Selective effector mechanisms for the expulsion of intestinal helminths

In the middle of the era of molecular biology, much less attention is paid to in vivo phenomena. However, carefully designed experimental systems in vivo still can provide valuable information as to the mechanisms underlying the establishment and maintenance of host-parasite relationships. In this review we describe the advantage of using concurrent infections with appropriately chosen combinations of different genera or different maturation stages of parasites to segregate the cellular responses of the host. By means of simple experimental approaches we have found that mucosal mast cells and goblet cells, both of which have long been considered as non-specific effectors, are in fact highly selective and specific effector cells of the host defence mechanisms capable of acting on the establishment and the expulsion of intestinal helminths.     

Different susceptibility to the IL-3 induced-protective effects between Strongyloides ratti and Nippostrongylus brasiliensis in C57BL/6 mice

Repetitive administration of recombinant IL-3 induced protection against Strongyloides ratti but not against Nippostrongylus brasiliensis in C57BL/6 mice. Numbers of S. ratti were negligible from day 4 to day 6 post-infection in mice injected with IL-3, whereas N. brasiliensis burdens were almost equal from day 4 to day 6 between mice injected with IL-3 or with medium. Mice treated with IL-3 and then concurrently infected with S. ratti and N. brasiliensis were protected from intestinal S. ratti but not from N. brasiliensis. The numbers of intestinal mucosal mast cells were increased by the repetitive IL-3 treatment on one day after the final injection and was augmented by subsequent infection with both nematodes.     

Clonal and non-clonal karyotypically abnormal cells in haemophagocytic lymphohistiocytosis

We studied chromosomes in bone marrow (BM) or peripheral blood cells of nine patients with haemophagocytic lymphohistiocytosis (HLH); three of them had a family history of HLH and four others underwent concurrent Epstein-Barr virus (EBV) infection. In addition to a large population of normal mitotic cells, karyotypically abnormal clonal cells were found in two patients, abnormal clonal cells and a nonclonal (single) abnormal cell in one, and nonclonal abnormal cells in three. All the six patients with chromosome abnormalities died of progressive disease; one of them also had EBV infection and EBV-associated clonal proliferation. Two of three patients with EBV infection and only normal mitotic cells in BM completely recovered from the disease.
Although HLH did not show histological and/or haema-tological evidence of a neoplastic disease, clonal chromosome abnormalities and the fatal clinical outcome found in some of the patients suggest that the disease may be heterogenous and include malignancy. HLH patients with karyotypically abnormal clonal cells in BM should warrant more intensive chemotherapy than that presently being applied to them and should be considered as candidates for BM transplantation.     

Laparoscopic cholecystectomy in the elderly: Analysis of pre-operative risk factors and postoperative complications

A retrospective study was conducted of two groups of patients over (group 1, n= 57) and under (group 2, n= 655) the age of 70 years who underwent laparoscopic cholecystectomy (LC). The pre-operative physical status and systemic complications, operation time, postoperative complications, postoperative hospital stay and other clinical features of the two groups were compared. The incidence of pre-operative complications in group 1 was significantly higher than that in group 2 (P < 0.05). Postoperatively no severe complication was found in any patient. Group 1 showed significantly prolonged operation time and postoperative hospital stay compared with group 2 (P < 0.05). The difference between the groups in the intra-operative treatment time and postoperative treatment is attributed to the greater prevalence of common bile duct stone in group 1 as there was little difference between the groups in the postoperative recovery after exclusion of these patients. No pulmonary complications, which are associated with LC, were observed; the postprocedure pain was slight and the period of bedrest was short. If complications associated with pneumoperitoneum can be prevented, this surgery is an excellent measure to improve the quality of life of even elderly patients with cholecystolithiasis.     

