bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential expression of neural‐cadherin in pulmonary epithelial tumours
Authors: Zynger D L , Dimov N D , Ho L C , Laskin W B , Yeldandi A V
Published: February 2008

Aims:  Neural (N)‐cadherin belongs to a group of transmembrane molecules with a crucial role in tissue morphogenesis and maintenance of an epithelioid phenotype and increased N‐cadherin expression is implicated in tumour progression and dedifferentiation. The aim was to determine whether evaluation of N‐cadherin in pulmonary tumours might assist in identifying lesions with more aggressive potential.

Methods and results:  One hundred and fifty‐five pulmonary lesions were analysed for N‐cadherin expression using immunohistochemistry, including neuroendocrine hyperplasia (n = 3), typical carcinoid (n = 59), atypical carcinoid (n = 12), small cell lung carcinoma (n = 11), large cell neuroendocrine carcinoma (n = 12), adenocarcinoma (n = 35) and squamous cell carcinoma (n = 23). Lymph node status was correlated with immunohistochemical expression. N‐cadherin expression was demonstrated in all cases of neuroendocrine hyperplasia, 96% of typical carcinoids, 83% of atypical carcinoids, 63% of the small cell lung carcinomas and 32% of large cell neuroendocrine carcinomas. Over 90% of the adenocarcinomas and 100% of the squamous cell carcinomas were negative. Increased N‐cadherin expression in typical carcinoids was associated with negative lymph node status (P < 0.001).

Discussion:  N‐cadherin is differentially expressed in pulmonary tumours and is predominantly observed in neuroendocrine lung lesions with high expression in typical and atypical pulmonary carcinoids. The level of expression of N‐cadherin between types of lung tumours does not appear to indicate malignant potential or aggressive behaviour.
Differential expression of glucocorticoid receptor in carcinomas of the human digestive system
Authors: Lien H‐C , Lu Y‐S , Shun C‐T , Yao Y‐T , Chang W‐C , Cheng A‐L
Published: February 2008

Aims:  To investigate the in situ expression profile of glucocorticoid receptor (GR) in normal and carcinomatous tissues of the human digestive system.

Methods and results:  Specimens from 306 carcinomas of the human digestive tract were assayed for the expression of GR by immunohistochemistry. GR expression was strong in oesophageal squamous epithelia, pancreatic islet cells and hepatocytes, but generally weak or negative in non‐squamous epithelia. Consistently, GR expression was found in a high percentage of oesophageal squamous cell carcinomas (SCC) (98.1%) and hepatocellular carcinomas (HCC) (92.9%), but rarely in gastric adenocarcinomas (7.4%) and not at all in colorectal adenocarcinomas (0%). Dexamethasone (DEX) was found to confer chemoresistance in oesophageal SCC and HCC cells, suggesting that GR expression may be biologically important in some GR‐expressing carcinomas.

Conclusions:  Distribution of GR expression is markedly diverse among tissues of the human digestive system. The general lack of GR in adenocarcinomas contrasts with the high percentage of SCCs and HCCs expressing GR, and, along with the generation of chemoresistance by DEX, warrants prospective study of the effects of steroids on these cancers.
Lipoblastoma in adolescents and young adults: report of six cases with FISH analysis
Authors: De Saint Aubain Somerhausen N , Coindre J M , Debiec‐Rychter M , Delplace J , Sciot R
Published: February 2008

Aims:  Lipoblastoma is a rare benign adipocytic neoplasm that occurs primarily in infancy and early childhood. Histologically, there is some morphological overlap with atypical lipomatous tumour and myxoid liposarcoma and the age at presentation is often regarded as a major diagnostic criterion. However, we recently encountered several cases of lipoblastoma occurring in adolescents and young adults. The aim was to document the occurrence of lipoblastoma in older patients, with cytogenetic confirmation.

Methods and results:  Six cases of lipoblastoma in patients >12 years old were identified. The tumours occurred in four male and two female patients ranging from 14 to 24 years old. Our cases showed the classical histological features of lipoblastoma. Three tumours were composed predominantly of mature adipocytes and the three other cases showed an immature appearance, with a prominent myxoid matrix. Fluorescence in situ hybridization (FISH) demonstrated rearrangements of the PLAG1 region in two cases and polysomy for chromosome 8 in three other cases. None of the tumours had amplification of MDM2 or CDK4.

Conclusions:  Lipoblastoma occurs rarely in young adults and should enter into the differential diagnosis of ‘atypical’ fatty tumours in adults. Our report underscores the diagnostic value of FISH analysis.
Independent prognostic value of the basal‐like phenotype of breast cancer and associations with EGFR and candidate stem cell marker BMI‐1
Authors: Arnes J B , Collett K , Akslen L A
Published: February 2008

Aims:  To study the relationship between basal‐like breast cancers, epidermal growth factor receptor (EGFR) and candidate stem cell markers (BMI‐1, EZH2, Oct‐4) in a population‐based setting.

Methods and results:  Immunohistochemistry was evaluated in a series of 190 breast cancers. Basal‐like phenotype (BLP) 1–5 was found in 4.3–14.3% of cases. EGFR was expressed in 9% of cases and associated with cytokeratin (CK) 5 and P‐cadherin positivity, but not with survival; 28% of CK5+ cases were EGFR+. On multivariate analysis, basal‐like differentiation and lymph node status were independent prognostic factors of comparable strength. BMI‐1 positivity (42.6%) was associated with absence of basal‐like features, oestrogen receptor positivity and low Ki67, but not related to survival. BMI was not associated with EZH2 expression, and these markers tended to show opposite associations with other variables, suggesting different roles in breast cancer. Oct‐4 expression was not detected in this series.

