[Surgery for emphysematous giant bullae]

We address 3 important keys to obtain successful outcomes in surgery for emphysematous giant bullae. It is the 1st step to select patients who might benefit from bullectomy based on functional imaging. The chest computed tomography (CT) and pulmonary perfusion scintigram provide information regarding with pulmonary vascular beds which could be recruited by bullectomy. In addition, dynamic-magnetic resonance imaging (MRI) during breathing can show a patient with paradoxical inflation of giant bulla during expiration, which means impairment of ventilation of the adjacent normal parenchyma, and is a promising sign for successful outcome of bullectomy. Second, it should be emphasized to perform a proper procedure in bullectomy. If a giant bulla has a wide bottom, it should be recommended to open the bulla and to plicate it by sutures without injury of vessels on the bottom of the bulla rather than simple bullectomy with staples. Finally, it is important to keep inflated lung avoiding atelectasis following operation by minimum pressure of suction. We show here sequential bullectomies on a 41-year-old male with chronic obstructive pulmonary disease (COPD) GOLD IV due to bilateral giant bullae and poor vascular reserve, and address our strategy described above.

Allogeneic hematopoietic SCT as treatment option for patients with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE): a consensus conference proposal for a standardized approach

Allogeneic hematopoietic SCT (HSCT) has been proposed as a treatment for patients with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). HSCT has been performed in nine patients using different protocols with varying success. Based on this preliminary experience, participants of the first consensus conference propose a common approach to allogeneic HSCT in MNGIE. Standardization of the transplant protocol and the clinical and biochemical assessments will allow evaluation of the safety and efficacy of HSCT as well as optimization of therapy for patients with MNGIE.

Single crystal growth of nanoporous C12A7:e- by controlling melt state

It has been known that electron doped 12CaO x 7Al2O3 (C12A7:e-, electride) single crystals, which are composed of a closed-packed periodic quantum dot structure, may be prepared by strong reduction of the precursor C12A7:O2-, but direct single crystal growth of the C12A7:e- from the melt state has never been achieved to date. We report the melt state of polycrystalline electride in pure dry Ar atmosphere at temperatures of 1290 approximately 1500 degrees C, which leads to the direct single crystal growth of the C12A7:e- from the melt. The electride single crystals with a diameter of 7 mm and a length of 43 mm have been grown by a floating zone method, where a polycrystalline electride feed and an electride single crystal seed rod were employed. The electron concentration in the crystal increased up to approximately 1.0 x 10(20) cm(-3) as the growth proceeded. The present findings suggest that electron-entrapped local structure may exist in the melt and the electrons may act as a template for the formation of C12A7 electride in the solidification process of the C12A7 lattice.

Mitochondrial disease mimicking Charcot-Marie Tooth disease

Charcot-Marie tooth disease (CMT) is a heterogenous group of peripheral neuropathies caused by various genetic defects. Three cases of mitochondrial myopathy, neuropathy and gastrointestinal encephalopathy (MNGIE) which initially presented with a peripheral neuropathy resembling CMT are described here. The diagnosis in all three cases was made after they developed eye signs and abdominal complaints. Young patients with mutation negative CMT should be followed up to monitor for signs of MNGIE.

Genotyping of Strawberry (Fragaria ananassa Duch.) Cultivars by DNA Markers: Interlaboratory Study

Fourteen Japanese laboratories validated the reproducibility of genotyping by 25 cleavage amplified polymorphic sequence (CAPS) markers for discrimination of strawberry (Fragaria ananassa Duch.) cultivars. Both the sensitivity and specificity rate of 12 markers were 100, those of another 12 were >95, and those of 1 were >90. These results indicate that the method of genotyping by the CAPS markers was highly reproducible and could provide a useful basis for practical identification of strawberry cultivars. This is the first report of the statistical validation of crop genotyping by DNA markers.

Highly enantioselective construction of axial chirality by palladium-catalyzed cycloisomerization of N-alkenyl arylethynylamides

A cationic palladium(II)/(S)-xyl-Segphos complex catalyzes enantioselective cycloisomerizations of N-alkenyl arylethynylamides leading to axially chiral 4-aryl-2-pyridones in high yields with high ee values. The present catalysis represents the first enantioselective construction of axial chirality by the transition-metal-catalyzed cycloisomerization.

