Epidermal differentiation complex protein involucrin is down-regulated in eosinophilic esophagitis

Background and aims

Epidermal differential complex (EDC) proteins, such as filaggrin, involucrin, and loricrin, play key roles to protect the mucosal surface against invading pathogens. Eosinophilic esophagitis (EoE) is an allergic gastrointestinal disease that features eosinophilic infiltration of esophageal mucosa, though the function of EDC proteins in its pathogenesis remains unknown. The aim of this study was to investigate possible differences of EDC protein expression in the epithelium of the esophagus, pharynx, and tongue. Furthermore, we examined that expression in esophageal specimens obtained from patients with EoE.

Methods

For evaluating EDC protein expression in epithelium from different locations, we enrolled 72 patients who underwent surgical resection for esophageal, pharyngeal, or tongue squamous cell carcinoma. Pathological samples were used for analysis of expression by immunohistochemistry. In addition, samples were obtained from 10 patients with EoE and 11 healthy subjects, and compared for esophageal epithelial expression of EDC proteins.

Results

In epithelium samples obtained from the esophagus, pharynx, and tongue, the presence of EDC proteins was confirmed by immunohistochemistry analysis findings, though the expression patterns were notably different in comparison to that in epidermis samples. In EoE patients, the expression of involucrin was dramatically down-regulated in esophageal mucosa, whereas down-regulation of filaggrin and loricrin did not reach a statistically significant level.

Conclusion

EDC protein expression was clearly detected in pharyngoesophageal epithelium samples, while that of involucrin alone was markedly reduced in patients with EoE.

     

Efficient palatal expansion with a quadhelix appliance: an in vitro study using an experimental dental arch model

This study used an experimental dental arch model to examine the orthodontic forces generated by a quadhelix appliance in terms of parallel expansion, fan expansion, or a combination of the two. Strain gauges were attached to experimental brass rods that represented the teeth arranged in the shape of an average dental arch to detect forces in the buccal, lingual, mesial, and distal directions. Orthodontic forces generated by different types of activation were compared by Scheffe's multiple test. The largest orthodontic force generated during parallel expansion was observed at the first molar in the buccal direction. When fan expansion was applied, significant orthodontic force was observed at the canine in the mesial and labial directions, whereas force in the mesial and lingual directions was noted at the first molar. When a combination of 3 mm parallel and 5 mm fan expansion was used, the forces generated at the canine and first and second premolar, and first molar were nearly equivalent. Depending on the type of malocclusion, the most appropriate expansion technique may be parallel or fan expansion or a combination of the two. When expanding the entire dental arch simultaneously, a combination of 3 mm parallel and 5 mm fan expansion may be the most suitable.     

Influence of light dose on bond strength of orthodontic light-cured adhesives

Although the polymerization reaction in light-cured orthodontic adhesive continues for some time after light irradiation, it is unclear whether insufficiently irradiated adhesive develops sufficient bond strength. This in vitro study examined the maturation of bond strength after exposure of a variety of light doses. Large metal brackets were bonded to the enamel of 288 bovine mandibular incisors by irradiation at two light intensities (200 and 400 mW/cm(2)) and for three exposure times (3, 5, and 10 seconds) using three orthodontic adhesives (TB, OP, and BOB). Shear bond strengths and adhesive remnant indices (ARIs) were determined immediately (T1) and 24 hours after bonding (T2; n = 8 in each group). Comparisons were made using the Kruskal-Wallis H-test, the Bonferroni-corrected Mann-Whitney U-test, and the Yates-corrected chi-square test. Bond strengths of the adhesives that showed maturation at low light intensity (200 mW/cm(2)) increased by 1.4- to 2.0-fold in 24 hours. An increase in exposure time increased bond strength more than did an increase in light intensity for most orthodontic adhesives. With an exposure time of 3 seconds at 200 mW/cm(2), the ARI scores of TB and OP differed significantly between T1 and T2. Thus, the most acceptable procedure when applying low-dose light intensity to a bracket before the placement of a wire is to increase the exposure time and/or wait for sufficient maturation of bond strength.     

Clinical and pathological characteristics of surgically resected intrapulmonary lymph nodes: Can they be differentiated from other malignant nodules?

Background

Intrapulmonary lymph nodes (IPLNs) are often recognized as sub-centimeter solid pulmonary nodules (SCPNs). The present study investigated their clinical and pathological characteristics to allow clinicians to distinguish them from malignant nodules.

Operable non-small cell lung cancer diagnosed by transpleural techniques : do they affect relapse and prognosis?

STUDY OBJECTIVE: We assessed whether transpleural methods for diagnosing peripheral lung cancer, such as needle aspiration or tumor excision, affect relapse and prognosis, because these techniques have potential to spread malignant cells from the tumor. DESIGN: A retrospective study. SETTING: National referral hospital. PATIENTS: We reviewed 239 patients who underwent surgery between 1990 and 1998 and for whom non-small cell lung cancer (NSCLC) of < 3 cm in maximum diameter was completely resected. The duration of postoperative follow-up ranged from 12 to 105 months, with a median period of 45 months. INTERVENTIONS: We defined the transbronchial method as using a bronchoscope, and the transpleural method as using needle aspiration cytology or tumor excision. Dichotomous variables included gender, histologic type of squamous cell carcinoma or other type of carcinoma, pathologic stage, and whether the diagnostic method was the transbronchial type only (first-line method) or the transpleural type (second-line method). RESULTS: NSCLC was diagnosed in 45 patients by the transpleural technique and in 194 patients by the transbronchial technique. There were no significant statistical differences in age of patients, gender, histologic type, pathologic stage, and tumor size. There were 42 relapses, 7 in the transpleural technique group and 35 in the transbronchial technique group (p = 0.90). Of the 7 patients in the transpleural group, there were 4 distant metastasis and 3 local relapses; of the 35 patients in the transbronchial group, there were 20 distant metastasis and 15 local relapses (p = 0.99). Pleural carcinomatosis occurred in none of the 45 patients in the transpleural group and in 1 case (0.5%) in the 194 patients in the transbronchial group (p = 0.99). Patients in the transpleural group had a statistically better 5-year survival rate than patients in the transbronchial group (79.4% vs 60.3%, p = 0.04). This is also confirmed as an independent prognostic factor in a multivariate analysis. CONCLUSIONS: Transpleural methods seem to be an advisable way to diagnose operable lung cancer that is difficult to diagnose using bronchoscopy, because these methods did not affect relapse and prognosis in the patients in our study.     

Hepatic portal venous gas and hyper-dense aortic wall as postmortem computed tomography finding

Postmortem computed tomography (PMCT) is useful for diagnosis of cause of death not only by emergency physicians but also medical examiners or police surgeons conducting postmortem studies. However, postmortem biological conditions are quite different from those in the living body. Hepatic portal venous gas (HPVG) and a hyperdense aortic wall (HDAW) are often found by PMCT, although no significant autopsy findings are evident in the liver or aorta. In this study we compared the findings of PMCT with those obtained at autopsy, and discussed the cause of these PMCT features. PMCT was conducted in 12 autopsy cases, comprising eight cases of natural death and four of unnatural death. HPVG was seen in five cases and HDAW in seven. In the cases showing HPVG, visceral abdominal injury, bowel distention or acute circulatory dysfunction was found at autopsy. In the cases showing HDAW, atherosclerosis or an increase in blood viscosity due to dehydration or postmortem changes was evident. Although the precise causes of these PMCT findings are not completely clear, the changes evident at autopsy provide some clues.