Clinicopathological features of chronic hypersensitivity pneumonitis

OBJECTIVE: Only limited information exists concerning the clinical and pathological features of chronic hypersensitivity pneumonitis (HP) in Japan and elsewhere. We present data on clinicopathological features of chronic HP obtained through a Japanese nationwide survey. METHODOLOGY: We studied the clinical and pathological findings in 10 patients with chronic HP who underwent surgical lung biopsy or postmortem examination. RESULTS: There were three types of clinical course: six of the 10 patients had persistent symptoms followed by repeated acute episodes; two showed a subacute onset with persistent symptoms; and two exhibited an insidious onset. Five patients made no attempt to avoid antigen exposure and they all had progressive disease. Pathological findings indicated that lesions were mainly centrilobular with or without epithelioid cell granulomas in specimens obtained during the acute or subacute stage. In contrast, most patients in the chronic stage predominantly showed interstitial fibrosis with a usual interstitial pneumonia pattern. CONCLUSIONS: The pathological findings of chronic HP depend on the stage of the disease at tissue sampling.     

The effect of heat-treated human bone morphogenetic protein on clinical implantation

For the clinical usage of human-derived bones, it is necessary to treat bones to reduce the risk of contamination by microorganisms. Bone morphogenetic protein is vulnerable to chemicals, but shows resistance to thermal heat to 70 degrees C in a short time. In this experiment, crude human bone morphogenetic protein was extracted from heat-treated bones at 60 degrees C for 10 hours and from nonheated bones. Sodium dodecyl sulfate polyacrylamide gel electrophoresis for these specimens was done. Gelatin capsules containing 5 mg of crude human bone morphogenetic protein extracted from heated and nonheated bones were implanted into thigh muscle pouches of five mice. At 20 days after implantation, the heterotopic bone formation was compared by evaluating the radiographic and histologic analyses. The sodium dodecyl sulfate polyacrylamide gel electrophoresis pattern of the human bone morphogenetic proteins showed five main bands (16, 22, 28, 35, and 67 kDa) that were almost identical. Heterotopic bone formation observed on the radiograph was induced by crude human bone morphogenetic protein from heated bones in a manner similar to that used for nonheated bones. The results from this study show that heat-treated bone preserves osteoinduction.     

Complications of percutaneously inserted central venous catheters in Japanese neonates

Background: To determine institutional policies concerning percutaneously inserted central venous catheter (PICC) utilization and also frequencies of complications such as pericardial effusion (PCE), cardiac tamponade (CT), pleural effusion, ascites, venous thrombosis, and catheter removal difficulties. Methods: Nationwide postal questionnaire survey was carried out that included institutional policies on PICC and numbers of complications recorded from January 1999 to December 2003. Results: A total of 98 replies were received from 193 neonatal intensive care units (NICU) in Japan. As a catheter tip location, positions outside of the heart were highly preferred, while only 9% accepted a right atrial position. Twenty‐eight cases of PCE or CT were reported, representing an estimated frequency of 0.07–0.11% of PICC insertions. Pleural effusion/ascites and removal difficulties (36 and 35 cases, respectively) were encountered in approximately 0.09–0.14% of insertions. Conclusions: Frequency of PCE/CT appeared comparable to previously reported occurrences. Also, pleural effusion/ascites and removal difficulty appeared to be rare complications.     

Monitoring of 3H surface contamination by noncontact radioluminography

A phosphor screen imaging technique has been developed to detect 3H contamination on floor surfaces. A 3H imaging plate is elevated a maximum of 0.1 cm above the surface being monitored. This technique prevents the imaging plate from being cross-contaminated. Unlike the traditional smear test, this technique can be used to monitor fixed contamination.     

Hemostasis for the Ramstedt procedure: Use of a fibrin adhesive

Pre- and postoperative blood counts were retrospectively compared between patients with no hemostatic management (group A,n = 30) and patients with a fibrin adhesive (Beriplast P) applied to the cut edges (group B,n = 8) when pyloromyotomy was performed for hypertrophic pyloric stenosis. Postoperative red blood cell count, hematocrit, and hemoglobin were significantly decreased in group A (P <0.01) while there was no significant change in group B. It has been stated that the Ramstedt operation does not require any special hemostatic management. However, as postoperative peritoneal bleeding is suspected, hemostatic management with a fibrin adhesive applied to the incised region of the serosa and muscle layer is recommended.     

