Juniper pollen monitoring by Burkard sampler in Galveston, Texas, USA and Japanese cedar pollen counting in Fukuoka, Japan -- introduction of Pan American Aerobiology Association protocol counting technique]

We have monitored Juniper pollen which caused winter allergy symptoms by Burkard sampler in Galveston, Texas. We identified and counted Juniper pollen grains by PAAA protocol which was a comprehensive guideline for the operation of Hirst-Type suction bioaerosol sampler, (original of Burkard sampler) in the USA. In Galveston we were able to detect the Mountain Cedar (Juniperus ashei) pollen from December to of January, and Eastern Red Cedar (Juniperus virginiana) which has cross reactivity to MC from almost middle of January to February. There is no MC vegetation in Galveston. We found the pollen grains were transported from west at Edward Plateau in West Texas where it was thickly wooded. Then, we tried to monitor Japanese Cedar (JC) pollen grains in Fukuoka, Japan according with the same method. We found the significant positive correlation between the pollen counts using one single longitudinal traverse counting technique in the PAAA protocol and the JC pollen counting on the whole of Melinex tape per 24 hours (R2=0.9212, p=0.0001), and the gravitational method that is Durham sampler's pollen counting in 2002 (R2=0.489, p=0.0001), and in 2003 (R2=0.948, p=0.0001) respectively. We suggested that we can use the PAAA protocol for airborne pollen investigation in Japan by Burkard sampler.     

Pyelovenous backflow in left renal vein hypertension: case report

Retrograde pyelography for a patient with left renal vein hypertension due to "nutcracker phenomenon" revealed pyelovenous backflow. This is considered to be the first actual demonstration of renal bleeding during the nutcracker phenomenon.     

Prediction of operative mortality by a discriminant analysis for organ functions in patients with esophageal cancer--organ function index

An "organ function index" (OFI) predicting the risk of operative mortality was presented. OFI was estimated on the basis of dysfunction of the systemic organs in patients with esophageal cancer. The pulmonary, cardiac, hepatic and renal functions were assessed by 23 parameters in 108 patients when they were admitted. Operative death was defined as death due to operative complications occurring within 120 days after esophagectomy or by-pass operation. For a discriminant analysis, patients were limited to those in the early period (from October 1981 until December 1985) when the incidence of operative mortality was relatively higher and the parameters were also limited to statistically evaluable ones. Then, a discriminant analysis was performed using data on 18 parameters of four organs in 35 patients each of whom had no deficit in these data. Operative death occurred in 8 out of these 35 patients. Based on the data, an equation to calculate OFI was generated. It consisted of 7 parameters regarding pulmonary, hepatic and renal functions. The values of OFI less than zero predicted no operative death while those more than zero did predict operative death. The prediction rate on presence or absence of operative mortality by this equation was 91.4% in 35 patients. For clinical application, the predictable risk of operative mortality based on OFI was classified as high (OFI less than 1.4), intermediate (0 less than OFI less than 1.4), or low (OFI less than 0).(ABSTRACT TRUNCATED AT 250 WORDS)     

A case study: interferon-beta-induced remission of ulcerative colitis in a patient with type C chronic hepatitis

A 66-year-old man patient with chronic hepatitis (CH) C and complications from ulcerative colitis (UC) was treated with interferon-beta (IFN-beta). Endoscopically, the UC disease activity was moderate before IFN-beta treatment but was in remission eight week after treatment. However, a few months after stopping IFN treatment, endoscopy revealed that the UC disease activity had returned to moderate levels. This result shows that UC improved with IFN treatment.     

Size does not determine the grade of malignancy of early invasive colorectal cancer

AIM： To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers （EI-CRCs）, and to determine whether malignancy grade depends on size. METHODS： A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study. Lesions were classified into two groups based on size： small （≤10 ram） and large （〉10 ram）. Clinicopathological features, incidence of lymph node metastasis （LNM） and risk factors for LNM, such as depth of invasion, lymphovascular invasion （LVI） and poorly differentiated adenocarcinoma （PDA） were analyzed in all resected specimens. RESULTS： There were 120 （21%） small and 463 （79%） large lesions. Histopathological analysis of the small lesion group revealed submucosal deep cancer （sin： 1〉1000 μm） in 90 （75%） cases, LVI in 26 （22%） cases, and PDA in 12 （10%） cases. Similarly, the large lesion group exhibited submucosal deep cancer in 380 （82%） cases, LVI in 125 （27%） cases, and PDA in 79 （17%） cases. The rate of LNM was 11.2% and 12.1% in the small and large lesion groups, respectively.CONCLUSION： Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer.     

