Expression of classical protein kinase C subspecies in non-neoplastic lymphocytes and non-Hodgkin's lymphomas: an immunohistochemical study

It is generally accepted that phosphorylation plays a pivotal role in the cellular response of cell differentiation and proliferation. Immunohistochemical expression of classical protein kinase C (cPKC) subspecies (alpha, beta and gamma) in eight reactive lymphoid tissues, three normal spleens and 149 non-Hodgkin's lymphomas was examined. cPKC beta was observed primarily in the mantle zone B cells, but appeared as very faint staining in Ki-67 positive proliferated B cells in the germinal centers of secondary lymph follicles. In contrast to the reactive state, high levels of cPKC subspecies were recognized in the majority of 149 cases of non-Hodgkin's lymphoma, including those thought to have arisen from germinal center cells such as follicular lymphoma. The expression of cPKC alpha was found in higher frequency in T cell lymphomas than B cell lymphomas (P < 0.01) by the Chi-squared test. High levels of cPKC alpha were present only in high grade or highly aggressive lymphomas, showing the highest incidence in the small non-cleaved cell type, according to the International Working Formulation and National Cancer Institute (P < 0.01). cPKC gamma was not detected in normal lymphoid cells and was expressed in only four cases of non-Hodgkin's lymphomas. It is presumed that cPKC alpha and beta have a relationship to cell activation and proliferation of lymphoid cells of reactive and neoplastic states. It might be considered that the expression of cPKC alpha may have a relationship with aggressiveness in non-Hodgkin's lymphomas.     

Airway cytokine expression measured by means of protein array in exhaled breath condensate: correlation with physiologic properties in asthmatic patients

BACKGROUND: Simultaneous monitoring of airway inflammation and physiology might be useful for asthma management. OBJECTIVE: We examined the upregulated molecules in asthmatic airways. Furthermore, we investigated the relationship between these molecules and the airway physiologic properties of asthma. METHODS: Ten nonsmoking healthy subjects and 16 steroid-naive asthmatic patients were enrolled. Exhaled breath condensate (EBC) sampling, spirometry, and methacholine inhalation challenge were performed on one occasion in this cross-sectional study. Peak expiratory flow was also measured for 4 weeks. Airway cytokine-chemokine-growth factor production was analyzed with a protein array. RESULTS: The expressions of IL-4, IL-8, IL-17, TNF-alpha, RANTES, IFN-gamma-inducible protein 10, TGF-beta, and macrophage inflammatory protein 1alpha and 1beta were significantly upregulated in asthmatic airways compared with those of nonsmoking healthy subjects. Among the upregulated molecules, RANTES expression was significantly correlated with the parameters that represent airway caliber, FEV(1) and respiratory resistance values. In addition, the levels of both TNF-alpha and TGF-beta were significantly correlated with the methacholine threshold and peak expiratory flow variability for the week. CONCLUSION: Inflammatory molecule analysis with EBC appeared to be useful for monitoring the asthmatic airway condition. CLINICAL IMPLICATIONS: Measurements of cytokine levels in EBC might be a promising approach to assess the efficacy of pharmacologic interventions and to investigate the pathophysiology of asthma.     

Attitudes of Japanese nursing personnel toward patients who have attempted suicide

Objective

The aim of this study was to examine the attitudes among Japanese nurses together with their perceived need for training in relation to understanding the nature of suicidal behavior and preventive strategies.

Methods

The Understanding Suicidal Patients scale together with additional questions reflecting training and the psychiatric treatment of suicide attempters were administered.

Results

A total of 323 nurses attended this study. Overall, the nurses thought patients who attempted suicide were not treated well. The nurses who worked in the psychiatric unit or had the experience in psychiatric nursing had more favorable attitudes toward suicidal patients and viewed themselves as having more relevant skill training in dealing with suicidal patients than those who did not. The nurses who worked at emergency care/intensive care unit were less likely to understand suicidal patients, and were less inclined to be sympathetic and to verbally interact with suicidal patients concerning their problems. The nurses who have confidence in the psychiatric care of suicidal patients, confidence in their own skills, and have a need for more training had the more positive attitudes.

Conclusions

The results suggest that less favorable attitudes may to some extent be the result of lack of knowledge regarding suicidal patients. Future studies should focus on the evaluation of educational experiences on attitudes and skill acquisition of nurses.     

Bilateral anterior optic neuritis in adult measles infection without encephalomyelitis

PURPOSE: To describe anterior optic neuritis in adult measles infection.DESIGN: Interventional case report. METHODS: A 31-year-old woman presented with bilateral visual loss 6 days after the onset of maculopapular rash. Complete ophthalmic and neurologic examinations, radiologic studies, and lumbar puncture were performed. RESULTS: Visual acuities were counting fingers in both eyes, with bilateral optic disk hyperemia and swelling noted. Neurologic examination was unremarkable, and computed tomography and magnetic resonance imaging of the brain were normal. The cerebrospinal fluid (CSF) was devoid of white cells, although measles immunoglobulin M (IgM) antibodies were detected in both CSF and serum. Intravenous corticosteroids were administered, and clinical findings resolved within 1 month. A fall in serum IgM and a rise in serum IgG titers were observed. CONCLUSIONS: Although rare, optic neuritis in the absence of encephalomyelitis may occur in measles. Whether treatment is effective is unknown.     