Seven cases of breast cancer recurrence limited to the central nervous system without other visceral metastases

We report 7 rare cases of recurrent breast cancers who presented with central nervous system (CNS) metastases as the initial relapse site without any other organ metastases. The average age of the patients at surgery was 42.6 years old of age (median 45:range 32-60), and 6 of the 7 cases (86%) were premenopausal. The mean disease-free period was 25.7 months (median 22, range 2-60 months). The primary tumors were all invasive ductal carcinomas. The estrogen receptor and progesterone receptor status of the 3 tumors available for study were all negative. The metastatic CNS lesions included the cerebrum (4 cases), cerebellum, cervical spinal cord, and meninges. In 6 out of these 7 cases (86%), the CNS metastasis was the initial recurrent lesion. Multidisciplinary treatments including surgery, radiotherapy and systemic or intrathecal chemotherapy were given. Although the mean survival time from clinical manifestations of the metastases of the 4 deceased patients was 20 months (median 20.5; range 6-33), one patient treated with surgery and radiotherapy is been still alive18 years later. These cases were also notable for the fact that the only metastatic site was in the CNS only during the entire clinical course, except for 2 cases, one with ocular adnexa metastasis, and the other with cervical lymph node metastasis. Premenopausal patients with negative hormone receptor status are more likely to develop this type of recurrence, regardless of the histological type. It is necessary to pay attention to neurological symptoms and signs during follow-up of breast cancer patients.     

Ocular convergence-related neuronal responses in the lateral suprasylvian area of alert cats.

Neuronal spike discharges were recorded from the lateral suprasylvian (LS) area while ocular convergence was elicited in five alert cats. Ocular convergence was elicited by presenting a visual target moving in depth. Cats were rewarded for convergence eye movement. In 9 out of 426 cells sampled in the caudal postero-medial LS area, the number of spikes was positively correlated with the peak eye velocities during ocular convergence. Significant correlation was found mostly within 400 ms preceding the moment at which the maximum velocity of ocular convergence was obtained. The result favors the hypothesis that the LS area plays an important role in the integrative control of ocular convergence.     

New Hepatocellular Carcinoma Cell Line SUHC-1 Established from a Patient with Hepatitis C Virus RNA in Serum

A new human hepatocellular carcinoma cell (HCC) line, designated SUHC-1, was derived from a Japanese patient with hepatocellular carcinoma having antibody to hepatitis C virus (HCV) and HCV-RNA in his serum, and established in tissue culture. This cell line exhibited typical epithelial cell morphology in culture as observed by phase-contrast and electron microscopy. The SUHC-1 cells produced albumin and α₂-macroglobulin. Chromosomal analysis showed several rearrangements at short and long arms of chromosome 1, 17 and 20 (1p–, 1q–, i(1q), i(17q) and 20q +) with a modal number of 91. HCV-RNA was not detected in the supernatant of SUHC-1 cells by nested polymerase chain reaction assay or in the SUHC-1 cells by the in situ hybridization method. We concluded that complete HCV does not exist in the SUHC-1 cell line. The SUHC-1 cell line is the first line of HCC to have been derived from a patient with persistent HCV infection, and may provide a suitable model for studies of hepatocarcinogenesis related to HCV.     

Differentiation of both rod and cone types of photoreceptors in the in vivo and in vitro developing pineal glands of the quail.

The avian pineal is a photo-endocrinal organ and is considered to synthesize and secrete melatonin in an intrapineal rhythm which can be modified by direct light stimulation of the pineal photoreceptors. Since the avian retina contains numerous different types of photoreceptors, at least 6 types in the quail retina, it is interesting to ask how many types of photoreceptors are present in the avian pineal. In the present study, we have identified two types of photoreceptors in the quail pineal organ, one appears rod-like and the other cone-like, using an immunohistochemical method with highly specific anti-chicken rhodopsin and anti-iodopsin monoclonal antibodies. Rhodopsin-immunoreactive (Rho-I) cells were much larger in number than iodopsin-immunoreactive (Iodo-I) cells. During pineal development, Rho-I cells were first observed at embryonic day 13 (E13: 13 days of incubation), whereas Iodo-I cells were found at day E15. Rho-I cells showed numerous neurite-like processes, but Iodo-I cells had few, if any, processes. We developed a new culture system for avian pineal cell differentiation by seeding cells on nitrocellulose membrane filters. By this method both types of pineal photoreceptors differentiated in vitro: Rho-I cells were much larger in number and had much more fine processes than Iodo-I cells, similar to those seen in the intact developing pineal. With the new culture system the relation between pineal photoreceptor differentiation and sympathetic innervation was examined in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)