Epstein-Barr virus in gastric carcinoma in Suzhou, China and Osaka, Japan: association with clinico-pathologic factors and HLA-subtype

Information on geographic differences of Epstein-Barr virus (EBV) positivity and association with HLA in gastric carcinoma are limited. Therefore, the association of gastric carcinoma with EBV was examined in 118 patients from Suzhou, China, where the incidence of nasopharyngeal carcinoma (NPC) is high, and in 216 patients from Osaka, Japan, where the incidence of NPC is low, NPC being one of the EBV-associated carcinomas. Expression of HLA-A2 was also examined in some of these cases. The EBV genome was evidenced by PCR and in the tumor cells by in situ hybridization in 7/90 and 9/151 of cases from Suzhou and Osaka, respectively. Immunohistochemistry revealed that cancer cells in all cases with EBV did not express latent membrane protein-I. Type A was found in all cases positive for EBV. Among several histologic and clinical factors, only age of patients showed a correlation with EBV positivity: patients over 60 showed a higher frequency than patients below 60 years of age (p < 0.05). Typing of the HLA-A locus was possible in 16 cases positive for the EBV genome: 3 of 4 cases from Suzhou and 4 of 7 from Osaka were positive for HLA-A2 products. Severe lymphoid cell infiltration was found in 2 of 7 cases and 1 of 4 cases with and without the HLA-A2 type, respectively. The reported frequency of EBV positivity in Chinese living in Taiwan and in Japanese living in Hawaii is higher than in Suzhou, China, and Osaka, Japan, respectively. Our findings suggest that EBV association with gastric carcinoma is influenced by environmental and cultural factors.

The effects of transmural pressure on prostacyclin release from porcine endocardial endothelial cells--comparison with vascular endothelial cells

We assessed the effect of pressure on the release of prostacyclin (PGI2) from cultured endocardial endothelial cells (EECs) and vascular endothelial cells (VECs). EECs were harvested from the right ventricle (RV) and left ventricle (LV) of porcine hearts, and VECs from pulmonary artery (PA), aorta (Ao) and coronary artery (CA). Confluent EECs and VECs were incubated for 30 min under various pressures (0, 50, 100, 150 mmHg) and PGI2 release from each cell was measured. Pressure-induced PGI2 release from LV-EECs was larger than that from RV-EECs. Pressure also increased PGI2 release from both PA- and Ao-VECs, but not from CA-VECs. These findings suggest that endocardium can produce PGI2 in response to pressure and PGI2 released into the coronary blood from the ventricle may play an important role in the prevention of myocardial ischemia.

Structural feature of the major but not cytokine-inducing molecular species of lipoteichoic acid

Previously, lipoteichoic acid (LTA) of Enterococcus hirae was found to exhibit definite cytokine-inducing activity but synthetic specimens which share the fundamental structural principles proposed for LTA had no corresponding activity. We also showed recently that several minor components totally less than 5% of the LTA fraction from E. hirae ATCC 9790 possessed the activity, whereas the major component (over 90%) did not [Suda, Y., Tochio, H., Kawano, K., Takada, H., Yoshida, T., Kotani, S., and Kusumoto, S. (1995) FEMS Immun. Med. Microbiol. 12, 97-112]. In the present study, the structure of the major component of LTA was studied in an attempt to elucidate the reason for the lack of the activity in the synthetic compounds. The major component of the LTA was first digested by hydrofluoric acid hydrolysis to cleave phosphodiester linkages present. The hydrolysis products were separated and characterized by means of NMR and MS. The linkage positions of the original phosphodiesters were determined from the NMR spectra of an alkali-treated product without hydrofluoric acid degradation. The compound was proved to consist of 1,3-linked poly(glycerophosphate) and a lipid anchor, Glc(alpha1-2)Glc(alpha1-3)acyl(2)Gro, the former being linked to the 6-position of the distal glucose of the latter. The 2-position of the glycerol residues in the glycerophosphate part were substituted by oligoglucose esterified partially with alanine. The gross structure elucidated here thus coincides with the previous conclusion described by Fischer [Fischer, W. (1990) in Glycolipids, Phosphoglycolipids and Sulfoglycolipids (Kates, M., ed.) pp. 123 234, Plenum Press, New York]. Thus, the molecular species with this so-called "LTA structure" is not responsible for the cytokine-inducing activity.