Conclusions:  Basal‐like features and lymph node status were strong and independent prognostic factors in this population‐based series of breast cancer. Neither EGFR nor BMI‐1 had significant prognostic impact, whereas EZH2 expression was associated with decreased survival. BMI‐1 was inversely related to basal‐like factors, and a stem cell phenotype of the basal‐like subgroup could not be verified by this marker.
Clinical role of flow cytometry in redefining bone marrow involvement in diffuse large B‐cell lymphoma (DLBCL) – a new perspective
Authors: Talaulikar D , Shadbolt B , Bell J , Khan K , Dahlstrom J E , McDonald A , Pidcock M , Broomfield A
Published: February 2008

Aims:  The clinical role of flow cytometry in staging bone marrow in diffuse large B‐cell lymphoma (DLBCL), especially its impact on outcome, remains uncertain. The aim was to determine the contribution of flow cytometry to conventional staging, and to study the impact of this revised staging on survival.

Methods and results:  One hundred and thirteen cases of DLBCL diagnosed at The Canberra Hospital from 1996 to 2005 were identified. Blinded analysis of bone marrow (BM) morphology and flow cytometric data showed involvement on morphology (M) in 25 (22.1%) cases, on flow cytometry (F) in 21 (18.6%) cases and overall (M + F) in 32 cases (28.3%); discordance was noted in 16 cases (16.1%). Cases with and without marrow involvement on conventional staging alone (M) had no significant difference in survival (P = NS). However, when BM involvement was defined as positivity on morphology and/or flow cytometry (M + F), the median survival of patients with involvement was significantly worse than patients without involvement (P = 0.026).

Conclusions:  Flow cytometry‐positive cases should be included with those positive on morphology in a summative model to define BM involvement in DLBCL, as it may have a potential impact on predicting outcome.
From generative fit to generative capacity: exploring an emerging dimension of information systems design and task performance
Authors: Avital Michel , Te'eni Dov
Published: February 2008

Information systems (IS) research has been long concerned with improving task‐related performance. The concept of fit is often used to explain how system design can improve performance and overall value. So far, the literature has focused mainly on performance evaluation criteria that are based on measures of task efficiency, accuracy, or productivity. However, nowadays, productivity gain is no longer the single evaluation criterion. In many instances, computer systems are expected to enhance our creativity, reveal opportunities and open new vistas of uncharted frontiers.

To address this void, we introduce the concept of generativity in the context of IS design and develop two corresponding design considerations –‘generative capacity’ that refers to one's ability to produce something ingenious or at least new in a particular context, and ‘generative fit’ that refers to the extent to which an IT artefact is conducive to evoking and enhancing that generative capacity. We offer an extended view of the concept of fit and realign the prevailing approaches to human–computer interaction design with current leading‐edge applications and users' expectations. Our findings guide systems designers who aim to enhance creative work, unstructured syntheses, serendipitous discoveries, and any other form of computer‐aided tasks that involve unexplored outcomes or aim to enhance our ability to go boldly where no one has gone before.

In this paper, we explore the underpinnings of ‘generative capacity’ and argue that it should be included in the evaluation of task‐related performance. Then, we briefly explore the role of fit in IS research, position ‘generative fit’ in that context, explain its role and impact on performance, and provide key design considerations that enhance generative fit. Finally, we demonstrate our thesis with an illustrative vignette of good generative fit, and conclude with ideas for further research.
Antecedents of flow in online shopping: a test of alternative models
Authors: Guo Yi Maggie , Poole Marshall Scott
Published: February 2008

Flow is an optimal state of experience that has been studied in various situations, including online environments. In such environments, it has been found to be positively related to exploratory behaviour, revisit and purchase intention, and positive attitude towards web sites. Based on flow theory, this study tests the complete structure of the flow model as it was originally formulated in an online shopping context. The role of the preconditions of flow is elaborated and the effect of web site complexity, an important interface design variable, on flow is examined. Results show that web site complexity affects flow through the mediating effects of the three preconditions of flow. Theoretical and practical implications of this finding are discussed.
Peer observation of teaching in the online environment: an action research approach
Authors: Swinglehurst D. , Russell J. , Greenhalgh T.
Published: February 2008

Abstract  This paper describes a collaborative action research approach used to explore peer observation of teaching (POT) within the online environment. Although POT has become familiar in face‐to‐face teaching contexts, little is understood of its potential role in online settings. We conducted ‘virtual’ focus groups to explore the experience and views of 28 teachers and subjected our data to a thematic analysis. This informed the implementation of an innovative programme of POT, ‘Peer‐to‐peer Reflection on Pedagogical Practice’ (PROPP) among tutors of a Web‐based MSc in International Primary Health Care at University College London. Modeled on an action learning set, the programme encourages collaborative reflection on teaching practices, based on participants' specific examples of online teaching. The PROPP model is consistent with Quality Enhancement, which we distinguish from Quality Assurance. Here, we describe the implementation of the PROPP programme within an action research framework and identify the factors that we consider critical to the success of peer observation within online courses. We highlight examples of aspects of teaching that have been discussed within the PROPP programme and offer suggestions of the kinds of evidence that could be incorporated into a portfolio to demonstrate the effectiveness of such an initiative.
Ectopic AtCBF1 over‐expression enhances freezing tolerance and induces cold acclimation‐associated physiological modifications in potato
Authors: PINO MARÍA‐TERESA , SKINNER JEFFREY S. , JEKNIĆ ZORAN , HAYES PATRICK M. , SOELDNER ALFRED H. , THOMASHOW MICHAEL F. , CHEN TONY H. H.
Published: February 2008

