Multiple hepatic peribiliary cysts in a young pig

Histopathologic features of hepatic peribiliary cysts were described in a young slaughtered pig. The animal was an apparently healthy 6-month-old pig of mixed breed. Macroscopically, all lobes of the liver contained numerous cysts of varying size containing serous fluid in all lobes. Histopathologically, the cysts were located mainly around the large bile duct and in the connective tissue of the portal tracts. Within serial sections, these cysts were assumed to be solitary or multilocular, but they were separated from the bile duct. The cysts were lined by a single layer of columnar, cuboidal, and flattened epithelial cells. Occasionally, goblet cells were observed. The epithelial cells were stained with periodic acid-Schiff/alcian blue and high-iron diamine/alcian blue, indicating the presence of neutral mucin, sialomucin, and sulfomucin. Grimalius' method revealed the presence of endocrine cells in the lining epithelium. There was no bile pigment in the cysts by the Hall method.

Intraspecific variation of Spirometra erinaceieuropaei and phylogenetic relationship between Spirometra and Diphyllobothrium inferred from mitochondrial CO1 gene sequences

Spirometra erinaceieuropaei is a diphyllobothriid cestode whose adult stage occurs mainly in cat-like carnivores, but occasionally in canids and humans. Although it is generally accepted that the distribution of S. erinaceieuropaei is cosmopolitan, it is controversial as to whether all of S. erinaceieuropaei reported are the same species. This study determined partial sequences of the CO1 gene from several isolates in Asian countries and compared them to sequence data from the GenBank/EMBL/DDBJ nucleotide sequence database. Then intraspecific variation of S. erinaceieuropaei and its phylogenetic relationship with Diphyllobothrium were evaluated. The level of nucleotide variation in the CO1 gene sequences within S. erinaceieuropaei was less than 2.6%. Although it was a little larger than that within each species of Diphyllobothrium (0.1-1.0%), it was much smaller than the interspecific variation within the genus Diphyllobothrium (6.2-14%). These facts indicate that all isolates of S. erinaceieuropaei used in this study, which were collected from Asia, Australia and New Zealand, belong to the same species. Based on CO1 gene sequences, genus Spirometra is clearly separate from the genus Diphyllobothrium. It seems that the genus Spirometra is not a synonym of the genus Diphyllobothrium. The phylogenetic relationship between S. erinaceieuropaei and Sparganum proliferum inferred from the CO1 gene clearly confirm the previous opinion that S. proliferum is a distinct species from S. erinaceieuropaei.

Cryopreservation of wild mouse spermatozoa

Spermatozoa of wild mice from China, Czechoslovakia, Denmark, India, Japan and Switzerland were frozen and stored at -196 degrees C. After thawing, intact oocytes were inseminated in vitro with relatively high motility frozen-thawed mouse spermatozoa from Czechoslovakia, Denmark and India, while oocytes with a partially dissected zona were inseminated with low motility frozen-thawed spermatozoa from China, Japan and Switzerland. Embryos developing to the 2-cell stage from oocytes fertilized with frozen-thawed spermatozoa were transferred to the oviducts of female recipients on the first day of pseudopregnancy (day when a vaginal plug was confirmed). Successful embryo development to the 2-cell stage was 46 to 67%. Offspring resulted from 17 to 51% of these transferred 2-cell embryos.

Effectiveness of concurrent radiation therapy combined with peroral chemotherapy (UFT or TS-1 ) for T2N0 glottic cancer in Japanese population

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Background: The current study retrospectively reviewed 147 T2N0 glottic cancer patients treated at Kitasato University Hospital to compare concurrent radiation therapy combined with chemotherapy (most of them: UFT or TS-1, peroral anti-cancer drugs), with conventional radiation therapy. Methods: One-hundred and forty-seven patients with T2N0 glottic cancer treated with radiation therapy alone or radiation therapy combined with peroral (UFT or TS-1)or intravenous chemotherapy between 1974 and 2005 at Kitasato University Hospital. The median age of all patients was 64 years (range; 45–86 years). As for gender, 145 were males and the others were females. As for radiation therapy protocol, all except one were treated with 2 Gy per fraction, 5 fractions per week and a total of 60 Gy. Only one patient was treated with 1.8 Gy per fraction, 5 fractions per week and a total of 61.2 Gy. As for chemotherapy protocol, 83 patients were concurrently given UFT, (UFT group). 24 patients given TS-1, (TS-1 group) and 23 patients underwent intravenous chemotherapy using mainly cisplatin (Pt. group). The other 23 patients underwent no chemotherapy. Results: The median follow-up time was 61 months (range; 3–372 months). The 5-year local control rates of all patients was 83.4 %. Stratified by radiation therapy alone group (RT group) and concurrent chemoradiation therapy (CCRT group), The 5-year local control rates of RT group and CCRT group were 82.7%, 83.4%, respectively (p=NS). Stratified by chemotherapy regimens of CCRT group, 3-year local control rates of UFT group, TS-1 group and Pt. group were 90.1%, 100.0% and 73.4%, respectively, which indicated the peroral chemotherapy was not inferior to intravenous chemotherapy. As for morbidity, 2 patients of UFT group experienced severe enteritis . Conclusion: Concurrent radiation therapy combined with UFT or TS-1 for T2N0 glottic cancer might be the one of standard treatments in Japanese Population. Furthermore, concurrent use of TS-1 might perform break-through for T2N0 glottic cancer in terms of local control rate, overall survival and burdens of treatment on patients.