[Successful direct thrombolysis in a patient with extensive dural sinus thrombosis induced by danazol]

A 43-year-old woman was suffered from an increasing headache with nausea and vomiting for nine days. She had received danazol 400 mg daily for endometriosis last two months. CT scan and neurological examinations revealed no evidence of abnormality. MRI showed isosignal intensity on T1-weighted images and high signal intensity on T2-weighted images in the superior sagittal, right transverse, sigmoid and straight sinuses suggesting thrombosis. With angiography, we confirmed extensive dural sinus thrombosis in the superior sagittal, straight, right transverse and sigmoid sinuses. She, then, developed progressing neurological deterioration with dysarthria and drowsy. Microcatheter was placed directly into the thrombus at dural sinus via transfemoral route. Thrombolytic therapy with urokinase was performed in right transverse, confluens sinuum, superior sagittal and straight sinuses. Successful recanalization with remarkable improvement of symptoms was achieved except right transverse sinus. We believe danazol played a role in the occurrence of dural sinus thrombosis. MRI and MRV were noninvasive and useful for diagnosis and follow-up of dural sinus thrombosis. Direct thrombolysis should be considered for dural sinus thrombosis, especially when clinical symptoms are rapidly deterioration with conventional anticoagulant therapy.

[The causes and management of ischemic mitral regurgitation]

Ischemic mitral regurgitation (IMR) is recognized as one of the complications of coronary artery disease. The aim of this study is to evaluate the causes and surgical management of IMR. From October 1986 to March 1995, 443 of patients underwent isolated coronary artery bypass grafting (CABG). In forty-four of the patients (9.9%) who underwent isolated CABG, the severity of postoperative IMR was reduced by two or more grades by the Sellers index. Hemodynamic parameters of these patients included: left ventricle ejection fraction, left ventricle end-diastolic volume index and left ventricle regional wall motion. They were assessed by left ventriculography (LVG). In addition, cardiac index and pulmonary artery wedge pressure were assessed by S-G catheterization and mitral annulus diameter by ultrasonic echocardiography. Twenty-nine patients experienced an increase in IMR severity after CABG, one of whom required mitral valve replacement for cardiac failure, and later died due to low output syndrome postoperative. On the other hand, fifteen patients experience a reduction in IMR severity after CABG. We conclude that the causes of IMR were regional asynergy at the site of papillary muscle, mitral annulus dilation and left ventricle dilation. Our findings suggest that severe IMR patients required concomitant mitral valve surgery with CABG. Patients with mild or moderate IMR patients with mitral annulus dilation or regional asynergy at the site of mitral papillary muscle may require the same surgery.

[Long-term follow-up study of bone mineral density in a patient with adult idiopathic Fanconi syndrome]

A 64-year-old woman complaining of severe lumbar pain was admitted to our hospital because of the finding of pre-existing mitral valve regurgitation on examination. Laboratory data revealed the proximal type of renal tubular acidosis, renal glucosuria, phosphaturia, generalized aminoaciduria and low-molecular-weight proteinuria. She did not have any cause of these tubular dysfunctions, and was diagnosed as adult idiopathic Fanconi syndrome. Dual energy X-ray absorptiometry (DEXA) revealed a reduction of bone mineral density in the lumbar spine to about 65% of the age-and gender-matched control value. Alkali agents (sodium citrate and potassium citrate), calcium lactate and 1 alpha-hydroxyvitamin D3 were administered. Bone mineral density estimated with DEXA improved with a reduction of serum alkali phosphate and disappearance of lumbar pain, and was restored to 82% of the age-and gender-matched control value after about 30 months of treatment. DEXA is useful for the long-term follow-up study of bone mineral density in a patient with Fanconi syndrome.

Pretreatment virus load and multiple amino acid substitutions in the interferon sensitivity-determining region predict the outcome of interferon treatment in patients with chronic genotype 1b hepatitis C virus infection

