road that used to extend from Rome to China, these data imply that the virus may have been in circulation in this area due to the migration of the people via the Silk Road.
Phenotypic changes and cell cycle activation in early tubulointerstitial injury of rat adriamycin nephrosis
Authors: Shu Yujing , Hoshi Sachi , Tomari Shinsuke , Watanabe Teruo , Nagata Michio
Published: March 2003

Tubular response, including phenotypic changes against a variety of injuries, is an initial event that promotes tubulointerstitial injuries. Using the progressive kidney disease model of rat adriamycin (ADR) nephrosis, the present study focused on the cell cycle activation and phenotypic changes that occur in the tubuli in early tubulointerstitial injury in ADR nephrosis. At 12 weeks, experimental animals developed overt nephrosis with tubulointerstitial injury, which correlated well with the degree of proteinuria and incidence of glomerulosclerosis. Initial pathology of the tubuli showed a slight dilatation of tubuli, which tended to occur in individual nephrons. Immunohistochemistry demonstrated that vimentin‐positive tubuli and osteopontin (OPN)‐positive tubuli were associated mostly with proliferating cell nuclear antigen expression. Protein levels of OPN in the renal cortex were correlated with the level of proteinuria by western blotting. Vimentin‐ and OPN‐expressing tubuli were tightly associated with a peritubular influx of α‐smooth muscle actin (SMA)‐positive cells or ED‐1‐positive cells. In addition, we found thrombomodulin+/ TUNEL+ (dUTP‐biotin nick‐end labeling) peritubular endothelial cells and ED‐1+/α‐SMA+ cells at an early stage among interstitial inflammatory cells. These results suggest that cell cycle activation in tubular cells forms the background for the phenotypic tubular changes that are involved in chronic tubulointerstitial injury in ADR nephrosis.
Differentiation between ulcerative colitis and Crohn’s disease by a quantitative immunohistochemical evaluation of T lymphocytes, neutrophils, histiocytes and mast cells
Authors: Sasaki Yoshio , Tanaka Masanori , Kudo Hajime
Published: March 2003

Mucosal biopsy criteria has limited validity in terms of discrimination between ulcerative colitis (UC) and Crohn’s disease (CD). The aim of this study was to set up quantitative immunohistochemical criteria, with a special focus on inflammatory cell distribution within individual specimens and throughout the large bowel. Quantitative evaluation was performed for the density of CD8+, CD45RO+, neutrophil elastase+, CD68+ and mast cell tryptase+ cells in affected and unaffected mucosa taken from 41 patients with UC and 61 patients with CD. Each slide was examined at the highest and lowest density fields, which were further divided into the upper and deeper half of mucosa. Multiple logistic regression analysis using 51 features as independent variables constructed a predictive equation finding the probability of UC (PUC), and the diagnostic categories were subsequently defined based on a receiver–operating characteristic curve. The analysis disclosed five significant features suggesting UC; these implied intense infiltration of CD8+ and mast cell tryptase+ cells, diffuse infiltration of neutrophil elastase+ and CD68+ cells, and continuous infiltration of CD45RO+ cells. The criteria consisted of three diagnostic categories, ‘suggestive of UC (PUC ≥ 0.7)’, ‘indeterminate (0.3 < PUC < 0.7)’, and ‘suggestive of CD (PUC ≤ 0.3)’; the criteria had values for sensitivity and specificity exceeding 95%. The immunohistochemical criteria distinguishing UC from CD may help to confirm the diagnosis in patients with ambiguous endoscopic and histological diagnosis.
Expression of MUC5AC in colorectal carcinoma and relationship with prognosis
Authors: Kocer Belma , Soran Atilla , Erdogan Sibel , Karabeyoglu Melih , Yildirim Osman , Eroglu Abdullah , Bozkurt Betül , Cengiz Omer
Published: March 2003

Overexpression and alterations in the glycosylation of gastric mucins have been described in colorectal carcinoma. The purpose of our study was to confirm aberrant expression of MUC5AC in colorectal carcinoma, to investigate relationships between clinicopathological parameters and MUC5AC expression, and to determine if MUC5AC expression may be a prognostic factor for colorectal carcinoma. Immunohistochemical staining using an antibody against MUC5AC tandem repeat epitopes was performed on colorectal tumor specimens (n = 41), their metastatic tumors in regional lymph nodes (n = 21) and normal colonic mucosa (n = 41). We also documented clinicopathological parameters such as the age and sex of the patient, location, size, Dukes stage, histological type and grade of the tumor, pre‐sence and number of metastatic lymph nodes, lymphatic, venous and perineural invasion, presence of preoperative and postoperative metastatic tumors and tumor recurrence. MUC5AC was expressed in 34.1% of tumor samples, 24.4% of normal colonic mucosa samples and 19% of lymph node metastases. MUC5AC showed ectopic expression in colorectal carcinoma and was also expressed strongly in mucinous carcinoma (60%). The number of tumors that expressed MUC5AC was lower in patients older than 60 years, in rectum‐localized tumors and in patients who had evidence of recurrence and/or metastasis in the postoperative period. The patients with MUC5AC‐negative tumors had a lower incidence of being disease free and of overall survival. In conclusion, the patients with MUC5AC‐negative tumors had poor clinicopathological parameters and showed worse survival than patients with MUC5AC‐positive tumors. Absence of MUC5AC expression in tumors can be a prognostic factor for more aggressive colorectal carcinoma.
Application of the crypt isolation technique to the assessment of genetic alterations of colorectal carcinomas
Authors: Takahashi Hiroshi , Sugai Tamotsu , Habano Wataru , Nakamura Shin‐ichi
Published: March 2003