No significant financial relationships to disclose.

Outbreak of human metapneumovirus detected by use of the Vero E6 cell line in isolates collected in Yamagata, Japan, in 2004 and 2005

A number of epidemiological studies have shown human metapneumovirus (hMPV) to be one of the most important viral agents associated with acute respiratory infections in humans. However, due to the difficulty in growing the virus, all epidemiological studies of hMPV infection have been performed on the basis of the molecular method. Thus, the development of a cell line suitable for the isolation of hMPV from clinical specimens is a crucial step for further research. Using the Vero E6 cell line, which could be stably maintained for 1 month without passage or medium change, we succeeded in isolating 79 strains from 4,112 specimens obtained in Yamagata, Japan, in 2004 and 2005. The total isolation rate was 1.9% (79/4,112). The monthly distribution revealed that hMPV infections occurred between February and April in 2004 and throughout most of the year in 2005. Phylogenetic analysis indicated that subgenogroup B2 was predominant in 2004, whereas three subgenogroups, A2, B1, and B2, had cocirculated in 2005. Although multiple subgenogroups cocirculated in 2005, each individual subgenogroup strain was found to predominate at specific sites. An infectivity assay of hMPV strains also indicated that the infection efficiency in Vero E6 cells was better than that in LLC-MK2 cells. Finally, we found that Vero E6 cells are useful for the isolation of hMPVs and that this utility might aid further research into hMPVs beyond the epidemiological data shown in this study.

Clinicopathologic correlations of stage IE/IIE primary thyroid diffuse large B-cell lymphoma

BACKGROUND

We studied the clinicopathological characteristics and prognoses of localized stage thyroid diffuse large B-cell lymphoma (DLBCL).

PATIENTS AND METHODS

This study included 32 patients with stage I/IIE thyroid DLBCL. Their median age was 66 years, the male/female ratio was 10/22.

RESULTS

As to the cellular immunophenotype, CD20 was positive in 31/32, CD5 in 0/32, CD10 in 4/32, CD23 in 1/32, BCL2 in 14/30, and BCL6 in 24/32. Twelve cases showed abnormal karyotypes: two cases with t(8;14)(q24;q32), four cases with 3q27, two cases with 17p11, and four cases with other abnormal karyotypes. As for treatment, eight cases were treated with chemotherapy alone and 24 cases were treated with chemotherapy followed by radiotherapy. Complete response was achieved in 94%. The 5-year progression-free survival was 84% and the 5-year overall survival was 90% with a median follow-up period of 62 months. The germinal center B-cell (GCB) type had a significantly better prognosis than the non-GCB type.

CONCLUSION

Localized stage thyroid DLBCL is a disease with a relatively good prognosis. It is, however, a heterogeneous disease with regard to histological type and pathological state. Localized stage thyroid DLBCL has a good prognosis and it is that there are more GCB-type DLBCL lymphomas.

Lyn is an important component of the signal transduction pathway specific to FLT3/ITD and can be a therapeutic target in the treatment of AML with FLT3/ITD

Fms-like tyrosine kinase 3 (FLT3) is expressed in hematopoietic progenitor cells. An internal tandem duplication (ITD) of FLT3 (FLT3/ITD) is the most frequent mutation in human adult acute myeloid leukemia (AML). FLT3/ITD contributes to the constitutive activation of FLT3 itself and its downstream signal components, mitogen-activated protein kinase and signal transducers and activators of transcription 5 (STAT5), and enables interleukin (IL)-3-dependent cell lines to grow autonomously. In the present study, we showed the specific association of FLT3/ITD with Lyn, which led to the phosphorylation of Lyn in vivo. We also demonstrated that FLT3/ITD receptors displayed a higher affinity to bind to Lyn than wild-type FLT3 receptors in vitro and that this affinity was relative to the intensity of tyrosil phosphorylation of the receptor. Both treatment with small interfering RNA (siRNA) targeting Lyn and the Src family kinase inhibitor PP2 suppressed the IL-3-independent growth of FLT3/ITD-expressing 32D cells (FLT3/ITD-32D), reducing the constitutive phosphorylation of Lyn and STAT5. PP2 treatment of mice transplanted with FLT3/ITD-32D cells blocked the onset of tumors and decreased the size of established tumors. These results demonstrate that Lyn is an important component of the signal transduction pathway specific to FLT3/ITD and can be a therapeutic target in the treatment of AML with FLT3/ITD.

Expression and role of MHC class I-related chain in myeloma cells

BACKGROUND

The molecular mechanism of natural killer (NK) cell cytotoxicity to myeloma cells remains unclear. We investigated whether MHC class I-related chain (MIC), a ligand of NKG2D that is an activating NK cell receptor, is involved in the cytotoxicity of NK cells toward myeloma cells, and examined the effects of various drugs on the cytotoxicity.

