XANTHOMA-INDUCING β-LIPOPROTEIN IMMUNE COMPLEXES

Untreated rabbits and rabbits sensitized with human beta-lipoproteins were intracutaneously injected with either human or rabbit beta-lipoproteins (2 mg as protein). Forty-eight hours later, at the human beta-lipoprotein injection site, dense cell infiltrations stood out sharply demarcated from the surrounding region. The infiltrating cells were composed of polymorphonuclear cells, nuclear dust and histiocytes. Foam cell nests were observed in sensitized rabbit dermis one week after human beta-lipoprotein injection. Direct immunofluorescence employing fluorescein isothiocyanate labeled antihuman beta-lipoprotein antiserum showed that the injected human beta-lipoproteins were incorporated into the infiltrating cells of sensitized rabbit dermis up to 48 hours after injection. Specific fluorescence was greatly reduced but lipid autofluorescence remained in mature foam cells. During the 3-week examination period, no trace of foam cell nests was found at the site of human beta-lipoprotein injection on non-sensitized rabbits. Intracutaneous rabbit beta-lipoprotein injection revealed no histiocytic infiltrations in either sensitized or non-sensitized rabbits. These findings indicated that intracutaneously injected human beta-lipoporteins were incorporated into rabbit dermal histiocytes more easily in aggregated immune complex form than in their natural state. These histiocytes were easily transformed to foam cells. Apoproteins of the incorporated lipoproteins were degraded, and lipid residues accumulated in mature foam cells.

IMMUNOHISTOCHEMICAL STUDY OF HUMAN XANTHOMA

Specimens of human tuberous xanthomas obtained from two hyper-beta-lipoproteinemic patients were prepared with HE and Sudan III stain and by direct immunofluorescence with fluorescein isothiocyanate labeled antihuman beta-lipoprotein rabbit serum. In some histiocytes and foam cells in early stages, lipids were stained in granular patterns and specific fluorescence was observed. In some foam cell nests, specific fluorescence was weak or absent, and orange-colored lipid autofluorescence was present. The foam cells in such nests were probably late foam cells and corresponded to the large cytoplasmic foam cells stained densely and amorphously for lipids. It was concluded that at early stages of xanthoma formation, serum lipoproteins were incorporated into dermal histiocytes and early foam cells. The apoproteins of the incorporated lipoproteins were probably degraded and lipid residues accumulated in the cells. Specimens of tuberous xanthoma covered by plane xanthoma showed lipids and bright specific fluorescence at the basement membrane zone. A faint fluorescence was observed in the upper dermis and even in parts of the epidermal intercellular spaces.

Metabolomic investigation of pathogenesis of myxosporean emaciation disease of tiger puffer fish Takifugu rubripes

Serum biochemical analysis was undertaken to study the pathophysiological details of emaciation disease of the tiger puffer fish Takifugu rubripes (Temminck and Schlegel). Serum parameters were measured by biochemical analysis using automated dry chemistry and gas chromatography/mass spectrometry (GC/MS). Serum concentrations of albumin, amylase, calcium, creatinine, glucose and total protein were significantly lower in the emaciated fish when compared with those of normal fish. Regression analyses found close correlation between concentrations of total protein, albumin, amylase, glucose and progress of the disease. In contrast, serum alanine aminotransferase increased significantly in emaciated fish indicating liver function disorder. Further, GC/MS metabolic profiling of the puffer serum showed that the profile of the emaciated fish was distinct to that of non-infected control. The serum content of amino acids including glycine, 5-oxo-proline and proline, and ascorbic acid, fumaric acid and glycerol increased significantly in serum in moderately emaciated fish. The serum glucose, linolenic acid and tyrosine level decreased significantly in the late phase of the disease. Our results clearly show that prolonged intestinal damage caused by myxosporean infection impairs absorption of nutrients, resulting in extreme emaciation.

Partial lower axillary dissection for patients with clinically node-negative breast cancer

OBJECTIVE

To evaluate retrospectively the outcomes of partial lower axillary lymph node dissection caudal to the intercostobrachial nerve in patients with clinically node-negative (N(0)) breast cancer.

METHODS

Numbers of dissected and metastatic nodes, overall and disease-free survival rates, postoperative complication rates, and axillary recurrence were compared between patients who underwent breast cancer surgery with partial axillary node dissection (n = 1043) and historical controls who underwent conventional dissection (n = 1084).

RESULTS

The 5-year overall and disease-free survival rates were 95.6% and 89.7%, and 94.9% and 88.4%, respectively, in the partial dissection and conventional dissection groups; the differences were not significant. Mean duration of surgery (41.6 min versus 60.9 min), intraoperative blood loss (28.0 ml versus 51.3 ml), volume of lymphatic drainage at 2 weeks postoperatively (488 ml versus 836 ml), and persistent arm lymphoedema (0.0% versus 11.8%) were significantly different between the partial and conventional dissection groups, respectively.

CONCLUSIONS

Partial axillary lymph node dissection was associated with similar survival rates (but lower postoperative complication rates) compared with conventional axillary dissection and is recommended in patients with N(0) breast cancer.

CT-fluoroscopy in chest interventional radiology: sliding scale of imaging parameters based on radiation exposure dose and factors increasing radiation exposure dose

AIM

To verify the usefulness of a sliding scale of imaging parameters to reduce radiation exposure during chest interventional radiology (IR), and to identify factors that increase radiation exposure in order to obtain acceptable computed tomography (CT)-fluoroscopy image quality.

MATERIALS AND METHODS

The institutional review board approved this retrospective study, for which the need for informed consent was waived. Interventional radiologists determined the optimal CT-fluoroscopy imaging parameters using the sliding scale based on the radiation exposure dose. The imaging parameters were changed from those generating low radiation (120 kV/10 mA, 1.2 mGy/s) to others generating higher radiation exposure until acceptable image quality was obtained for each procedure. Validation of the imaging parameter sliding scale was done using regression analysis. Factors that increase radiation exposure were identified using multiple regression analysis.