Hepatitis C virus (HCV) genotype 1b and high pretreatment virus load are predictive factors of poor response to interferon therapy in patients with chronic hepatitis C. To further examine the factors predicting the response to interferon in patients with genotype 1b infection, we analyzed 110 consecutive patients with HCV who were treated with a total of 624 million units of lymphoblastoid interferon alfa. Thirty-six patients (33%) were responders, while the remaining 74 patients (67%) were nonresponders. Multivariate analysis showed that a high virus titer (assessed by serum core protein level, P = .0021) and the presence of more than two amino acid substitutions in the interferon sensitivity-determining region (ISDR) (P = .0036) correlated significantly with the response to interferon therapy. Because mutations analyzed by direct sequencing of polymerase chain reaction (PCR) products may reflect artifacts of direct sequencing, we further analyzed quasispecies of HCV in this region by cloning and sequencing. Although PCR-based analysis of responders with multiple amino acid substitutions in the ISDR showed the presence of a small amount of wild-type strain in their serum, the results obtained by direct sequencing and cloning were essentially the same. A longitudinal study of quasispecies in 2 patients who showed a dramatic change in the virus titer showed no conversion from wild type to mutant or vice versa. Our results indicate that amino acid substitutions and virus load are independent predictors of the response to interferon therapy. The ability of some patients with no mutation in the ISDR or high virus load to eliminate the virus suggests the presence of other unidentified factors, host or viral, that influence the response to interferon therapy.

Comparison of fast spin-echo and conventional spin-echo sequences in the MR diagnosis of rotator cuff tears

The fast spin-echo (FSE) technique has been a successful alternative to conventional spin-echo (CSE) imaging in the brain, spine, and pelvis, but not in the knee. This study evaluated the performance of the FSE technique in comparison with the established CSE technique as a reference standard. Oblique coronal images of 30 shoulders were obtained by both FSE and CSE techniques. The FSE images were compared with CSE images in terms of blurring and motion artifact, fat signal intensity, structural conspicuity, and visualization of joint effusion and rotator cuff tears. We imaged 30 consecutive patients with suspected rotator cuff tears who were referred for MR examination. FSE images often were worse in blurring and motion artifact than CSE images. FSE images showed higher fat signal intensity, but visualized structural conspicuity, joint effusion, and rotator cuff tear as well as CSE images. Our results suggest that the FSE technique is not equal to the CSE technique but can be used for the diagnosis of rotator cuff tears.

Accessory lobe of the liver mimicking a mass in the left adrenal gland. A case report

An accessory lobe of the liver is a rare anomaly which we have diagnosed in a patient by CT. The lesion appeared as a soft-tissue-density mass with the same density as the liver and attached to the liver. Radionuclide liver scintigraphy helped to confirm the diagnosis. The object of this report is to draw attention to this rare entity since it can cause diagnostic confusion.

Time interval determination from left atrial appendage ejection flow in patients with mitral stenosis

The feasibility of determining the time interval from left atrial appendage (LAA) flow was examined using transesophageal Doppler echocardiography. Time intervals were compared between LAA flow and mitral flow patterns during late diastole in 8 patients with mitral stenosis and in 12 controls. The start of ejection flow from the LAA was later than the initiation of mitral flow, but the termination was same in both flows, indicating the contribution of LAA ejection to the latter half of the left atrial booster pump function. The pre-ejection time and the time interval from P-wave to end-ejection correlated significantly with left atrial dimensions (r = 0.55, and r = 0.70, respectively). The pre-ejection time, duration of the ejection flow from the LAA, and duration of mitral flow in the atrial contraction phase were significantly longer in patients with mitral stenosis (126 +/- 14 msec, 131 +/- 36 msec, and 167 +/- 28 msec, respectively) than in the controls (109 +/- 13 msec, 108 +/- 15 msec, and 141 +/- 17 msec, respectively). These results indicate that electrical conduction time from the right atrium to LAA can be estimated from the LAA ejection flow, and the time is related to the left atrial size. In patients with mitral stenosis, LAA contraction may contribute to left ventricular filling in the latter half of the atrial contraction phase.

[Japanese version of the Neuropsychiatric Inventory--a scoring system for neuropsychiatric disturbance in dementia patients]

BACKGROUND AND PURPOSE

Neuropsychiatric disturbances are common and burdensome symptoms of dementias. Assessment and measurement of neuropsychiatric disturbances are indispensable to the management of patients with dementia and for clinical research. No standardized instruments have been developed for these purposes in Japan. The Neuropsychiatric Inventory (NPI), developed by Cummings et al., is a standardized, validated, and reliable tool to assess a wide range of neuropsychiatric derangements in patients with dementia, and has been used in clinical studies in North America. In this study, we prepared a Japanese version of the NPI and tested its reliability and usefulness in dementia patients.