METHODS

Two human myeloma cell lines and fresh myeloma cells from 10 patients were used. MIC expression was examined by flow cytometry and reverse transcription (RT)-PCR. NK cell cytotoxicity was examined using a 51Cr-release assay. The effects of various drugs, including thalidomide, all-trans retinoic acid, dexamethasone, IFN-alpha and incadronate, on the MIC expression and NK cell cytotoxicity were examined.

RESULTS

MIC was highly expressed on the human myeloma cell lines U266 and RPMI-8226 and in myeloma cells of one of 10 patients examined. MIC expression on these cells was not changed by various drugs except IFN-alpha, by which MIC expression was down-regulated. Although MIC and HLA class I molecules were similarly expressed at high levels on both cell lines, U266 was sensitive to NK cells whereas RPMI-8226 was not. Furthermore, cytolysis by NK cells was not inhibited by the addition of anti-MIC Ab or decreased expression of MIC caused by IFN-alpha.

DISCUSSION

MIC plays a role in the cytolysis by NK cells in multiple myeloma.

CagA protein secreted by the intact type IV secretion system leads to gastric epithelial inflammation in the Mongolian gerbil model

Helicobacter pylori causes various gastro-duodenal diseases, including gastric cancer. The CagA protein, an H. pylori virulence factor, induces morphological changes in host cells and may be associated with the development of peptic ulcer and gastric carcinoma. The present study has analysed the role of CagA protein in the pathogenesis of H. pylori infection in the Mongolian gerbil model. Mongolian gerbils were challenged with wild-type H. pylori strain TN2, which has a functional cag pathogenicity island or isogenic mutants with disrupted cagA (DeltacagA) or cagE (DeltacagE) genes. They were sacrificed at 7, 13, and 25 weeks after inoculation. Pathological changes of the gastric mucosa were determined and apoptosis was assessed by the TUNEL assay. Immunohistochemistry for PCNA, phospho-IkappaBalpha, and phospho-Erk was also performed. All of the bacterial strains colonized the gerbil stomach at similar densities; however, the DeltacagA mutant induced milder gastritis than did the wild type. The extent of apoptosis and lymphoid follicle formation in the epithelium appeared to depend on intact cagA. The DeltacagA mutant induced less phosphorylation of IkappaBalpha and Erk, and less expression of interferon-gamma and interleukin-1beta mRNA in the epithelium than did the wild type. It is concluded that CagA protein may be essential for the induction of severe gastritis in the Mongolian gerbil model.

Medullary sponge kidney in a 10-year-old Shih Tzu dog

Medullary sponge kidney was diagnosed in a 10-year-old male Shih Tzu dog with a long history of hyposthenuria, but with no other findings indicating renal failure or hormonal aberration. At the dog's death from heart failure, an autopsy was performed. On gross morphology, bilateral kidneys were normal size and had many cysts ranging from the corticomedullary junction to renal papillae. Histopathologic findings showed that almost all of the cysts were lined by monolayered or multilayered and columnar or cuboidal epithelium with chilium similar to epididymis. Immunohistochemically, all of these cells were strongly positive for AE1/AE3 and negative for vimentin. Many of these cells were positive for cytokeratin 7 (CK7), and only a few cells were positive for desmin. The results of staining are the same as those for epithelium of the collecting duct of normal canine kidney. This is the first report of this pathologic entity in the canine kidney.

Long-Term Outcome of Renal Transplantation in Focal Glomerulosclerosis

INTRODUCTION

Focal segmental glomerulosclerosis (FSGS) has a tendency to recur frequently after kidney transplantation. We evaluated 12 cases to examine the incidence and long-term outcomes of recurrent FSGS.

MATERIALS AND METHODS

Twelve patients with renal failure caused by FSGS received kidney allografts from living related donors. Tacrolimus or cyclosporine was used in combination with prednisolone and azathioprine or mycophenolate mofetil.

RESULTS

The mean graft survival was 87.4 +/- 46.8 months. The graft survival rates in FSGS recipients were at 1 year, 100%; 5 years, 79.6%; 10 years, 68.2%. Two out of four recipients experienced graft loss due to chronic rejection. The other two out of four recipients with graft loss displayed severe proteinuria diagnosed as recurrence of FSGS. To treat recurrent FSGS, plasma exchange was partially effective to reduce proteinuria.

CONCLUSION

Our incidence of recurrent FSGS is 16.7% with graft survivals at 5 and 10 years of 79.6% and 68.2%, respectively. The recurrence of FSGS happened after scheduled reductions in immunosuppressants. Careful observation is required with maintenance of immunosuppression in these patients.

Multi-layered network structure of amino acid (AA) metabolism characterized by each essential AA-deficient condition

The concentrations of free amino acids in plasma change coordinately and their profiles show distinctive features in various physiological conditions; however, their behavior can not always be explained by the conventional flow-based metabolic pathway network. In this study, we have revealed the interrelatedness of the plasma amino acids and inferred their network structure with threshold-test analysis and multilevel-digraph analysis methods using the plasma samples of rats which are fed diet deficient in single essential amino acid.

