Clinical evaluation of serum type IV collagen 7S in idiopathic pulmonary fibrosis

Abstract Type IV collagen is one of the major components of the basement membrane (BM). 7S domain (7S collagen) of type IV collagen is an N-terminal peptide which is stable against protease and heat. We investigated serum concentration of 7S collagen in patients with idiopathic pulmonary fibrosis (IPF) and other pulmonary diseases. The aim of this study was to evaluate whether changes in the serum concentration of 7S collagen reflect the fibrotic process of IPF. We measured the concentration of serum 7S collagen with radioimmunoassay in patients with IPF, chronic pulmonary emphysema (CPE), sarcoidosis, infectious pulmonary diseases (IPD) and normal healthy controls. We also monitored 7S collagen during the clinical course in some patients with IPF and investigated the correlation between the serum 7S collagen, and lactate dehydrogenase (LDH) and erthrocyte sedimentation rate (ESR) in patients with IPF. Patients with IPF showed significantly higher serum concentration of 7S collagen than other pulmonary diseases and healthy controls. The serum concentration of 7S collagen significantly decreased in IPF patients who showed roentgenographic improvement after corticosteroid treatment. There was a correlation between the serum 7S collagen and LDH, and ESR. In conclusion, serum concentrations of 7S collagen increase in patients with IPE The measurement of 7S collagen is useful for the evaluation of fibrotic change in the lung.     

Ascending Colon Stenosis:A Rare Presentation of Perforated Appendicitis

Abstract : Described is a 49-year-old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum. Large intestinal stenosis is a rare complication of appendicitis, and there have been only a few reported cases involving the ascending and sigmoid colon, and the rectum. In these cases, however, the polypoid lesions as seen in our case have never been described. In reviewing the literature, we found only two other cases in which a coarse or a polypoid lesion, similar to our case, was noted in the cecum, though the mucosal change was localized and luminal stenosis did not occur. Thus, when a patient with an ascending colon stenosis is encountered, a possibility of periappendiceal abscess must be kept in mind.     

The Role of Surgical Resection in the Management of Small Cell Carcinoma of the Lung

To assess the role of surgical resection in the management ofsmall cell carcinoma of the lung, experience with 118 patientswho were treated between 1973 and 1985 was reviewed. Twenty-fivepatients underwent surgical resection followed by combinationchemotherapy in all except one. The remaining 93 pa tients weretreated by combined chemotherapy and radiation therapy. The 5-year survival rate for patients with stage I disease undergoingsurgical resection was 50.8%. For all 25 patients operated on,the 5-year survival rate was 30.7%. In the patients not operated on, only those with complete responsehad long-term survival, for whom the 5-year survival rate was11.9% We consider that surgical resection is definitely indicatedin patients with stage I disease. If the response to initialchemotherapy is very good, patients with stage 11 or T3N0M0disease also probably should receive resection. Patients withN2 disease are not candidates for resection, unless distantmetastases are controlled completely by intensive chemotherapy.     

Effects of α1‐Blockers for Lower Urinary Tract Symptoms and Sleep Disorders in Patients with Benign Prostatic Hyperplasia

Objectives: We evaluated the association of lower urinary tract symptoms (LUTS) and sleep disorders (SD) in patients with benign prostatic hyperplasia (BPH). We also examined improvement of SD following the α1‐blocker therapy for LUTS. Methods: Sixty‐eight male patients were enrolled in the study, consisting of 38 cases with LUTS and BPH (BPH group), and 30 men without significant LUTS or BPH (non‐BPH group). The degree of LUTS and SD was evaluated by the International Prostate Symptom Score and the Pittsburg Sleep Quality Index (PSQI), respectively. The patients of BPH group then were treated with α1‐blocker for 4 weeks, and were re‐examined by all the questionnaires to evaluate the therapeutic efficacies. Results: The correlation analyses showed a significant association of LUTS with SD in BPH group (r = 0.4995, P = 0.0068). Twenty cases (52.6%) in BPH group showed 5.5 or more PSQI scores. Following 4 weeks of α1‐blocker administration, the average PSQI decreased significantly from 6.3 to 4.8 points (P < 0.001). Significant improvement was observed in domains of “sleep quality” and “sleep disturbances” among PSQI (P = 0.0215 and 0.0391, respectively). Moreover, significant association between α1‐blocker induced improvements of nocturia and SD was identified in patients with 5.5 or more PSQI score at baseline (r = 0.445, P = 0.0334). Conclusion: These results suggested that SD is associated with LUTS among BPH patients and therapeutic effects of α1‐blockers on LUTS lead to improvements of SD.     