We studied the effect of ectopic AtCBF over‐expression on physiological alterations that occur during cold exposure in frost‐sensitive Solanum tuberosum and frost‐tolerant Solanum commersonii. Relative to wild‐type plants, ectopic AtCBF1 over‐expression induced expression of COR genes without a cold stimulus in both species, and imparted a significant freezing tolerance gain in both species: 2 °C in S. tuberosum and up to 4 °C in S. commersonii. Transgenic S. commersonii displayed improved cold acclimation potential, whereas transgenic S. tuberosum was still incapable of cold acclimation. During cold treatment, leaves of wild‐type S. commersonii showed significant thickening resulting from palisade cell lengthening and intercellular space enlargement, whereas those of S. tuberosum did not. Ectopic AtCBF1 activity induced these same leaf alterations in the absence of cold in both species. In transgenic S. commersonii, AtCBF1 activity also mimicked cold treatment by increasing proline and total sugar contents in the absence of cold. Relative to wild type, transgenic S. commersonii leaves were darker green, had higher chlorophyll and lower anthocyanin levels, greater stomatal numbers, and displayed greater photosynthetic capacity, suggesting higher productivity potential. These results suggest an endogenous CBFpathway is involved in many of the structural, biochemical and physiological alterations associated with cold acclimation in these Solanum species.
Diel leaf growth cycles in Clusia spp. are related to changes between C3 photosynthesis and crassulacean acid metabolism during development and during water stress
Authors: WALTER ACHIM , CHRIST MAJA M. , RASCHER UWE , SCHURR ULRICH , OSMOND BARRY
Published: February 2008

This study reports evidence that the timing of leaf growth responds to developmental and environmental constraints in Clusia spp. We monitored diel patterns of leaf growth in the facultative C3‐crassulacean acid metabolism (CAM) species Clusia minor and in the supposedly obligate CAM species Clusia alata using imaging methods and followed diel patterns of CO2 exchange and acidification. Developing leaves of well‐watered C. minor showed a C3‐like diel pattern of gas exchange and growth, with maximum relative growth rate (RGR) in the early night period. Growth slowed when water was withheld, accompanied by nocturnal CO2 exchange and the diel acid change characteristic of CAM. Maximum leaf RGR shifted from early night to early in the day when water was withheld. In well‐watered C. alata, similar changes in the diel pattern of leaf growth occurred with the development of CAM during leaf ontogeny. We hypothesize that the shift in leaf growth cycle that accompanies the switch from C3 photosynthesis to CAM is mainly caused by the primary demand of CAM for substrates for nocturnal CO2 fixation and acid synthesis, thus reducing the availability of carbohydrates for leaf growth at night. Although the shift to leaf growth early in the light is presumably associated with the availability of carbohydrates, source–sink relationships and sustained diurnal acid levels in young leaves of Clusia spp. need further evaluation in relation to growth processes.
Peroxisome proliferation, wound‐activated responses and expression of peroxisome‐associated genes are cross‐regulated but uncoupled in Arabidopsis thaliana
Authors: CASTILLO MARI CRUZ , SANDALIO LUISA MARÍA , DEL RÍO LUÍS ALFONSO , LEÓN JOSÉ
Published: February 2008

Plant peroxisomes are multifunctional organelles that show plasticity in number, size, morphology, cellular location and metabolic functions. Many of these changes occur in response to environmental factors and are decisive for the development and defence of the plant. Among them, peroxisomal β‐oxidation‐mediated synthesis of jasmonic acid (JA) is a key process in regulating development as well as wound‐ or pathogen‐triggered defence responses. This work seeks for the connection between wound, JA and the proliferation of peroxisomes in Arabidopsis thaliana. The hypolipidemic drug clofibrate (CFB) induced the proliferation of peroxisomes and the expression of the β‐oxidation 3‐ketoacyl‐CoA thiolase 2 (KAT2) gene, coding for a key enzyme in the biosynthesis of JA, among other wound‐ and JA‐responsive gene transcripts in Arabidopsis leaves. The CFB‐activated expression of wound‐responsive genes was not dependent on JA synthesis or perception and those responsive to JA required the function of the F‐box protein COI1. In turn, wounding neither triggered peroxisome proliferation nor required peroxisome integrity to activate gene expression. Interestingly, cells from JA‐treated leaves contained fewer but larger peroxisomes than cells from untreated leaves. The proliferation of peroxisomes, the synthesis of JA and the activation of wound‐responsive genes by CFB, although functionally connected, were uncoupled in Arabidopsis.
Metabolic flux maps comparing the effect of temperature on protein and oil biosynthesis in developing soybean cotyledons
Authors: IYER VIDYA V. , SRIRAM GANESH , FULTON D. BRUCE , ZHOU RUILIAN , WESTGATE MARK E. , SHANKS JACQUELINE. V.
Published: February 2008

