Low-Specificity and High-Sensitivity Immunostaining for Demonstrating Pathogens in Formalin-Fixed, Paraffin-Embedded Sections

The present review describes a part of the author’s own experience in applying immunoperoxidase staining to routine histopathological diagnosis. The target disorder was focused on infection. In the practice of pathology diagnosis services, it is important for us diagnostic pathologists to judge whether the lesion is caused by an infection or not. When an infectious disease is highly likely, the visualization of pathogens within the inflammatory lesion is required to suggest a causative agent. Two main approaches the author would like to introduce include (1) the use of commercially available antisera showing wide cross-reactivity to a variety of bacteria and (2) the use of diluted patients’ sera. These immunohistochemical studies employing “low-specificity” and “high-sensitivity” probes are useful for confirming the localization of pathogen within the infectious lesion

Pathology of Gangrene

Pathological features of gangrene are described. Gangrene is commonly caused by infection of anaerobic bacteria. Dry gangrene belongs to noninfectious gangrene. The hypoxic/ischemic condition accelerates the growth of anaerobic bacteria and extensive necrosis of the involved tissue. Clostridial and non-clostridial gangrene provokes gas formation in the necrotic tissue. Acute gangrenous inflammation happens in a variety of tissues and organs, including the vermiform appendix, gallbladder, bile duct, lung, and eyeball. Emphysematous (gas-forming) infection such as emphysematous pyelonephritis may be provoked by Escherichia coli and Klebsiella pneumoniae. Rapidly progressive gangrene of the extremities (so-called “flesh-eating bacteria” infection) is seen in fulminant streptococcal, Vibrio vulnificus, and Aeromonas hydrophila infections. Fournier gangrene is an aggressive and life-threatening gangrenous disease seen in the scrotum and rectum. Necrotizing fasciitis is a subacute form of gangrene of the extremities. Of note is the fact that clostridial and streptococcal infections in the internal organs may result in a lethal hypercytokinemic state without association of gangrene of the arms and legs. Uncontrolled diabetes mellitus may play an important role for vulnerability of the infectious diseases. Pseudomonas-induced malignant otitis externa and craniofacial mucormycosis are special forms of the lethal gangrenous disorder

The characteristics of myelomatous pleural effusion（MPE） as a rare complication：a case and review of the literature.

We reported a patient with multiple myeloma who developed myelomatous pleural effusion （MPE）. This patient had nine courses of chemotherapy, and pleural effusion developed after the fourth course. Although administration of several chemotherapeutic agents and intrapleural administration of OK432 were performed, the patient died 4 months after the development of MPE. We analyzed the previous reports to clarify the characteristics of patients who developed MPE

High-mass star formation in Orion triggered by cloud-cloud collision II, Two merging molecular clouds in NGC2024

We analyzed the NANTEN2 13CO (J=2-1 and 1-0) datasets in NGC 2024. We found that the cloud consists of two velocity components, whereas the cloud shows mostly single-peaked CO profiles. The two components are physically connected to the HII region as evidenced by their close correlation with the dark lanes and the emission nebulosity. The two components show complementary distribution with a displacement of 0.4 pc. Such complementary distribution is typical to colliding clouds discovered in regions of high-mass star formation. We hypothesize that cloud-cloud collision between the two components triggered the formation of the late O stars and early B stars localized within 0.3 pc of the cloud peak. The collision timescale is estimated to be ~ 10^5 yrs from a ratio of the displacement and the relative velocity 3-4 km s-1 corrected for probable projection. The high column density of the colliding cloud 1023 cm-2 is similar to those in the other massive star clusters in RCW 38, Westerlund 2, NGC 3603, and M42, which are likely formed under trigger by cloud-cloud collision. The present results provide an additional piece of evidence favorable to high-mass star formation by a major cloud-cloud collision in Orion.Comment: 24 pages, 10 figures, submitted for publication in PASJ (cloud-cloud collision special issue

HCV Virus and Lymphoid Neoplasms

Hepatitis C virus (HCV) is one of the viruses known to cause hepatic cancer. HCV is also believed to be involved in malignant lymphoma. In this paper, we investigated characteristics of malignant lymphoma cases that were anti-HCV antibody (HCV-Ab) positive. We were able to perform pathological examinations on 13 out of 14 HCV-positive cases. Of these, lymphoid tissues of 10 stained positive for HCV-Ab. There was no significant correlation between the degree of HCV staining and the rate of recurrence or resistance to treatment. However, there did appear to be a consistent decrease in the amount of HCV-RNA between pre- and posttreatment among HCV-Ab-positive cases; that is, treatment-resistant cases that exhibited resistance from the first treatment and recurrent cases more frequently had a higher HCV level at treatment termination compared to the pretreatment level. This suggests that the HCV virus either accelerates oncogenesis by direct interaction with B cells or indirectly affects lymphoma prognosis

The synergistic effects of omega-3 fatty acids against 5-fluorouracil-induced mucosal impairment in mice

Background: Anti-cancer pharmaceuticals frequently have adverse side effects on patients such as gastrointestinal involvement limiting their clinical applications. These effects may be controlled by nutritional interventions, however, there are few studies that have shown any mechanistic effects. In this study, we examined effects of diet enhanced with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on 5-fluorouracil (5-FU)-induced intestinal impairment and immunity in mice. Methods: C57Bl6 mice were randomized to control diet, control diet + EPA, control + DHA, control + fish oil, or diet enchanced with DHA/EPA. After seven days of each respective diet, mice, excluding those in the sham group, were treated with 10 mg/kg/day 5-FU for 7 days. The effects of 5-FU-induced impairment in the small intestine were assessed using cytokine concentrations in serum and tissue, secretory immunoglobulin (Ig) A, diamine oxidase (DAO) activity, the length of the small intestine, and the expression of apoptosis signaling genes. Results: The EPA/DHA-enhanced diet resulted in the most beneficial, synergystic and protective effect against 5-FU induced weight loss. Protection against inflammation, impaired intestinal function, and immunity of the small intestine were also observed. Individually, a DHA-enriched diet demonstrated a protective effect against 5-FU damage with longer small intestine mucosal and crypt lengths, greater DAO activity, and higher IgA concentrations, whereas the EPA-enriched diet resulted in decreased inflammatory cytokine concentrations in both plasma and small intestine and expression of apoptosis target genes. Conclusions: In conclusion, a diet enhanced with EPA and DHA results in synergism protecting against the detrimental effects of 5-FU and limiting chemotherapy induced mucosal impairment

Diaper-zero program in nursing home

With an aging population, the number of older adults admitted to nursing homes has increased. Diapers are often used to manage nursing home resident urinary incontinence, yet only one-third of these required assistance from caregivers to urinate. Unnecessary diaper use was reported in 23.9% of people, mostly for precautionary purposes. In this study, the Diaper-zero program caregivers asked residents regularly (every 2-3 h) whether they required voiding and prompted them to void. Over 11 months, the effects on 38 nursing home residents’ diaper use, nursing care level, physical activity, daily energy, and water intake were measured. A higher rate of diaper wearing was initially observed with lower daily energy and water intakes at the beginning of the Diaper-zero program, but this association was not observed after 11 months of the program. The diaper usage rate decreased significantly from 71.1% to 47.4% after 11 months. During this period, for all subjects, nursing care level, physical activity, and total daily intakes of energy and water were unchanged. In conclusion, this program enhances the desire to void, minimizing diaper usage, thus protecting the human dignity of nursing home residents