The crypt isolation technique (CIT) allows for the isolation of pure tumor crypts from colon tumor tissue. In a previous study we reported on the genetic alterations found in colorectal tumor crypts using the CIT; however, a direct comparison of the genetic alterations found in colorectal carcinomas using either conventional methods (CM) or the CIT has not previously been performed. Here, we analyzed the impact of this method on the genetic analysis of colon tumor cells by comparing the observed frequency of genetic alterations in colon tumors isolated using CM or the CIT. We used a combination of the CIT and the fluorescent polymerase chain reaction assay to accurately assess the incidence of allelic imbalances (AI) at a number of chromosomal loci (17p, 5q, 18q, 1p, 8p, 22q), microsatellite instability (MSI), and mutations of cancer‐related genes (p53 and APC genes) in 48 sporadic colorectal carcinomas. In addition, genetic alterations seen in multiploid tumors (defined as tumors with both diploid and aneuploid cell populations) identified by the CIT were also examined. The incidence of AI at the chromosomal loci tested was more frequently detected in samples isolated from tumors using the CIT than in those isolated from the same tumors using CM. In contrast, we observed no differences in the frequency of MSI or cancer‐related gene mutation between the two groups. Although there was no difference in the frequency of genetic alterations between tumors with evidence of multiploidy, sorting of diploid and aneuploid populations allowed detection of distinct genetic changes. The crypt isolation method thus appears to be useful in that it allows purification of tumor cells and the accurate assessment of their genetic alterations. In addition, it may also be of benefit in clarifying the genetic profile of multiploid tumor cell populations.
Angiomyofibroblastoma‐like tumor (lipomatous variant) of the inguinal region of a male patient
Authors: Shintaku Masayuki , Naitou Masato , Nakashima Yasuaki
Published: March 2003

A case of angiomyofibroblastoma‐like tumor (lipomatous variant) that arose in the subcutis of the inguinal region of a 45‐year‐old man is presented. The maximum dimension of the tumor measured 39 mm and it was well circumscribed. Histopathological examination revealed a close admixture of plump spindle or stellate cells and mature adipocytes. These were arranged haphazardly or formed interconnecting thin cellular trabeculae on the myxoid or edematous background. The tumor was highly vascularized and contained a moderate amount of collagen fibers. Immunohistochemically, the tumor cells were positive for vimentin, CD34 and the estrogen receptor, but negative for α‐smooth muscle actin and desmin. The differential diagnosis between the lipomatous variant of angiomyofibroblastoma and cellular angiofibroma or spindle cell lipoma is discussed, and the pathogenetic hypotheses about the occurrence of mature adipocytes within benign fibroblastic or myofibroblastic neoplasms are mentioned briefly. It is important for surgical pathologists to be acquainted with the occasional presence of adipocytes in these neoplasms to avoid misinterpretation.
Histological grading and staging in chronic hepatitis:   Its practical correlation
Authors: Nakaji Miyuki , Hayashi Yoshitake , Ninomiya Toshiaki , Yano Yoshihiko , Yoon Seitetu , Seo Yasushi , Nagano Hidenobu , Komori Hideshi , Hashimoto Kimio , Orino Akio , Shirane Hirofumi , Yokozaki Hiroshi , Kasuga Masato
Published: March 2003

Although the histological features of various causes of chronic liver disease have been well described, usually the inflammatory activity of the disease is important after the cause has been established. Some patients have co‐infection or concomitant liver disease and on occasion it is difficult to decide the treatment. In order to clarify the histological differences, we investigated the inflammatory activity among autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), chronic hepatitis C (CHC) and chronic hepatitis B (CHB) in a standardized way using the modified histological activity index (HAI). According to the modified HAI, inflammatory activity is divided into four categories; categories A/D explains portal/periportal inflammation and categories B/C explains lobular activity. The inflammatory score of AIH tended to be greater in all categories from the early stage of fibrosis, whereas scores of PBC were lower, except for portal inflammation. Chronic hepatitis C patients had portal or periportal inflammation, and their inflammatory scores were linked to the development of fibrosis. Chronic hepatitis B patients tended to have severe lobular injury, but did not have a relationship between the inflammatory score and their stage. To know the distribution of inflammation using the modified HAI scoring system may be helpful and convenient in evaluating patients with chronic inflammatory liver disease.
Little divergence in ribosomal DNA internal transcribed spacer ‐1 and ‐2 sequences among non‐digitate species of Laminaria (Phaeophyceae) from Hokkaido, Japan
Authors: Yotsukura Norishige , Denboh Takashi , Motomura Taizo , Horiguchi Takeo , Coleman Annette W. , Ichimura Terunobu
Published: March 2003

