The diagnostic value of kappa/lambda ratios determined by flow cytometric analysis of biopsy specimens in B‐cell lymphoma

Flow cytometry (FC) is widely utilized in the diagnosis of lymphoma and the light chain ratio (LCR) is especially useful in the diagnosis of B‐cell malignancy. In this study we analysed, retrospectively, the predictive value of the LCR in the diagnosis of B‐cell lymphoma in 105 consecutive patients with persistent lymph node enlargement or extranodal masses who underwent biopsy. We used a receiver‐operating characteristic curve to establish a LCR threshold value of 2.0. The specificity, sensitivity, positive and negative predictive values were 92.3%, 73.1%, 90% and 77%, respectively. We concluded that determination of LCR is a useful adjunct to pathological diagnosis.     

Subtyping of uropathogenic Escherichia coli according to the pathogenicity island encoding uropathogenic-specific protein: Comparison with phylogenetic groups

BACKGROUND: Phylogenetic analysis has been used widely to characterize extraintestinal pathogenic Escherichia coli in molecular epidemiological studies. We have recently reported a putative pathogenicity island (PAI), carrying uropathogenic-specific protein (usp) and a unique mosaic structure of small open reading frames following usp, providing four subtypes of PAIusp classified from their sequential patterns. METHODS: A total of 427 E. coli isolates from uncomplicated urinary tract infections (194 cystitis, 76 pyelonephritis, and 107 prostatitis) and 50 fecal isolates were examined for phylogenetic grouping and PAIusp subtyping as well as the prevalence of virulence factors (VF) and O serogroups. RESULTS: Both phylogenetic group B2 and usp-positive strains were equally predominant in cystitis, pyelonephritis and prostatitis (B2, 80.9%, 86.8%, and 86.9%; usp, 79.4%, 93.4%, and 88.8%, respectively). Furthermore, each PAIusp subtype was shown to be closely associated with several VF genes as well as several common O serogroups of uropathogenic E. coli. CONCLUSIONS: In molecular epidemiological studies, PAIusp subtyping will provide additional informative findings of E. coli strains belonging to phylogenetic group B2.     

Up-titration of vardenafil dose from 10 mg to 20 mg improved erectile function in men with spinal cord injury

AIM: Vardenafil is a highly selective phosphodiesterase type-5 inhibitor for the treatment of erectile dysfunction (ED). Efficacy of vardenafil has been demonstrated in various ED populations, but that in Japanese patients with spinal cord injury (SCI) has not been assessed. METHODS: This was an open-label, multicenter, flexible dose, 12-week study in patients with ED due to SCI. Following a 4-week observation period, patients received vardenafil 10 mg for 4 weeks, and based on efficacy, tolerability and patient preference, doses for the remaining 8 weeks were decided by investigators. The primary efficacy parameter was erectile function domain score of the International Index of Erectile Function. RESULTS: Ten patients took 10 mg all through the study, while 22 patients took 20 mg after completing 4 weeks' treatment with 10 mg. The erectile function domain score increased from 12.2 at baseline to 25.0 at Last Observation Carried Forward (LOCF) in the former group and from 10.3 to 22.5 in the latter group, respectively. Importantly, there was a 5.0 point increase in erectile function domain score after up-titration in the latter group. Drug-related adverse events were observed in 22% of patients including hot flushes (9%) and headache (6%), but these were transient and mild in intensity. Serious adverse events and adverse events leading to discontinuation of the study drug were not reported. CONCLUSIONS: Vardenafil 10 and 20 mg was well tolerated and improved erectile function in patients with SCI. Of interest, erectile function was further improved by 20 mg in patients who were not sufficiently treated with 10 mg.     

