Two cases of bronchiolitis obliterans organizing pneumonia syndrome after postoperative irradiation for breast cancer

We report two cases of bronchiolitis obliterans organizing pneumonia (BOOP) syndrome that developed after postoperative radiation therapy for breast cancer. In both patients, chest radiographs and computed tomography (CT) showed multiple consolidations outside the irradiation fields after several months of tangential radiation therapy. These patients were diagnosed as having radiation-associated BOOP syndrome, based on their clinical course and the findings on examination. After treatment with a systemic corticosteroid, radiographic consolidations and symptoms improved rapidly. In cases where consolidations appear outside the irradiated field, it is important to consider BOOP syndrome as a pulmonary complication of radiation therapy for breast cancer

Influence of corticosteroid therapy on the serum antibody response to influenza vaccine in elderly patients with chronic pulmonary diseases

Annual influenza vaccination is strongly recommended for patients with chronic pulmonary diseases, such as bronchial asthma, chronic obstructive pulmonary disease (COPD), and interstitial pulmonary diseases. However, many of these patients regularly receive systemic and/or inhaled corticosteroid therapy, and the impact of corticosteroid therapy on influenza vaccine efficacy and safety is unclear. Patients with chronic pulmonary diseases were enrolled in the study and divided into three groups based on their maintenance therapy: (A) without corticosteroid therapy (17 males, three females; mean age, 72.3 ± 7.9), (B) oral corticosteroid therapy (four males, seven females; mean age, 66.1 ± 10.6), and (C) inhaled corticosteroid therapy (eight males, nine females; mean age, 62.4 ± 16.0). All patients received influenza vaccine, and serum hemagglutination inhibition (HI) antibodies against influenza strains A/H1N1, A/H3N2, and B were measured at baseline (before vaccination) and 4-6 weeks after vaccination. Sufficient antibody titers or significant increases were observed after vaccination compared with titers before vaccination in all three groups. No systemic reactions were reported. Long-term oral/inhaled corticosteroid therapy was not associated with vaccination side effects and did not affect the immune response to the influenza vaccine

Developmental expression of GLUT3 glucose transporter in the rat brain

AbstractThe ontogeny of the GLUT3 glucose transporter gene and protein expression was studied in rat brain. Northern blot analysis using total RNA from rat brains at different developmental stages revealed that the levels of GLUT3 mRNA were very low during the embryonic stage and increased towards the postnatal stage. Immunohistochemistry using a specific antibody showed that the expression of GLUT3 protein was barely detectable in the embryonic stage, but was clearly detected on the plasma membrane of neuronal cells from 10 days after birth to the adult. Expression of GLUT3 mRNA and protein in the cerebral neuronal cell cultures was also examined during the maturation of neurons. GLUT3 glucose transporter of primary neuronal cultured cerebral cortical neurons was only detected in mature neurons after they were cultured for 14 days. These results indicate that GLUT3 plays an important role in glucose homeostasis postnatally in neurons of the rat brain

Transcriptional factors associated with epithelial-mesenchymal transition in choroidal neovascularization

Purpose: To investigate the transcriptional factors associated with epithelial-mesenchymal transition (EMT) in choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Paraffin sections of CNV obtained from patients with AMD (n=12) were stained for transcriptional factors related to EMT, i.e., Snail, Slug, SIP1, and Twist. As a control, postmortem sections of ocular normal tissue were used. Furthermore, using a human retinal pigment epithelial (RPE) cell line (ARPE-19), reverse transcription–polymerase chain reaction (RT–PCR) and immunofluorescence microscopy were performed to explore the cellular localization and expression levels of EMT-associated transcriptional factors upon cytokine stimulation. Results: Of 12 specimens, 11 CNV tissues (91.6%) showed staining for Snail localized in cellular nuclei, particularly in those of RPE cells. Snail was strongly co-localized with α-smooth muscle antigen (SMA) in RPE cells. In contrast, postmortem human retina showed no Snail staining in RPE cells. Other transcriptional factors, Slug, Twist and SIP1 were not detected in CNV or normal human retina. In ARPE-19 cells, RT–PCR and immunofluorescence microscopy showed that Snail mRNA was upregulated by transforming growth factor (TGF)-β and VEGF stimulation. Furthermore, TGF-β induced relocalization of Snail to the nucleus in RPE cells. Conclusions: The current data indicate that Snail is a major transcriptional factor for EMT changes of RPE cells in human CNV