The nuclear ribosomal DNA internal transcribed spacer (ITS‐1 and ITS‐2) sequences were determined for 10 of 12 Japanese non‐digitate Laminaria species, Kjell‐maniella gyrata (Kjellman) Miyabe, Costaria costata (Turner) Saunders, Alaria praelonga Kjellman and Chorda filum (L.) Stackhouse collected at Hokkaido. Phyloge‐netic analyses (maximum parsimony and distance matrix) of these sequences, including published data for L. sac‐charina (L.) Lamouroux from Canada, showed strong nucleotide conservation among these species of Laminaria, but two phylogenetically distinct species groups were recognized. A L. japonica group encompassing L. yapon/ca Areschoug, L. religiosa Miyabe, L. ochotensis Miyabe, L. diabolica Miyabe, L. longipedalis Okamura, L. angustata Kjellman and L. longissima Miyabe; and a L. saccharina group including L. coriacea Miyabe, L. sac‐charina, L. cichorioides Miyabe and L. yendoana Miyabe. As to other laminarialean genera, Kjellmaniella gyrata was most closely related to the genus Laminaria, being related to the second Laminaria species group based on both parsimony and distant tree values.
Characterization of N‐methyl‐L‐methionine sulfoxide and isethionic acid from the red algaGrateloupia doryphora
Authors: Simon‐Colin Christelle , Kervarec Nelly , Pichon Roger , Bessières Marie‐Anne , Deslandes Eric
Published: March 2003

Isethionic acid (2‐hydroxyethane sulfonic acid) and N‐methyl‐L‐methionine sulfoxide (4‐methane sulfinyl‐2‐methylamino butyric acid) were isolated from the red algaGrateloupia doryphora(Cryptonemiales) collected from Brittany (France); they were identified as major organic solutes together with floridoside (α‐D‐galacto‐pyranosyl‐(1–2)‐glycerol). The presence of isethionic acid has recently been reported in certain red algae, however, the occurrence of N‐methyl‐L‐methionine sulfoxide is still very rare. This report deals with the first isolation of isethionic acid and N‐methyl‐L‐methionine sulfoxide fromG. doryphoraand their subsequent NMR characterization.
Pulmonary actinomycosis in Korea
Authors: Baik Jae‐Joong , Lee Gwi Lae , Yoo Chul‐Gyu , Han Sung Koo , Shim Young‐Soo , Kim Young Whan
Published: March 2003

Pulmonary actinomycosis is a chronic pulmonary infection caused by Actinomyces, a Gram‐positive, microaerophilic bacterium. Pulmonary involvement, other than cervicofacially or abdominopelvically, is uncommon and often leads to a misdiagnosis of pulmonary tuberculosis or lung cancer. In order to investigate the clinical, radiological, diagnostic and therapeutic characteristics of pulmonary actinomycosis, we reviewed a total of 25 cases reported in Korea. Thirteen were diagnosed at our hospital between 1985 and 1997 and 12 were reported in Korean publications. The condition occurred most frequently in middle‐aged males, the most common symptom being haemoptysis, followed by cough and sputum. The main radiological features were peripherally located mass or nodule and consolidation, with central low attenuation. Complications such as empyema, sinus fistula or mediastinitis did not occur. Diagnosis was confirmed by percutaneous needle aspiration (n = 8), bronchoscopic biopsy (n = 3) or thoracotomy (n = 13). Eleven of 25 cases were treated medically and in nine others, surgical resection was followed by treatment with antibiotics. In conclusion, when a middle‐aged male patient presents with haemoptysis and cough, together with radiologic findings of a peripheral mass or nodule with/without central low attenuation, pulmonary actinomycosis should be suspected.
Recent advances in the management of pleural sepsis: What is the evidence?
Authors: Lim Tk
Published: March 2003