Effects of Aminoglycoside Antibiotics on the Auditory Brainstem Response and Post Rotatory Nystagmus in Rats

Effects of three aminoglycoside antibiotics, amikacin (AMIK),tobramycin (TOB), and gentamicin (GM), on the auditory and vestibularfunctions were assessed in rats, the most frequently used speciesin toxicity studies. Chronic electrodes for auditory brainstemresponse (ABR) recording were implanted on the epidural surface,and those for post rotatory nystagmus (PRN) were implanted atthe nictitating membrane and the outer canthus. AMK, TOB, andGM were given intramuscularly twice daily for 3–4 weeksat a daily dose of 350, 150, and 100 mg/kg, respectively. Theamplitude of each wave of the ABR was decreased or disappearedin the groups treated with AMK, TOB, and GM. In the PRN, theduration of the nystagmus was decreased in the TOB group andcompletely lost in the GM group. No abnormality was observedin the PRN in the AMK group. These results were similar to thosereported in the ototoxicity studies of these drugs in guineapigs and indicate that ototoxicity can be evaluated in ratsas successfully as in guinea pigs by this procedure.     

Expression of thymidine phosphorylase in human superficial bladder cancer

BACKGROUND: The purpose of the present paper was to investigate the expression level of thymidine phosphorylase (TPase) in superficial bladder cancer tissues obtained by transurethral resection, and determine whether its expression correlates with tumor recurrence. METHODS: From March 1998 to December 2001, 99 patients with superficial bladder cancer were diagnosed and treated at eight affiliated hospitals. Tissue specimens obtained by transurethral resection of superficial bladder cancer (TURBT) were applied to immunohistochemical study using anti-TPase antibody as well as pathological diagnosis. The data were subjected to statistical analysis. RESULTS: Using MoAb 654-1 as the primary antibody, TPase was clearly stained in human bladder cancer tissues. The maximum TPase level measured by enzyme-linked immunosorbent assay (ELISA) method in normal bladder tissues was 18.7 U/mg protein. The TPase activity was 2.8-fold higher in tumors than in normal bladder samples (P = 0.037). The TPase positivity rates determined by immunohistochemical and ELISA methods were distinctly correlated (P = 0.046). For the recurrence-free rates in pT1 tumors treated by TURBT alone (n = 46), there were no statistically significant differences between Tpase-positive or -negative cases. CONCLUSIONS: The TPase expression determined by ELISA and immunohistochemistry is significantly up-regulated in superficial bladder tumors compared with normal bladder samples. However, TPase expression by immunohistochemistry is not a predictive index of recurrence-free rate for superficial bladder cancer treated with TURBT alone.     

Effect of obstructive jaundice on neutrophil chemotactic activity: An in vivo assessment in zymosan-induced peritonitis model in rats

The effect of obstructive jaundice on local neutrophil accumulation in response to inflammatory stimulus was investigated in rats. Obstructive jaundice was produced by bile duct ligation for 7 days. Zymosan (200 mg) was injected intraperitoneally and 4h later myeloperoxidase activity in the peritoneal fluid was measured to quantify neutrophil recruitment. Zymosan-induced neutrophil recruitment was significantly greater (more than two-fold) in bile duct-ligated rats than in sham-ligated or normal animals. Depletion of peritoneal cells significantly suppressed neutrophil recruitment after zymosan injection in all three groups, with no significant differences between the groups. In normal rats, replacement of their peritoneal cells by those from bile duct-ligated rats did not enhance zymosan-induced neutrophil recruitment. In contrast, bile duct-ligated rats treated with peritoneal cell replacement from normals showed significantly increased neutrophil recruitment after zymosan injection. In vitro neutrophil chemotaxis in response to formyl-Met-Leu-Phe was significantly enhanced in bile duct-ligated rats, compared with that in sham-ligated animals. The results suggest that local neutrophil recruitment in response to inflammation may be enhanced in obstructive jaundice and that increased neutrophil chemotactic activity, not macrophage activity, may play a prime role in the mechanism.     