SUBJECTS AND METHODS

The subjects were 174 patients with dementia, including Alzheimer's disease (140), frontotemporal dementia (12), vascular dementia (19), and normal pressure hydrocephalus (3), whose diagnosis was made on the basis of the results of extensive examinations including MRI and PET/SPECT of the brain and appropriate clinical diagnostic criteria for each disorder. The subjects consisted of 133 women and 41 men; their mean age was 72.6 +/- 7.7 years (S.D.; range: 49 to 88) years. An examiner (neurologist) used the NPI to interview a caregiver familiar with the patient's everyday behavior. In 24 randomly selected patients interview was repeated by another examiner (psychiatrist) one month later, and test-retest reliability was evaluated. The Clinical Dementia Rating (CDR), the Mini-Mental State Examination (MMSE), and the Alzheimer's Disease Assessment Scale (ADAS) were used to assess the severity of the dementia and cognitive impairment.

RESULTS

The MMSE scores ranged from 5 to 29 (mean +/- SD = 19.0 +/- 4.8) and the ADAS scores ranged from 7 to 63 (24.3 +/- 10.9). The CDR score was 0.5 in 17 patients, 1 in 95 patients, 2 in 52 patients, and 3 in 10 patient. Test-retest reliability of each score was acceptably high, and the correlation coefficient for each score obtained by repeated assessments in this study was similar to the coefficient in the original report. Apathy was the most common behavior in the ten abnormal behavioral domains, and euphoria was the least common. The prevalence of abnormal findings was also comparable to the results in the original report. The total NPI scores and many of the NPI subscale scores were significantly correlated with both the severity of dementia and cognitive impairment.

CONCLUSIONS

This Japanese version of NPI, whose reliability and competency are comparable to those of the original version, is a reliable and useful tool for measuring neuropsychiatric disturbances in dementia patients.

Serial dynamic magnetic resonance imaging of orbital cavernous hemangioma

PURPOSE

To assess serial dynamic magnetic resonance imaging after rapid intravenous injection of contrast material as a tool for diagnosing orbital cavernous hemangioma.

METHODS

Two patients with orbital cavernous hemangioma were studied. Gadolinium-DTPA, 0.1 mmol/kg, was injected intravenously in 10 seconds.

RESULTS

On early imaging after the injection, one small point of enhancement was initially noted, and then the tumor was homogeneously enhanced. The initial enhancement point represented the connecting point of feeding vessels to the lesion.

CONCLUSIONS

Dynamic magnetic resonance imaging is useful for diagnosing cavernous hemangioma and for estimating the connecting point of feeding vessels.

Malignant lymphoma of the kidney

BACKGROUND

Primary renal lymphoma (PRL) is a rare disease, making information including etiologic factors for PRL extremely limited.

METHODS

Clinical and pathologic findings of PRL in Japan are presented and compared with those from Western countries. The presence of Epstein-Barr virus (EBV) genomes in the tumor was also evaluated. Eight cases of PRL were collected from a review of the "Annual of the Pathological Autopsy Cases in Japan (1976-1992)". These cases fulfilled the following criteria: (1) presence of renal mass without extrarenal lymphomatous involvement at admission and (2) absence of a leukemic blood picture. For histologic and immunohistochemical studies, 10% formalin-fixed and paraffin-embedded histologic specimens were used. Presence of Epstein-Barr virus (EBV) genome was examined by polymerase chain reaction (PCR) and in situ hybridization (ISH).

RESULTS

There were five males and three females; age at admission ranged from 15 to 79 years (median 57 yr). Abdominal and/or flank pain were the most common presenting symptoms. No particular past history was present in any of the patients. Histologically, tumor cells in all cases showed a diffuse pattern of proliferation: large cell type in six cases, mixed cell type and small lymphocytic type in 1 each. Immunohistochemistry revealed B-cell nature of lymphoma cells in all cases. Neither PCR nor ISH showed the presence of EBV genome in any cases.

CONCLUSIONS

PRL is non-Hodgkin's lymphoma of predominantly large cell type with a B-cell immunophenotype. EBV etiology is unlikely in PRL.

Hydroxyl radical scavenging effect of nicaraven in myocardial and coronary endothelial preservation and reperfusion injury

OBJECTIVE

We investigated the efficacy of nicaraven in reducing myocardial as well as coronary endothelial preservation-reperfusion (P/R) injury.