The management of pleural sepsis involves early diagnosis, administration of appropriate antibiotics, recognition of poor prognostic features and timely intervention to drain the infected pleural space. Important recent advances in the management of pleural sepsis include better imaging techniques, the use of flexible image‐guided drainage catheters, adjunctive intrapleural thrombolytic therapy and the introduction of interventional thorascopy. These advances have been augmented, in the past year, by results from prospective controlled studies comparing different therapeutic options. This review describes an evidence‐based approach to the management of pleural sepsis which incorporates recent therapeutic advances.
Effect of the Chinese herbal medicine, Bakumondo‐to, on airway hyperresponsiveness induced by ozone exposure in guinea‐pigs
Authors: Aizawa Hisamichi , Shigyo Matsumi , Nakano Hiroyuki , Matsumoto Koichiro , Inoue Hiromasa , Hara Nobayuki
Published: March 2003

Objective:

Bakumondo‐to (Maimendong tang) is a Chinese herbal medicine that has been used as an anti‐tussive agent. However, the effects of Bakumondo‐to on airway hyperresponsiveness are unknown. We examine whether Bakumondo‐to can inhibit airway hyperresponsiveness induced by ozone.

Methodology: Measurements of airway responsiveness and plasma extravasation and bronchoalveolar lavage (BAL) were performed before and after ozone exposure (3 p.p.m., 2 h). Guinea‐pigs were anaesthetized with pentobarbital sodium and mechanically ventilated. Airway responsiveness was determined by an inhalation of doubling concentration of histamine, and the concentration of histamine required to produce a 200% increase in RL (PC200) was calculated by log‐linear interpolation. Plasma extravasation was evaluated by measuring the extravasation of Evans blue dye in the airway.

Results: Ozone produced significant airway hyperresponsiveness and plasma extravasation, with an influx of neutrophils in BAL fluid. Bakumondo‐to (400 mg/kg p.o.) significantly inhibited airway hyperresponsiveness, but had no effect on neutrophil influx or plasma extravasation.

Conclusions: We demonstrated that Bakumondo‐to can attenuate airway hyperresponsiveness induced by ozone without affecting airway inflammation, which suggests that Bakumondo‐to may act on the subsequent mechanisms after the induction of inflammation, such as mediator release.
A case of idiopathic constrictive bronchiolitis in a middle‐aged male smoker
Authors: Tsujino Ichizo , Nishimura Masaharu , Ohira Kouji , Yoshimura Haruhiko , Fukuda Yuh
Published: March 2003

When one sees a middle‐aged male smoker who presents with progressive exertional dyspnoea and irreversible airflow obstruction, the most likely clinical diagnosis is pulmonary emphysema or chronic obstructive pulmonary disease (COPD). We report a 45‐year‐old male smoker who was initially suspected to have such a disease but was eventually diagnosed as having idiopathic constrictive bronchiolitis by lung biopsy, clinical history, and laboratory findings. A finding on lung computed tomography of diffuse hyperinflation but few low attenuation areas and relatively well‐preserved diffusing capacity of carbon monoxide seems to be the key for suspecting this rare clinical entity. The pathological difference between this bronchiolitis and small airway disease observed in COPD will be also discussed.
The relationships between patients' related variables in asthma: Implications for asthma management
Authors: Abdulwadud Omar A. , Abramson Michael J. , Forbes Andrew B. , Walters E. Haydn
Published: March 2003

Objective: Understanding patients' personal characteristics is essential for better asthma management. This study assessed the relationships between patients' related variables in asthma and identified key associations relevant to asthma management.

Methodology: Subjects were recruited from the Alfred Hospital Asthma and Allergy Clinic (Melbourne, Victoria, Australia) and general practices. Their clinical and demographic characteristics, asthma knowledge, impact of asthma on their quality of life, their self‐management skills and attitudes to asthma were assessed.

Results: One hundred and sixty‐nine subjects participated in the study. Fifty‐seven per cent had one or more previous hospital admissions, 94% had either moderate or severe asthma, and 51% reported nocturnal symptoms in the last 6 weeks. Patients who spoke only English, had been admitted to an intensive care unit, had a peak flow meter, and an asthma action plan had significantly better asthma knowledge than those who did not. The impact of asthma was greatest in patients who had a peak flow meter, used oral steroids, had exercise limitation, and developed asthma between the ages of 31–45 years. Female patients had better self‐management skills than males. Patients with asthma‐related distress were more likely to use oral steroids or theophylline and to have a history of previous hospital admissions. Patient self‐confidence was negatively correlated with age.