In the inferred network, we could draw some interesting interrelations between plasma amino acids as follows: 1) Lysine is located at the top control level and has effects on almost all of the other plasma amino acids. 2) Threonine plays a role in a hub in the network, which has direct links to the most number of other amino acids. 3) Threonine and methionine are interrelated to each other and form a loop structure.

Electromyography of the cricoarytenoid unit during supracricoid laryngectomy with a cricohyoidoepiglottopexy procedure

Two patients who received supracricoid laryngectomy with cricohyoidoepiglottopexy to treat laryngeal cancers, underwent intra-operative electromyography analysis. After the lesion was removed and the electrodes were inserted into the remaining intrinsic laryngeal muscles, the depth of anaesthesia was carefully reduced. Gentle tactile stimulations were applied to the pharynx to trigger the reflex movement of the remaining arytenoids. Recordings were made when reflex movement was achieved.

Case one: Electromyography (EMG) of the remaining arytenoid demonstrated clear phase differences indicating reciprocal activities between the adductor group (lateral cricoarytenoid muscle, interarytenoid muscle) and the abductor muscle (posterior cricoarytenoid muscle). Case two: EMG of the remaining arytenoid demonstrated reciprocal activities between the interarytenoid muscle and the posterior cricoarytenoid muscle. Activity of the lateral cricoarytenoid muscle was not evident because the muscle was excised during removal of the paraglottic space. Mobility of the arytenoid was attributed to interaction between the interarytenoid muscle and posterior cricoarytenoid muscle. Reciprocal interaction between the interarytenoid muscle and posterior cricoarytenoid muscle alone is also capable of maintaining post-operative laryngeal functions after supracricoid laryngectomy with cricohyoidoepiglottopexy.

High frequency of several PIG-A mutations in patients with aplastic anemia and myelodysplastic syndrome

To clarify some characteristics of phosphatidylinositol glycan-class A gene (PIG-A) mutations in aplastic anemia (AA) and myelodysplastic syndrome (MDS) patients compared with those in paroxysmal nocturnal hemoglobinuria (PNH) patients, we investigated PIG-A mutations in CD59- granulocytes and CD48- monocytes from seven AA, eight MDS, and 11 PNH Japanese patients. The most frequent base or type abnormalities of the PIG-A gene in AA and MDS patients were base substitutions or missense mutations, respectively, and deletions or frameshift mutations, respectively, in PNH patients. Several PIG-A mutations, most of which were statistically minor, were found in glycosylphosphatidylinositol-negative cells from all AA and MDS patients but not from all PNH patients. However, the common PIG-A mutations during the clinical course between CD59- granulocytes and/or CD48- monocytes from each AA or MDS patient, except for Case 5, were not found. PIG-A mutations were different between the granulocytes and monocytes from five AA and five MDS patients. Our results indicate that there were some characteristics of PIG-A mutations in AA and MDS patients compared with PNH patients and that several minor PNH clones in these patients occurred at random during the clinical course. This partly explains the transformation of AA or MDS to PNH at intervals.

Expression of lactate dehydrogenase-A and -B messenger ribonucleic acids in chick glycogen body

Glucose is a main metabolic substrate in the central nervous system (CNS). Recently, lactate has attracted renewed attention because it plays an important role in the CNS as a metabolic substrate between neurons and astrocytes. Lactate and lactate dehydrogenase (LDH), a key enzyme for lactate and pyruvate interconversion, have been investigated. The glycogen body (GB) is a gelatinous tissue in the dorsal area of the lumbosacral spinal cord in birds. It is composed of uniform cells with high glycogen storage and is thought to be in the astroglia lineage. In this article, we investigated the LDH enzyme activity in embryo GB (embryonic d 12, 14, 16, 17, and 18) and chickens. To detect the subtype of the LDH, mRNA expressions in GB were investigated and compared with those of cerebral cortex and spinal cord. By histochemical observations, LDH enzyme activity was detected in the cytoplasm of GB cells of all embryonic periods after embryonic d 12. In biochemical analysis, the enzymatic activities of the GB were higher than in the cerebral cortex. In the GB the subtype of LDH mRNA was LDM-B only, and in the cerebral cortex and spinal cord, the subtype of LDH mRNA was predominantly LDH-B, and a small amount of LDH-A was found in the chicken and embryo. The LDH-B mRNA expression in GB was detected during all periods of the study (after embryonic d 12). These observations suggest that GB expressed only LDH-B and that GB cells are not lactate-producing cells, like astrocyte, but rather are lactate-consuming cells, similar to neurons in CNS.

