Impaired systemic cell-mediated immunity and increased susceptibility to acute respiratory tract infections in patients with COPD

Although it has been reported that chronic obstructive pulmonary disease (COPD) is frequently associated with systemic immune disturbances, negative impact of these disturbances on the increased prevalence of acute respiratory tract infections (aRTIs) has remained unclear. We evaluated circulating levels of interferon-gamma (IFN-gamma), soluble interleukin-2 receptor (sIL-2R), neopterin, and soluble intercellular adhesion molecule-1 (sICAM-1) in 35 clinically stable patients with COPD and in 22 age-matched healthy controls, since these molecules are considered to reflect the in vivo status of systemic cell-mediated immunity (CMI). We found that circulating levels of sIL-2R (1.52+/-1.25 vs. 0.97+/-0.48 ng/ml; P<0.05), neopterin (7.23+/-4.24 vs. 4.95+/-1.52 nmol/l; P<0.05), and sICAM-1 (665+/-302 vs. 328+/-164 ng/ml; P<0.0001), but not IFN-gamma (7.55+/-4.72 vs. 6.65+/-1.13 pg/ml; P=NS) were significantly higher in patients with COPD than in the controls. Importantly, follow-up study for 12 months demonstrated that patients in subgroup with relatively higher circulating levels of sIL-2R (2.20+/-1.44 ng/ml, n=18) had significantly higher risk of developing aRTIs (P=0.0204) than those in subgroup with relatively lower circulating levels of sIL-2R (0.80+/-0.23 ng/ml, n=17). These results may suggest that impaired systemic CMI observed in COPD patients is associated with the increased susceptibility to aRTIs in these patients.     

Mesangiolysis in the glomerular lesion of cyanotic congenital heart disease

Mesangiolysis associated with glomerulomegaly was observed in an autopsy case of an 11-year-old boy with cyanotic congenital heart disease, i.e. complete transposition of the great vessels with large VSD. Microscopical examination of the kidney revealed marked enlargement of glomeruli with mesangiolysis mainly found in the midzonal cortex involving 16 to 20% of all glomeruli. The glomerular basement membrane in the mesangiolytic lesion showed splitting, between which red blood cells were occasionally encountered. By reconstruction study with serial sectioning, the mesangiolysis was observed to be obviously focal and segmental. Immunofluorescent study revealed no positive results for IgG, IgA, IgM, C3, and fibrinogen/fibrin. By electron microscopic study on the post formalin fixed specimens, no remarkable dense deposits were found in any structural components of the glomeruli. It was assumed that the mesangiolysis might have been provoked by some circulatory disturbances, which superimposed on the preexisting glomerular lesion of cyanotic congenital heart disease in the terminal stage of the clinical course.     

Effective antigen-retrieval method for immunohistochemical detection of abnormal isoform of prion proteins in animals

For immunohistochemistry of the prion diseases, several pretreatment methods to enhance the immunoreactivity of human and animal abnormal proteinase-resistant prion protein (PrP^Sc) on the tissue sections have been employed. The method of 121°C hydrated autoclaving pretreatment or the combination method of 121°C hydrated autoclaving with a certain chemical reagent (formic acid or proteinase K, etc) are now widely used. We found that an improved hydrated autoclaving method at 135°C, more effectively enhanced PrP^Sc immunoreactivity for the antibodies recognizing the linear epitope. In addition, this method was more effective for the long-term fixation samples as compared with other previous methods. However, this modified method could not retrieve PrP^Sc antigenic epitopes composed of conformational structures or several discontinuous epitopes. We describe the comparative studies between our improved method and other antigen-retrieval procedures reported previously. Based on the differences of reaction among the antibodies, we also discuss the mechanisms of the hydrated autoclaving methods to retrieve PrP^Sc immunoreactivity.     

Recurrent pericardial tamponade from atrial hemangioma

We encountered a 72-year-old woman with a left atrial hemangioma arising in the appendage and growing like an extracardiac mass. Life-threatening cardiac tamponade, recurrent over a 5-year clinical course, was the only sign of this rare tumor. The extraatrial growth pattern of the tumor made it difficult to distinguish the cardiac origin from a paracardiac mass. With the aid of cardiopulmonary bypass, the tumor was removed from the left atrium at the base of the appendage. Pathologic diagnosis was a combination of cavernous- and venous-type hemangioma. The postoperative course was uneventful, and the patient was doing well with no pericardial effusion at the 10-month follow-up.     

Reducing exposure from 57Co sources during breast lymphoscintigraphy by optimizing energy windows and other suggested enhancements of acquisition and the display of images