METHODS

In experiment I, isolated rat hearts were mounted on a Langendorff (L) apparatus to estimate the baseline cardiac function. Group 1, 8- and 12-h storage in histidine-tryptophan-ketoglutarate (HTK) solution; group 2, 8- and 12-h storage in HTK solution with superoxide dismutase (2.5 x 10(5) U/I) and catalase (2 x 10(5) U/I); group 3, 8- and 12-h storage in HTK solution with nicaraven (10(-3) M). Following storage for 8 and 12 h at 4 degrees C, they were reperfused and post-preservative cardiac function was evaluated. The hearts were then switched back to L-mode and paced at 330 beats/min. Coronary flow (CF) following perfusion with KHB solution containing 5-hydroxytryptamine (5-HT) and nitroglycerin was also measured. In experiment 2, segments of pig coronary artery were suspended in organ chambers and exposed to hydroxyl radicals in the presence or absence of nicaraven. The sensitivity of relaxation response to bradykinin of the prior-exposed rings was measured.

RESULTS

The recovery of CF and LV dp/dt following 8 h of storage in group 3 was higher than that in group 1, although there were no significant differences in the other parameters of cardiac functional recovery among the groups. The absolute values of cardiac function following 12 h of storage in groups 1-3 were as follows: 6.6 +/- 2.4, 9.1 +/- 0.8, 15.6 +/- 3.1 ml/min of cardiac output (CO); 1.9 +/- 0.9, 2.3 +/- 0.4, 6.0 +/- 2.3 ml/min of aortic flow (AF); 4.5 +/- 1.3, 6.0 +/- 0.5, 9.5 +/- 0.8 ml/min of CF, respectively. The recovery of CO, AF, CF, SP, MP, and left ventricular (LV) dp/dt were significantly improved in group 3, compared with those in group 1. CF and CO in group 3 were higher than those in group 2.5-HT caused vasoconstriction in all groups, but the vasoconstriction in group 3 was less than in group 1. Prior exposure to FeSO4/H2O2 produced significant endothelial damage as reflected by the right-ward shift of the dose-response curve of bradykinin-induced endothelium-dependent relaxation. In the presence on nicaraven, the dose-response curve recovered to the control level.

CONCLUSIONS

Nicaraven may improve coronary endothelial and myocardial function following P/R by its hydroxyl radical scavenging activity.

Identification of arginine vasopressin mRNA in rat aortic smooth muscle cells

We investigated the expression of mRNA for arginine vasopressin in vascular smooth muscle cells and A10 cells using reverse transcription-polymerase chain reaction and Northern blot analysis. Arginine vasopressin mRNA was identified both in rat aortic smooth muscle cells and A10 cells, suggesting that arginine vasopressin is locally produced in vascular smooth muscle cells. Arginine vasopressin, a potent vasoconstrictor, may modulate vascular function in an autocrine or paracrine fashion.

Stomach-partitioning gastrojejunostomy for unresectable gastric carcinoma

OBJECTIVES

To analyze the results of a new type of bypass procedure, stomach-partitioning gastrojejunostomy (SPGJ), for unresectable gastric carcinoma and to compare these results with those of conventional gastrojejunostomy (GJ).

DESIGN

Retrospective review.

SETTING

A university hospital in Japan.

PATIENTS

Eight patients underwent SPGJ in 1 group, and 13 underwent conventional GJ in the other group. Staging was determined using preoperative diagnostic imagings and intraoperative findings.

MAIN OUTCOME MEASURES

Assessment of food intake and mean survival rates.

RESULTS

There were no significant differences between the 2 groups regarding male-female ratio, mean age, and histological type of carcinoma. All patients had stage IV cancers according to the classification of the Union Internationale Contre le Cancer. The rates of taking a regular meal at 2 weeks after an operation were 88% in the SPGJ group and 31% in the GJ group (P < .05). The mean 1-year survival rates for SPGJ and GJ groups were 42.9% and 7.7%, respectively (P < .05). The mean survival times were 13.4 months in the SPGJ group and 5.8 months in the GJ group (P < .05).

CONCLUSIONS

Stomach-partitioning gastrojejunostomy achieved an improved quality of life and a better prognosis for patients, and it is the preferred bypass procedure for unresectable gastric carcinoma.