A collaborative study to establish the 1st International Standard for factor XIII plasma

BACKGROUND: An international collaborative study, involving 23 laboratories, was carried out, under the auspices of the FXIII Standardization Working Party (SWP), to calibrate the 1st International Standard (IS) for factor XIII (FXIII) plasma. METHODS: Potency estimates for the proposed candidate FXIII plasma (preparation Y: NIBSC code 02/206) were calculated relative to locally collected normal plasma pools (pool N), for both FXIII activity and antigen levels. RESULTS: Estimates of FXIII activity potency for preparation Y showed good agreement between laboratories, with an interlaboratory geometric coefficient of variation (GCV) of 11.5% and a mean value of 0.91 U mL(-1). Furthermore, there was a negligible difference in potencies by two commercially available methods, the potencies differing only by approximately 1%. Estimates of FXIII antigen (A(2)B(2) complex) potency for preparation Y showed good agreement between laboratories, with an interlaboratory GCV of 16.3% and a mean value of 0.93 U mL(-1). Accelerated degradation studies showed that the proposed standard is very stable, with a predicted loss of activity (and antigen) per year of< 0.06% at the recommended storage temperature of -20 degrees C. CONCLUSIONS: The suitability and potency of preparation Y were considered by the participants, members of the ISTH/SSC FXIII Subcommittee, the Scientific and Standardization Committee and the SWP. Following their approval, preparation Y was proposed to and accepted by the Expert Committee on Biological Standardization of the World Health Organization to be the 1st IS for FXIII plasma with an activity potency of 0.91 IU per ampoule and an antigen potency of 0.93 IU per ampoule.     

Usefulness of contrast-enhanced ultrasound for the diagnosis of recurrent renal cell carcinoma in contralateral kidney

We studied contrast-enhanced ultrasound (CEU) for recurrence of renal cell carcinoma (RCC) at the contralateral kidney during postoperative follow up of localized renal cell carcinoma. CEU successfully detected all recurring cases, despite the fact that 5/6 cases were observed using conventional ultrasound; the remaining one case was not detected using conventional ultrasound. CEU using Levovisto successfully revealed renal tumors as RCC. Lesions were diagnosed as cystic renal tumors by Bosniac classification, and pathological findings demonstrated RCC, in accordance with the prior tumor.     

Sarcoidosis induced by interferon therapy for chronic myelogenous leukaemia

A 31-year-old male was diagnosed as having chronic myelogenous leukaemia and has been treated with hydroxyurea and interferon-α since February 1995. After 16 months, he complained of low-grade fever and a cough. Bilateral hilar lymph node enlargement was detected on the chest X-ray film and multiple subcutaneous erythematous nodules appeared. A skin biopsy revealed subcutaneous sarcoid granuloma. Two months after the cessation of interferon therapy, the subcutaneous nodules and the hilar lymph node enlargement resolved. It is possible that continuous interferon administration can promote granuloma formation in sarcoidosis by activating T cells and macrophages.     

A new, simple and accurate method for evaluating masticatory ability

A new method has been devised to measure masticatory ability. Pigment-coated granules were prepared, and 730 mg (730–740 granules) were sealed in a rubber capsule. This capsule was used as a test material and was chewed by the subject under standardized conditions. The masticatory ability, defined as the joules of work performed, was calculated based on the concentration of pigment leaked from the crushed granules during the process of mastication. The procedure is rapid, simple and reliable, and can be used for a large number of clinical samples and studies. The measurement error, defined as the coefficient of variation, was 2.1%. The intraindividual variation of measurements of twenty volunteers ranged from 3.6 to 16.9%. A series of tests in each subject was necessary to obtain a reliable value of masticatory ability.