Oral management with polaprezinc solution reduces adverse events in haematopoietic stem cell transplantation patients.

The aim of this study was to analyse the effects of gargling with and then swallowing PPAA (polaprezinc in polyacrylic acid solution), in addition to regular oral management, on patients with a haematopoietic neoplasm scheduled for haematopoietic stem cell transplantation (HSCT). A total of 120 patients scheduled for HSCT during the years 2006-2016 were recruited. Patient background, oral adverse events, the incidence and severity of systemic adverse events (sepsis/septic shock, acute graft-versus-host disease (GVHD) after transplantation), and outcomes (survival/death) were compared between groups treated with and without PPAA. The severities of oral adverse events (oral mucositis, oral pain, and dysgeusia) were significantly lower in patients treated with PPAA. There was no significant difference in the incidence of febrile neutropenia (P=0.622) or sepsis/septic shock (P=0.665) as systemic adverse events. The severity of allograft-induced acute graft-versus-host disease (GVHD) was significantly lower in the PPAA group (P=0.011). There was no significant difference in outcome between the two groups (P=0.285). Within the limitations of the study design, it may be concluded that oral management with PPAA reduces adverse events in HSCT. Oral management with concomitant use of PPAA decreased oral adverse events and reduced the systemic complication of GVHD.

Desempenho e características bioquímicas de leitões submetidos a dietas com aditivos probióticos, prebióticos, simbióticos e antibióticos / Performance and biochemical parameters of piglets and the use of alternative additives as antibiotic replacement

Avaliaram-se o desempenho e as características bioquímicas de leitões desmamados, utilizando-se aditivos alternativos em substituição aos antibióticos. Foram utilizados 480 leitões machos, distribuídos em delineamento inteiramente ao acaso, composto por cinco tratamentos. A ração foi à base de milho, farelo de soja e um núcleo comercial para leitões. Os tratamentos consistiram em T1: ração sem aditivos, T2: dieta basal com antibiótico, T3: dieta basal com adição de prebiótico, T4: dieta basal com adição de probiótico e T5: dieta basal com adição de simbiótico. Foram avaliados peso corporal, ganho de peso, consumo de ração e conversão alimentar. Em 50 amostras de sangue de leitões, sendo 10 amostras de cada tratamento, avaliaram-se as concentrações séricas de proteínas totais, de albumina e globulina, a relação albumina:globulina e a fosfatase alcalina, creatinina, alanina aminotransferase, aspartato aminotransferase, gama- glutamiltransferase, colesterol, ureia, cálcio e fósforo e a relação cálcio:fósforo. A substituição de antibióticos por aditivos alternativos não influenciou o desempenho nem as características bioquímicas dos leitões.

The experiment was conducted to evaluate the performance and biochemical parameters in weaned piglets using alternative supplements to replace antibiotics. A total of 480 male pigs were used, randomly distributed in delineation with five treatments. The feed was based on corn, soybean meal and a commercial core for piglets. The treatments were T1: diet without supplements or basal diet, T2: basal diet with antibiotics, T3: basal diet with added probiotic, T4: basal diet with added probiotic and T5: basal diet with addition of symbiotic. In the experiment we evaluated performance characteristics, body weight, weight gain, feed intake and feed conversion. In the second part of the experiment, we evaluated the biochemical parameters of piglets used in the first experiment, fifty blood samples, ten samples of each treatment, were taken, and after separation of the clot, the serum was frozen at -20°C. Subsequently we analyzed the serum levels of total protein, albumin, globulin, albumin/globulin, ALP, creatinine, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, cholesterol, urea, calcium, phosphorus and calcium/phosphorus ratio. No significant differences in biochemical parameters or in the performance of piglets submitted to different diets were found.

Surgical management of early stage central (hilar) and peripheral nonsmall cell lung carcinoma.