[Relationship between medical services utilization and preventive health behavior]

The purpose of this study was to examine the relationship between medical services utilization and preventive health behavior and to seek the factors affecting them. Subjects were 568 persons who were from 40 to 59 years old and lived in a community. Preventive health behaviors they actually performed and their interests in health were asked by questionnaire. Preventive health behaviors assessed included smoking behavior, drinking behavior, adequate hours of sleep, physical exercise, regularity of meals, and medical checkups. Medical services utilization, which included the number of visits to medical care providers, was measured by their medical claims during one year. Except for adequate hours of sleep, preventive health behaviors correlated positively with each other. A strong positive correlation was found between medical services utilization and medical checkups. However, correlations between medical services utilization and other preventive health behaviors were not statistically significant. Persons who performed preventive health behaviors and persons who utilized medical services scored higher in interest in health than persons who didn't. These results show that medical services utilization and preventive health behavior are strongly associated with interest in health, but are weakly correlated with each other.

Direct measurement of doxorubicin concentration in the intact, living single cancer cell during hyperthermia

BACKGROUND

It is well known that the effect of doxorubicin on cancer cells is enhanced by hyperthermia. The mechanism of this phenomenon is not fully understood.

METHODS

Two esophageal squamous cell carcinoma cell lines, TE-2 and TE-6, were used; these cell lines have different sensitivities for doxorubicin. The cells were exposed to 1 microgram/mL of doxorubicin for 30 minutes. With a confocal laser scanning microscope and a transparent warming plate, doxorubicin concentration was measured continuously in the intact, living single cancer cells, and the two-dimensional distribution of the drug during hyperthermia (43 degrees C) was analyzed.

RESULTS

A doxorubicin sensitivity difference was confirmed between TE-2 and TE-6 cells by colonogenic assay (P < 0.05). Hyperthermia increased the sensitivity of both cell lines to the drug (P < 0.05) and eliminated the sensitivity difference. Doxorubicin accumulated in the nuclei in both cell lines 30 minutes after exposure to the drug in a time-dependent manner (P < 0.05). Without hyperthermia, the doxorubicin concentration in the nuclei of the TE-2 cells (4.8 +/- 0.3 micrograms/mL) was higher than in the nuclei of the TE-6 cells (2.3 +/- 0.5 micrograms/mL) (P < 0.05). With hyperthermia, there was no significant difference in doxorubicin concentration between the nuclei of the TE-2 cells (20.8 +/- 1.3 micrograms/mL) and the nuclei of the TE-6 cells (16.5 +/- 3.9 micrograms/mL).

CONCLUSIONS

Hyperthermia increased the uptake of doxorubicin in the nuclei of cancer cells. Thus, the authors concluded that hyperthermia increases the cells' sensitivity to the drug.

Epstein-Barr virus in lymphoproliferative diseases in the sino-nasal region: close association with CD56+ immunophenotype and polymorphic-reticulosis morphology

Association between Epstein-Barr virus (EBV) and nasal T-cell lymphoma (NTL) has been demonstrated. NTL has 2 types of histologic figures: one is ordinary non-Hodgkin's lymphoma (NHL) with monomorphous proliferation, and the other is polymorphic-reticulosis (PR) morphology. The presence of the EBV genome and its sub-types (A and B) were examined on paraffin-embedded specimens from 36 cases of sino-nasal lymphomas (SNL) collected from Seoul, Republic of Korea, where the frequency of NTL is high. Patients' ages ranged from 2 to 74 years (median 54 years) with a male-to-female ratio of 2.5:1. Immunophenotypically, 8 cases were B-cell type, 11 were T-cell type with CD56-, 14 were CD56+ type, and 3 were null-cell type. Five of 11 cases with ordinary NHL of T-cell type and 9 of 14 cases with PR were CD56+. The EBV genome was found by polymerase chain reaction (PCR) and in the tumor cells by in situ hybridization (ISH) in 1 of 4 B-cell type (25%), 5 of 10 T-cell type (50%), 11 of 13 CD56+ type (85%), and in both of null-cell type (100%). Of 16 cases with PR morphology, 15 (94%) were positive for the EBV genome. All of the 5 NTLs of ordinary NHL with CD56- were negative for EBV. Concerning the sub-type of EBV, 16 cases had type A, while none had type-B EBV. These findings suggest that NTL comprises 2 groups: EBV-positive NTLs are CD56+ and/or histologically PR, and EBV-negative NTLs are CD56- and histologically ordinary NHL. The current results on Korean patients, together with earlier studies on Japanese and Malaysian patients, have shown the predominance of type-A EBV in sino-nasal lymphoma in Asia.