Conclusions: There are significant relationships between many of patients' variables related to asthma, including their personal clinical, demographic and psychological characteristics. The findings have implications for optimizing asthma management.
Lemierre's syndrome
Authors: Turay Ülkü Yilmaz , Erdogˇan Yurdanur , Ergün Pinar , Biber Çigˇdem , Çiftçi Bülent , Ayaz Ayşe
Published: March 2003

This is a case report of Lemierre's syndrome in a 17‐year‐old male patient. Lemierre's disease consists of suppurative thrombophelebitis of the internal jugular vein (SIJVT) in the presence of oropharyngeal infection and can be complicated by septic pulmonary embolism. Other causes of SIJVT include deep neck infections and central venous catheterization. The disease usually results from Gram‐negative anaerobic organisms such as Fusobacterium necrophorum.
Longitudinal follow‐up study of 11 patients with pulmonary lymphangioleiomyomatosis: Diverse clinical courses of LAM allow some patients to be treated without anti‐hormone therapy
Authors: SEYAMA KUNIAKI , KIRA SHIRO , TAKAHASHI HIDEKI , OHNISHI MASAHIRO , KODAMA YUZO , DAMBARA TAKASHI , KOBAYASHI JUNE , KITAMURA SATOSHI , FUKUCHI YOSHINOSUKE
Published: March 2003

Objective: The purpose of this study is to clarify the existing issues on the clinical diversity, natural history, and mode of disease progression of pulmonary lymphangioleiomyomatosis (LAM).

Methodology: Eleven patients with LAM were reviewed retrospectively with special reference to serial changes in pulmonary function and radiological findings during the course of their disease, treatment, and outcome. All patients were female with a mean age of 33.8 years at presentation and the observation period ranged from 2.1 to 20.8 years (mean 7.4 years).

Results: Four of six patients, treated with anti‐hormone therapy, presented with exertional
dyspnoea, marked airflow limitation (forced expiratory volume in 1 s/forced vital
capacity, 23–38%), and severely impaired diffusing capacity (%DLCO, 21.4–36% of the predicted). The remaining two patients showed only a decreased diffusing capacity (70.6% and 59.4% of the predicted) which rapidly deteriorated with subsequent development of airflow limitation. Repeated chest computed tomographic (CT) examinations revealed increasing numbers of cysts with simultaneous loss of normal lung parenchyma in these two patients. In contrast, the five patients who received no anti‐hormone therapy had no respiratory symptoms aside from pneumothorax at onset. Remarkable differences were noted, with pulmonary function being well maintained and slow progression of cystic changes on CT being observed in the latter group.

Conclusions: Diverse clinical courses observed in patients with pulmonary LAM can be well delineated and assessed by periodic examinations including pulmonary function tests and chest CT imaging. Anti‐hormone therapy is not always necessary for a certain group of LAM patients and they appear to have a stable course and favourable outcomes without anti‐hormone treatment.
Infection of replication‐deficient adenoviral vector enhances interleukin‐8 production in small airway epithelial cells more than in large airway epithelial cells
Authors: KODAMA YUZO , SETOGUCHI YASUHIRO , FUKUCHI YOSHINOSUKE
Published: March 2003

Objective: In clinical trials or experiments of gene therapy, airway administration of an adenoviral‐based vector (E1A‐deleted) elicits a dose‐dependent inflammatory response with limitation in the duration of transgene expression. The purpose of this study was to evaluate the possibility that the adenoviral‐based vector directly enhances IL‐8 production independent of adenoviral E1A in normal human airway epithelial cells and to examine the different responses between primary human bronchial epithelial cells (HBE) and primary human small airway epithelial cells (HSAE) in production of IL‐8 following exposure to an adenovirus vector.

Methodology: Interleukin (IL)‐8 levels were evaluated in the culture medium from HBE and HSAE treated with increasing doses of E1A‐deleted adenoviral vector contained the Escherichia
coli LacZ reporter gene (AdCMVLacZ). To clarify the mechanism of enhancing IL‐8 production in airway epithelial cells by infection with adenovirus vector, αvβ5 agonistic antibody as an analogue of adenoviral capsid and adenoviral capsid vector denatured by exposure to ultraviolet (UV) light were used in the present study.

Results: Inoculation of HBE with AdCMVLacZ at a multiplicity of infection (MOI) of between 1 and 200 resulted in a dose‐dependent expression of LacZ, and maximal expression was observed at a MOI of 100. In contrast, inoculation of HSAE with AdCMVLacZ resulted in maximum expression of LacZ at a MOI of 10. Interleukin‐8 levels in culture media from the same experiments revealed significantly greater production of IL‐8 in HSAE inoculated with AdCMVLacZ at a MOI of 50, compared to HBE under the same conditions. The capsid‐denatured adenoviral vector did not enhance IL‐8 production, and αvβ5 agonistic antibody induced IL‐8 enhancement.

