Distribution of Mast Cells in Mediastinal Lymph Nodes from Lung Cancer Patients

BACKGROUND: Mast cells have been documented to have several key functions with regards to malignant neoplasms. However, the functional significance of their accumulation is largely unknown. An analysis of the mast cell profile in mediastinal lymph nodes from lung cancer patients is reported here. METHODS: One hundred thirty-four, randomly selected lymph nodes (63 with positive pathological lymph node status) from 39 surgically treated lung cancer patients were examined. All cancer negative nodes were obtained from stage I patients. Mast cells were stained with Alcian blue and safranin O. Metastatic cancer cells were stained using anti-cytokeratin antibody. RESULTS: Immunohistochemical studies with cytokeratin revealed micro metastasis in 9/71 (12.68%) nodes previously diagnosed as histological negative. In tumor-free mediastinal lymph nodes, the mast cell count was significantly higher than in metastatic nodes. In all cases, mast cells were observed primarily in the T-cell area. CONCLUSIONS: An inverse relationship was observed between the number of mast cells and the amount of tumor tissue. The presence of mast cells primarily in the T-cell area implies a relationship between mast cells and the T-cell system. From the present study it is not possible to conclude whether mast cells in lymph nodes are for or against tumor spread

Emergent Completion Pneumonectomy for Postoperative Hemorrhage from Rupture of the Infected Pulmonary Artery in Lung Cancer Surgery

Completion pneumonectomy (CP) is one of the most difficult procedures and known to be associated with a high morbidity and mortality. A 74-year-old male underwent a left upper lobectomy for pulmonary adenocarcinoma (T3N0M0); six days later after the surgery, he had a sudden postoperative intrathoracic excessive hemorrhage with shock. Emergent redo thoracotomy was performed to treat the bleeding from the ablated interlobar pulmonary artery by suturing with prolene. However, 3 days later after the second operation, he had the second intrathoracic bleeding. Emergent CP was performed with cardiopulmonary bypass by anterior transpericarsial approach via a median sternotomy. The hemorrhage was caused by a rupture of the proximal fragile and infected pulmonary artery. We performed omentopexy for the infected intrathoracic cavity and for covering of the divided main bronchial stump. We had a rare experience of two times of postoperative life-threatening hemorrhage from rupture of the infected pulmonary artery after left upper lobectomy. Emergent CP as salvage surgery should have an advantage in control of infected proximal pulmonary arterial hemorrhage. We should take care of tearing off of adventitia of pulmonary artery in lobectomy because of a possibility of postoperative hemorrhage under a fragility of the injured pulmonary artery with infection

Silkworm Pupae Function as Efficient Producers of Recombinant Glycoproteins with Stable-Isotope Labeling

Baculovirus-infected silkworms are promising bioreactors for producing recombinant glycoproteins, including antibodies. Previously, we developed a method for isotope labeling of glycoproteins for nuclear magnetic resonance (NMR) studies using silkworm larvae reared on an artificial diet containing 15N-labeled yeast crude protein extract. Here, we further develop this method by introducing a technique for the expression of isotope-labeled glycoproteins by silkworm pupae, which has several potential advantages relative to larvae-based techniques in terms of production yield, ease of handling, and storage. Here, we fed fifth instar larvae an artificial diet with an optimized composition containing [methyl-13C]methionine, leading to pupation. Nine-day-old pupae were then injected with recombinant Bombyx mori nucleopolyhedrovirus (BmNPV) bacmid for expression of recombinant human immunoglobulin G (IgG). From the whole-body homogenates of pupae, 0.35 mg/pupa of IgG was harvested, which is a yield that is five times higher than can be obtained from larvae. Recombinant IgG, thus prepared, exhibited mainly three kinds of pauci-mannose-type oligosaccharides and had a 13C-enrichment ratio of approximately 80%. This enabled selective observation of NMR signals originating from the methionyl methyl group of IgG, confirming its conformational integrity. These data demonstrate the utility of silkworm pupae as factories for producing recombinant glycoproteins with amino-acid-selective isotope labeling

Transcatheter Embolization for Systemic-pulmonary Artery Collaterals after Correction of Extreme Tetralogy of Fallot

The selective obliteration of systemic-pulmonary arterial collaterals by wire coil embolization, usually recognized in cyanotic congenital disease, is described in this report. A 11 year-old boy, who had received Blalock-Taussig shunt for extreme tetralogy of Fallot (TOF) at 1.5 year-old, had total correction and ligation of Blalock-Taussig shunt. After cardiac surgery, two times successful collateral transcatheter embolizations were performed for difficulty of weaning from left heart failure. We stressed that post operative transcatheter embolization was very effective and had many merits in these cases than the ligations of collaterals by means of thoracotomy

Experimental Evaluation of Effects of Intra-Aortic Balloon Pumping (IABP) on Ischemic Heart

The intraaortic balloon pumping (IABP) has been widely empoyed in the management of ventricular power failure. The effects of IABP were studied in a large number of reports. However, the efficacy of IABP has not been certified with reference to the severity of myocardial ischemia. Experimentally augmentation of coronary blood flow were observed on acute ischemic heart by ligation of the anterior descending artery. It has shown from the view of increased coronary blood flow that excess of 50ml/min/kg of coronary blood flow were obtained in functional reserved myocardium with ischemia. However, the efficacy of IABP on acute ischemic heart can not be precipitated by severe damage of the myocardium. The usefulness of IABP was elucidated by functional myocardial level of at least 50mmHg of LVP, 40mmHg of LVEDP and 1000mmHg/sec of max dp/dt respectivelly and it is emphasized that immediate application of IABP for cardiogenic shock allows to improve the further myocardial depression