Metabolic flux maps developed from 13C metabolic flux analysis (13C MFA) are effective tools for assessing the response of biological systems to genetic or environmental perturbations, and for identifying possible metabolic engineering targets. Experimental treatments were designed to distinguish between temperature effects prior to, and during incubation in vitro, on primary metabolism in developing soybeans. Biomass accumulation increased with temperature as did carbon partitioning into lipids. The flux through the plastidic oxidative pentose phosphate pathway (pglP) relative to sucrose intake remained fairly constant [∼56% (±24%)] when cotyledons were transferred from an optimum growth temperature to varying temperatures in in vitro culture, signifying a rigid node under these conditions. However, pglP flux ranged from 57 to 77% of sucrose intake when growth temperature in planta varied and were cultured in vitro at the same temperature (as the plant), indicating a flexible node for this case. The carbon flux through the anaplerotic reactions catalysed by plastidic malic enzyme (meP), cytosolic phosphoenolpyruvate (PEP) carboxylase and the malate (Mal) transporter from the cytosol to mitochondrion varied dramatically with temperature and had a direct influence on the carbon partitioning into protein and oil from the plastidic pyruvate (Pyr) pool. These results of the in vitro culture indicate that temperature during early stages of development has a dominant effect on establishing capacity for flux through certain components of central carbon metabolism.
An international collaborative study to establish the 2nd World Health Organization International Standard for hepatitis B virus DNA nucleic acid amplification technology‐based assays
Authors: Baylis S. A. , Heath A. B. , Chudy M. , Pisani G. , Klotz A. , Kerby S. , Gerlich W.
Published: February 2008

Background and Objectives  The aim of this study was to replace the 1st World Health Organization International Standard for hepatitis B virus DNA for nucleic acid amplification technique (NAT)‐based assays (code 97/746) with a new International Standard. Two lyophilized preparations freeze dried from the same bulk were evaluated in the original collaborative study (coded 97/746 and 97/750, and termed AA and BB, respectively, in the original study). This present study re‐evaluates these two preparations in terms of potency and real‐time stability.

Materials and Methods  The 1st International Standard (97/746) and the second lyophilized preparation (97/750) were coded Samples 1 and 2, respectively, in the present study. The samples were distributed to six laboratories and assayed on four separate occasions. Accelerated thermal degradation samples of the two preparations were examined after long‐term storage at 4 °C and 20 °C for more than 51 months.

Results  Data were returned from a total of nine different NAT‐based assays, five in qualitative format and four in quantitative format. The results of this study confirm the results of the original collaborative study, with no significant differences being found in estimated international units (IU)/ml or polymerase chain reaction‐detectable units/ml for the 1st International Standard (Sample 1 in this study) and the proposed replacement preparation, Sample 2 (97/750). Real‐time and accelerated degradation studies indicate that both samples are very stable. Storage of both preparations at 20 °C for more than 51 months resulted in no detectable degradation.

Conclusions  On the basis of the data presented in this collaborative study, Sample 2 (code 97/750) was established as the 2nd International Standard for hepatitis B virus DNA for NAT‐based assays with a potency of 106 IU/ml (500 000 IU/vial).
The dynamics of clot formation in fresh‐frozen plasma
Authors: Lawrie A. S. , Cardigan R. A. , Williamson L. M. , Machin S. J. , Mackie I. J.
Published: February 2008

Background  Factor VIII (FVIII) levels are used as a quality marker of fresh‐frozen plasma (FFP); however, other clotting factors are not routinely measured.

Methods  We assessed additional haemostatic parameters and the dynamics of coagulation using Thrombelastography (TEG®) and a thrombin generation test (TGT). FFP was prepared on the day of donation (Day 0) or after overnight hold at 4°C (Day 1).

Results  Factor VIII in Day 1 FFP was 18% lower than in Day 0. TEG® parameters in Day 1 FFP were consistent with increased coagulability and did not correlate with altered levels of clotting factors, but were consistent with the increased levels of microparticles seen in the Day 1 samples. TGT studies exhibited increased lag time, time to peak and reduced peak thrombin generation, but no change in endogenous thrombin potential (ETP) on Day 1. There was a weak association between FVIII level and both ETP and peak thrombin (ETP rs≥ 0·22, P≤ 0·003; peak thrombin rs≥ 0·48, P≤ 0·0001), which was influenced by ABO group, with the lowest levels in group O.

Conclusion  We conclude that levels of FVIII do not predict the haemostatic potential of FFP and that there may be a role for alternative technologies in monitoring the quality of FFP.
Glycinebetaine Improves Chilling Tolerance in Hybrid Maize
Authors: Farooq M. , Aziz T. , Hussain M. , Rehman H. , Jabran K. , Khan M. B.
Published: February 2008

Plant growth and development is hampered by various environmental stresses including chilling. We investigated the possibility of improving chilling tolerance in hybrid maize by glycinebetaine (GB) seed treatments. Maize hybrid (Hycorn 8288) seeds were soaked in 50, 100 and 150 mg l−1(p.p.m.) aerated solution of GB for 24 h and were dried back. Treated and untreated seeds were sown at 27 °C (optimal temperature) and at 15 °C (chilling stress) under controlled conditions. Germination and seedling growth was significantly hindered under chilling stress. Moreover, chilling stress significantly reduced the starch metabolism and relative water contents (RWC), and increased the membrane electrolyte leakage. However, activities of antioxidants (catalase, superoxide dismutase and ascorbate peroxidase) were increased under stress conditions. Seed treatments with GB improved the germination rate, root and shoot length, seedling fresh and dry weights, leaf and root scores, RWC, soluble sugars, α‐amylase activity and antioxidants significantly compared with untreated seeds under optimal and stress conditions. Induction of chilling tolerance was attributed to maintenance of high tissue water contents, reduced membrane electrolyte leakage, and higher antioxidant activities and carbohydrate metabolism. Seed treatment with 100 mg l−1GB was the best treatment for improving the performance of hybrid maize under normal and stress conditions compared with control and other levels used.
Respiratory infections and lung function in an Australian Aboriginal community
Authors: MUSK A.W. (Bill) , JAMES Alan L. , PALMER Lyle J. , RYAN Gerard F. , LAKE Fiona , GOLLEDGE Clayton L. , De KLERK Nicholas H.
Published: February 2008

Background and objective:  To investigate the association between serological evidence of past infections with common respiratory pathogens and lung function in members of an isolated community of Aborigines from tropical coastal north‐western Australia.