Conclusion: These results suggest that the adenoviral vector directly induces the expression of airway epithelial inflammatory cytokines in the pathogenesis of inflammation and that small airway cells have a greater affinity for adenovirus than other airway epithelial cells.
A case of extrapleural empyema
Authors: OSAKI SHIN‐ICHI , NAKANISHI YOICHI , ANDOU KOUEI , TAKANO KOICHI , TAKAYAMA KOICHI , HIROTA NOBUO , ISHIBASHI TSUNEO , HARA NOBUYUKI
Published: March 2003

Abstract: A 49‐year‐old man with diabetes mellitus and alcoholic liver cirrhosis presented with dyspnoea and fever. A chest computed tomography scan revealed three areas of loculated pleural effusion. Initially, the patient was thought to have an intrapleural empyema and was treated with intravenous antibiotics and closed drainage. However, as he did not improve, he was then treated with open drainage. During open drainage, the patient was diagnosed to have an extrapleural empyema and improved following open drainage treatment.
Mesothelial cells: Their structure, function and role in serosal repair
Authors: MUTSAERS Steven E.
Published: March 2003

The mesothelium is composed of an extensive monolayer of specialized cells (mesothelial cells) that line the body's serous cavities and internal organs. Traditionally, this layer was thought to be a simple tissue with the sole function of providing a slippery, non‐adhesive and protective surface to facilitate intracoelomic movement. However, with the gradual accumulation of information about serosal tissues over the years, the mesothelium is now recognized as a dynamic cellular membrane with many important functions. These include transport and movement of fluid and particulate matter across the serosal cavities, leucocyte migration in response to inflammatory mediators, synthesis of pro‐inflammatory cytokines, growth factors and extracellular matrix proteins to aid in serosal repair, release of factors to promote both the deposition and clearance of fibrin, and antigen presentation. Furthermore, the secretion of molecules, such as glycosaminoglycans and lubricants, not only protects tissues from abrasion, but also from infection and possibly tumour dissemination. Mesothelium is also unlike other epithelial‐like surfaces because healing appears diffusely across the denuded surface, whereas in true epithelia, healing occurs solely at the wound edges as sheets of cells. Although controversial, recent studies have begun to shed light on the mechanisms involved in mesothelial regeneration. In the present review, the current understanding of the structure and function of the mesothelium and the biology of mesothelial cells is discussed, together with recent insights into the mechanisms regulating its repair.
Strongyloides hyperinfection in a patient with sarcoidosis
Authors: ALMASIDOU Despina , MANIATIS Maria , VASSIOU Katerina , DAMANI Eleni , VAKALIS Nikolaos , FESOULIDIS Ioannis , GOURGOULIANIS Kostas Ioannou
Published: March 2003

Abstract:  A 51‐year‐old‐woman presented with chronic eosinophilia, a diffuse interstitial lung pattern on CT and splenomegaly with hypodense lesions. A diagnosis of sarcoidosis was determined from a lung biopsy. Hyperinfection with strongyloides following treatment with systemic steroids explains the presence of eosinophilia and splenic involvement.
Effect of ploidy level on fruit morphology, seed germination and juvenile growth in scurvy grass (Cochlearia officinalis L. s.l., Brassicaceae)
Authors: Pegtel Dick M.
Published: March 2003

The biennial to short‐lived wintergreen perennial Cochlearia officinalis L. s.l. (basic chromosome number x = 6) encompasses a group of closely related taxa that is difficult to delimitate morphologically. Despite a lack of distinct sets of discontinuous morphological characters, at least six numerically different cytotypes have commonly been recognized, and they have different ecologic distributions. Evolution of the wide ploidy level was likely brought about by hybridization and polyploidization. Because plants are short‐lived, seed germination was established and was likely to favor subsequent establishment. Therefore, shoot growth of juveniles was also compared. Five ecologically allopatric populations of C. officinalis s.l., each supposedly representing a different cytotype, were sampled for flowering shoots and seeds to establish shoot morphological traits, germination capabilities and chromosome number. The sampled populations differed in chromosome number: 2n = 2x = 12 (diploid); 2n = 4x = 24 (tetraploid); 2n = 33; 2n = 6x = 36 (hexaploid); and 2n = 8x = 48 (octaploid), representing the taxa C. pyrenaica DC, C. officinalis L. s.s., C. danica L. ×C. officinalis L. s.s., C. x hollandica Henrard and C. anglica L., respectively. All cytotypes produced abundant seeds and seed weight was proportional to the ploidy level. Seed weight of the diploid C. pyrenaica did not follow this correlation. Germination capacity immediately after seed collection was high over a wide temperature range. Germination was non‐photoblastic. High germination capability accentuated the short‐lived life‐cycles of the five cytotypes. Seed germination of the coastal cytotypes (C. x hollandica and C. anglica) were less negatively affected by NaCl compared to the non‐coastal cytotypes (C. pyrenaica and C. officinalis s.s.) and the very rare coastal hybrid C. danica×C. officinalis s.s. The cytotypes differed markedly in growth characteristics but there was no simple relationship between them. Increases in ploidy level were not paralleled by increased shoot growth. The hexaploid hybrid C. x hollandica indicated hybrid vigor in both shoot growth (yield) and petiole length of the strongly ascending leaves. Leaves of C. anglica were arranged in a prostratous rosette and the difference in shoot architecture between both C. x hollandica and C. anglica may be one of the reasons why this species is being replaced by the hexaploid hybrid, if sympatric, in coastal regions of The Netherlands. The 2n = 33‐hybrid C. danica×C. officinalis s.s. showed no such heterosis effects in shoot growth characteristics.
Reproductive biology ofPedicularis(Scrophulariaceae) in the Sichuan Himalaya
Authors: Macior Lazarus Walter , Ya Tang , Zhang Jianchen
Published: March 2003