Direct maxacalcitol injection into hyperplastic parathyroids improves skeletal changes in secondary hyperparathyroidism

Direct maxacalcitol (OCT) injection into a parathyroid gland (PTG) ameliorates several important etiologic factors of resistance to medical treatments for secondary hyperparathyroidism (s-HPT): the upregulations of vitamin D receptor (VDR) and Ca-sensing receptor (CaSR) in PTGs and the regression of PTG hyperplasia by the induction of apoptosis. In this study, we evaluated the bone histomorphology on the basis of maintaining these effects in advanced s-HPT. Five/six nephrectomized Sprague-Dawley rats were fed a high-phosphorus and low-calcium diet for 8 weeks. These rats were divided into four treatment groups: (1) basic uremic (at the baseline), (2) direct OCT single injection into PTGs (DI-OCT) followed by OCT intravenous administration for 4 weeks (IV-OCT), (3) direct vehicle injection and IV-OCT, and (4) no treatment for an additional 4 weeks. The effects of these treatments on serum intact-parathyroid hormone (PTH) level, PTG weight, VDR and CaSR expression levels in PTGs, and bone histomorphometric parameters were investigated. In the DI-OCT+IV-OCT group, the significant decrease in serum intact-PTH level was maintained by the following IV-OCT. A significant decrease in PTG weight and the upregulations of VDR and CaSR expression levels in PTGs were also observed. Bone histomorphometric analysis showed significant improvements in osteitis fibrosa in both cancellous and cortical bones. However, these findings were not observed in the other groups. These results suggest that osteitis fibrosa caused by advanced s-HPT can be successfully reversed by a control of PTH at an appropriate level through the improvement of PTG hyperplasia as induced by DI-OCT+IV-OCT.

Morphology and properties of Asian and Caucasian hair

Various aspects of Asian and Caucasian hairs were investigated and compared. We started by studying their cuticle structures--the number of cuticle layers, width of the cuticle cells, degree of their inclination, and the interval between surface cuticle edges. As a result of this study, on about two hundred subjects for each race, it was shown that there were statistically meaningful differences between all these attributes for the two hair types. Asian hair has more cuticle layers and wider cuticle cells than Caucasian hair, and the cuticular inclination of Asian hair is steeper and its cuticular interval is narrower than in Caucasian hair. In addition, it was also found that there are differences in how cuticle cells begin to fail. Under extension stress, Asian hair cuticles fail as large pieces while keeping their original shape. On the other hand, Caucasian hair cuticles tend to collapse to form small fragments. AFM measurements revealed that Caucasian cuticles are indeed more fragile than Asian cuticles. These results suggest that the strength of cuticular subcomponents is different between Asian and Caucasian hair and that the weakest point, where stress is first absorbed, differs between races. It was proven that the cuticles of Asian hair are more easily peeled off than Caucasian hair cuticles during daily grooming. This can be attributed to the difference in how stress is absorbed.

Adolescent smoking behaviour and cigarette brand preference in Japan

OBJECTIVES

As part of efforts to develop a smoking control strategy for Japanese adolescents, the results of two nationwide surveys on adolescent smoking behaviour were compared.

DESIGN

Descriptive study on smoking behaviour among high school students was conducted. Self-reporting anonymous questionnaires were administered to 115,814 students in 1996 and 106,297 in 2000 through randomly sampled junior and senior high schools throughout Japan.

MAIN OUTCOME MEASURES

Smoking prevalence, proportion of smokers by usual sources of cigarettes, national estimated cigarettes consumed by minors, share of cigarette brands smoked by high school students.

RESULTS

The experiment rate among junior high school boys decreased in 2000 compared with that in 1996, whereas current and daily smoking rates did not. Although prevalence among Japanese girls was much lower than that among boys, prevalence among girls increased in 2000. The main source of cigarettes among high school smokers was vending machines. The proportion of smokers who usually purchased cigarettes from vending machines increased in 2000, in spite of the 1998 introduction of restrictions on night-time operations. Japanese adolescents were more likely than adults to smoke American cigarette brands, and the adolescent market share of American brands has increased rapidly, especially for menthol brands.

CONCLUSIONS

This survey revealed the seriousness of the problem of smoking behaviour among Japanese high school students, and suggested that this behaviour may be influenced by social environmental factors, including the marketing strategies of the tobacco industry. Action should be taken to reduce the prevalence and impact of pro-tobacco marketing messages and to abolish cigarette vending machines.

Pleomorphic adenoma of the salivary gland in two dogs

Pleomorphic adenomas of the salivary gland were diagnosed in two dogs. The tumours were single, firm and well circumscribed, with a smooth cut surface. Metastatic tumours were not detected. Histopathological examination revealed that the tumours contained multiple cysts lined with luminal epithelial cells and myoepithelial cells, and mucinous, myxochondroid and cartilaginous tissues. Immunohistochemical examination demonstrated labelling of luminal epithelial cells and myoepithelial cells, and mucinous, myxochondroid and cartilaginous tissues with antibodies to cytokeratin LU-5, AE1/AE3, CK-14, CALP, a-SMA, vimentin, GFAP, and S-100. Labelling for GFAP indicated stromal transformation into myxoid and chondroid tissues.