Methods:  FEV1 and FVC were assessed by dry bellows spirometer. Serum IgG titres to 11 common respiratory pathogens were assayed. Smoking history was assessed by questionnaire. Reciprocal positive IgG titres were taken as ≥10 for all pathogens with the exception of Legionella spp. (≥40) and Burkholderia pseudomallei (≥20). Linear regression analysis examined associations between titres and lung function after adjustment for age, height, gender and smoking, separately for adults (age > 17 years) and children.

Results:  An increased total number of positive IgG titres was significantly associated with reduced FEV1 (P = 0.01) and FEV1/FVC ratio (P = 0.01) suggesting the presence of airflow obstruction. This association was independent of age, gender, height, weight and smoking status.

Conclusions:  The burden of past respiratory infections may be an important determinant of airway function in this Aboriginal community.
Predictors for failed dose reduction of inhaled corticosteroids in childhood asthma
Authors: LI Albert M. , TSANG Tony W. T. , LAM Hugh S. , SUNG Rita Y. T. , CHANG Anne B.
Published: February 2008

Background and objective:  Studies of Western populations have shown that increased exhaled nitric oxide (FeNO) and/or sputum eosinophils (sp‐Eos) are predictive of asthma exacerbations. However, the utility of these measurements in different populations and settings is unknown. This study aimed to determine the predictors for failure of reduction of inhaled corticosteroid (ICS) doses in children with stable asthma.

Methods:  Fifty children (median age 11.8 years, interquartile range (IQR) 5.9 years) had their dose of ICS halved every 8 weeks until they reached the study end‐point (exacerbation or weaned off ICS). Spirometry, FeNO and induced sputum cells were measured at baseline and at each stage of ICS reduction.

Results:  Eleven subjects suffered an asthma exacerbation and the remainder was successfully weaned off ICS. Subjects with an exacerbation were older (15.4 years (IQR 5.4) vs 11.4 years (IQR 3.9), P = 0.019) and more likely to be boys (P = 0.035). FeNO (median 156 p.p.b. (IQR 131) vs 76.1 p.p.b. (IQR 79.5), P = 0.013) and sp‐Eos (17.3% (IQR 33.8%) vs 7.1% (IQR 9.9%), P = 0.019) were significantly greater in those who had an exacerbation. The areas under the receiver operating characteristic curves for FeNO (0.78, 95% CI: 0.59–0.97, P = 0.013) and sp‐Eos (0.76, 95% CI: 0.56–0.96, P = 0.016) were similar (P = 0.88) and both were significantly greater than that for FEV1% predicted (0.12, 95% CI: 0.08–0.56, P = 0.0013).

Conclusions:  Older boys with raised FeNO and sp‐Eos are at higher risk of failure of reduction in their ICS dose. Monitoring airway inflammation in children with asthma using FeNO or sp‐Eos is clinically useful in guiding ICS dose reduction in a non‐Western outpatient setting.
Enhanced immediate inflammatory response to Streptococcus pneumoniae in the lungs of mice with pulmonary emphysema
Authors: TOKAIRIN Yoshikane , SHIBATA Yoko , SATA Makoto , ABE Shuichi , TAKABATAKE Noriaki , IGARASHI Akira , ISHIKAWA Tomomi , INOUE Sumito , KUBOTA Isao
Published: February 2008

Background and objective:  Pulmonary emphysema is associated with frequent respiratory infections but little is known about the reasons for this susceptibility to bacterial infection. We previously demonstrated an impaired inflammatory response to Streptococcus pneumoniae in an experimental emphysema mouse model at 24 h, or longer following bacterial inoculation. Toll‐like receptors (TLR) have been recognized as regulators in the inflammatory response. We examined the expression of TLR on alveolar macrophages in experimental emphysema mice and evaluated the immediate inflammatory response of the emphysematous lung to streptococcal infection.

Methods:  Elastase was administered once into mice trachea to induce pulmonary emphysema. Three weeks later, expression of TLR‐2 and TLR‐4 in the BAL cells was examined by immunostaining. Following the intratracheal inoculation of Streptococcus pneumoniae, pro‐inflammatory cytokine concentrations were measured in the BAL fluids of the control and emphysema mice.

Results:  The expression of TLR‐2 and TLR‐4 was significantly elevated in the alveolar macrophages of emphysema mice. Six hours after infection, neutrophils in the BAL fluid of emphysema mice were significantly increased, and the levels of tumour necrosis factor‐α, IL‐1β and IL‐6 were significantly elevated, compared with the control mice. At 3 h post inoculation, macrophage inflammatory protein‐2 levels were significantly elevated.

Conclusions:  The immediate inflammatory response in the emphysematous lung is significantly enhanced in response to streptococcal infection. This may be partly attributed to the increased expression of TLR in the alveolar macrophages of emphysema mice.
Comparison of serological tests for detection of immunoglobulin M antibodies to Chlamydophila pneumoniae
Authors: MIYASHITA Naoyuki , OUCHI Kazunobu , KAWASAKI Kozo , KOMURA Hayashi , KAWAI Yasuhiro , TSUMURA Naoki , BANNAI Hisaichi , IWATA Satoshi , OKA Mikio
Published: February 2008

Background and objective:  To evaluate an enzyme immunoassay (EIA) (AniLab C. pneumoniae) for detecting anti‐Chlamydophila pneumoniae‐specific IgM antibody, by comparing it with an ELISA, Hitazyme C. pneumoniae, and a micro‐immunofluorescence (MIF) test.