BACKGROUND: To the authors' knowledge, the definitions of early lung carcinoma used in Japan are not yet approved internationally. In the current study the diagnostic methods, pathology, and results of the surgical treatment of early hilar and peripheral nonsmall cell lung carcinoma cases defined by Japanese criteria are presented. METHODS: Between 1977 and 1998, 43 patients with early hilar lung carcinoma were encountered. These patients constituted 14.5% of 200 hilar lung carcinoma patients who underwent resection during the same period. Between 1973 and 1998, there were 174 early peripheral lung carcinomas, which comprised 14.8% of 1173 peripheral lung carcinoma patients who underwent resection during the same period. RESULTS: The 5-year and 10-year survival rates of the early hilar lung carcinoma were 100% and 96.9%, respectively. The majority of the patients underwent bronchoplastic surgery, such as sleeve lobectomy and parenchymal-sparing surgery including seven sleeve segmentectomies and two second carinal resections. The effectiveness of the parenchymal-sparing resections was assessed by the conventional pulmonary function test as well as perfusion and ventilation scanning. There were 174 cases of peripheral early lung carcinoma among the 218 cases of peripheral lung carcinoma with tumor dimensions of < or = 2 cm. The cell types were 142 (81.6%) cases of adenocarcinoma, 18 (10.3%) cases of squamous cell carcinoma, and 14 (8%) cases of other cell types. These 174 patients comprised 14.8% of 1173 patients with peripheral nonsmall cell lung carcinoma who underwent surgery during the same period. The 5-year and 10-year survival rates for adenocarcinoma were 89.6% and 86.8%, respectively. The 5-year and 10-year survival rates for other cell types were both 71.8%. The overall 5-year and 10-year survival rates were 86.8% and 84.6%, respectively. CONCLUSIONS: Early lung carcinoma in both the hilar and peripheral regions, is curable if it is properly diagnosed and treated.

Growth induction of rat primary hepatocytes using antisense oligonucleotides.

We examined growth control of adult and fetal hepatocytes by regulating the expression of cell-cycle-related proteins using antisense S-oligonucleotides to tumor suppressors retinoblastoma (RB) protein and p53, and cyclin-dependent kinase (CDK) inhibitors p21 and p27. The protein expression in both adult and fetal hepatocytes was significantly suppressed with the addition of corresponding antisense oligonucleotides at a concentration of 2.5 microM. For the evaluation of growth, 3H-thymidine incorporation and DNA content were measured and the results demonstrated that all the antisense oligonucleotides had growth-promoting effects and the promoting potential was equivalent or slightly greater than that with the addition of hepatocyte growth factor (HGF) (10 ng/ml). The growth-promoting effect of the antisense oligonucleotides was enhanced by HGF in both adult and fetal hepatocyte cultures, and the effects on hepatocyte growth were also observed in a suspension culture.

Partially covered Gianturco stent for tracheobronchial stricture caused by intraluminal tumor.

Partially covered Gianturco stents were used successfully in two patients to treat tracheobronchial strictures caused by intraluminal tumor growth. The stents were accurately placed without complications. The covered portion of the stent compressed the tumor, and prevented tumor ingrowth until the patients' deaths. This stent seems to act as effective palliation for tracheobronchial stricture caused by intraluminal tumor.

[Screening CT of the lungs: image quality compared with conventional CT].

More sensitive imaging methods may be required in the screening of early peripheral lung cancer. Among new radiologic techniques, helical volumetric computed tomography (CT) seems to be attractive. The image quality of helical CT with single breath-hold and low-dose technique (screening CT) was compared with conventional sequential CT in 12 patients to detect the pulmonary metastases. The screening CT protocol consisted of a 20 mm/sec table feed during a 20-second breath-hold at 40 mA, with reconstruction of images at 10 mm intervals. Conventional CT was performed with a 1-second scan time, 200 mA, and contiguous 10 mm-thick sections. In the evaluation of mediastinal vessels, bronchi and pulmonary nodules, screening CT showed high detectability images comparable to conventional CT. But subsegmental bronchi or small nodules overlapping pulmonary vessels were more difficult to visualize by screening CT because of image noise. The authors conclude that although further improvement is necessary, screening CT of the lung is an attractive new application of CT.

Clinical application of single dual-energy subtraction technique with digital storage-phosphor radiography.

We used a single-exposure dual-energy subtraction technique with a storage-phosphor computed radiography (CR) system to evaluate various pulmonary diseases. Clinical applications of this method have been studies at our institution. In our experience, the dual-energy subtraction technique provided better visualization of pulmonary nodules, tracheobronchial abnormalities, pulmonary vascular diseases, calcification in a nodule, and rib lesions than conventional CR images did. Single-exposure dual-energy subtraction images were obtained with a sandwich technique using two storage-phosphor imaging plates with a 1-mm-thick copper filter interleaved between the two. The front plate obtains a lower kilovoltage image, whereas the back plate obtains a higher kilovoltage image. We can visualize soft tissue and bone images as well as unsubtracted digital images by the subtraction process.