Neuroendocrine carcinoma in the nasal cavity of ten dogs

Neuroendocrine (NE) carcinoma was diagnosed in 10 dogs. In six cases examined by cephalometric radiography and computerized tomography, a large mass was seen to fill the nasal cavity. Histopathologically, sheets, nests or ribbons of neoplastic cells were separated by delicate or thick fibrovascular stroma. The neoplastic cells were round, oval, or spindle-shaped; cytoplasmic granules and hyperchromatic nuclei with prominent nucleoli were present. Neoplastic cells were invariably immunohistochemically positive for cytokeratin (CK) AE1/AE3, neuron-specific enolase, chromogranin A and vasoactive intestinal polypeptide. Eight dogs were positive for S100 protein, seven for synaptophysin, five for protein gene product 9.5, two for somatostatin, and one for Leu-7. Immunolabelling gave negative results for CK 8, CK 19, calcitonin, calcitonin gene-related polypeptide, neurofilaments, serotonin, gastrin and glial fibrillary acidic protein. Ultrastructurally, the neoplastic cells contained a large number of round, membrane-bounded, densely-cored granules corresponding to neurosecretory granules. These observations were consistent with the neuroendocrine nature of the carcinomas.

Therapeutic drug monitoring of mycophenolic acid in renal transplant recipients

Immunosuppressive regimens including mycophenolate mofetil (MMF, Cellcept) were used in a renal transplant transplant program since May 2000 including 67 patients in whom it was the primary drug. Acute rejection (AR) occurred in 9 cases (13%) with 1-year graft survival rate of 96.8%. Pharmacokinetic (PK) studies of mycophenolic acid (MPA) were performed in 46 recent patients (total, 127 times). There was no correlation between dose (mg/kg) and blood concentration (AUC0-9: r2= 0.27). AUC0-9 was well correlated with AUC0-4 (r2= 0.91), but not with a single timepoint concentration. MPA AUC0-9 level was significantly higher among the AR-negative group (n = 33; 34.2 +/- 16.8 ng.hr/mL) compared with AR-positive group (n = 3; 28.2 +/- 1.9 ng.hr/mL; P = .04085) over the 2 weeks after transplantation. MPA AUC0-9 level was higher among the adverse event (AE-positive) group (n = 15; 39.2 +/- 22.8 ng.hr/mL) compared with the negative group (n = 21; 30.1 +/- 8.0 ng.hr/mL; P = .08772) within 2 weeks after transplantation. These results suggest the necessity of measuring AUC for therapeutic drug monitoring (TDM) of MMF-containing immunosuppressive therapy. The possible target level of MPA AUC0-9 would be approximately 30 ng.hr/mL using the present immunosuppressive regimen.

Charmed-meson decay constants in three-flavor lattice QCD

We present the first lattice QCD calculation with realistic sea quark content of the D+-meson decay constant f(D+). We use the MILC Collaboration's publicly available ensembles of lattice gauge fields, which have a quark sea with two flavors (up and down) much lighter than a third (strange). We obtain f(D+)=201+/-3+/-17 MeV, where the errors are statistical and a combination of systematic errors. We also obtain f(Ds)=249+/-3+/-16 MeV for the Ds meson.

Isolation of equine herpesvirus-1 lacking glycoprotein C from a dead neonatal foal in Japan

We isolated a variant equine herpesvirus-1 (EHV-1), strain 5089, from the lung of a dead neonatal foal in Japan and characterized the biological nature of the virus. The virus spread in cultured cells mainly by cell-to-cell infection, unlike wild-type EHV-1, which spreads efficiently as a cell-free virus. The virus titer in cultured supernatant and the intracellular virus titer were low compared to those of wild-type EHV-1. Heparin treatment of the virus had no effect on viral infectivity in cell culture. Glycoprotein C (gC) was not detected by Western blotting and fluorescent antibody tests in 5089 virions and 5089-infected cells, respectively. RT-PCR analysis revealed that the expression level of 5089 gC mRNA was reduced considerably compared to that of wild-type EHV-1. Sequencing analysis of the 5089 gC coding region showed a point mutation in the promoter region of the gC open reading frame. However, the mutation did not affect the promoter activity. These results suggested that the lack of gC in 5089 virions might be one of the reasons for spread of the virus by cell-to-cell infection and that gC mRNA expression might not be activated efficiently due to factors other than the mutation in the gC promoter region.

The relationship between self-reported difficulty with hearing in the worse ear and the better ear

OBJECTIVES

To investigate the relationship of self-reported hearing difficulty with hearing in the worse ear and the better ear at 1 and 4 kHz.

DESIGN

Receiver-operating characteristic (ROC) curve analysis in community-residing population.

SETTINGS

The Settsu City Health Center (Osaka, Japan).

PARTICIPANTS

A total of 919 consecutive participants who were provided health check-ups.

MAIN OUTCOMES MEASURES

Comparison is based on the measurement of the area under the curve (AUC) of ROC.

RESULTS

At 1 kHz, the area under the curve (AUC) of the worse ear (0.625 +/- 0.021) was significantly larger than that of the better ear (0.570 +/- 0.021) (P < 0.01). At 4 kHz, the AUC of the worse ear (0.665 +/- 0.019) was significantly larger than that of the better ear (0.622 +/- 0.020) (P < 0.01). Excluding the subjects with noise exposure, tinnitus and ear disease, at both frequencies, the AUC of the worse ear was not significantly larger than that of the better ear at both 1 and 4 kHz. Hearing in the worse ear was significantly more related to self-reported hearing difficulty than in the better ear without excluding those with noise exposure, tinnitus and ear disease.