Methods:  Antibodies in sera from three groups of patients were measured: eight serum samples collected serially from a patient with acute C. pneumoniae pneumonia, 34 serum samples with Hitazyme‐ELISA false‐positive results, and 137 serum samples from patients with community‐acquired pneumonia.

Results:  The IgM antibody titre in the patient with acute C. pneumoniae pneumonia showed almost identical variation with the EIA, ELISA and MIF tests. Among the 34 samples found to be false‐positive for IgM with ELISA, EIA revealed no positive cases. When a true positive case was defined as one for which a positive reaction was obtained with at least two tests, the sensitivities of the EIA, ELISA and MIF tests were 97.1%, 100% and 74.3%, with specificities of 100%, 37.3% and 100%, respectively.

Conclusions:  EIA was highly sensitive and specific as compared with the MIF test, and the ELISA test showed the lowest specificity. Consequently, the AniLab‐EIA, rather than the Hitazyme‐ELISA, is recommended as the routine method for accurately diagnosing acute C. pneumoniae infection.
Azoospermia with Klippel‐Feil anomaly
Authors: Umemoto Yukihiro , Sasaki Shoichi , Kojima Yoshiyuki , Kaneko Tomoyoshi , Yanai Yoshimasa , Kohri Kenjiro
Published: February 2008

Abstract:  We present a case of azoospermia with Klippel‐Feil anomaly. Klippel‐Feil anomaly is characterized by the fusion of two or more cervical vertebrae and a short neck, limitation of head movement, and low posterior hairline. The association of this anomaly with MURCS (Müllerian‐duct asplasia, renal agenesis, and cervical somite dysplasia) is traditionally regarded as being limited to females, but it has been hypothesized that men displaying the combination of azoospermia, segmentation abnormalities of the cervicothoracic spine, and renal anomalies have a male analog of MURCS. Here we describe the first case of MURCS in a male in whom testicular sperm extraction was carried out.
Comparison of prostate and transition zone volume measured by the ellipsoid and planimetric methods with transrectal ultrasonography before seed implantation of prostate cancer
Authors: Ikeda Tetsuhiro , Shinohara Katsuto
Published: February 2008

Abstract:  A total of 122 men who were diagnosed with localized prostatic cancer underwent transrectal ultrasound and the volumes of their prostates and transitional zones were obtained using the planimetric method and the ellipsoid method. Mean age was 64.2 ±13.4 (48.2–85.8), and mean preimplant prostate specific antigen was 6.01 ± 2.35 mg/mL (0.92–15.5). The clinical stage was T1c in 70 patients, T2a in 46 and T2b in 6. Prostatic volumes and transitional zone volumes obtained by the planimetric method were 18 % and 39% greater than those obtained by the ellipsoid method, respectively. There were significant differences between the volumes obtained by the two different methods. However, there was a good correlation between the prostatic volume and the transitional zone volume obtained by both the ellipsoid method (r = 0.851) and the planimetric method (r = 0.908). The regression line of the prostate volume between these two methods was calculated as .
Modified technique for improving tubeless cutaneous ureterostomy by Ariyoshi method
Authors: Wada Yoshihiro , Kikuchi Ken , Imamura Takahisa , Suenaga Takatoshi , Matsumoto Koichiro , Kodama Kodo
Published: February 2008

Objectives:  The cutaneous ureterostomy is the simplest urinary diversion method; however, it often causes stomal stenosis, requiring sustained catheterization with regular catheter exchange. In an attempt to prevent stomal stenosis after surgery, the fascia (S‐U fascia) between the spermatic cords and the ureters, which is usually cut off, was preserved. The remaining capillaries in the fascia could supply blood to the ureters, which is one of the most important factors for ureter patency.

Methods:  In 58 patients (93 renal units) undergoing cutaneous ureterostomy, 36 patients (66 renal units) were treated by the modified technique.

Results:  The surgeries carried out with the modified technique were significantly different in the type of operation, the side relationship, and the catheter‐free rate using the univariate analysis by means of the predicted tests, in comparison with 22 patients (27 renal units) that were treated with the conventional technique. Multivariate analysis for the type of operation determined that of the side relationship and the method, only the latter was a significant factor. The modified method allowed ∼90% of the patients to have a catheter‐free life; otherwise 74% of the patients had stomal stenosis, followed by catheterization.

Conclusion:  The presented cutaneous ureterostomy technique to preserve the fascia is useful not only to prevent stomal stenosis and maintaining good quality of life without catheterization, but also to apply to other types of ureter surgery.
Uretero‐appendiceal fistula
Authors: Iwamoto Yoichi , Onishi Takehisa , Suzuki Ryuichi , Arima Kiminobu , Sugimura Yoshiki
Published: February 2008

Abstract:  We report a case of uretero‐appendiceal fistula. A 63‐year‐old woman was admitted to our hospital with high grade fever and loss of 5 kg of body weight over 6 months. Pyonephrosis was diagnosed. A retrograde ureterogram and barium enema showed a connection between cecum and ureter. Right nephroureterectomy and right hemicolectomy were carried out. The final diagnosis was uretero‐appendiceal fistula.
A case of testicular angiomyolipoma
Authors: Saito Mitsuru , Yuasa Takeshi , Nanjo Hiroshi , Tsuchiya Norihiko , Satoh Shigeru , Habuchi Tomonori
Published: February 2008

