Long-Term Follow-Up of Autoimmune Pancreatitis: Characteristics of Chronic Disease and Recurrence

Autoimmune pancreatitis is a unique disease, characterized by lymphoplasmacytic inflammation in the acute stages. However, the active clinical features are unlikely to persist for long periods. Through long-term follow-up, we investigated the disease course in 51 patients with autoimmune pancreatitis. We found recurrence in 21 (41%) patients and pancreatic stone formation in 9 (18%) patients. Pancreatic stone formation was significantly more frequent in the recurrence group (7/21, 33%), compared with the nonrecurrence group (2/30, 7%). Moreover, we found high serum immunoglobulin G4 concentrations in 13 of 175 (7.4%) patients with ordinary chronic pancreatitis. This suggested that pancreatic stone formation is closely associated with recurrence and that autoimmune pancreatitis might transform into ordinary chronic pancreatitis after several recurrences. We found that the immune complex level, with a cutoff value of 10 mu g/dL, served as a good predictor of recurrence, with high sensitivity (61.9%), specificity (70.0%), and efficacy (66.7%). We also confirmed that HLA and cytotoxic T-lymphocyte antigen-4 polymorphisms were useful predictors for AIP recurrence.ArticleCLINICAL GASTROENTEROLOGY AND HEPATOLOGYjournal articl

Risk factors for pancreatic stone formation in autoimmune pancreatitis over a long-term course

Autoimmune pancreatitis (AIP) has the potential to progress to a chronic state that forms pancreatic stones. The aim of this study was to clarify the risk factors underlying pancreatic stone formation in AIP. Sixty-nine patients with AIP who had been followed for at least 3 years were enrolled for evaluation of clinical and laboratory factors as well as computed tomography and endoscopic retrograde cholangiopancreatography findings. During the course of this study, increased or de novo stone formation was seen in 28 patients, who were defined as the stone-forming group. No stones were observed in 32 patients, who were defined as the non-stone-forming group. Nine patients who had stones at diagnosis but showed no change during the course of this study were excluded from our cohort. Univariate analysis revealed no significant differences in clinical or laboratory factors associated with AIP-specific inflammation between the two groups. However, pancreatic head swelling (P = 0.006) and narrowing of both Wirsung's and Santorini's ducts in the pancreatic head region (P = 0.010) were significantly more frequent in the stone-forming group. Furthermore, multivariate analysis identified Wirsung and Santorini duct narrowing at diagnosis as a significant independent risk factor for pancreatic stone formation (OR 4.4, P = 0.019). A primary risk factor for pancreatic stone formation in AIP was narrowing of both Wirsung's and Santorini's ducts, which most presumably led to pancreatic juice stasis and stone development.ArticleJOURNAL OF GASTROENTEROLOGY. 47(5):553-560 (2012)journal articl

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for the Diagnosis of Intrathoracic Lesions : Experience of a Single Academic Medical Center

Article信州医学雑誌 60(5): 249-255(2012)journal articl

Thallium transport and the evaluation of olfactory nerve connectivity between the nasal cavity and olfactory bulb

金沢大学医学部附属病院耳鼻咽喉科Little is known regarding how alkali metal ions are transported in the olfactory nerve following their intranasal administration. In this study, we show that an alkali metal ion, thallium is transported in the olfactory nerve fibers to the olfactory bulb in mice. The olfactory nerve fibers of mice were transected on both sides of the body under anesthesia. A double tracer solution (thallium-201, 201Tl; manganese-54, 54Mn) was administered into the nasal cavity the following day. Radioactivity in the olfactory bulb and nasal turbinate was analyzed with gamma spectrometry. Auto radiographic images were obtained from coronal slices of frozen heads of mice administered with 201Tl or 54Mn. The transection of the olfactory nerve fibers was confirmed with a neuronal tracer. The transport of intranasal administered 201Tl/54Mn to the olfactory bulb was significantly reduced by the transection of olfactory nerve fibers. The olfactory nerve transection also significantly inhibited the accumulation of fluoro-ruby in the olfactory bulb. Findings indicate that thallium is transported by the olfactory nerve fibers to the olfactory bulb in mice. The assessment of thallium transport following head injury may provide a new diagnostic method for the evaluation of olfactory nerve injury. © The Author 2007. Published by Oxford University Press. All rights reserved

トクシマ ケンナイ ノ カンゴ ショクイン コウド ジンザイ イクセイ ケンシュウ スイシン ジギョウ ニオケル トクテイ コウイ ニ カカル ジッタイ チョウサ

