Provoked asthma and mast cells

There is now very substantial evidence to implicate mediators in the pathogenesis of asthma during both the early- and late-phase response. It seems likely that mast cells are activated since histamine was detected in early- and late-phase allergen- and exercise-induced asthma. On the other hand, the origin of NCA is still in some doubt, and the possibility exists that it may be derived from other cell types. Furthermore, there is no firm evidence that the mast cell is directly involved in pathogenesis and some evidence that it may have a secondary or amplifying role. There is an urgent need for further details of other mast-cell-associated mediators such as prostaglandins and leukotrienes. Measurements in the blood have the obvious disadvantage of only indirectly reflecting events in the lung. It seems likely that more invasive procedures such as fiberoptic bronchoscopy will yield more critical information regarding mast cells and their mediators in early- and late-phase reactions, as well as the effects of selective drugs and the role of other cell types.     

Fifteen-year follow-up of 92 hospitalized adults with Down's syndrome: incidence of cognitive decline, its relationship to age and neuropathology

Background The clinical and neuropathological features associated with dementia in Down’s syndrome (DS) are not well established. Aims To examine clinico‐pathological correlations and the incidence of cognitive decline in a cohort of adults with DS. Method A total of 92 hospitalized persons with DS were followed up from 1985 to December 2000. At outset, 87 participants were dementia‐free, with a median age of 38 years. Assessments included the Prudhoe Cognitive Function Test (PCFT) and the Adaptive Behavior Scale (ABS), to measure cognitive and behavioural deterioration. Dementia was diagnosed from case records and caregivers’ reports. Results Eighteen (21%) patients developed dementia during follow‐up, with a median age of onset 55.5 years (range 45–74). The PCFT demonstrated cognitive decline among those with a less severe intellectual disability (mild and moderate) but not among the profoundly disabled people (severe and profound). Clinical dementia was associated with neuropathological features of Alzheimer’s disease, and correlated with neocortical neurofibrillary tangle densities. At the age of 60 years and above, a little more than 50% of patients still alive had clinical evidence of dementia. Conclusions Clinical dementia associated with measurable cognitive and functional decline is frequent in people with DS after middle age, and can be readily diagnosed among less severely intellectually disabled persons using measures of cognitive function such as the PCFT and behavioural scales such as the ABS. In the more profoundly disabled people, the diagnosis of dementia is facilitated by the use of behavioural and neurological criteria. In this study, the largest prospective DS series including neuropathology on deceased patients, the density of neurofibrillary tangles related more closely to the dementia of DS than senile plaques. In people with DS surviving to middle and old age, the development of dementia of Alzheimer type is frequent but not inevitable, and some people with DS reach old age without clinical features of dementia.     

Production of monoclonal antibodies against human bladder cancer cells and application to immunohistochemical analysis of bladder cancer

Two hybridomas secreting two monoclonal antibodies IgG1 B1.4 and IgG2a B1.6 were obtained by immunizing BALB/c mice with human bladder cancer cell line EJ-1. In immunohistochemical staining of cryopreserved tissues, B1.4 reacted with 0 of 9 grade 1 TCC, 6 of 11 grade 2, all of 6 grade 3 and five metastatic specimens. The antigen recognized by B1.4 was not expressed by normal urothelial cells but were expressed by vascular endothelial cells and muscle of tunica media. The target antigen of B1.6 was expressed by normal urothelial cells and all grade of TCC. In this study, it was demonstrated that poorly differentiated bladder cancer and metastatic specimens of bladder cancer express a vascular carbohydrate antigen. Taking the escape mechanism of immune surveillance, into consideration, it is possible that the antigen recognized by B1.4 is an indicator of metastatic potential of bladder cancer.     

Comparison of the Effectiveness of Two Bowel Programs for CVA Patients

The purpose of the study described in this article was to compare the effectiveness of two bowel training programs for patients who had experienced a cerebrovascular accident (CVA) and to determine the length of time required to establish a regulated program. A quasi-experimental design was used to compare the existing bowel program that incorporated every-other-day digital stimulation (DS) with a program using daily DS. The convenience sample of 48 CVA patients included 23 in the control group who had DS every other day and 25 in the experimental group who had daily DS. Demographic data showed no significant differences between the two groups. The t-test showed that more subjects in the experimental group established regularity; however, the subjects in the control group who did achieve regularity took less time to do it. Subjects with right-side hemiplegia and less mobility required more time to become established. As a result of these findings, the routine protocol for bowel training in this rehabilitation unit has been changed to include daily digital stimulation.     

A case of metastatic rib tumor from thyroid cancer confirmed by the presence of thyroglobulin]

A 63-year-old female, with a chief complaint of right chest pain was referred to our hospital because of an abnormal right chest wall shadow on chest X-ray. A rib tumor was suspected based on her chest CT scan. Percutaneous needle biopsy yielded a diagnosis of well-differentiated adenocarcinoma. As metastatic rib tumor was suspected, the primary tumor was sought for. A thyroid gland nodule was recognized by ultrasonography, and the cytological diagnosis was class V. Immunohistological demonstration of the thyroglobulin studies of the rib tumor tissue revealed papillary and trabecular patterns of cell arrangement and the presence of thyroglobulin existence. Definitive diagnosis of metastatic rib tumor from thyroid cancer was established. Immunohistological examination is useful to confirm the diagnosis of metastatic cancer of thyroid origin.