Abstract:  The majority of testicular tumors are germ cell tumors, which are the most prevalent solid malignancies in young adult males. Non‐germ cell tumors of the testis are rare. Here, we report a case of testicular angiomyolipoma (AML). A 22‐year‐old male underwent left orchiectomy under a diagnosis of testicular tumor. Pathological analysis demonstrated that it was composed of adipose tissue and vasculature with foci of myomatous component. The tumor demonstrated neither cytological atypia nor widespread mitotic activity. In addition, the tumor cells showed intense expression of CD34 and smooth muscle actin, whereas HMB‐45 was entirely negative. Although the true cellular origin and its clinical implications remain unknown, pathological and immunohistochemical studies strongly indicated benign testicular AML with a non‐germ cell origin. To our knowledge, this is only the second case of a primary testicular AML in the published reports and the detailed pathological findings are first described in this report.
Ten year trend in prostate cancer screening with high prostate‐specific antigen exposure rate in Japan
Authors: Okihara Koji , Kitamura Koji , Okada Koichi , Mikami Kazuya , Ukimura Osamu , Miki Tsuneharu
Published: February 2008

Background:  The tendency of the results and quality control of prostate cancer screening serially performed for 10 years in an area of Japan were evaluated.

Methods:  A total of 39 213 men over 55 years of age have participated in the mass screening of prostate cancer in the Otokuni District, since 1995. Men whose prostate‐specific antigen (PSA) levels were more than 4.1 ng/mL were indicated for the second screening. In the second screening, prostate‐specific antigen density (PSAD) was calculated in men whose PSA levels ranged from 4.1 to 10.0 ng/mL.

Results:  Secondary screening was indicated in a total of 2428 subjects, of whom 1633 underwent it. Prostate cancer was diagnosed in 267 men. As a result of the evaluation of the indication of prostate biopsy according to the PSAD in 894 who underwent secondary screening for the first time, the procedure was judged to be unnecessary in 269 (35%) of 765 cases. Of these 269 subjects, 23 (8.5%) were found to have cancer. Clinically localized prostate cancer increased by 17%, and locally advanced and metastatic cancers decreased by 12% in the second compared with the first five years of the ten‐year period. The exposure rate of PSA screening in the Otokuni District was 65% with the application for the rate of screenees whose PSA level was 4.1 ng/mL or above.

Conclusions:  The Japanese basic health screening system allows the determination of high‐PSA exposure areas. Serial prostate cancer screening showed a tendency of stage migration in the screened cancer patients. The use of PSAD in secondary screening substantially reduces the necessity of prostate biopsy; however, the encouragement of PSA‐positive individuals to periodically receive prostate cancer screening is essential to maintain the quality of the screening system.
Ultrasonographic diagnosis and typing of renal tuberculosis
Authors: Rui Xuefang , Li Xin‐De , Cai SongLiang , Chen Geming , Cai Baisen
Published: February 2008

Aim:  To evaluate the clinical value of sonography in the diagnosis and typing of renal tuberculosis.

Methods:  A total of 258 cases of renal tuberculosis with complete sonographic data were reviewed. The distinguishing features of the ultrasound images of these cases were retrospectively analyzed.

Results:  The coincidence rate of ultrasonography in the diagnosis of renal tuberculosis was 58.9% (152/258). According to the distinguishing features of the ultrasound images, renal tuberculosis could be classified under six types. Type I: nephrectasia type, 23 cases; type II: hydrops type, 21 cases; type III: empyema type, 13 cases; type IV: inflammatory and atrophy type, 15 cases; type V: calcification type, 34 cases; type VI: mixed type, 46 cases.

Conclusion:  Ultrasonographic examination has convenient, low‐priced and non‐invasive advantages. The typing of renal tuberculosis based on the distinguishing features of the ultrasound images provides important and reliable information for the clinical diagnosis, differential diagnosis and treatment of renal tuberculosis.
Inflammatory myofibroblastic tumor of the urinary bladder in a 27‐year‐old woman with systemic lupus erythematosus
Authors: Hoene Kelly A , Kaufman Melissa R , Cates Justin M , Chang Sam S
Published: February 2008

Abstract:  Spindle cell lesions of the urinary bladder are uncommon tumors, and are most often spindle cell (sarcomatoid) carcinomas, non‐neoplastic reactive mesenchymal proliferations, or soft tissue sarcomas. Inflammatory myofibroblastic tumors (IMTs) may also occur in this location. Herein, we report an unusual case of an IMT arising in a previously uninstrumented bladder of a 27‐year‐old African American female with systemic lupus erythematosus. To our knowledge, IMT has not been reported in the clinical setting of rheumatologic disease.
LAPAROSCOPIC ANTERIOR 90° FUNDOPLICATION FOR REFLUX OR LARGE HIATUS HERNIA
Authors: Shukri Mohammed J. , Watson David I. , Lally Carolyn J. , Devitt Peter G. , Jamieson Glyn G.
Published: February 2008