Some Factors Concerning the Distribution of Bronchial Glands

It is well known that the secretion from bronchial glands play an important role to make the airway clean up against sticky bronchial secret. The aim of the present study was to evaluate the relationship between the functional modality of bronchial glands and occurrence of postoperative pulmonary complication due to difficulty of expectoration. However, the noteworthy development of bronchial glands was proved histologically with a distribution index (DI) in each circumstances of either the elderly more than 40 of age or existing inflammation of bronchial trees. Based on histochemical examination by means of PAS stain, the almost same attitudes in regard to magnitude of secretion were not necessarily documented even among bronchial glands with marked development. It was of note that the intimate correlation between secretory behavior of bronchial glands and development of bronchial glands was not certified in the series of this study and that secretory function of bronchial glands did not compatible with pronounced distribution and marked development of them. As a result of this study, the preventive role of bronchial glands from occurrence of postoperative pulmonary complication has not been substantiated by morphological and biochemical study

Clinical Evaluation of Immune Response in Patients with Lung Cancer

In patients with lung cancer, the immune response was observed with an analysis of various factors which mostly related to its prognosis. Its response was extremly depressed in the course of following surgery in advanced cases of stage III and IVas well as in unresectable cases for lung cancer, compared with those of stage I and II . Furthermore, it showed that the high levels of immune response were seen in those of long term survivors given OK-432 during follow-up period. It was obvious from this study that the use of OK-432 was suitable for activation of the immune reaction against host as one of the immunopotentiators. Meanwhile, from the immunological mechanism of view, the hyperactivity of immune response enable the patient to be free from recurrence of cancer for a long term following surgery, in contrast the low level of the immune response showed to be poor prognosis owing to early appearance of recurrence. Furthermore, the effectiveness in use of OK-432 was clinically presented in patients with malignant pleural effusion, which showed direct cytocidal action of OK-432 given intrapleurally with a 10 or 14 days interval

The Effect of Surgical Repair for Pectum Excavatum on Cardiopulmonary Function

In five patients with corrective surgery for pectus Excavatum, the effectiveness of surgical repair were evaluated from the results of pulmonary function test as well as the finding on ECG according to follow-up study postoperativelly. Of five patient undergone the corrective surgery which sternoturnover with costalplasty employed in 4, and sternoplasty alone in I, all of them were male and the average age except 3 years of age was 14.8 years ranging from 10 to 21 years. There are no manifestation of clinical syndrome in all 5 cases. However, the fair mental growth demands psychologically the early corrective surgery in young chidren. By follow-up study after surgical correction for pectus excavatum during a period from 3 months to 3 years and 3 months, the finding on EKG of right ventricular overload revealed the improvement within 2 months after surgical correction in contrast the results of pulmonary function test disclosed no marked changes until 2 months following surgery. From the view of cosmetic efficacy of corrective surgery, sternoturnover with or without costalplasty are one of the adovocating operative procedures

An Experimental Evaluation of Tracheal Blood Flow with Special Referrence to Operative Procedure of Tracheal Mobilization

Based on the study with special referrence to blood flow in the trachea, the factors influential on the operative procedure of tracheal mobilization were carefully evaluated to ensure optimal surgical results. It has already been assumed with an aid of microangiographic technique that the main trancheal blood flow comprise two routes, namely, adventitial and submucosal layers. The amount of blood flow in the trachea divided into individual two layers were measured by hydrogen clearance test with wire electrodes placed in either adventitial or submucosal layer. When employed the procedure of extensive mobilization of the trachea, the level of tracheal blood flow reduced in adventitial layer rather lthan in submucosal layer. Blood flow in submucosal layer, however, remain closely near the normal level, which is thought to compensate a decreased blood supply in the tracheal adventitia. Meanwhile, when proposed an excessive tension of more than 800g at the site of anastomosis, a decrease in submucosal blood flow has become manifest despite of a slight decrease in adventitial blood flow simultaneously. Greater emphasis has been focused upo

Clinical and immunohistochemical study of eight cases with thymic carcinoma

BACKGROUND: Thymic carcinoma is a rare neoplasm with extremely poor prognosis. To evaluate the biological characteristics of thymic carcinoma, we reviewed 8 patients. METHODS: There were 2 men and 6 women: ages ranged from 19 to 67 years old (mean 54.8 years). None of these patients had concomitant myasthenia gravis and pure red cell aplasia. No patient had stage I disease, 1 stage II, 5 stage III, and 2 stage IV. The pathologic subtypes of thymic carcinoma included 5 squamous cell carcinomas, 1 adenosquamous cell carcinomas, 1 clear cell carcinoma, and 1 small cell carcinoma. Immunohistochemical study was performed using antibodies against p53, bcl-2, Ki-67, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), nm23-H1, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF-2) and factor VIII. RESULTS: Curative resection could be done in 4 patients (50%). Our data indicates a trend toward an association between complete resection and patient survival. Expression of p53, bcl-2, CEA, EMA, nm23-H1, VEGF and FGF-2 was detected in 5/8, 3/8, 4/8, 5/8, 6/8, 5/8 and 3/8, respectively. Mean Ki-67 labeling index and microvessel density was 7.01 and 34.36 (per 200× field), respectively. When compared with our previous studies, immunohistochemical staining of these proteins in thymomas, the expression rates of these proteins in thymic carcinomas were higher than those in thymomas. CONCLUSIONS: In this small series, it is suggested that a complete resection suggests a favorable result. Immunohistochemical results reveal that the expression of these proteins might indicate the aggressiveness of thymic carcinoma