Clinicopathological study of primary malignant tumors of the lung: an analysis of 993 tumors resected at the Kanazawa University Hospital between 1979-1993.

A retrospective study was conducted of 993 malignant tumors of the lung in 977 patients. The male-female sex ratio was 2.6:1. The age distribution of the males did not differ from that of the females and the overall mean age was 64.3 +/- 9.5 years (range, 13-85 years). Forty-three percent of the patients were in their seventh decade. The location was peripheral in 81% of the tumors and central in 19%. Of the central tumors, 85% were squamous cell (epidermoid) carcinoma (SCC), while 58% of the peripheral tumors were adenocarcinoma (ADENO). In males, 49% of all tumors were SCC and 36% ADENO, while in females 76% were ADENO. The incidence of positive lymph node metastasis increased in parallel with the pT status in both central and peripheral carcinomas. However, it was noted that, of peripheral lung carcinomas, no SCC with a diameter of 15 mm or less had lymph node metastasis, whereas 18.9% of the ADENO of this size were positive for lymph node metastasis. These results indicate that lymph node metastasis can occur even in small-sized peripheral ADENO less than 15 mm. Thus, early detection and surgery together with mediastinal lymph node dissection are necessary even for small-sized tumors to improve the prognosis in patients with peripheral ADENO of the lung.

Small giant cell carcinoma of the lung diagnosed preoperatively by transthoracic aspiration cytology. A case report.

Giant cell carcinoma (GCC) of the lung is considered an aggressive form of lung cancer. Most patients with GCC have large tumors with widespread metastases on hospital admission. We describe a small GCC in the lower lobe of the right lung. Preoperative aspiration cytology showed numerous bizarre, giant epithelial cells, highly suggestive of GCC. The resected tumor measured 1.2 x 1.0 x 0.7 cm in diameter, with an ill-defined margin. Histologically the tumor was composed of pleomorphic mononucleate or multinucleate giant cells without adenocarcinoma or squamous cell differentiation. The tumor cells were loosely organized and noncohesive or free in the alveolar space. The histology was interpreted as GCC of the lung. The clinicopathologic features of giant cell carcinoma are discussed.

Crossflow filtration of yeast broth cultivated in molasses.

A broth of yeast cells cultivated in molasses was crossfiltered with a thin-channel module. The permeation flux gradually decreased at a constant cell concentration. The flux was much lower than that obtained for yeast broth cultivated in yeast extract, polypeptone, and dextrose (YPD) medium during the filtration. The flux did not depend on the membrane pore size (0.45 to 5 mum). The steady-state flux was one-twentieth that calculated for a cake filtration mode from the amount of cake per unit filtration area and the specific resistance of the cake measured in a dead-end filtration apparatus. The lower flux was due to small particles (most of which were less than 1 mum in diameter) in the molasses. The mehanism of crossflow filtration of broths of yeast cells cultivated in molasses was clarified by analysis of the change in flux with time and observations with scanning electron microscopy. At the initial stage of crossflow filtration the yeast cells and particles from the molasses were deposited on the membrane to form the molasses were deposited on the membrane to form a cake in a similar way to dead-end filtration. After the deposition of cells onto the membrane ceased, the fine particles from molasses formed a thin layer, which had higher resistance than the cake formed next to the membrane. The backwashing method was effective to increase the flux. The flux increased low when the pore size was 0.45 to 0.08 mum, but using larger pores of 3 to 5 mum it returned almost to the bases line. (c) 1994 John Wiley & Sons, Inc.

Simultaneous occurrence of lung adenocarcinoma and fibular osteosarcoma in a 13-year-old girl.

Bronchogenic cancer in the pediatric age group is extremely rare and less than 100 cases have been reported in the world literature. We report a 13-year-old girl with simultaneous occurrence of lung adenocarcinoma and osteosarcoma. The patient was admitted with lower leg pain, and an abnormal shadow in the right fibula was noted on X-ray examination. Further examination of the fibular lesion including tumor biopsy revealed an osteosarcoma. Following completion of the first course of preoperative chemotherapy, multiple lung shadows were found on chest X-ray films. After five courses of preoperative chemotherapy, however, all lung shadows except one in the right lower lobe disappeared. The fibular tumor was then resected. Postoperatively, an additional six courses of chemotherapy was given. However, the lung shadow in the right lower lobe was still present. Exploratory thoracotomy was performed. Pathologically, the lung tumor measured 0.8 cm in diameter with an ill-defined border, and histological examination revealed a well differentiated papillary adenocarcinoma. To our knowledge, only a few cases of pediatric lung cancers have been reported to be associated with congenital cystic malformation of the lung. However, this combination of pediatric lung adenocarcinoma and osteosarcoma has not been previously reported.