CONCLUSIONS

ROC curve analysis would provide a method to help us judge the difference between the worse hearing ear and the better hearing ear on the subject of hearing loss.

Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study

BACKGROUND AND AIMS

Helicobacter pylori infection and gastric atrophy are both risk factors for gastric cancer. We aimed to elucidate the natural history of gastric cancer development according to H pylori infection and gastric atrophy status.

SUBJECTS AND METHODS

A total of 9293 participants in a mass health appraisal programme were candidates for inclusion in the present prospective cohort study: 6983 subjects revisited the follow up programme. Subjects were classified into four groups according to serological status at initial endoscopy. Group A (n = 3324) had "normal" pepsinogen and were negative for H pylori antibody; group B (n = 2134) had "normal" pepsinogen and were positive for H pylori antibody; group C (n = 1082) had "atrophic" pepsinogen and were positive for H pylori antibody; and group D (n = 443) had "atrophic" pepsinogen and were negative for H pylori antibody. Incidence of gastric cancer was determined by annual endoscopic examination.

RESULTS

Mean duration of follow up was 4.7 years and the average number of endoscopic examinations was 5.1. The annual incidence of gastric cancer was 0.04% (95% confidence interval (CI) 0.02-0.09), 0.06% (0.03-0.13), 0.35% (0.23-0.57), and 0.60% (0.34-1.05) in groups A, B, C, and D, respectively. Hazard ratios compared with group A were 1.1 (95% CI 0.4-3.4), 6.0 (2.4-14.5), and 8.2 (3.2-21.5) in groups B, C, and D, respectively. Age, sex, and "group" significantly served as independent valuables by multivariate analysis.

CONCLUSIONS

The combination of serum pepsinogen and anti-H pylori antibody provides a good predictive marker for the development of gastric cancer.

Clinical significance of enhancer of zeste homolog 2 expression in colorectal cancer cases

INTRODUCTION

Enhancer of zeste homolog 2 (EZH-2) is a polycomb group (PcG) protein, and the clinical significance of this protein has not yet been determined in colorectal cancer (CRC) cases. Recently, investigations of CRC cases have focused on the interaction between EZH-2 and histone deacetylase-1 (HDAC-1).

PATIENTS AND METHODS

We performed real time RT-PCR to evaluate the expression of EZH-2 mRNA quantitatively in tumour and normal tissue samples from 61 cases of CRC. The expression of HDAC-1 in CRC cases was also examined in order to compare its levels with those of EZH-2.

RESULTS

Among the CRC cases, 32 patients whose tumour tissue showed overexpression of EZH-2 also had a significantly worse prognosis than did 29 patients whose tumour tissue showed low EZH-2 expression (p<0.05). In addition, a significant correlation between EZH-2 and HDAC-1 expression was observed in 61 CRC cases (p<0.05). Moreover, 20 cases of both high EZH-2 and high HDAC-1 expression showed poor prognoses than did 19 cases in which there was low EZH-2 and low HDAC-1 expression (p<0.05).

CONCLUSION

The abundant expression of EZH-2 in CRC cases indicated that EZH-2 may be an oncogene and a prognostic marker for CRC cases. We discovered there was concordant expression of HDAC-1 with EZH-2 in clinical CRC cases, in addition to the fact that higher expression levels of both genes predicted a poor prognosis.

Improved Graft Survival in ABO-Incompatible Living Donor Kidney Transplantation

INTRODUCTION

We reviewed ABO-incompatible living donor kidney transplantations (LDKT) performed in our institute.

PATIENTS

Fourteen ABO-incompatible LDKT were carried out in the first era (September 1990-August 1996) and 13 were in the second era (October 2001-July 2004). All patients were treated with sessions of plasmapheresis before transplantation to reduce antibody titers <1:8. In the second era, those with rebound increase of antibody titers >1:64 after repeated plasmapheresis were not subjected to transplantation. Posttransplantation immunosuppression consisted of cyclosporin, predonisone, azathioprine, gusperimus hydrochloride (DSG), and antilymphocyte globulin (ALG) in the first era, and tacrolimus, mycophenolate mofetil, predonisone, and DSG in the second era. Splenectomy was performed during the transplantation. Anticoagulant therapy was introduced in the second era.

RESULTS

One-, 2-, and 5-year graft survival in the first era was 57%, 57%, and 50%, respectively, values that were significantly lower than those of ABO-compatible cases in the same period (n = 101), namely, 1-, 3-, and 5-year graft survival rates 93%, 83%, and 76%, respectively. The main reason for graft and patient losses was infectious complications. In the second era, no recipient suffered a severe infectious complication and 1- and 2-year graft survival rates were both 100%. Four patients in the first era and 1 in the second era experienced a graft rejection episode between 10 days and 14 months after transplantation, but they were successfully treated with steroid pulse therapy.

CONCLUSION

Although patients with high blood group antibody titers remain problematic, ABO-incompatible LDKT is an increasingly viable option for patients whose only donor is blood group-incompatible.

