Cytological findings of pre-invasive bronchial lesions detected by light-induced fluorescence endoscopy in a lung cancer screening system

Lung cancer is a global epidemic and the number one cause of death among all cancers,with a very high morbidity.A new strategy for the treatment of lung cancer is the detection and eradication of pre-invasive bronchial lesions before they become invasive carcinomas.We conducted a detailed investigation into the use of fluorescence broncho-scopy in the detection of pre-invasive bronchial lesions in patients with sputum cytology suspicious or positive for malignancy.We also studied the distinctive cytological findings in the sputum specimens corresponding to the pre-invasive bronchial lesions.Sputum examinations were performed by mass screening a high-risk group of participants.From 1997 to 1999,61 participants with sputum cytology suspicious or positive for malignancy were referred to our institute,and were examined with both white-light and fluorescence bronchoscopy.For the cytological findings,the collection of sputum was performed in the early morning.Conventional white-light examinations were first performed,and areas with abnormal findings were recorded for subsequent biopsy.Fluorescence bronchoscopy examinations were then carried out.Biopsy specimens for a pathological examin-ation were taken from all the suspicious or abnormal areas discovered by the white-light bronchoscopy,or fluorescence bronchoscopy examination, or both.The laser-induced fluor-escence bronchoscopic examination showed a high sensitivity for invasive carcinoma,carcinoma in situ,as well as severe,moderate,and mild dysplasia.In the sputum cytological findings,a thickened cytoplasm and slight hyperchromasia were frequently observed in the mild dysplasias compared with the squamous cells without atypia.Hyperchromasia and an Orange G(OG)-philic cytoplasm of squamous cells were frequently observed in the moderate compared with the mild dysplasias.A thickened cytoplasm,a nuclear pleomorphism,a thickened nuclear rim,a coarse chromatin,an uneven chromatin distribution,and an OG-philic cytoplasm were frequently observed in the carcinomas in situ and severe dysplasias compared with the moderate dysplasias.We found that the use of fluorescence bronchoscopy in addition to convectional white-light examination can enhance the detec-tion and localization of pre-invasive bronchial lesions in patients with sputum cytology suspicious or positive for malignancy.Sputum cytology is therefore a potential approach to diagnosing pre-invasive bronchial lesions

Mini Nutritional Assessment as a useful method to predict the development of pressure ulcer among elderly inpatients

Abstract: OBJECTIVES: Malnutrition is a major risk factor of pressure ulcers (PU). However, the best method of nutritional assessment to prevent PU is still unclear. This study was designed to determine the usefulness of Mini Nutritional Assessment (MNA) and plasma amino acid analysis to predict the formation of PU among inpatients. DESIGN: This was a prospective, observational cohort study with a mean observation period of 62.2±86.4 days. SETTING: Intermediate and acute care wards of a hospital in rural Japan. PARTICIPANTS: The 422 patients analyzed had an average age of 85.0±7.6 years. MEASUREMENTS: MNA, Subjective Global Assessment (SGA), Braden Scale (PU prognostic score), pressure ulcer formation, and biochemical analysis including plasma amino acid concentrations. RESULTS: PU developed in 7.1% of the patients. A MNA score of less than 8 was more sensitive than a rating of moderate or severe malnourishment on the SGA combined with a Braden Scale score of <15 in predicting future PU. Area under the receiver operating characteristic curve (AUC) of MNA was superior to that of the Braden Scale. Braden Scale nutrition subscore had the lowest AUC among the six Braden Scale subscores. The PU group showed significantly lower plasma arginine concentrations than the No PU group. CONCLUSION: MNA was able to predict the development of PU. A MNA of <8 performed better than the SGA, Braden Scale, and plasma arginine levels in predicting PU development. Although lower plasma arginine concentration at time of admission was associated with PU development, the area under the ROC curve was not significant. The findings from this prospective study support the use of nutritional assessment among inpatients in order to predict PU risk and target appropriate interventions

Identification and Characterization of a Novel Lysophosphatidic Acid Receptor, p2y5/LPA6*

p2y5 is an orphan G protein-coupled receptor that is closely related to the fourth lysophosphatidic acid (LPA) receptor, LPA4. Here we report that p2y5 is a novel LPA receptor coupling to the G13-Rho signaling pathway. “LPA receptor-null” RH7777 and B103 cells exogenously expressing p2y5 showed [3H]LPA binding, LPA-induced [35S]guanosine 5′-3-O-(thio)triphosphate binding, Rho-dependent alternation of cellular morphology, and Gs/13 chimeric protein-mediated cAMP accumulation. LPA-induced contraction of human umbilical vein endothelial cells was suppressed by small interfering RNA knockdown of endogenously expressed p2y5. We also found that 2-acyl-LPA had higher activity to p2y5 than 1-acyl-LPA. A recent study has suggested that p2y5 is an LPA receptor essential for human hair growth. We confirmed that p2y5 is a functional LPA receptor and propose to designate this receptor LPA6

Effectiveness of Influenza Vaccine in Children (6 m/o-12 y/o) According to Hospital (A to V).

<p>a Among four hospitals which used IRDTs that can detect A(H1N1)pdm09.</p><p>b Number of patients vaccinated.</p><p>c Number of patients unvaccinated.</p><p>d VE against any influenza and VE against influenza B were higher in the north area than in the middle or south area (Breslow-Day, p < 0.05).</p><p>Effectiveness of Influenza Vaccine in Children (6 m/o-12 y/o) According to Hospital (A to V).</p

Effectiveness of Influenza Vaccine for Children in 2013/14 Influenza Season (N = 4727).

<p>a Adjusted for comorbidity (yes or no, except H1N1 analysis), area (north area, middle area, south of the Kanto region), months of onset.</p><p>b Adjusted for age (0–15 y/o).</p><p>c Adjusted for time tested after the onset (<12, 12–48 and >48 hours).</p><p>d Patients tested only >12 hours after onset.</p><p>Data for 3046 patients were available; 1499 for any influenza (A; 537, H1N1; 43, B; 962) and 1547 for influenza negative.</p><p>e Two hospitals have no information on comorbidity.</p><p>f Only four institutes used IRDTs that can detect A(H1N1)pdm09. One hospital had no information on comorbidity.</p><p>g Not analyzed because few patients developed influenza.</p><p>* (vaccinated/cases) [vaccinated/controls].</p><p>Effectiveness of Influenza Vaccine for Children in 2013/14 Influenza Season (N = 4727).</p

Effectiveness of Influenza Vaccine for Preventing Influenza Hospitalization.

<p>a Among the 4 hospitals which used IRDTs that can detect A(H1N1)pdm09.</p><p>Effectiveness of Influenza Vaccine for Preventing Influenza Hospitalization.</p

Effectiveness of Influenza Vaccine, by Phase.

<p>a Among four hospitals which used IRDTs that can detect A(H1N1)pdm09.</p><p>* (vaccinated/cases) [vaccinated/controls].</p><p>Effectiveness of Influenza Vaccine, by Phase.</p

Effectiveness of Influenza Vaccine for Children, by Vaccine Doses (6m/o-12y/o).

<p>a Among the 4 hospitals which used IRDTs that can detect H1N1pdm09.</p><p>Effectiveness of Influenza Vaccine for Children, by Vaccine Doses (6m/o-12y/o).</p