Simultaneous detection of intercellular adhesion molecule-1 (CD54) and carcinoembryonic antigen in lung adenocarcinoma.

Simultaneous detection of intercellular adhesion molecules-1 (ICAM-1) and carcinoembryonic antigen (CEA) was investigated in AMeX (Acetone, Methyl benzoate and Xylene)-fixed, paraffin-embedded tumor sections of 24 adenocarcinomas of the lung, using the avidin-biotin-peroxidase complex (ABC) method. Distinct expression of both ICAM-1 and CEA was found in tumor cells in all cases. The staining pattern of these two antigens was quite similar and was mainly affected by the tumor grade. In well-differentiated adenocarcinoma, uniformly positive staining was demonstrated predominantly along the apical surfaces of the tumor cell nests, and to a lesser degree on the lateral cell surface and in the cytoplasm with apical concentration, but no positive staining was found on the basal cell surfaces. In poorly differentiated adenocarcinoma, positive staining was found along the entire cell surface and in the cell cytoplasm without any apical concentration, and the staining intensity varied from region to region in the same tumor cell and from cell to cell within the same tumor cell nest. In moderately differentiated adenocarcinoma, the staining pattern was intermediate between those of well and poorly differentiated adenocarcinoma with some degree of apical concentration. The expression pattern of ICAM-1 or CEA on tumor cells did not correlate well with stromal inflammatory cell infiltration. These results indicate that the expression pattern of CEA and ICAM-1 is an inherent characteristic of tumor cells, and that their abnormal expression may play an important role in the physiological behavior of tumor cells because the polarity of their expression is lost in parallel with histological tumor grades.

[Dual-energy subtraction technique with FCR: clinical application for diagnosis of pulmonary vascular diseases].

The use of dual-energy techniques has already proved to be beneficial in nodule detection and characterization of the calcification in nodules. Other clinical applications, in which simplification of the background might lead to improved results, should be investigated. We evaluated the image quality of pulmonary vessels in the dual-energy techniques with FCR. In visualization of the pulmonary vessels of normal patients, dual-energy soft tissue images were equal or inferior to the original unsubtracted digital images because of increased noise. In the diagnosis of some pulmonary vascular diseases (e.g., Takayasu's arteritis), however, soft tissue images resulted in improved conspicuity of involved sites compared with the unsubtracted images.

Abscessing bronchioloectasia with elements of plasma cell granuloma.

A 79-year-old male was admitted to the hospital with the complaint of bloody sputum. Chest X-ray revealed an abnormal shadow in the right upper lobe. Macroscopically, the lesion measured about 3.5 x 2.5 x 2.0 cm with a central cavity containing pus. Histologically, the lesion was composed of interlacing fibroblastic proliferation with abundant plasma cell infiltration and central cavitation. The inner surface of the cavity wall was partially covered by bronchial epithelial cells; there was no cartilage found, suggesting that the lesion had developed from chronic inflammatory processes in relation to ectatic bronchioles. Since the pathogenesis of plasma cell granuloma (PCG) has not been well established, it is probable that this case represents one stage in the development of classic PCG.

Factors affecting the performance of crossflow filtration of yeast cell suspension.

Factors affecting the performance of crossflow filtration were investigated with a thin-channel module and yeast cells. In crossflow filtration of Saccharomyces cerevisiae cells cultivated with YPD medium (Yeast extract, polypeptone, and dextrose) and suspended in saline, a steady state was attained within several minutes when the cell concentration was low and the circulation flow rate was high. The steady-state flux and the change in flux during the initial unsteady state were explained well by conventional filtration theory, with the amount of cake deposited and the mean specific resistance to the cake measured in a dead-end filtration apparatus used in calculation. When the circulation flow rate was lower than a critical value, a part of the channel of the crossflow filtration module was plugged with cell cake, and thus the steady-state flux was low. In crossflow filtration of suspensions of commercially available baker's yeast, the flux gradually decreased, and the flux after 8 h of filtration was lower than the value calculated by filtration theory. Fine particles contaminating the baker's yeast was responsible for the decrease. A similar phenomenon was responsible for the decrease. A similar phenomenon was observed in crossflow filtration of a broth of S. cerevisiae cells cultivated in molasses medium, which also contains such particles, had no effect of the permeation flux during crossflow filtration.