Validation of limulus tests for endotoxin evaluation in dialysate

Summary: To measure endotoxin (ET) levels in dialysate accurately, three commercial limulus tests (Endospecy, Seikagaku, Tokyo, Japan; Kinetic QCL, BioWhittacker, MD, USA; ET single test-ES, Wako, Osaka, Japan) were validated in order to determine whether or not they are enhanced or inhibited by bicarbonate dialysate. Two reference standard ET, one from US Pharmacopoeia (Escherichia coli reference standard endotoxin; RSE) and the other from European Pharmacopoeia (Salmonella RSE), were adjusted with dialysate at concentrations of 0.05, 0.10 and 0.15 EU/mL for measurement by each kit. A simple linear regression line forced to the origin was generated for each kit. the validation criteria, based upon accuracy and precision analysis, includes the fact that the range of slope of the regression line of 95% confidence must fall between 0.75 and 1.25, and the correlation coefficient must be no less than 0.99 with significance ( P < 0.05). No enhancement/inhibition was observed with Endospecy. Kinetic QCL showed enhancement with Salmonella RSE and no enhancement/inhibition with E. coli RSE. the ET single test-ES kit was inhibited with both RSE. Clinical dialysate samples were also measured for ET activity by each limulus kit which revealed that Endospecy and Kinetic QCL gave almost identical values; however, the ET single test-ES kit gave significantly lower values (41%) than the others ( P < 0.05). These results suggest that either the validation test using RSE or comparative analysis with an already validated kit (Endospecy) is necessary for measuring ET levels in dialysate.     

The possibility of ''de novo'' cancer in the prostate

BACKGROUND: To investigate the possibility of 'de novo' prostate cancer by analyzing the relationship between high grade prostatic intraepithelial neoplasia (HGPIN) and latent prostate cancer. MATERIALS AND METHODS: Latent prostate cancers found at autopsy were examined and 55 cancer foci with a poorly (Gleason grade 4 and 5) or moderately (Gleason grade 3) differentiated component were selected. The 55 foci were separated into two groups: (i) foci with either a poorly or moderately differentiated component only (single differentiation group, SDG); and (ii) mixed foci with two or more types of differentiation components (mixed differentiation group, MDG). High grade intraepithelial neoplasia was defined as positive if it was observed within 2 mm from the edge of the cancer focus and the relationship between HGPIN and the two groups was investigated. RESULTS: The MDG had 39 cancer foci (71.0%) and there were 16 in the SDG (29.0%). There were 31 foci that were small-volume cancers (<0.2 mL). In the MDG, 13 small-volume cancer foci were HGPIN positive, but in the SDG, none of the small-volume cancers were HGPIN positive. CONCLUSIONS: Small-volume cancer foci without HGPIN in the SDG may be candidates for de novo prostate cancers.     

皮肤不同层对脂溶性药物经皮渗透的影响

目的　评价皮肤角质层和真皮层对药物经皮渗透的影响。方法　选择 5 氟尿嘧啶 ,茶碱 ,氢醌 ,巴比妥 ,硝酸异山梨酯和酮基布洛芬共 6种具不同脂溶性的药物 ,以贴片为试验药剂 ,采用改进Franz扩散池法 ,考察药物经完整皮肤和剥离角质层皮肤的体外透皮能力。结果　药物的脂溶性LogPc和药物经完整或角质层剥离皮肤的透皮能力 (Kp ,cm·h-1)间均具有抛物线关系。然而 ,角质层剥离后 ,药物Kp增加率主要同药物在水中的溶解度有关。渗透促进剂肉豆蔻酸异丙酯 (IPM )加入到贴片中后 ,药物的脂溶性LogPc和其Kp间无抛物线关系。药物经完整皮肤渗透时 ,因加入IPM而引起的Kp增加率随药物LogPc的变小而增加。药物经角质层剥离皮肤渗透时 ,因加入IPM而引起的Kp增加率随药物在IPM中的溶解度增大而增加。结论　本实验为皮肤病态条件 ,如皮肤受伤或溃疡等时药物经皮渗透规律研究提供一种新的方法