Impact of treatment extending to 60 Gy on the outcome of radiotherapy for nasopharyngeal carcinoma

PURPOSE: To clarify the impact of treatment duration on the outcome of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Forty-three patients with NPC were treated with definitive radiotherapy from January 1980 through May 1996. The male-to-female ratio was 32:11, and median age was 58 years (10-78 years). According to the fifth UICC classification, 4 patients were stage I, 12 were stage II, 6 were stage III, and 21 were stage IV. Twenty-nine patients received chemotherapy. Each patient was treated to various doses according to their disease extension. Thus, treatment duration was defined as the duration from the start of radiotherapy to the end of 60 Gy. The median follow-up period was 63 months (2-164 months). RESULTS: The 5-year overall and disease-free survival rates of all patients were 66% and 59%, respectively. The 5-year disease-free survival rates of the patients treated with the short treatment duration (< or = 8 weeks) and those treated with the long treatment duration (> 8 weeks) were 76% and 38%, respectively (p = 0.008). CONCLUSION: Long treatment duration may lead to poor treatment outcome in NPC.     

Identification of antibiotic clarithromycin binding peptide displayed by T7 phage particles

Peptide libraries displayed by T7 phage, which contain random cDNA fragments insets, were screened for their ability to bind to a biotinylated derivative of clarithromycin. Phage particles bound to an immobilized derivative of the antibiotic were isolated and the inserted cDNA was amplified and sequenced. A common selected peptide sequence, composed of 19 amino acids, was obtained and a synthetic peptide with this sequence was produced. Surface plasmon resonance experiments showed that the synthetic peptide immobilized on a sensor chip bound to clarithromycin and the dissociation constant was determined to be 2.1 x 10(-3) M. The dissociation constants of other macrolide antibiotics, erythromycin, roxithromycin, azithromycin and josamycin were also determined to be 5.4 x 10(-3) M, 6.2 x 10(-5) M, 1.1 M and 3.4 x 10(-2) M, respectively. These results indicated that T7 phage display method might be useful to determine relatively weak interactions between small molecule drugs and the selected peptides which could represent a possible binding site conserved in binding proteins.     

ABCA4 gene mutations in Japanese patients with Stargardt disease and retinitis pigmentosa

PURPOSE: To evaluate photoreceptor cell-specific adenosine triphosphate (ATP)-binding cassette transporter (ABCA4) gene mutations in Japanese patients with Stargardt disease (STGD) and the correlation of these mutations to clinical phenotypes. METHODS: Serum was obtained from 10 unrelated Japanese patients with STGD and 96 unrelated Japanese patients with autosomal recessive retinitis pigmentosa (arRP). All 50 ABCA4 gene exons of the patients with STGD were screened for mutations by a combination of single-strand conformation polymorphism analysis and polymerase chain reaction (PCR) direct-sequencing techniques. By restriction enzyme digestion, primer extension analysis, and PCR direct sequencing techniques, the patients with arRP were screened for three segregated, presumably null ABCA4 gene mutations observed in Japanese patients with STGD. RESULTS: Three novel, presumably null mutations of the ABCA4 gene, IVS7-45_952delinsTCTGACC, IVS12+2T-->G, and 1894delA, were identified. The Arg2149stop mutation that had been found in a white patient with STGD in a prior study was also found in a Japanese patient. Two arRP-affected siblings and two unrelated patients with STGD were found to be homozygous for the same IVS12+2T-->G mutation, and three other arRP-affected siblings were carriers of the IVS12+2T-->G mutation and/or the IVS7-45_952delinsTCTGACC mutation. These three siblings with arRP showed only atrophic degeneration in the macula early after the onset of the disease, and STGD had been diagnosed. CONCLUSIONS: Three novel ABCA4 gene mutations were identified in Japanese patients with STGD and arRP. Mutations in the ABCA4 gene can cause panretinal degeneration that changes its clinical appearance from STGD to arRP over time.     

Eight case reports on sex‐hormone profiles in sexually mature male Down syndrome

Down syndrome (DS) is a congenital disorder usually caused by an extra copy of chromosome 21. Although the number of postpubertal patients with DS is increasing, only limited information is available on their gonadal and sexual development. The aim of this case report was to examine sex‐hormone profiles in sexually mature male patients with DS. Eight postpubertal male patients with trisomy 21 (mean age 28 years, range 15–54 years) participated in this study. The serum level of luteinizing hormone and follicle‐stimulating hormone was significantly elevated and testosterone was slightly decreased. The testicular volume was smaller in all eight cases than that observed in healthy male subjects. The elevated luteinizing hormone and follicle‐stimulating hormone levels, the lower testosterone levels and a smaller testicular volume observed in all eight cases suggest a significant degree of germinal cell hypoplasia in mature male patients with DS.     

Case of peripartum cardiomyopathy developed after an emergency cesarean section--a case report

A 28-year-old woman was admitted because of pregnancy induced hypertension at 35 weeks of gestation with twin babies. The premature labor had been inhibited for 2 weeks with ritodrine (100 microg min(-1) continuous infusion). At 37 weeks of gestation, an emergency cesarean section was carried out under combined spinal epidural anesthesia. After the delivery, oxytocin 5 units was injected to the uterine muscle and methylergometrin 0.2 mg was given intravenously to induce uterine contraction. One hour after the operation, she developed severe pulmonary edema. An echocardiography showed diffuse hypokinesis of the left ventricle with ejection fraction of 23%. She was diagnosed as having peripartum cardiomyopathy by cardiologist. The patient's condition improved in a few days but the abnormal cardiac function continued for two months.