Demonstration of nucleolar organizer regions in lung carcinoma by silver staining.

Nucleolar organizer regions (NORs) were investigated in lung carcinomas by silver staining. This method was applied to 111 lung carcinoma specimens, including 40 with squamous cell carcinoma (SCC), 42 with adenocarcinoma (ADENO), 8 with adenosquamous carcinoma (ADESQ), 8 with small cell carcinoma (SMCC), 6 with large cell carcinoma (LGCC), and 7 with typical carcinoid tumors (CAOID). The mean AgNOR counts of ADENO, SCC, ADESQ, SMCC, and LGCC were significantly higher than those of the normal bronchial surface and those of the glandular or alveolar epithelium. The mean AgNOR count of CAOID was significantly higher than those of the normal glandular and alveolar epithelium but not that of the surface epithelium. The mean AgNOR count of SCC was significantly higher than that of bronchial squamous metaplasia, and the count of SMCC was significantly higher than that of CAOID. Within the same cancer category, the mean number of AgNORs increased in parallel with the histological tumor grades. These results indicate that the AgNOR method is useful for differentiating lung carcinoma from its normal counterparts and for evaluating histological tumor grades in the same lineage of lung carcinoma.

A new animal model for split liver transplantation using an infrahepatic IVC graft.

An animal model of split liver transplantation using pigs is described herein. The donor liver was divided into two grafts, the right graft consisting of the right medial and lateral segments with the caudate lobe, and the left graft consisting of the left lateral and medial segments. To make implantation easier, a distal part of the donor's inferior vena cava (IVC) was isolated and attached to the left graft with an anastomosis between the orifice of the renal vein and the graft's hepatic vein. The left graft thereby contained a newly constructed retrohepatic IVC for anastomosis to the recipient. During the anhepatic phase, no conventional bypass procedure was used, but an abdominal aortic clamp in combination with general hypothermia was employed. Ten pigs were used as donors and a total 20 liver transplantations performed. No immunosuppressive drugs were given in this series. Ten of the 20 recipients survived for more than 2 days, the mean survival time being 4.7 days, with a range of 2-14 days. The mean survival time of the left grafts was much longer than that of the right grafts, although no technical problems such as kinking of the graft or occlusion of the hepatic vein were encountered in either. This model is the first report of split liver transplantation in animals. The advantages of using the infrahepatic IVC graft include stability of the graft and safe hepatectomy. This model will therefore be useful for the experimental study of split liver transplantation and may also be employed for clinical use in the future.

Primary extramedullary plasmacytoma of the lung.

A case with primary plasmacytoma of the lung is described. The patient, a 55-year-old Japanese female, who simultaneously had a pulmonary plasmacytoma and bladder carcinoma. The bladder tumor was treated with transurethral resection. Pathologically, the bladder tumor was a non-invasive, papillary transitional cell carcinoma, grade II. The lung tumor was located in the right upper lobe and upper lobectomy was performed. The tumor measured 2.8 x 2.7 x 2.0 cm and had a white-yellowish cut surface. Histologic, electron microscopic and immunohistochemical examinations of the lung tumor revealed monoclonal proliferation of plasma cells (IgA, lambda light chain). There was no evidence of multiple myeloma.

Seven patients with plasma cell granuloma (inflammatory pseudotumor) of the lung, including two with intrabronchial growth: an immunohistochemical and electron microscopic study.

Seven patients (mean age, 50.7 +/- 20.4 years; range 21-77) with plasma cell granuloma (PCG) of the lung are reported. Cough and sputum were the most common presenting symptoms, followed by fever. Elevated erythrocyte sedimentation rate and serum C-reactive protein levels were found in all patients tested. Radiologically, five cases presented as solitary, well-circumscribed masses and two as ill-defined, pneumonia-like densities. One showed focal calcification. No predilection of occurrence was observed in either lobe of the lung. Histologically, the lesions consisted of a proliferation of mature plasma cells and reticulo-endothelial cells supported by a stroma of granulation tissue, with varying degrees of myxoid change or collagenization. Angioinvasion within the lesion was observed in 4 of the 7 cases. Immunohistochemical staining revealed the IgG-predominant polyclonal nature of the plasma cells, indicating a reactive inflammatory process rather than a neoplastic one. Electron microscopy confirmed the benign nature of the plasma cells with fibroblast and myofibroblast proliferation admixed with that of other inflammatory cells.