Video-assisted thoracic surgery for lung cancer in hemodialysis patients

INTRODUCTION

In recent years, the number of hemodialysis patients has been continuously increasing. At the same time, the use of video-assisted thoracic surgery (VATS) for lung cancer has also increased. However, reports of the outcome of VATS in hemodialysis patients are still quite rare.

METHODS

From 1995 to 2011, 14 patients with non-small cell lung cancer who were also receiving hemodialysis underwent lung resection by open thoracotomy or VATS at our institution. These patients were divided into two groups as follows: open (five men and four women, mean age: 68.7 years) and (2) VATS (three men and two women, mean age: 64.0 years). We compared the clinical outcomes of these two groups.

RESULTS

Lobectomy was performed in eight patients in the open group, including one patient who also underwent a pneumonectomy, and in four patients in the VATS group, including one who also underwent a wedge resection. There were no significant difference between the groups' operation times, intraoperative blood loss, length of postoperative chest drainage, and length of postoperative hospitalization. There were no hospital deaths in either group. The 5-year survival rate was 42.9% in the open group and 37.5% in the VATS group. This difference was not significant (P=0.73).

CONCLUSION

VATS lung resection for lung cancer patients on hemodialysis is considered an acceptable treatment modality, though the long-term survival rate of such patients is relatively low, which can be attributed to the diseases underlying the need for hemodialysis.

T cell-specific overexpression of interleukin-27 receptor α subunit (WSX-1) prevents spontaneous skin inflammation in MRL/lpr mice

BACKGROUND

Interleukin (IL)-27 and WSX-1, the receptor α-specific subunit, have been shown to play important roles in initiating Th1 responses and in inducing immune modulation, and the immunosuppressive effect of IL-27 appears to be exerted via suppression of IL-10 and IL-17, which may participate in the pathogenesis of human systemic lupus erythematosus (SLE).

OBJECTIVES

To examine the significance of IL-27/WSX-1 signalling in spontaneous skin inflammation of MRL/lpr mice, a model for SLE.

METHODS

The severity and development of skin lesions, dermal inflammatory cells and epidermal-dermal depositions in the skin lesions of MRL/lpr mice with CD2-promoted WSX-1 overexpression (WSX-1 Tg mice) and those with globally disrupted WSX-1 (WSX-1 KO mice) were examined and compared with those of MRL/lpr mice.

RESULTS

By 4 months of age, both WSX-1 KO mice and control MRL/lpr mice developed predominantly similar skin inflammation, while WSX-1 Tg mice hardly did so, demonstrating that intensifying IL-27/WSX-1 signalling on T cells prevents the spontaneous skin inflammation. WSX-1 KO mice showed Th2-type skin inflammation as evidenced by the Th2-prone dermal infiltrating cells and an absence of cutaneous Th1-type IgG deposition. Interestingly, there were significant IL-17+ dermal infiltrating cells in both WSX-1 KO and control MRL/lpr mice, which might potentially contribute to the formation of skin inflammation in these mice.

CONCLUSIONS

These data indicate that IL-27/WSX-1 signalling may play a protective role in the development of SLE-like skin inflammation, and modulating IL-27/WSX-1 signalling might be an interesting therapeutic strategy in the treatment of SLE.

Tacrolimus is effective for lupus nephritis patients with persistent proteinuria

OBJECTIVES

To evaluate the safety and potential efficacy of tacrolimus for the treatment of patients with lupus nephritis and persistent proteinuria.

METHODS

A total of 23 Japanese patients with lupus nephritis (21 females/2 males) were enrolled in this study. Patients were administered tacrolimus at a dose of 2-3 mg once daily after the evening meal for 6 months. The dose of tacrolimus was unchanged throughout the study period. Concomitant prednisolone therapy was unchanged or gradually tapered, while other immunosuppressants were stopped at the start of tacrolimus treatment.

RESULTS

Tacrolimus was well tolerated, and none of the patients developed adverse drug reactions that required discontinuation of the study. Daily urinary protein loss, the U-prot/U-creat ratio, and serum albumin were significantly improved after 4 months, 3 months, and 1 month of treatment with tacrolimus (p<0.05), respectively, and the improvement persisted until 6 months. The serum complement hemolytic activity (CH50), complement C3 level, and CRP level were also significantly improved after treatment with tacrolimus (p<0.05). Improvement of the U-prot/U-creat ratio was most prominent for patients who were in WHO class IV.

CONCLUSIONS

Tacrolimus is safe and effective as maintenance therapy for patients with lupus nephritis, at least for 6 months. A larger randomised, controlled trial over a longer period is needed to confirm these results.

Isolation of folate-producing microalgae, from oligotrophic ponds in Yamaguchi, Japan

AIMS

Folate (FA) is a B-vitamin that plays an important role in the prevention of several disorders. Although synthetic FA currently dominates the market, consumers tend to demand natural FA. Because microalgae can produce organic compounds photoautotrophically, we isolated and characterized FA-producing microalgal strains.

METHODS AND RESULTS

To isolate microalgae that produce vitamins de novo, fresh water samples were cultivated in a mineral salts medium without any vitamins. After repeated subculture, 11 isolates were obtained. A biological assay revealed that four isolates accumulated FA at significantly higher levels (15-36 mg kg(-1) in dry biomass) than any known commercial microalgae. Thiamine content of the isolates was also remarkably high (71-90 mg kg(-1) in dry biomass). Phylogenetic studies based on SSU-rDNA suggested that one isolate was Chlamydomonas reinhardtii, while others were likely novel species of Chlorococcum.

CONCLUSION

There are no reports of toxicity associated with Chlamydomonas and Chlorococcum; therefore, the isolates are expected to be safe and useful not only as a promising alternative source of FA and thiamine but also as nutraceuticals for humans and animals.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present results advance our understanding of FA-producing microalgae in aquatic environments and suggest their potentials for application to biotechnological vitamin production.