Detection of peripheral blood and bronchoalveolar lavage fluid lymphocytes in rat lung transplantation for early diagnosis of rejection

Left lung transplantation was performed in two combinations of rat strains. In group 1, lung grafts were rejected within 7 day postoperatively, and in group 2, grafts were rejected within 18 day postoperatively. The histological appearance of rejection was classified into 4 stages, and lymphocytes from peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) were collected at each stage. In group 1, a significant decrease in the number of lymphocytes in PB was observed as the rejection progressed, whereas the number of lymphocytes in PB increased slightly in group 2. The number of total cells in BALF increased significantly as the rejection progressed in both groups. A marked increase in the value of spontaneous blastogenesis (SB) was observed in stage 2 in BALF lymphocytes, whereas that in PB lymphocytes was found to increase after stage 3 in both groups. The ratio of T-helper/T-nonhelper did not change significantly in PB lymphocytes in both groups. On the other hand, a significant decrease in the value of T-helper/T-nonhelper (less than 1.0) was observed in BALF at stage 3 and 4 in both groups. These results show that the studies of BALF lymphocytes were very useful for early diagnosis of rejection in lung transplantation.     

Endoscopic diagnosis of ulcerative colitis

Endoscopic findings of ulcerative colitis are classified into three groups according to the degree of inflammation, i.e. mild, moderate and severe. 1)mild: Edema, erythema, yellow spots, fine granular appearance are conspicuous signs of early disease. The mucosal vascular pattern disappears. 2)moderate: Coarse mucosa with mucous, pus, blood are characteristic findings. Erosions or shallow ulcers are scattered. The erythematous mucosa is friable and bleeds easily. 3)severe: There are deep, widespread ulcers. Marked bleeding is seen from granulation tissue of ulcer base. We remind that inflammation often take a turn for the worse due to endoscopic examination. Total colonoscopy is not always necessary in the cases of ulcerative colitis.     

Prognostic Significance of Hiatal Hernia in Patients with Gastric Cancer Located within the Upper-Third of the Stomach

World Journal of Surgery - Gastric cancers located within the upper-third of the stomach (UGC), especially the esophagogastric junction GC (EGJGC), have distinct clinicopathological features due to...     

Individual Variation in Adaptive Immune Responses and Risk of Hip Fracture—A NOREPOS Population-Based Cohort Study

Immune-mediated bone loss significantly impacts fracture risk in patients with autoimmune disease, but to what extent individual variations in immune responses affect fracture risk on a population level is unknown. To examine how immune responses relate to risk of hip fracture, we looked at the individual variation in a post-vaccination skin test response that involves some of the immune pathways that also drive bone loss. From 1963 to 1975, the vast majority of the Norwegian adult population was examined as part of the compulsory nationwide Norwegian mass tuberculosis screening. These examinations included standardized tuberculin skin tests (TSTs). Our study population included young individuals (born 1940 to 1960 and aged 14 to 30 years at examination) who had all received Bacille Calmette-Guerin (BCG) vaccination after a negative TST at least 1 year prior and had no signs of tuberculosis upon clinical examination. The study population ultimately included 244,607 individuals, whose data were linked with a national database of all hospitalized hip fractures in Norway from 1994 to 2013. There were 3517 incident hip fractures during follow-up. Using a predefined Cox model, we found that men with a positive or a strong positive TST result had a 20% (hazard ratio [HR] = 1.20, 95% confidence interval [CI] 1.01–1.44) and 24% (HR = 1.24, 95% CI 1.03–1.49) increased risk of hip fracture, respectively, compared with men with a negative TST. This association was strengthened in sensitivity analyses. Total hip bone mineral density (BMD) was available for a limited subsample and similarly revealed a non-significantly reduced BMD among men with a positive TST. Interestingly, no such clear association was observed in women. An increased immune response after vaccination is associated with an increased risk of hip fracture decades later among men, possibly because of increased immune-mediated bone loss. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

Alteration of choroidal vascular structure in diabetic macular edema

Graefe's Archive for Clinical and Experimental Ophthalmology - The aim of this study was to analyze choroidal structures in healthy subjects and patients with/without diabetic macular edema...     