In 1997–1998, the reproductive biology ofPedicularis bidentata,Pedicularis cranolopha,Pedicularis davidii,Pedicularis longifloravar.hongyuanensis,Pedicularis longiflorassp.tubiformis,Pedicularis plicata,Pedicularis polyodonta,Pedicularis rhinanthoidesssp.labellata,Pedicularis roylei,Pedicularis semitorta,Pedicularis spicataandPedicularis verticillatawas studied in the subalpine–alpine zone of the Chinese Himalaya in western Sichuan Province. Except forApispollinators onP. polyodontaandP. spicata, only workers and queens ofBombus filchnerae,Bombus patagiatus,Bombus potanini,Bombus sicheliiandBombus waltonipollinatedPedicularis. Nectariferous, erostrate flowers were pollinated nototribically and sternotribically, during foraging for nectar and pollen, respectively, whereas nectarless, rostrate (including very long‐tubed) flowers were pollinated sternotribically during foraging for pollen only. Insect exclusion from flowers revealed thatP. longiflorassp.tubiformis,P. royleiandP. verticillataare insect‐pollinator dependent. Analysis of the corbicular pollen loads of pollinators revealed a moderate degree of pollen‐foraging fidelity. Pollinator frequency onPedicularisdid not exceed three insects per hour, butBombuspollinators were more common on other plant genera. No evidence of lepidopteran pollination on long‐tubedPedicularisspecies was found, nor was there any evidence of species–species specificity betweenBombuspollinators andPedicularisflowers.
Mexican species of the genus Stevia (Eupatorieae, Asteraceae): Chromosome numbers and geographical distribution
Authors: Watanabe Kuniaki , Yahara Tetsukazu , Soejima Akiko , Ito Motomi
Published: March 2003

Chromosome numbers from 244 accessions representing 73 species, five varieties and two putative species hybrids in Mexican Stevia are reported with comments on agamospermy, cytogeography and chromosomal evolution. The chromosome numbers of 47 species and two varieties were counted for the first time. Counts of 12 species and two varieties were new cytotypes, or differed from all previously reported numbers for the same species. B chromosomes were found in 16 species and two varieties. All species of shrubs or shrublets were sexual diploids (2n = 24). Perennial herbs were diploids or polyploids based on x = 11 or 12 and the widespread prevalence of agamospermous polyploids was revealed. Chromosome numbers of annual herbs varied from 2n = 24 to 2n = 8. The cytogeographical survey revealed five distributional patterns of agamic complexes based on the relative abundance of polyploids compared to their diploid ancestors. The wider distributional range (extending to northern and inland areas) of some agamospermous polyploids have been achieved by recent colonization accompanying climatic warming after the last glaciation. This has occurred even in lower latitudes such as Mexico, due to more successful founder population reproduction and the acceleration of seed dispersal, as well as the creation of new and open habitats by human activities.
Physiologic significance of nitric oxide and endothelin‐1 in circulatory adaptation
Authors: Endo Akihiko , Ayusawa Mamoru , Minato Michiyoshi , Takada Masaaki , Takahashi Shigeru , Harada Kensuke
Published: March 2003

Abstract Background: The purpose of the present paper was to evaluate the physiologic significance of nitric oxide (NO) and endothelin (ET)‐1 in circulatory adaptation in the neonate.

Methods
: The serum levels of NO metabolites (NOx; the sum of nitrites and nitrates) and the plasma level of ET‐1 were determined in 14 healthy full‐term infants at 0–6 h, 24 h and 5 days after birth. We measured the heart rate, the mean systemic blood pressure and the mean pulmonary arterial pressure, estimated by pulsed Doppler echocardiography, at each time point.

Results
: The serum concentration of NOx was lowest at birth and increased with age. The plasma concentration of ET‐1 was highest at birth and decreased with age. The ratio of NOx to ET‐1 was inversely related to the estimated mean pulmonary arterial pressure in the early neonatal period. The ratio of NOx to ET‐1 was not correlated with the systemic blood pressure.

Conclusion
: Increased NO synthesis and decreased production of ET‐1 during the early neonatal period may contribute to the decrease in pulmonary arterial pressure.
Hypothetical pathophysiology of acute encephalopathy and encephalitis related to influenza virus infection and hypothermia therapy
Authors: Yokota, Shumpei , Imagawa, Tomoyuki , Miyamae, Takako , Ito, Shu‐Ichi , Nakajima, Shoko , Nezu Atsuo , Mori Masaaki
Published: March 2003

Abstract

Background
: To establish a treatment strategy for acute encephalopathy and encephalitis associated with influenza virus infection, the pathophysiology of the disease was investigated through manifestations and laboratory findings of patients.