Abscesses caused by "dropped" stones after laparoscopic cholecystectomy for cholelithiasis: a report of three cases

While laparoscopic cholecystectomy is a standard therapeutic option for gallbladder stones, it is associated with a significant risk of injury to the gallbladder wall, which may result in the dispersion of free stones within the peritoneal cavity. However, the incidence and consequences of these dropped stones remains unclear. We report herein the cases of three patients in whom abdominal abscesses developed as a result of dropped stones during this procedure. Of particular interest was the relatively long interval from the procedure to the onset of symptoms and the unusual progression of the inflammation. These case reports strongly reinforce the risk of dropped stones during laparoscopic cholecystectomy.

Growth patterns of benign and malignant thyroid tumors estimated by CT

Thyroid tumors affect adjacent structures and reveal their nature as they grow. Differences in benign and malignant tumor growth patterns were studied by CT. Twenty-nine benign (follicular adenoma) and 29 malignant (papillary carcinoma) tumors with their findings were arranged according to size to speculate on how they grew. Benign tumors grew expansively and made a beak-like appearance in the marginal thyroid tissue (beak sign). They displaced vessels but kept a fat plane or deep sulcus between them (sulcus sign). Malignant tumors, on the other hand, grew invasively and reached the trachea rapidly without the beak sign. They destroyed the fat plane and contacted the vessels without the sulcus sign. Expansive and invasive growth forms of benign and malignant thyroid tumors could be represented schematically.

Responses of monkeys with pollinosis to two major allergens of Japanese cedar pollen

We examined the responses of two Japanese monkeys with pollinosis to two major allergens (Cry j 1 and Cry j 2) of Japanese cedar pollen. The two monkeys (A and B) had specific IgE antibodies to the allergens and showed a strong positive reaction to both of them in the intradermal test. In the histamine release test with peripheral blood mononuclear cells (PBMC), monkey A showed a typical pattern similar to that seen in human patients, while monkey B released a low level of histamine. The proliferative response of PBMC to both allergens in monkey A was weak, but was typical in monkey B. From clinical as well as immunological points of view, these monkeys may be a suitable animal model for Japanese cedar pollinosis in humans.

Haplotypic diversity of DQA1*03 and *05 subtypes differing at amino acid residue 160 encoded in the third exon in 2215 Japanese individuals

We analyzed the frequencies and haplotypes of DQA1*03 and *05 subtypes, DQA1*03011 or DQA1*0302 and DQA1*0501 or DQA1*0503, respectively, differing only at codon 160 in the non-polymorphic third exon of the DQA1 gene. Of these, 1,862 and 337 individuals selected as DQA1*03- and DQA1*05-positive samples, respectively among 2,215 unrelated Japanese were typed for their nucleotide variation at residue 160 using PCR-SSP. As observed in other populations, all the samples carrying DQA1*03011 (Gene Frequency, GF: 7.8%) were found to share DQB1*0302, whereas those carrying DQA1*0302 (GF: 44.3%) were associated with a variety of DQB1 alleles including DQB1*0302. Both of the DQA1-DQB1 haplotypes with DQA1*03011 and DQA1*0302 carrying DRB1*0406, DQA1*03011-DQB1*0302 and DQA1*0302-DQB1*0302, showed a strong linkage disequilibrium with B62 (p < 0.001, p < 0.05). These results suggested that DQA1*03011 was generated from a single amino acid change at residue 160 in the DQA1*0302-DQB1*0302 haplotype. However, none of the haplotypes with two different DQA1*03 subtypes carrying DRB1*0403,*0405,*0802 and *0901 showed a linkage disequilibrium with any common B-locus antigens, revealing extensive haplotypic diversity of the DQA1*03 group. For example, DRB1*0802 haplotypes showed linkage disequilibria with two different B-locus antigens, B35 and B61 depending on the presence of DQA1*03011 and DQA1*0302, respectively. The GFs of DQA1*0501 and *0503 were 5.1% and 2.7%, respectively. The DQA1*05 associated haplotypes in the DR52-antigen group with DQB1*0301 were divided into two groups, depending on the bimorphism at residue 160. Such a high degree of haplotypic diversity in association with DRB1 and B alleles observed in the DQA1*03 and *05 groups related to amino acid variation at residue 160, which may affect biological function such as the interaction between CD4 and HLA-DQ molecules, seems to reflect selective pressure in the evolutionary process of HLA antigens.