ABSTRACT
A 74-year-old man was admitted with respiratory failure and treated for tracheobronchial stenosis due to metastasis of renal cell carcinoma. It improved after implantation of an expandable metallic stent (EMS). One year later, the metastatic tumor at the near distal side of the EMS increased; eventually serious respiratory failure occurred again. However, the delivery catheter of EMS could not be inserted by the usual procedure because there was a strong tracheobronchial curve. Finally it passed along the inside of the endotracheal intubation tube. The respiratory failure was improved by the second implantation of EMS with the method of stent in stent. EMS is often effective in a case with a strong curve and twist of the trachea/bronchi. It was also considered one way of letting the delivery catheter pass inside the endotracheal intubation tube if the patient's respiratory condition was maintained.
Subject(s)
Intubation, Intratracheal/methods , Metals , Palliative Care , Respiratory Insufficiency/surgery , Stents , Tracheal Stenosis/surgery , Aged , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/secondary , Humans , Kidney Neoplasms/pathology , Lung Neoplasms/complications , Lung Neoplasms/secondary , Male , Reoperation , Respiratory Insufficiency/etiology , Tracheal Stenosis/etiology , Treatment OutcomeABSTRACT
The popularity of imaging mass spectrometry (IMS) of tissue samples, which enables the direct scanning of tissue sections within a short time-period, has been considerably increasing in cancer proteomics. Most pathological specimens stored in medical institutes are formalin-fixed; thus, they had been regarded to be unsuitable for proteomic analyses, including IMS, until recently. Here, we report an easy-to-use screening method that enables the analysis of multiple samples in one experiment without extractions and purifications of proteins. We scanned, with an IMS technique, a tissue microarray (TMA) of formalin-fixed paraffin-embedded (FFPE) specimens. We detected a large amount of signals from trypsin-treated FFPE-TMA samples of gastric carcinoma tissues of different histological types. Of the signals detected, 54 were classified as signals specific to cancer with statistically significant differences between adenocarcinomas and normal tissues. We detected a total of 14 of the 54 signals as histological type-specific with the support of statistical analyses. Tandem MS revealed that a signal specific to poorly differentiated cancer tissue corresponded to histone H4. Finally, we verified the IMS-based finding by immunohistochemical analysis of more than 300 specimens spotted on TMAs; the immunoreactivity of histone H4 was remarkably strong in poorly differentiated cancer tissues. Thus, the application of IMS to FFPE-TMA can enable high-throughput analysis in cancer proteomics to aid in the understanding of molecular mechanisms underlying carcinogenesis, invasiveness, metastasis, and prognosis. Further, results obtained from the IMS of FFPE-TMA can be readily confirmed by commonly used immunohistochemical analyses.
Subject(s)
Mass Spectrometry/methods , Neoplasm Proteins/analysis , Stomach Neoplasms/chemistry , Tissue Array Analysis/methods , Formaldehyde , Histones/analysis , Humans , Immunohistochemistry , Paraffin Embedding , Proteomics , Tissue FixationABSTRACT
Subpopulations of regular and atypical lymphocytes in the peripheral blood of a 24-year-old man with an infectious mononucleosis (IM)-like syndrome associated with hepatitis A virus (HAV) infection were analyzed. The ratio of CD4+ to CD8+ cells was in the normal range (1.19 and 1.23 in the regular and atypical lymphocytes, respectively), with no increase in CD8+ cells. The percentage of CD8+/CD11b- cells was not increased in the atypical lymphocytes. However, CD45RO+ was expressed on 86.3% of CD4+ atypical lymphocytes. The present data suggest that atypical lymphocytes expressing CD4+/CD45RO+ may play the role of helper T cells in the immune system in the development of IM-like syndrome associated with HAV infection.
Subject(s)
CD4 Antigens/immunology , Hepatitis A/complications , Infectious Mononucleosis/immunology , Leukocyte Common Antigens/immunology , T-Lymphocytes/immunology , CD4-CD8 Ratio , Hepatitis A/immunology , Humans , Infectious Mononucleosis/blood , Infectious Mononucleosis/virology , Lymphocyte Count , Male , Young AdultABSTRACT
The number of immunocompromised host has been increasing recently. In this article, the defect of host-defence system, immune system and the way to prevent infections in these host were reviewed.
Subject(s)
Immunocompromised Host , Antibiotic Prophylaxis , Antibody Formation , Cross Infection/prevention & control , Humans , Immunity, Cellular , Immunocompromised Host/immunology , Infection Control/methods , Opportunistic Infections/etiology , Opportunistic Infections/prevention & controlABSTRACT
A 75-year-old male suffered from interstitial pneumonia in December 2000 and treated with predonisolone. The treatment was effective, and the dosage of predonisolone had been gradually tapered. In January 2001, when the dosage was 30 mg/day, he complained of cough and yellowish sputum. The chest X-ray and CT revealed bilateral infiltrations with cavities. He was treated with cefozopram and fluconazole. However, there were no improvements. The sputa of the 2nd, 3rd, 6th and 8th hospital days showed the presence of gram-positive branched rods, which were identified as Nocardia farcinica. Therefore, the treatment was changed to sulfamethoxazole-trimethoprim. During the treatment, serum concentration of sulfamethoxazole was repeatedly measured, and kept over 60 microgram/ml. He was swiftly recovered after the start of sulfamethoxazole-trimethoprim. This case was supposed to be the seventh one of N. farcinica pneumonia in Japan, and the measurement of the concentration of sulfamethoxazole was useful to determine its dosage.