Literature review of international intervention studies in patients with cognitive dysfunction associated with cancer treatment

【目的】国外におけるがん治療に関連した認知機能障害がある患者に対する介入研究について文献をレビューし，介入およびその成果から看護師の役割について示唆を得ることである．【方法】文献検索は，MEDLINE，CINAHLのデータベースを用いて行い，期間は2014年～2021年12月までとした．検索用語は「Cognitive dysfunction」，「cancer related cognitive impairment」，「cancer」，「nursing」のキーワードを用いて，英語に限定して行った．選定基準と除外基準を満たした８件を抽出し，分析した．【結果】国外文献におけるがん治療に関連した認知機能障害がある患者に対する介入方法は，認知行動療法が４件，補完代替療法が４件であった．介入の対象者はすべてがStageI～III期までの乳がん患者であり，年齢は18～75歳で代替補助療法が終了している，もしくはホルモン療法を継続している状況であった．認知行動療法は，コンピューターを用いた脳トレーニングと集団教育を組み合わせたものや代償的認知トレーニングの介入であった．補完代替療法は，マインドフルネスストレス低減法や気功，ピアノの個別レッスンなどの介入方法であった．すべての介入において認知機能や認知機能に関連する疲労やQOLの改善が示されていた．【考察】がん治療に関連した認知機能障害がある患者に対する介入は，長期間を要するため早期に発見する必要がある．また，治療前オリエンテーション時から認知機能障害に対する知識や対処について準備教育を行うことや，補完代替療法の技能を有する職種への連携や調整は看護師が担う役割であると考える．さらに，患者が介入方法を生活の中に取り入れ，習慣化できるよう地域連携を含めた継続支援も看護師の重要な役割である．Purpose The purpose of this study was to review the international literature on intervention studies for patients with cognitive impairment related to cancer treatment and to draw implications for the role of nurses from the interventions and their outcomes. Methods A literature search was conducted using the MEDLINE and CINAHL databases from January 2014 to December 2021. Search terms were limited to the English language using the keywords "cognitive dysfunction", "cancer-related cognitive impairment", "cancer", and "nursing". Eight articles that met the selection criteria were analyzed. Results Interventions for patients with cancer treatment-related cognitive dysfunction in the international literature included four cognitive-behavioral therapies and four complementary and alternative therapies. All interventions were offered to patients with Stage I-III breast cancer, aged 20-75 years, and who had completed alternative adjuvant therapy or were continuing hormonal therapy. Cognitive-behavioral therapy consisted of a combination of computer-based brain training, group education, and compensatory cognitive training interventions. Complementary and alternative medicine included interventions such as mindfulness-based stress reduction, qigong, and individual piano lessons. All interventions showed improvements in cognitive function, fatigue related to cognitive function, and quality of life. Discussion Interventions for patients with cognitive dysfunction related to cancer treatment require a long period of time and need to be identified early. The role of nurses is to educate patients about cognitive dysfunction from the time of pre-treatment orientation, and to coordinate and collaborate with professionals who have skills in complementary and alternative therapies. Furthermore, nurses also play an important role in providing ongoing support, including community collaboration, so that intervention methods can be incorporated into patients' lives and become a habit

Enhanced interleukin-10 signaling with 14-member macrolides in lipopolysaccharide-stimulated macrophages