Patients and Methods
: A child with central nervous system (CNS) complications during the course of influenza virus infection was analyzed in view of immunologic abnormalities. In addition, four children with acute encephalopathy and encephalitis were enrolled in the hypothermia treatment for the purpose of stabilizing the cytokine storm in the CNS.

Results
: The CNS symptoms preceded the systemic progression to the failure of multiple organs (MOF) and disseminated intravascular coagulopathy (DIC). The mild hypothermia suppressed the brain edema on computed tomography (CT) scanning and protected the brain from the subsequent irreversible neural cell damage.

Conclusion
: The replicated viruses at the nasopharyngeal epithelium may disrupt the olfactory mucosa and gain access to the brain via the olfactory nerve system. The direct virus–glial cell interaction or viral stimulation of the glial cells induces the production and accumulation of the pro‐inflammatory cytokines, especially tumor necrosis factor (TNF)‐α, in the CNS. The cytokine storm results in neural cell damage as well as the apoptosis of astrocytes, due to the TNF‐α–induced mitochondrial respiratory failure. The disruption of the blood–brain barrier progresses to the systemic cytokine storm, resulting in DIC and MOF. Mild hypothermia appears promising in stabilizing the immune activation and the brain edema to protect the brain from ongoing functional, apoptotic neural and glial damage and the systemic expansion of the cytokine storm.
Epidemiology of rotavirus infection in Thailand
Authors: Maneekarn Niwat , Ushijima Hiroshi
Published: March 2003

Abstract Rotavirus is a major cause of acute severe diarrhea in children worldwide and an important cause of death among young children in developing countries. Group A rotaviruses are antigenically complex and multiple serotypes infect humans. Reassortant rotavirus vaccines are now available which offer protection against severe illness caused by rotavirus serotypes G1–4. Before vaccines are introduced into target populations, it is necessary to establish the baseline data of the epidemiology of rotavirus infection in those countries. The purpose of the present study is to provide information related to the epidemiology of rotavirus infection in Thailand. All rotavirus studies performed in Thailand were found through Medline and Thai Index Medicus searches. A total of 26 of the most relevant studies published in international and national journals are reviewed. Most studies reported that the prevalence of rotavirus infection in Thailand was 27–34%, although a few studies have reported a prevalence above this range. The peak seasonal distribution of rotavirus infection among children hospitalized with diarrhea in Thailand was seen in the dry cool seasons: October to February. The prevalence of rotavirus infection was most frequently found in children aged 6–11 months up to 2 years. G1 was the most prevalent serotype in Thailand, followed by G2, G4 and G3, respectively. At least three G serotypes, mostly G1, G2 and G4, are seen to coexist in Thailand each epidemic year and in some studies all four G‐serotypes were reported in the same epidemics. In a 1996–1997 study, G9 was the third prevailing serotype after G1 and G2, respectively. These results indicate that rotavirus epidemics occur in Thailand every year and children are the most affected population. In Thailand, although G1–G4 have been reported, G1 is the most prevalent serotype in each epidemic and G9 is becoming increasingly common.
Parental concern towards the use of inhaled therapy in children with chronic asthma
Authors: Chan PWK , DeBruyne JA
Published: March 2003

Abstract Background: Parental attitudes towards the use of inhaled therapy in children with chronic asthma influence treatment adherence and outcome. In the present study, we evaluated the perceptions and concerns of parents of children with chronic asthma towards inhaled therapy.

Methods
: A self‐administered standard questionnaire was distributed to parents of children attending the Paediatric Asthma Clinic. All these children required inhaled steroids for treatment.

Results
: One‐hundred and twelve of 170 parents (66%) surveyed were concerned with inhaled therapy. The most common concern with its use was medication side effects (91%), followed by ‘inhaler dependency’ (86%), cost of the inhaler (34%) and difficulty in using the inhaler (15%). Parental perception that the oral route was superior to the inhaled route, preference for the oral route for asthma prophylaxis and a higher steroid dose required for prophylaxis were more likely to be associated with concerns towards inhaled therapy. More importantly, these children were also more likely to miss >25% of their prescribed doses of inhaled steroids (46 vs 22% in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P=0.007) and had a higher mean number of nebulization treatments in the last year (3.2~2.9 vs 1.8~1.3 in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P=0.01).

Conclusions
: A significant proportion of parents whose children were on inhaled prophylaxis had concerns towards the use of inhaled therapy. Parental concern towards inhaled therapy appeared to increase the problem of non‐adherence to treatment. Education for these parents will need to be addressed to improve asthma management in our patient population.