Concentration gradient of oxalate from cortex to papilla in rat kidney

BACKGROUND: The kidney eliminates the major fraction of plasma oxalate. It is well known that oxalate is freely filtered by glomeruli and secreted by the proximal tubules. However, the renal handling of oxalate in distal nephrons, which is considered as playing an important role in stone formation, remains obscure. METHODS: At 15-180 min after intravenous injection of 14C-oxalate to rats, the intrarenal localization of radioactivity was quantitatively measured by the radioluminographic method using a bioimaging analyzer. Tissue radioactivity was compared with plasma, and urinary radioactivities were measured by a liquid scintillation counter. The control study was conducted with 14C-inulin. RESULTS: The radioactivity of 14C-oxalate in the papilla was 10 times greater than in the cortex and eight times greater than in the medulla 180 min after injection when almost no radioactivity was present in the urine. In contrast, the radioactivity of 14C-inulin was nine times less in the papilla than in the cortex at the same time. CONCLUSION: Oxalate remains in the renal papilla for an extended period. This accumulation of oxalate may be attributed to calcium oxalate crystal fixation along the deep nephron which is considered to be the first step of stone formation.     

Atypical findings in a patient with a renal milky stone including a cake of stone

A 54-year-old woman was admitted to our department with the diagnosis of a renal calculus. She exhibited dull left flank pain. A plain film revealed a round opaque calcific density in the left kidney in the supine and the upright position. There was no connection between the calcification and the renal collecting system by retrograde pyelography. Computed tomography in the supine position showed a rounded calcification in the left renal parenchyma without a semilunar configuration. She was diagnosed with left renal calyceal diverticula calculi. She underwent a surgical intervention which found a renal milky stone including a 10-mm. diameter stone. The examination of the fluid and the stone material disclosed three components: calcium phosphate, calcium oxalate and calcium carbonate. The present case is interesting because its characteristics differ from the common features of renal milky stone.     

Non-invasive estimation of intraurethral pressure profile from uroflowmetric curve

BACKGROUND: An intraurethral pressure-time profile as urodynamic information was obtained in a non-invasive manner using an equivalent equation as a voiding model. METHODS: The reasonability of the voiding model was confirmed by applying it to an experimental flow curve likened to urinary flow. The flow curve was approximated and the pressure profile was estimated. From the uroflowmetric curves obtained in a normal subject and a patient with bladder outlet obstruction, the respective intraurethral pressure profiles were estimated. RESULTS: The pressure profile estimated from the approximated flow curve was found consistent with the profile of the difference between the pressure actually measured at two different portions in the experimental system. CONCLUSION: Non-invasive estimation of intraurethral pressure profile from uroflowmetric curves may be very useful to grasp intraurethral urodynamic information in clinical practice.     

ATP‐Induced Dormant Pulmonary Veins Originating from the Carina Region After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation

Dormant Pulmonary Veins from the Carina Region . Introduction: Elimination of transient pulmonary vein recurrences (dormant PVs) induced by an ATP injection and ablation at the PV carina region is an effective strategy for atrial fibrillation (AF) ablation. The relationship between dormant PVs and the PV carina region has not been evaluated. Methods: A total of 212 consecutive symptomatic AF patients underwent circumferential PV electrical isolation (CPVEI) with a double lasso technique. They were divided into 2 groups in a retrospective review; Group 1: those given an ATP injection during an intravenous isoproterenol infusion after the CPVEI (n = 106), and Group 2: those in which it was not given after the CPVEI (n = 106). Radiofrequency energy was applied at the earliest dormant PV activation site identified using a Lasso catheter on the CPVEI line and then PV carina region if it was ineffective. Results: After a successful PVEI, 54 patients (51%) in Group 1 had PV reconnections during an ATP injection. Acute PVEI sites were observed on the carina region within the CPVEI line in the right PVs (16%) and left PVs (10%). Dormant PVs were reisolated at the carina region in the right PVs (23%) and left PVs (26%). The distribution of the dormant PV sites, except for the RIPV, significantly differed from that of the acute PVEI sites (P < 0.05). Further, AF recurred significantly in the Group 2 patients as compared to those in Group 1 during 16 ± 6.1 months of follow‐up (P < 0.05). Conclusion: PV carina region origins may partly be responsible for an acute PVEI and potential recurrences. (J Cardiovasc Electrophysiol, Vol. 21, pp. 494‐500, May 2010)