Recurrence of focal glomerulosclerosis in post-renal transplant recipients: report of two cases

INTRODUCTION

Focal segmental glomerulosclerosis (FGS) has a tendency to recur frequently after kidney transplantation. To evaluate the incidence and outcome of recurrence of FGS, we report 2 cases of recurrence.

PATIENTS

Among 12 patients with renal failure caused by biopsy-proved FGS who received kidney allografts from living related donors, 2 experienced recurrent FGS.

CASE REPORTS

Case 1 was a 28-year-old man who received a renal transplant from his mother. The recurrence of FGS happened just after the scheduled reduction in immunosuppressants at 36 months after the transplantation. He developed subsequently end-stage renal failure (ESRD) 50 months after transplantation. Case 2 was a 22-year-old man who received a renal transplant from this ABO disparate mother. A few days after renal transplantation, he displayed a severe nephrotic syndrome due to recurrent FGS, reaching ESRD at 23 months. To treat recurrent FGS, plasma exchange was partially effective, reducing the proteinuria but not stopping the progression of disease.

DISCUSSION

Two recipients with severe proteinuria were diagnosed as having recurrent FGS. The incidence of recurrent FGS was 16.7% with 5-year and 10-year graft survival rates among recipients with ESRD caused by FGS of 79.6% and 68.2%, respectively. The incidence and graft survival rates were better than those expected based upon previous reports. Once the recurrence occurred, it was difficult to halt the progression of disease. Effective prevention of FGS and careful observations with maintained of immunosuppression are necessary in these patients.

Twenty-Five-Year Survival of Living Related Kidney Transplants: Thirty-Five Years' Experience

AIM

Although better graft survival in patients treated with CsA has been obtained, chronic rejection continues to be a common complication in renal transplantation. In this study, we examined the graft survivals and complications among renal transplant patients followed for more than 25 years.

METHODS

Between April 1970 and April 1979, 110 consecutive renal transplantations from living donors were performed in 110 patients. There were 83 men and 27 women of mean age of 27 +/- 7.0 years. A combination of azathioprine (AZ) and prednisolone (PSL) was used for the initial immunosuppressive therapy in all patients.

RESULTS

Over 25 years postoperatively, 41 patients died with or without a functioning graft due to complications including infections and malignancies. Therefore, the 25-year patient survival was 62.5% and 34 patients returned to hemodialysis, yielding an actual 25-year graft survival of 36/110 (32.1%). The longest surviving graft is 30 years and 2 months. The main causes of death were infectious disease and malignancy; 73% of graft loss was due to chronic rejection. Mean serum creatinine of the patient with functioning grafts over 25 years is 1.2 mg/dL; 75% of patients displayed a value under 1.5 mg/dL. The mean dosage of Az was 52.3 mg/d and PSL was 5.6 mg/d.

Renovascular Reconstruction of Grafts With Renal Artery Variations in Living Kidney Transplantation

INTRODUCTION

The shortage of grafts in living kidney transplantation has forced the use of marginal grafts with arterial disease or grafts with multiple renal arteries (MRA). We reviewed the outcomes of transplants using allografts with MRA procured by open donor nephrectomy and report two cases requiring vascular reconstruction.

PATIENTS AND METHODS

We reviewed 31 cases where renovascular reconstruction of an MRA graft was performed. A ex vivo pantaloon (side-to-side) anastomosis to create a common channel was performed in 24 cases including two cases of renal artery aneurysms in the grafts, where vascular reconstruction was performed in the same fashion after resection of the aneurysm. In four cases, an accessory artery was anastomosed sequentially after revasculization of the main artery. In three cases of grafts with multiple renal arteries, multiple anastomoses were done in situ after various ex vivo renovascular reconstructions.

RESULTS

Twenty one MRA grafts including grafts with a renal aneurysm are functioning well for a mean follow-up 135 months. The graft survival rate was 71.0% at 5 years after transplantation and 67.7% at 10 years. The donors whose grafts had a renal aneurysm were also well and normotensive with normal renal function at present. Ten grafts failed mainly due to chronic allograft nephropathy.

CONCLUSION

MRA grafts procured by open nephrectomy, including those with renal artery aneurysms, were engrafted successfully by applying appropriate renovascular surgery. The use of those grafts was safe for both the recipient and the donor.

Semileptonic decays of d mesons in three-flavor lattice QCD

We present the first three-flavor lattice QCD calculations for D-->pilnu and D-->Klnu semileptonic decays. Simulations are carried out using ensembles of unquenched gauge fields generated by the MILC Collaboration. With an improved staggered action for light quarks, we are able to simulate at light quark masses down to 1/8 of the strange mass. Consequently, the systematic error from the chiral extrapolation is much smaller than in previous calculations with Wilson-type light quarks. Our results for the form factors at q(2)=0 are f(D-->pi)(+)(0)=0.64(3)(6) and f(D-->K)(+)(0)=0.73(3)(7), where the first error is statistical and the second is systematic, added in quadrature. Combining our results with experimental branching ratios, we obtain the Cabibbo-Kobayashi-Maskawa matrix elements |V(cd)|=0.239(10)(24)(20) and |V(cs)|=0.969(39)(94)(24), where the last errors are from experimental uncertainties.