We set out to measure the reduction in exposure attained by using a weak 57Co sheet source with optimal energy windows. METHODS: Two groups of 10 lymphoscintigraphy studies were analyzed. Group 1 consisted of 10 studies obtained with a stronger source of 57Co, 59 MBq (1.6 mCi) at the time of data acquisition, with transmission images acquired at 3 energy windows of 115-129, 130-134, and 135-150 keV. Group 2 consisted of 10 studies with a weaker sheet source of 57Co, 11 MBq (0.3 mCi). Transmission images were acquired at 3 energy windows of 112-132, 130-134, and 135-150 keV. Same-sized regions of interest (ROIs) were drawn on the patient's torso (PT) and on the nonattenuated image of the transmission source itself (TS), all 1-min images. The counts in each ROI obtained over 1 min and the ratios between the TS ROI and the PT ROI were calculated for all of the energies. Dosimetry calculations based on measured exposure rates and the activity of the sheet sources were used to calculate the patient equivalent dose at 30 cm. RESULTS: For the 57Co energy window, group 1 had an average ROI count of 1,955 in the TS region and 135 counts in the PT region. The average ratio of TS/PT was 15.4. Similarly, group 2 had an average ROI count of 646.4 in the TS region and 91.2 counts in the PT region. The average ratio of TS/PT was 8.6. The relative "outlining performance," when comparing the 57Co and 99mTc windows, showed an average improvement when using the 57Co window of 4.4 and 5.8 times for group 1 and group 2, respectively (TS/PT at 57Co window)/(TS/PT at 99mTc window). Estimates of the patient equivalent dose per study were 2.30 microSv for the stronger 57Co flood source and 0.46 microSv for the weaker 57Co flood source, a 5-fold reduction in equivalent dose. Technologists received less than half of the above doses. CONCLUSION: Use of expanded, separate energy windows optimized for the primary 122-keV photon of 57Co greatly improves transmission scan image quality compared with the standard 140-keV 99mTc windows used for the delineation of the sentinel node. This markedly reduces exposure for all, by allowing the use of a weaker source, and can save time.     

Comparison of ropivacaine with bupivacaine and lidocaine for ilioinguinal block after ambulatory inguinal hernia repair in children

BACKGROUND: We have compared ropivacaine with bupivacaine and lidocaine for ilioinguinal block in thirty children undergoing ambulatory inguinal hernia repair. METHODS: Patients were assigned randomly to receive 0.5 ml.kg(-1) of 0.2% ropivacaine (Group R, n = 10), 0.25% bupivacaine (Group B, n = 10) or 1% lidocaine (Group L, n = 10). The patients' parents, who were not informed of the type of local anaesthetic employed, evaluated the postoperative pain at 2 h and 6 h after operation using the Wong-Baker FACES Pain Rating Scale. RESULTS: There was a significant difference in the face scale score between Group R and Group L, and Group B and Group L. There was no difference in the face scale score between Group R and Group B. There were no complications or clinical evidence of local anaesthetic toxicity. CONCLUSIONS: We have confirmed that bupivacaine and ropivacaine are more effective than lidocaine in the prevention of postoperative pain after children's inguinal hernia repair. We suggest that ropivacaine 0.2% is an alternative to bupivacaine 0.25% for ilioinguinal block in ambulatory paediatric surgery.     

Germinated barley foodstuff prolongs remission in patients with ulcerative colitis

Germinated barley foodstuff (GBF) is a prebiotic which increases luminal butyrate production by modulating the microfloral distribution. GBF has been shown to reduce both clinical activity and mucosal damage in active ulcerative colitis (UC) with mild to moderate activity. However, the efficacy of GBF in patients with UC during the remission stage is unknown. The aim of this study was to investigate the efficacy of GBF as a maintenance therapy in patients with UC while in remission. Fifty-nine patients with UC in remission according to Rachmilewitz's clinical activity index (CAI) score of 相似文献   

Perfluorooctane sulfonate (PFOS) and related perfluorinated compounds in human maternal and cord blood samples: assessment of PFOS exposure in a susceptible population during pregnancy

Fluorinated organic compounds (FOCs), such as perfluorooctane sulfonate (PFOS), perfluoro-octanoate (PFOA), and perfluorooctane sulfonylamide (PFOSA), are widely used in the manufacture of plastic, electronics, textile, and construction material in the apparel, leather, and upholstery industries. FOCs have been detected in human blood samples. Studies have indicated that FOCs may be detrimental to rodent development possibly by affecting thyroid hormone levels. In the present study, we determined the concentrations of FOCs in maternal and cord blood samples. Pregnant women 17-37 years of age were enrolled as subjects. FOCs in 15 pairs of maternal and cord blood samples were analyzed by liquid chromatography-electrospray mass spectrometry coupled with online extraction. The limits of quantification of PFOS, PFOA, and PFOSA in human plasma or serum were 0.5, 0.5, and 1.0 ng/mL, respectively. The method enables the precise determination of FOCs and can be applied to the detection of FOCs in human blood samples for monitoring human exposure. PFOS concentrations in maternal samples ranged from 4.9 to 17.6 ng/mL, whereas those in fetal samples ranged from 1.6 to 5.3 ng/mL. In contrast, PFOSA was not detected in fetal or maternal samples, whereas PFOA was detected only in maternal samples (range, < 0.5 to 2.3 ng/mL, 4 of 15). Our results revealed a high correlation between PFOS concentrations in maternal and cord blood (r2 = 0.876). However, we did not find any significant correlations between PFOS concentration in maternal and cord blood samples and age bracket, birth weight, or levels of thyroid-stimulating hormone or free thyroxine. Our study revealed that human fetuses in Japan may be exposed to relatively high levels of FOCs. Further investigation is required to determine the postnatal effects of fetal exposure to FOCs. Key words: cord blood, fluorinated organic compounds, human, PFOA, PFOS, PFOSA, pregnancy.