Anterior 90°partial fundoplication has been proposed as technique to minimize the risk of side‐effects following surgery for gastro‐oesophageal reflux. We have applied this approach for the treatment of gastro‐oesophageal reflux and/or large hiatus hernias. Previous studies have shown that this type of procedure can achieve good control of reflux, with fewer side‐effects. However, only short‐term follow up has been reported. In this study, we determined later clinical outcomes in patients who have undergone this procedure. All patients who underwent a laparoscopic anterior 90°partial fundoplication surgery were identified from a database, which collected prospective clinical data. Patients completed a standardized questionnaire 3 months after surgery and then yearly to assess clinical symptoms of reflux and postoperative side‐effects. Between February 1999 and January 2006, 246 patients underwent surgery – 74 in conjunction with repair of a large hiatus hernia and 172 for reflux. Three patients underwent further surgery within 2 days of the original procedure (one for repair of a perforated oesophagus) and four underwent later surgical revision (reflux 3, dysphagia 1). Clinical follow‐up data were available for 98% at 3–84 months (median 36). Most patients had effective relief of reflux symptoms at up to 3 years follow up. Dysphagia scores improved following surgery. The magnitude of this improvement was greater in patients with large hiatus hernias. More than 80% of the patients were able to belch normally at all time points after surgery and most were highly satisfied with the overall outcome. Satisfaction scores were higher following repair of a large hiatus hernia. The clinical results of laparoscopic anterior 90°fundoplication for either reflux or as part of repair of a large hiatus hernia are encouraging, although longer‐term follow up is required to confirm durability of reflux control.
LIVER TRANSPLANTATION: A SMALL‐VOLUME UNIT EXPERIENCE
Authors: Nieuwenhuijs Vincent B. , Chen John W. , John Libby , Ring John , Harley Hugh , Dolan Paul M. , Padbury Robert T. A.
Published: February 2008

Background:  Results of liver transplantation have improved significantly over the last three decades. Hospital volume has been cited as an important outcome factor. The South Australian (SA) programme commenced in 1992 as the fourth centre in Australia.

Methods:  Patient and graft survival curves were computed from the Australian and New Zealand (ANZ) Liver Transplant Registry. SA results were compared with the rest of ANZ. All recipients of a cadaveric liver from the start of the SA programme in 1992 until the 100th case in 2005 were included and compared with recipients from ANZ in the same period.

Results:  In SA, 100 recipients received 104 grafts (average 8.0/year). In the same period 1438 recipients received 1530 grafts in ANZ (mean 23.4/year per unit). The median follow up was 6.2 years. Patient and graft survival curves were similar (P = 0.51, log‐rank test.) Survival rates at 1, 5 and 10 years were 0.93, 0.83, 0.61 and 0.88, 0.80, 0.72 for SA and ANZ, respectively (P = NS). There was trend towards a higher mortality rate of recurrent hepatitis C in SA patients when compared with the rest of ANZ (4.0 vs 1.3% respectively, P = 0.06). Recipient variables, such as age and primary liver disease did not differ between SA and ANZ. For the SA patients the biliary anastomotic stricture rate was 20%, primary non‐function rate was 2%, hepatic artery thrombosis 1% and portal vein thrombosis 1%.

Conclusion:  Good results are possible in a small‐volume unit for cadaveric adult liver transplant.
HURTHLE CELL NEOPLASM OF THE THYROID GLAND
Authors: Ahmed Mohammed , Yousef Hussam Bin , Greer William , Faraz Haroon , Al Sobhi Saif , Al Zahrani Ali , Raef Hussein , Al Ghamdi Abduallah , Al Kadhi Yusuf , Al Dayel Fouad
Published: February 2008

Background:  A clinicopathological analysis and long‐term follow up of 32 patients with Hurthle cell neoplasm (HCN) was undertaken to contrast the clinical and histological features between benign versus malignant HCN of thyroid and to examine the effect of treatment on the outcome.

Methods:  This is a retrospective study of 32 patients with HCN who were identified out of an archival clinical/pathological/imaging database of 3752 thyroid cancer patients seen between 1976 and June 2006. All patients underwent thyroid surgery. Data for the non‐surgical treatment along with follow up were also analysed.

Results:  Seventeen patients were classified as malignant HCN (MHCN) and 15 as benign HCN (BHCN). Among the MHCN, there were 11 women and 6 men, whereas among BHCN there were 14 women and 1 man. Three patients designated MHCN presented with metastases, one with pulmonary metastases and two others with skeletal metastases who developed lung metastases 9–19 months later. The mean tumour size was 4.43 ± 0.66 cm for MHCN, and 2.57 ± 0.32 cm for BHCN (P = 0.03). Multicentric tumour foci were evident in five cases (29%) of MHCN but none among the BHCN (P = 0.03). At neck exploration cervical lymph node dissection was carried out in nine MHCN patients with findings of tumour metastases in 33%. Postoperatively, three MHCN patients had no thyroid remnant on ultrasound and computed tomography of neck and undetectable serum thyroglobulin; these were considered to be in remission. Fourteen other MHCN patients with postoperative thyroid remnant and/or distant metastases received 131I treatment. Eight of these patients had negative whole‐body scans after 131I treatment and undetectable thyroglobulin. Accordingly, 11 MHCN patients (64.7%) showed evidence of remission and 6 patients did not respond to 131I treatment. After a mean follow up of 35 months, all BHCN patients are alive with no evidence of disease. Of the MHCN, 11 (64.7%) were in remission and 35% had evidence of persistence/recurrence. One patient who had recurrence is dead. A lack of effectiveness of 131I therapy in two patients with distant metastases is an important finding.

Conclusion:  Features of MHCN consisted of a large tumour size, unequivocal capsular and vascular invasion, multicentric tumour foci, metastatic lymph node deposits in one‐third of patients and presence of distant metastasis in a few. Findings of dominant Hurthle cell cytology in a fine‐needle aspiration biopsy from a thyroid nodule should prompt surgical resection of the lesion to assess malignancy.