Risk factors for lymph node metastasis of submucosal invasive differentiated type gastric carcinoma: clinical significance of histological heterogeneity

Background. The use of endoscopic resection for submucosal invasive gastric carcinoma (Sm-ca) with histologically differentiated type has been expected. However, the treatment criteria remain controversial. The purpose of this study was to clarify the relationship between lymph node metastasis and the histologic features of differentiated Sm-ca. Methods. The clinicopathologic features of 35 patients with node-positive differentiated Sm-ca were compared with those of 221 patients with node-negative differentiated Sm-ca by multivariate analysis with logistic regression. To clarify the metastatic behavior of differentiated Sm-ca, we examined mucin-histochemical expression and immunohistochemical staining, using Ki-67, p53, and c-erbB2. Results. The rate of lymph node metastasis was significantly higher in differentiated Sm-ca with histologi-cal heterogeneity (combined differentiated type, with poorly differentiated component) than in that without histological heterogeneity (27% vs 7%; P < 0.001). Multivariate analysis revealed that lymphatic vessel invasion was the most significant determinant (odds ratio, 8.68) for lymph node metastasis. Histological heterogeneity (odds ratio, 3.88) was next, followed by papillary adenocarcinoma (odds ratio, 3.28), and submucosal invasion level (odds ratio, 2.34). The mean value of the Ki-67 labeling index for node-positive differentiated Sm-ca was higher than that of node-negative differentiated Sm-ca (47% vs 39%; P < 0.05). Conclusions. When the extension of endoscopic surgery to differentiated Sm-ca is considered, this therapeutic technique should be limited to the differentiated type of Sm-ca without histological heterogeneity. The Ki-67 labeling index provides useful information for identifying those patients with a high risk of lymph node metastasis. Received: January 9, 2001 / Accepted: April 13, 2001     

A Cost-effectiveness Analysis of Biliary Anastomosis With or Without T-tube after Orthotopic Liver Transplantation

Biliary reconstruction continues to be a major source of morbidity following orthotopic liver transplantation. We wished to determine if choledochocholedochostomy without a T-tube was associated with fewer biliary complications and was less costly than choledochocholedochostomy with a T-tube. A retrospective cohort study of patients who underwent liver transplantation was performed. Patients were stratified into two groups: group I had bile duct reconstruction with T-tube and group II did not have a T-tube. The results were interpreted on an intention-to-treat analysis. We identified 147 adult patients who underwent initial liver transplantation. There were 76 patients in group I and 71 patients in group II. There were no statistical differences between the two groups regarding underlying cause of liver disease, patient age, gender or United Network for Organ Sharing status. As the decision to use a T-tube was made at the time of surgery, the two groups may not be strictly comparable. The mean hospital stay was longer in group I (31.1 +/- 27.9d) than in group II (18.8 +/- 15.5d) (p = 0.001). Biliary complications were statistically more frequent in patients from group I patients (25/76, 32.9%) than in patients from group II (11/71, 15.5%) (p = 0.01). There was a trend for the costs associated with diagnostic and therapeutic procedures for the management of biliary complications to be greater for group I than for group II, although this was not statistically significant (p = 0.235). Our study suggests choledochocholedochostomy without T-tube reconstruction is the preferred strategy for biliary reconstruction in orthotopic liver transplantation. It is not only associated with fewer biliary complications, but also less costly than using choledochocholedochostomy over a T-tube. Randomized prospective studies are needed to confirm our results.     

GAPDH knockdown rescues mesencephalic dopaminergic neurons from MPP+ -induced apoptosis.

Glyceraldehyde-3-phosphate dehydrogenase (GAPDH; EC 1.2.1.12) has a number of diverse functions apart from glycolytic function. We explored the possible involvement of GAPDH in 1-methyl-4-phenylpyridinium (MPP+)-induced death of mesencephalic dopaminergic neurons (MDNs) in culture. MPP+ (10 and 20 microM, 24 h) exposure selectively decreased the survival of tyrosine hydroxylase positive (TH+) MDNs, which manifested apoptotic features including shrinkage of the cell body, chromatin condensation and nuclear fragmentation. Two types of GAPDH antisense oligonucleotides almost completely rescued MDNs from MPP+ toxicity. GAPDH was strongly expressed in apoptotic TH+ neurons, and MPP+ exposure significantly increased the percentage of TH+ neurons in which GAPDH is over-expressed. Confocal microscopic analysis demonstrated the nuclear accumulation of GAPDH in neurons undergoing MPP+-induced apoptosis. These results suggest that MPP+ causes apoptosis of MDNs, concomitant with the over-expression and nuclear accumulation of GAPDH.     

Airway hyperresponsiveness and pulmonary function in adult asthma.

BACKGROUND: Airway hyperresponsiveness (AHR) is a very important factor in the pathogenesis of bronchial asthma. OBJECTIVES: To examine the relationship between airway obstruction and AHR in adult asthma. METHODS: This study was a retrospective study in 161 adult asthmatic patients. Nonspecific AHR to methacholine was measured. We examined the correlations between AHR and pulmonary function, severity of asthma, type of asthma and age. RESULTS: In the moderate and severe groups, peripheral airway obstruction was more aggravated compared to the mild group, and AHR was significantly more severe. Analysis of AHR by age showed that the degree of airway obstruction increased with aging, but age did not clearly correlate with airway sensitivity. Airway reactivity decreased with aging. Aspirin-induced asthma tended to be severe. In fatal asthma, central airway obstruction was significantly more severe. Although AHR in fatal asthma did not significantly differ from that in the severe group, airway sensitivity and airway reactivity tended to be increased. CONCLUSIONS: AHR is an important factor determining the severity of asthma, and airway obstruction is an important index for the prediction of death from asthma. An evaluation of the degree of AHR and airway obstruction is considered to be the first step in controlling asthma.