Organizer-Like Reticular Stromal Cell Layer Common to Adult Secondary Lymphoid Organs

Abstract Mesenchymal stromal cells are crucial components of secondary lymphoid organs (SLOs). Organogenesis of SLOs involves specialized stromal cells, designated lymphoid tissue organizer (LTo) in the embryonic anlagen; in the adult, several distinct stromal lineages construct elaborate tissue architecture and regulate lymphocyte compartmentalization. The relationship between the LTo and adult stromal cells, however, remains unclear, as does the precise number of stromal cell types that constitute mature SLOs are unclear. From mouse lymph nodes, we established a VCAM-1+ICAM-1+MAdCAM-1+ reticular cell line that can produce CXCL13 upon LTβR stimulation and support primary B cell adhesion and migration in vitro. A similar stromal population sharing many characteristics with the LTo, designated marginal reticular cells (MRCs), was found in the outer follicular region immediately underneath the subcapsular sinus of lymph nodes. Moreover, MRCs were commonly observed at particular sites in various SLOs even in Rag2−/− mice, but were not found in ectopic lymphoid tissues, suggesting that MRCs are a developmentally determined element. These findings lead to a comprehensive view of the stromal composition and architecture of SLOs

フクマク ハシュ オ キタシタ アクセイド フメイナ シキュウ ヘイカツキン シュヨウ ノ 1レイ

悪性度不明な子宮平滑筋腫瘍は再発・転移をきたすことが知られているが、特に腹膜播種再発した症例の報告は乏しく、その治療方針は定まっていない。今回我々は初回の子宮全摘術から約13年、腹膜再発切除から約8年経過した後に腹膜へ再再発をきたした悪性度不明な子宮平滑筋腫瘍の1例を経験したため報告する。症例は68歳、女性。55歳時に両側付属器切除と子宮全摘術を受け、低異型度子宮肉腫と診断された。60歳時に骨盤内の10mm大の再発病巣を切除した。脾臓近傍に55mm×55mm×40mm大の境界明瞭で内部均一な増大傾向を示す腫瘤性病変を認めたことから子宮肉腫の再発を含めた診断かつ治療目的に手術の方針とした。開腹手術にて術前画像診断で指摘されなかった播種病変を認めたが、全ての病変を肉眼的に局所切除し得た。病理診断にて悪性度不明な子宮平滑筋腫瘍と診断された。術後1年経過して再発兆候を認めていない。悪性度不明な子宮平滑筋腫瘍は術後長期間を経て腹膜播種再発することがある。再発病変に対しては局所切除が可能であり、手術が勧められる。Smooth muscle tumor with uncertain malignant potential can recur and become metastatic; however, reports regarding its recurrence are scarce. Here we present a case of a 68-year-old woman with a smooth muscle tumor with uncertain malignant potential with peritoneal dissemination recurrence that occurred approximately 13 years after initial hysterectomy. The patient had a history of bilateral salpingo-oophorectomy and total hysterectomy for low-grade uterine sarcoma at the age of 55 years. The patient underwent open surgery for recurrence in the pelvis at the age of 60 years. At follow-up, abdominal computed tomography revealed a uniform tumor measuring approximately 55 mm × 55 mm × 40 mm near the spleen with a clear boundary. During laparotomy, peritoneal dissemination recurrence, which was not detected preoperatively, was revealed. All recurrent tumors were macroscopically removed. The patient was pathologically diagnosed with smooth muscle tumor of uncertain malignant potential. No recurrence was found at postoperative 1 year. Smooth muscle tumors with uncertain malignant potential may recur with peritoneal metastasis long after surgery. Based on our experience, we concluded that local resection is possible in such cases. Therefore, surgery is recommended for recurrent smooth muscle tumors with an uncertain malignant potential.departmental bulletin pape

Studies on the Tissue Mast Cells in the Liver 2. Observations on the Tissue Mast Cells in the Experimental Damaged Liver

In the preceding report, the author studied the changes of tissue mast cells (TMC) in the specimens of liver biopsy specimens of viral hepatitis. The present study was attempted to confirm, by animal experiments, the data described in the previous report. Animals used were male dogs, mice and rabbits. Chloroform and carbon tetrachloride were administrated for experimental damage of the liver tissue. The experiments gave the following results: 1. TMC were found both in intralobular and periportal region of the liver. Destructive processes such as dispersion, degranulation, destruction and condensation of the granule in TMC were found in an early stage of the liver damage. A marked increase in number and morphological changes of TMC as the remarkable proliferation of the connective tissue in periportal and intralobular regions were noted in such chronic stage. 2. A marked decrease in number and remarkable morphological changes of TMC were observed in the cases on an adrenocorticosteroid hormon therapy. 3. TMC were chiefly found in the periportal region of rat's liver, and a increase in number and morphological changes were found when the connective tissue increased in the periportal field after long-term administration of hepato-toxic drugs. 4. The asministration of the adrenal cortical hormones induced a marked decrease in number and destractive and condensed chages of TMC granules at this stage. 5. Administrations of the remedies for liver damage such as glucronic acid, thioctic acid, multi-vitamines and communin induced a slight increase in mumber and slight changes in the morphological findings comparing with control groups. The only remarkable change were the condensation of TMC granules. 6. Only a few TMC were found in rabbit's liver, and there were minimal or no changes in TMC, even in the stage of marked damage of the liver tissue. 7. These results lead to the following conculsions: There is a close relation between the proliferation of the connective tissue in dog's and rat's liver and the changes of TMC

Surveillance of Extended-Spectrum β-Lactamase-producing Carriage in a Japanese Intensive Care Unit: a Retrospective Analysis

Background The effectiveness of surveillance to identify extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriers is controversial during a non-outbreak situation. We performed additional stool cultures for ESBL-E among intensive care unit (ICU) patients already under active surveillance by means of sputum and urine cultures. We aimed to assess the efficacy of stool cultures for screening for ESBL-E in a non-outbreak situation. Methods We conducted a retrospective cohort study in an ICU. Sputum and urine samples were cultured for ESBL-E surveillance purposes from January to September 2013 (phase 1). Stool cultures were routinely performed in addition from January to September 2014 (phase 2). Antimicrobial use density values and clinical outcomes were investigated and compared between phase 1 and 2. Results We identified 512 and 478 patients in phase 1 and phase 2, respectively. ESBL-E were found in the feces of 65 (13.6%) patients in phase 2. The antimicrobial use density values (expressed as defined daily doses per 1,000 bed-days) were not significantly different between the two phases for fluoroquinolones (7 vs. 10, p = 0.376), third-generation cephalosporins (24.2 vs. 29.5, p = 0.724), tazobactam/ piperacillin (44.6 vs. 57.3, p = 0.489), and carbapenems (73 vs. 55.5, p = 0.222). Moreover, there were no significant differences in ICU mortality and length of stay (11.5% vs. 9.8%, p = 0.412, and 9 vs. 10 days, p = 0.28, respectively). Conclusions Stool culture seemed ineffective in improving the antimicrobial use density of broad-spectrum antimicrobials, clinical outcomes, and ICU length of stay, and is not recommended for surveillance of ESBL-E in a non-outbreak situation