Polyphenols in lahpet-so and two new catechin metabolites produced by anaerobic microbial fermentation of green tea

The phenolic constituents of lahpet-so, a traditional postfermented tea of Myanmar produced under anaerobic conditions, were examined. The major polyphenols were identified to be pyrogallol and 4′-hydroxyphenyl-3-(2′′,4′′,6′′-trihydroxyphenyl)-propan-2-ol, 3′,4′-dihydroxyphenyl-3-(2′′,4′′,6′′-trihydroxyphenyl)-propan-2-ol, and 3′,4′,5′-trihydroxyphenyl-3-(2′′,4′′,6′′-trihydroxyphenyl)-propan-2-ol. The hydroxydiphenylpropan-2-ols were identical to the initial metabolites produced from green tea catechins by mammalian intestinal bacteria. In addition, an anaerobic mixed-fermentation experiment using lahpet-so and Japanese commercial green tea afforded two new catechin degradation products together with known compound bruguierol B and the above-mentioned catechin metabolites. Based on spectroscopic evidence, the structures of the new compounds were concluded to be 4-(2,5-dihydroxyhexyl)benzene-1,2-diol and (5S,8R)-6,7,8,9-tetrahydro-5-methyl-5·8-epoxy-5H-benzocycloheptene-2,3,4-triol. Interestingly, the production mechanism was deduced to be the inverse of the biosynthesis of the flavan-3-ol A ring.     

Mechanism of the toxicity induced by natural humic acid on human vascular endothelial cells

Humic acid (HA), a group of high‐molecular weight organic compounds characterized by an ability to bind heavy metals, is normally found in natural water. Although the impairment of vascular endothelial cells in the presence of humic substances has been reported to be involved in some diseases, the mechanisms responsible for this involvement remain unclear. In this study, we examined the cytotoxicity of HA obtained from peatland in Central Kalimantan, Indonesia, to human vascular endothelial cells, as well as the mechanisms behind these effects. It was found that 50 mg/L HA showed cytotoxicity, which we considered to be mediated by apoptosis through the mitochondrial pathway because of an increase in the expression of caspases 6 and 9 in response to HA administration. In addition, this cytotoxicity was enhanced when cells in this experimental system were exposed to oxidative stress, while it was decreased by the addition of vitamin C. Thus, we conclude that the apoptosis induced by HA depends upon oxidative stress. Furthermore, an iron chelator, DFO, showed a tendency to decrease HA‐induced cytotoxicity, suggesting that iron may potentially mediate HA‐induced oxidative stress. In conclusion, long‐term consumption of HA‐rich water obtained from our study area may cause damage to endothelial cells and subsequent chronic health problems. © 2012 Wiley Periodicals, Inc. Environ Toxicol 29: 916–925, 2014.     

Maintaining a Surgery Service for Local Hospitals Under the Situation of a Decreasing Number of Surgeons in a Region of Japan

Background

The number of surgeons is decreasing in Japan, leading to the problem of how to maintain a surgery service in local hospitals. We introduce our strategy for supporting ongoing surgical services in regional hospitals by dispatching surgeons temporarily to assist in operations.

Methods

We conducted a questionnaire-based survey at three local hospitals in Tottori and a neighboring prefecture to which surgeons from our department were temporarily dispatched over 5 years from January 2008 to March 2013.

Results

We supported 686 operations at three hospitals over 5 years. The average age of the patients was 72.4 years. Of the diseases treated, 45.1 % were malignant, and 54.9 % were benign. The emergency operation rate was 17.3 %.

Conclusions

Our strategy has produced a continuous surgical service at local hospitals in the face of diminishing numbers of surgeons. We recommend that such a strategy be adopted in other regions in which there are a decreasing number of surgeons and where it is not easy to move patients elsewhere for care.