RESULTS

In 125 patients, 217 procedures were performed, of which 72 procedures (33.2%, 72/217) were performed with imaging parameters of minimum radiation exposure, but increased radiation exposure was necessary in 145 (66.8%, 145/217). Significant correlation was found between the radiation exposure dose and the percentage achievement of acceptable image quality (R(2) = 0.98). Multivariate regression analysis showed that high body weight (p < 0.0001), long device passage (p < 0.0001), and lesions above the aortic arch (p = 0.04) were significant independent factors increasing radiation exposure.

CONCLUSION

Although increased radiation exposure dose might be necessary to obtain acceptable chest CT-fluoroscopy images depending on the patient, lesion, and procedure characteristics, a sliding scale of imaging parameters helps to reduce radiation exposure.

Evaluation of whole-body FDG-PET in breast cancer screening

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Background: The utility of whole-body FDG-PET for the detection of breast cancers in a screening program is not well investigated.

Methods: We analyzed data from a cancer screening program including whole-body FDG-PET performed for consecutive 2065 asymptomatic women (age: 40 to 80 y.o. with mean ± SD of 56.1 ± 8.6 y.o.) without a previous history of breast cancer. They underwent the initial screening between September 2003 and December 2008. The screening included neither mammography nor ultrasonography of the breast. Final results of cancers and/or follow-up data more than 1 year following the screening were available in 1822 of the 2065 (88.2%: 941 by the following screening and 881 by the response to questionnaires). Data of the second screening in 670 women (age: 55.0 ± 8.0 y.o.) of the 941, who didn’t have cancer at the initial screening and received the second screening by December 2008 and within 2 years of the initial screening were also analyzed. Final results and/or follow-up data more than 1 year were available in 642 of the 670 (95.8%: 573 by a subsequent screening and 69 by the response to questionnaires).

Results: Data were analyzed as of the end of 2010. In 2 years after the initial screening, 57 cancers of a variety of organs including 12 of the breast were confirmed. Nine (stage 0: 1, I: 7 and IIA: 1) of the 12 were proven in 29 women with PET positive results and 3 (stage I: 1, IIA: 1 and not available: 1) in 2036 women with PET negative results. In 2 years after the second screening, 9 cancers including 4 of the breast were confirmed. Three of the 4 (stage 0: 1, I: 1 and IIB: 1) were diagnosed in 9 women with PET positive results and 1 (stage I) in 661 with PET negative results. Two of the 4 PET negative cancers were diagnosed after developing symptoms and the remaining 2 were detected by another screening. Sensitivity, specificity, positive and negative predictive values and false positive rate of the initial screening were 75.0% (9/12), 99.0% (2033/2053), 31.0% (9/29), 99.9% (2033/2036) and 1.0% (20/2053), respectively.

Conclusions: Whole-body FDG-PET had the capability to screen the breast with a very low false positive rate and high positive and negative predictive values, and could detect breast cancers of asymptomatic women at early stages with reasonable sensitivity.

Spatial distribution of hexabromocyclododecanes (HBCDs), polybrominated diphenyl ethers (PBDEs) and organochlorines in bivalves from Japanese coastal waters

In order to elucidate the spatial distribution of brominated flame retardants (BFRs) in the Japanese coastal environment, hexabromocyclododecanes (HBCDs), polybrominated diphenyl ethers (PBDEs) and organochlorines (OCs: PCBs, DDTs, CHLs, HCHs, HCB) were determined in bivalves (oysters and mussels) collected from Japanese coastal waters. HBCDs and PBDEs were detected in all samples analyzed. Concentration ranges of HBCDs were 12-5200 ng g(-1) lipid wt., followed by PCBs (20-3100 ng g(-1))>PBDEs (3.1-86 ng g(-1) lipid wt.). The highest concentration of HBCDs was found in the Osaka region. This result indicates that HBCDs are ubiquitous and predominant compounds in bivalves from the Japanese coastal waters. Since no species differences between oysters and mussels were observed for the bioaccumulation properties of HBCDs and PBDEs, oysters could be utilized for BFR contamination monitoring worldwide as an alternative to mussels. Global comparisons between oysters and mussels showed that HBCD concentrations in Japan are among the highest levels reported from Asia and Europe. Estimated dietary exposures of HBCDs and PBDEs through seafood were 0.45-34 ng kg body weight(-1)d(-1), and 0.054-6.8 ng kg body weight(-1)d(-1), respectively. These exposure levels were more than 1000 times lower than the lowest observable effects or no observable adverse effects levels for HBCDs and PBDEs, respectively.

Thymic stromal cells produce soluble factors which increase polarization of chicken thymocytes

The effects were examined of soluble factors present in culture supernatant (CS) of thymic stromal cells (TSC) on the differentiation and locomotor activity of chicken thymocytes. The locomotor activity of thymocytes was assessed by cell polarization assay. When thymocytes were incubated in the presence of TSC-CS, the proportion of polarized cells increased. This indicates that thymocytes acquired a potent locomotor activity. A high proportion of peanut agglutinin-positive (PNA + ) thymocytes, as well as CD4(-)CD8(-) and CD4(+)CD8(+) thymocytes showed polarization in TSC-CS. Bone marrow cells exhibited higher level of polarizing activity compared to CD4(+)CD8(-) and CD4(-)CD8(+) thymocytes and spleen T cells. These results suggest that thymic stromal cells secrete a soluble factor(s) which enhances mobilizing activity of immature T cells. The factor may take part in the intrathymic migration of progenitor T cells into the site of differentiation.