The purpose of this survey was to determine nurse administrators and hospital directors’ perspectives about nurses’ abilities in performing specific medical practices in hospitals in Tokushima Prefecture. The nurse administrators and hospital directors of all hospitals （１１３ hospitals） in Tokushima Prefecture were invited to respond to a survey questionnaire by mail posted during the period between February and March of ２０１５. Responses were received from ４６ nurse administrators （response rate, ４１％） and ３８ hospital directors （response rate, ３４％）. The obtained data were analyzed using descriptive statistics and the narrative descriptions summarized. Majority of responses from nurse administrators and hospital directors were accepting that nurses have responsibilities for administering medicines such as tranquilizers, anti-anxiety and anticonvulsant drugs. This result was not affected by the size of the hospital, in which fifty four percent （５４％） of respondents were from hospitals with less than １００ beds. In Japan, only hospitals with １００ beds or more may have procedures involving highly invasive treatments. Because of this, many of the respondents answered “not applicable” to statements in the questionnaire which were related to invasive treatments. Recruitment of nurses, strategies to cope with accidents and education curriculum were important concerns of nurse administrators and hospital directors which remain to be answered in future investigations

エンドウ PISUM SATIVUM L. ニ オケル HISTIDINE セヨウ ニ ヨル ニッケル ドクセイ ケイゲン コウカ

HistidineがNi超集積植物以外の植物におけるNi耐性に関与しているか否かについて明らかにする目的で,histidineが養液栽培のエンドウ(Pisum sativum L.)のNi耐性に与える影響を検討した。植物体内のhistidine含有率はNi施用により増加した。また,Ni施用によって減少した生育量は外因性のhistidineをNiと同時に施用すると軽減された。予めhistidineを植物体に吸収させた後にNiを施用すると,それらを同時に添加した場合よりも低かったがNi毒性軽減効果は認められた。従って,外因性のhistidineは培養液中および植物体内で,ある程度Niを無毒化していることが考えられた。Effects of histidine on nickel tolerance of pea (Pisum sativa L.) were investigated, to determine whether histidine participates in Ni tolerance in plants other than Ni hyperaccumulation plants. Histidine content in pea increased by the treatment with Ni. In addition, exogenous histidine reduced the inhibitory effects of Ni on the growth of pea. When adding nickel after histidine (and then histidine was removed from culture medium), the effect of histidine was lower than in the case in which it was added simultaneously. Therefore, it is suggested that exogenous histidine detoxifies Ni to some extent in the culture medium and in the plant

A circulating subset of iNKT cells mediates antitumor and antiviral immunity

新規の循環型iNKT細胞を発見 --抗腫瘍・抗ウイルス感染効果の高い免疫細胞療法の開発への貢献に期待--. 京都大学プレスリリース. 2022-10-24.Invariant natural killer T (iNKT) cells are a group of innate-like T lymphocytes that recognize lipid antigens. They are supposed to be tissue resident and important for systemic and local immune regulation. To investigate the heterogeneity of iNKT cells, we recharacterized iNKT cells in the thymus and peripheral tissues. iNKT cells in the thymus were divided into three subpopulations by the expression of the natural killer cell receptor CD244 and the chemokine receptor CXCR6 and designated as C0 (CD244⁻CXCR6⁻), C1 (CD244⁻CXCR6⁺), or C2 (CD244⁺CXCR6⁺) iNKT cells. The development and maturation of C2 iNKT cells from C0 iNKT cells strictly depended on IL-15 produced by thymic epithelial cells. C2 iNKT cells expressed high levels of IFN-γ and granzymes and exhibited more NK cell–like features, whereas C1 iNKT cells showed more T cell–like characteristics. C2 iNKT cells were influenced by the microbiome and aging and suppressed the expression of the autoimmune regulator AIRE in the thymus. In peripheral tissues, C2 iNKT cells were circulating that were distinct from conventional tissue-resident C1 iNKT cells. Functionally, C2 iNKT cells protected mice from the tumor metastasis of melanoma cells by enhancing antitumor immunity and promoted antiviral immune responses against influenza virus infection. Furthermore, we identified human CD244⁺CXCR6⁺ iNKT cells with high cytotoxic properties as a counterpart of mouse C2 iNKT cells. Thus, this study reveals a circulating subset of iNKT cells with NK cell–like properties distinct from conventional tissue-resident iNKT cells