Immunomodulatory effects of 14-member macrolides, namely erythromycin (EM) and clarithromycin (CAM), have been reported in chronic respiratory infectious diseases. It has been suggested that 14-member macrolides have immunomodulatory effects on various lung cells such as alveolar macrophages. Interleukin (IL)-10 is an immunomodulatory cytokine that performs an irreplaceable role in negatively regulating inflammation, primarily via a mechanism that selectively blocks the expression of pro-inflammatory genes. It activates sig-nal transducer and activator of transcription (STAT)-3, and subsequently induces the suppres-sor of cytokine signaling-3 (SOCS-3), resulting in the resolution of inflammatory response in macrophages. However, it has been still unclear whether 14-member macrolides exert immu-nomodulatory effects via IL-10 signaling pathway. We aimed to evaluate whether 14-member macrolides affect the IL-10 signaling pathway. The RAW264.7 macrophage cell line was pre-treated with EM or CAM, and stimulated with lipopolysaccharide (LPS). The levels of IL-10, IL-10 receptor, phosphorylated (p) STAT-3, and SOCS-3 were determined by RT-PCR, ELISA and immunoblotting. We observed increased levels of IL-10, p-STAT-3 and SOCS-3 in the treated cells. In addition, while the levels of tumor necrosis factor-α 6 h after LPS stimulation was equal between vehicle-treated and CAM-treated macrophage cells, those of CAM-treated cells were repressed 36 h following LPS stimulation, compared with those of the control cells. Therefore, the 14-member macrolides may initiate an early resolution of inflammation, in part, via the enhancement of the IL-10/STAT-3/SOCS-3 pathway

Effect of antibiotic therapy on the inflammatory responses during streptococcal pneumonia in emphysematous mice

Background and objective: Bacterial infection is one of the most important causes of acute exacerbation of respiratory failure in patients with chronic obstructive pulmonary disease (COPD). There were few studies evaluating the effects of early intervention by antibiotic on respiratory bacterial infection in COPD subjects. We investigated the effect of early intervention by respiratory quinolone antibiotic on the systemic inflammatory responses induced by streptococcal pneumonia using a mouse model of experimental emphysema. Methods: Experimental pulmonary emphysema was developed by a single intratracheal instillation of porcine pancreatic elastase in ICR mice. Three weeks later, lethal doses of Streptococcus pneumoniae were intratracheally inoculated, followed by oral administration of 50 mg/kg body weight of Grepafloxacin (GPFX) every day from a day after tracheal inoculation. Results: While all emphysematous mice without GPFX treatment died within 8 days, all emphysematous mice with GPFX treatment survived. Seventy two hrs after infection, serum levels of tumor necrosis factor alpha, chemokine (C-X-C motif) ligand 1, and CXCL2 (Macrophage inflammatory protein-2) in emphysematous mice with antibiotic therapy were significantly lower than those without therapy. Conclusions: Thus, the early intervention using a respiratory quinolone antibiotic prevents emphysematous mice with pneumonia from severe systemic inflammation, and rescues these mice from death. These results suggest that early intervention using a respiratory quinolone may improve the outcome of the exacerbated COPD patients

Roles of FoxP3-positive Regulatory T Cells in Lymphoid Follicle Formation Associated with Lung Squamous Cell Carcinoma

Background：We previously reported that lymphoid follicle formation by tumor infiltrating lymphocytes（TILs）is a negative predictor of prognosis in patients with lung squamous cell carcinoma（SCC）following surgery. However, the roles of FoxP3⁺/CD4⁺/CD25⁺-regulatory T cells（Tregs）in formation of lymphoid follicles as well as survival remain unclear.Methods：Specimens obtained from patients during resection of lung SCC were examined for lymphoid follicle formation and subjected to immunohistochemistry analysis for the presence of TILs.Results：The appearance of Tregs was correlated with lymphoid follicle formation（p＝0.001）. Univariate analysis also showed that Tregs tended to be correlated with overall survival（p＝0.097）, whereas multivariate analysis revealed that lymphoid follicle formation（p＝0.042）and pleural invasion（p＝0.031）were independent prognostic factors related to overall survival, while the appearance of Tregs was not.Conclusion：Treg appearance was correlated with lymphoid follicle formation. That lymphoid follicle formation, rather than appearance of Tregs, is a predictor of patients survival following surgery for lung SCC