Neutrophil survival factors (TNF-alpha, GM-CSF, and G-CSF) produced by macrophages in cats infected with feline infectious peritonitis virus contribute to the pathogenesis of granulomatous lesions.

Feline infectious peritonitis (FIP) is a feline coronavirus (FCoV)-induced fatal disease of domestic and wild cats. The infiltration of neutrophils into granulomatous lesions is unusual for a viral disease, but it is a typical finding of FIP. This study aimed to investigate the reason for the lesions containing neutrophils in cats with FIP. Neutrophils of cats with FIP were cultured, and changes in the cell survival rate were assessed. In addition, the presence or absence of neutrophil survival factors was investigated in specimens collected from cats with FIP. Furthermore, it was investigated whether macrophages, one of the target cells of FIPV infection, produce neutrophil survival factors (TNF-alpha, GM-CSF, and G-CSF). We showed that virus-infected macrophages overproduce neutrophil survival factors, and these factors act on neutrophils and up-regulate their survival. These observations suggest that sustained production of neutrophil survival factors by macrophages during FCoV infection is sufficient for neutrophil survival and contributes to development of granulomatous lesions.

[Toward the promotion of effective communication between medical doctors and medical technologists--strategy beyond the team].

It is essential to establish effective communication between medical doctors (MDs) and medical technologists (MTs), such as during telephone conversations, to ensure high quality and clinically significant laboratory test results. However, the level of communication between MDs and MTs is still inadequate in Japan. Suggested here in are resources to promote effective MD-MT communication through a case analysis of severe sepsis with disseminated intravascular coagulation (DIC), since, even today, DIC remains life-threatening, and the rapid response of the clinical laboratory is critical. Recently, in our laboratory, a Customer Support Center has been launched to improve the information flow between MDs and MTs and support further mutual understanding. In conclusion, effective communication between MDs and MTs will result in faster and higher quality laboratory tests that are essential for efficient diagnosis and treatment, and thus ensure a better outcome for patients.

Small intestinal intussusceptions due to the placement of a percutaneous endoscopic jejunostomy tube.

Percutaneous endoscopic jejunostomy (PEJ) has been developed and is considered to be a better method than percutaneous endoscopic gastrostomy for preventing the occurrence of aspiration pneumonia. However, the incidence of other complications associated with this procedure is less clear. We herein report a rare case with a small intestinal intussusception due to a PEJ placement. In this case, a radiologic examination with gastrografin was useful to detect the typical findings of a small intestinal intussusception, a beak-like filling defect, and identify the location of the lesion. An endoscopic examination that was carefully performed with a thin scope was effective to observe the ischaemic change of the small intestine and immediately determine the indication for surgical treatment. This case highlights the necessity to carefully manage patients with a PEJ placement, considering the risk of small intestinal intussusceptions when the patient complains of symptoms that are suspicious for an intestinal obstruction.

Physiological characteristics of the body fluid in lymphedematous patients postbreast cancer surgery, focusing on the intracellular/extracellular fluid ratio of the upper limb.

AIM: The aim of this research was to determine the physiological characteristics of patients with lymphedema following breast cancer surgery, based on differences between the quantity of body water in the right and left fingertips, with a view to establishing whether or not this simple measurement could serve as a predictive index for the onset of lymphedema. METHOD: The research was conducted at a hospital in Hiroshima, Japan (August 2004 to December 2004). Observations were made on 39 female breast cancer patients who had undergone surgery and 45 healthy female participants. Additional information was collected via interviews with the individual participants. The quantity of body water in all the participants was measured by using a bioimpedance spectrum analysis system. Comparisons of the intracellular/extracellular fluid ratios (I/Es) were made between the edema patients and the non-edema patients, with further testing being done between the affected and unaffected sides of the upper limb in the edema patients. RESULTS: In the edema patients, significant differences were recognized between the affected side's upper limb I/E and the unaffected side's upper limb I/E. In relation to the affected side's upper limb I/E of the edema patients, even when the mean value and standard deviation were included, the value did not exceed 1.0 and the mean - 3 SD value of the affected side's upper limb I/E in the non-edema patients was 1.04. CONCLUSIONS: The results suggest that measurements of the affected and unaffected sides' upper limb I/E showed a potential for use as a reliable predictive index for lymphedema.

Comparison of the body fluid levels in healthy individuals and those with schizophrenia in Japan: using the bioelectrical impedance method.

Polydipsia and water intoxication have been found to be care problems in people with schizophrenia in many countries. This Japanese study measured the body fluid distribution and body fat of 80 males with long standing schizophrenia and compared this to that of 64 healthy males, using bioelectrical impedance spectrum analysis (BIS). Participants with schizophrenia exhibited significantly lower percentages of intracellular fluid and total body fluid, and significantly higher percentages of fat. Moreover, the percentage of extracellular fluid was distributed over a wider range. When the percentage body fluid was compared between the two groups by matching body mass index and body fat, intracellular fluid was significantly lower for those participants with schizophrenia. There findings suggest that nurses and other health professionals need to be very cautious when attempting to modify the excessive drinking of fluids by patients with schizophrenia. In mistakenly trying to prevent water intoxication, they may in fact be contributing to dehydration.

Induction of inducible nitric oxide (NO) synthase mRNA and NO production in macrophages infected with influenza A/PR/8 virus and stimulated with its ether-split product.

We investigated the inductive activity of infective influenza A/PR/8/34 (PR8) virus and its ether-split product (ESP) on the expression of inducible nitric oxide (NO) synthase (iNOS) and NO production in RAW264.7 (RAW) cells, a murine macrophage (M psi) cell line, and thioglycolate-elicited peritoneal M psi (TPM). In both cells, PR8 virus infection induced iNOS mRNA between 4 hr and 24 hr, attaining a peak value at 12 hr. In correlation with induction of iNOS mRNA, NO amounts increased significantly from 12 to 24 hr. Moreover, this study demonstrated that ESP with the same hemagglutination titer as PR8 virus could induce iNOS mRNA and NO production, although the inductive activity of ESP was weaker than that of PR8 virus. Considering the dual role (beneficial and detrimental roles) of NO on certain inflammatory disorders and virus infections, the inductive activity of influenza virus on the iNOS-mediated NO production independent of its infectivity might contribute to a modification of influenza virus infection.