Hyperparathyroidism among atomic bomb survivors in Hiroshima.

To determine the effect of exposure to atomic bomb radiation on the occurrence of hyperparathyroidism, the prevalence was determined among a population of 3,948 atomic bomb survivors and their controls in Hiroshima. The diagnosis of hyperparathyroidism was based upon histopathological findings or the presence of consistent hypercalcemia and elevated levels of serum parathyroid hormone. Primary hyperparathyroidism was diagnosed in 19 persons (3 males, 16 females). Females had approximately a threefold higher overall prevalence of hyperparathyroidism than males (P less than 0.05). The prevalence rates of hyperparathyroidism increased with radiation dose (chi2(1) = 12, P less than 0.001) after adjusting for sex and age at the time of the bombing. The estimated relative risk was 4.1 at 1 Gy (95% confidence limits 1.7 to 14). There was some evidence that the effect of radiation was greater for individuals who were younger at the time of the bombing. In conclusion, exposure to atomic bomb radiation affected the occurrence of hyperparathyroidism, suggesting that doses of radiation lower than those used in radiotherapy may also induce this disorder.     

Papillary carcinoma of the thyroid arising from dyshormonogenetic goiter

A case of thyroid papillary carcinoma associated with dyshormonogenetic goiter is reported. The patient, a 35-year-old male, has been on thyroid hormone therapy since the age of three because of familial dyshormonogenetic goiter. He developed a distinct tumor in the right lobe, which was suggestive of carcinoma upon physical as well as ultrasonographic examination. Total thyroidectomy was performed, since a frozen section disclosed a focus of papillary carcinoma and the possibility of future development of further malignancy in any remaining thyroid tissue was considered. The patient is currently well with complete thyroid hormone supplementation one and a half years after the operation.     

3D Evaluation of the Lamina Cribrosa with Swept-Source Optical Coherence Tomography in Normal Tension Glaucoma

Purpose

Although the lamina cribrosa (LC) is the primary site of axonal damage in glaucoma, adequate methods to image and measure it are currently lacking. Here, we describe a noninvasive, in vivo method of evaluating the LC, based on swept-source optical coherence tomography (SS-OCT), and determine this method’s ability to quantify LC thickness.

Methods

This study comprised 54 eyes, including normal (n = 18), preperimetric glaucoma (PPG; n = 18), and normal tension glaucoma (NTG; n = 18) eyes. We used SS-OCT to obtain 3 x 3 mm cube scans of an area centered on the optic disc, and then synchronized reconstructed B- and en-face images from this data. We identified the LC in these B-scan images by marking the visible borders of the LC pores. We marked points on the anterior and posterior borders of the LC in 12 B-scan images in order to create a skeleton model of the LC. Finally, we used B-spline interpolation to form a 3D model of the LC, including only reliably measured scan areas. We calculated the average LC thickness (avgLCT) in this model and used Spearman''s rank correlation coefficient to compare it with circumpapillary retinal nerve fiber layer thickness (cpRNFLT).

Results

We found that the correlation coefficient of avgLCT and cpRNFLT was 0.64 (p < 0.01). The coefficient of variation for avgLCT was 5.1%. AvgLCT differed significantly in the groups (normal: 282.6 ± 20.6 μm, PPG: 261.4 ± 15.8 μm, NTG: 232.6 ± 33.3 μm). The normal, PPG and NTG groups did not significantly differ in age, sex, refractive error or intraocular pressure (IOP), although the normal and NTG groups differed significantly in cpRNFLT and Humphrey field analyzer measurements of mean deviation.

Conclusion

Thus, our results indicate that the parameters of our newly developed method of measuring LC thickness with SS-OCT may provide useful and important data for glaucoma diagnosis and research.     

Role of gastric mast cells in the regulation of central TRH analog-induced hyperemia in rats

RX 77368 (RX) increases gastric mucosal blood flow by a vagal cholinergic mechanism. The relative roles of mucosal and connective tissue mast cells (MMC and CTMC) were investigated in RX-injected rats. Blood flow and mast cell degranulation were measured after intracisternal RX. RX significantly increased gastric mucosal blood flow, and sequentially degranulated CTMC and MMC. Ketotifen or doxantrazole inhibited the hyperemic response. Ondansetron, RS-039604-90, or famotidine, but not ketanserin or pyrilamine, reduced hyperemia. Mast cells mediate RX-induced gastric hyperemia via 5-HT3, 5-HT4, and H2 receptors; initial increase depends upon CTMC whereas MMC contributes to the later response.     

The role of ICOS in the CXCR5+ follicular B helper T cell maintenance in vivo

ICOS is a new member of the CD28 family of costimulatory molecules that is expressed on activated T cells. Its ligand B7RP-1 is constitutively expressed on B cells. Although the blockade of ICOS/B7RP-1 interaction inhibits T cell-dependent Ab production and germinal center formation, the mechanism remains unclear. We examined the contribution of ICOS/B7RP-1 to the generation of CXCR5+ follicular B helper T (T(FH)) cells in vivo, which preferentially migrate to the B cell zone where they provide cognate help to B cells. In the spleen, anti-B7RP-1 mAb-treated or ICOS-deficient mice showed substantially impaired development of CXCR5+ T(FH) cells and peanut agglutinin+ germinal center B cells in response to primary or secondary immunization with SRBC. Expression of CXCR5 on CD4+ T cells was associated with ICOS expression. Adoptive transfer experiments showed that the development of CXCR5+ T(FH) cells was enhanced by interaction with B cells, which was abrogated by anti-B7RP-1 mAb treatment. The development of CXCR5+ T(FH) cells in the lymph nodes was also inhibited by the anti-B7RP-1 mAb treatment. These results indicated that the ICOS/B7RP-1 interaction plays an essential role in the development of CXCR5+ T(FH) cells in vivo.     

A Combined test using both cell sediment and supernatant cell‐free DNA in pleural effusion shows increased sensitivity in detecting activating EGFR mutation in lung cancer patients

Introduction

The aim of this study was to examine whether a combined test using both cell sediment and supernatant cytology cell‐free DNA (ccfDNA) is more useful in detecting EGFR mutation than using cell sediment DNA or supernatant ccfDNA alone in pleural effusion of lung cancer patients.

Methods

A total of 74 lung adenocarcinoma patients with paired samples between primary tumour and corresponding metastatic tumour with both cell sediment and supernatant ccfDNA of pleural effusion cytology were enrolled in this study. Cell sediment and supernatant ccfDNA were analysed separately for EGFR mutations by polymerase chain reaction.

Results

Out of 45 patients with mutant EGFR in primary tumours, EGFR mutations were detected in 23 cell sediments of corresponding metastases (sensitivity; 51.1%) and 20 supernatant ccfDNA corresponding metastases (sensitivity; 44.4%). By contrast, the combined test detected EGFR mutations in 27 corresponding metastases (sensitivity; 60.0%), and had a higher sensitivity than the cell sediment or the supernatant ccfDNA alone (P < .05). Out of 45 patients with mutant EGFR, 24, three and 18 were cytologically diagnosed as positive, atypical or negative, respectively. The detection rate in the combined test was highest (95.8%) in the positive group, and mutant EGFR was also detected in four of 18 samples (22.2%) in the negative group.

Conclusions

A combined test using both cell sediment DNA and supernatant ccfDNA samples increases the concordance rate of EGFR mutations between primary tumour and corresponding metastases. Our findings indicate that supernatant ccfDNA is useful even in cases where the cytological diagnosis is negative.