Pseudoisotropic upper critical field in cobalt-doped SrFe2As2 epitaxial films

We present resistivity measurements of the complete superconducting upper critical field (H{c2}) phase diagram as a function of angle (theta) and temperature (T) for cobalt-doped SrFe2As2 epitaxial films to 0.5 K and 50 T. Although H{c2}(theta) at 10 K is indistinguishable from that derived from a single-band anisotropy model, the apparent anisotropy H{c2}{ perpendicularc}/H{c2};{ parallelc} linearly decreases to 1 at low T, with H{c2}(0)=47 T. The data are well described by a two-band model with small, opposing anisotropies for the bands. This unusual relationship is confirmed by the observation of a local maximum for H{c2};{ parallelc} at low T.

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in irritable bowel syndrome

Enhanced stress responsiveness has been implicated as a potential mechanism contributing to the pathophysiology of irritable bowel syndrome (IBS), and should be reflected in altered function of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Both of these systems can modulate mucosal immune function. The aims of this study were: (i) to characterize the basal circadian rhythm of adrenocorticotropin hormone (ACTH) and cortisol in IBS vs healthy controls; (ii) to compare stimulated ACTH, cortisol and noradrenaline responses to a pelvic visceral stressor (sigmoidoscopy) in IBS and controls; and (iii) to correlate neuroendocrine responses with colonic mucosal cytokine expression and symptoms in IBS. Two separate studies were conducted in women. In Study 1, basal cortisol levels were analysed in 41 IBS and 25 controls using 24-h collections of plasma ACTH and cortisol (q10 min sampling). In Study 2, 10 IBS patients with diarrhoea (IBS-D) and 10 controls underwent sigmoidoscopy with measurements of stimulated neuroendocrine responses and cytokine mRNA expression in colonic tissue. Basal ACTH levels were significantly blunted (P < 0.05), while basal and stimulated plasma cortisol levels were higher in patients. Basal cortisol levels prior to an experimental visceral stressor positively correlated with anxiety symptoms (P < 0.004), but not IBS symptoms. Irritable bowel syndrome patients with diarrhoea had significantly decreased mRNA expression of mucosal cytokines [interleukin (IL)-2, IL-6] in the sigmoid colon vs controls (P < 0.05). Although dysregulations in stress-responsive systems such as the HPA axis and mucosal immune function are demonstrated in IBS, they do not appear to have a primary role in modulating IBS severity and abdominal pain.

A clinicopathological study of nm23-H1 expression in classical Hodgkin's lymphoma

BACKGROUND

We carried out immunohistochemistry to examine the expression of nm23-H1 in Hodgkin and Reed-Sternberg cells in patients with classical Hodgkin's lymphoma (CHL).

PATIENTS AND METHODS

We evaluated 128 patients with CHL [87 patients with nodular sclerosis (NS) and 41 patients with mixed cellularity (MC)] for CD15, CD20, Ki-67, EBER, TIA-1, and nm23-H1 by immunohistochemistry.

RESULTS

CD15 was expressed in 79%, CD20 in 11%, Ki-67 in 93%, EBER in 34%, TIA-1 in 11%, and nm23-H1 in 60% of the CHL patients. NS patients showed a significantly higher rate of nm23-H1 expression than MC patients (P < 0.001). The serum nm23-H1 level was significantly higher in patients with positive nm23 expression. Univariate analysis showed that stage IV, poor performance status, low hemoglobin level, low serum albumin level, age of 45 years or older, TIA-1-positive status, and nm23-H1-positive status were associated with significantly shorter progression-free survival. Multivariate analysis with these factors showed TIA-1 and cytoplasmic nm23-H1 expression to be significant and independent prognostic factors.

CONCLUSIONS

Our results indicate that nm23-H1 expression is a prognostic factor for CHL and that it is as important as serum nm23-H1, both of which are useful for planning the treatment strategy.