-
[show abstract]
[hide abstract]
ABSTRACT: We used a rat model of acute lung injury to evaluate the role of apoptosis of type II pneumocytes in alveolar remodeling during the resolution phase.
Controlled animal study.
University research laboratory.
Sprague-Dawley rats.
Sprague-Dawley rats had Escherichia coli lipopolysaccharide instilled transtracheally to induce acute lung injury. Animals were killed on various days after lipopolysaccharide instillation. Lung specimens from all animals were examined for the presence of apoptosis in type II pneumocytes by an in situ apoptosis assay and for proliferative nuclear antigen, cytokeratin-18, Fas, and Fas ligand with an immunohistochemical stain. Fas and Fas ligand expression in both lung tissue and bronchoalveolar lavage fluid was examined by Western blot analysis.
Histologic examination revealed that the lungs of rats with acute lung injury showed infiltration of numerous inflammatory cells in the intra-alveolar and/or interstitial space and hyperplasia of type II pneumocytes. Type II pneumocyte proliferation, detected by proliferative nuclear antigen staining, developed maximally around day 3 after acute lung injury. In the in situ apoptosis assay, positive signals in type II pneumocytes were obvious and were distributed diffusely in the lung parenchyma from day 1 after acute lung injury, became maximal around day 7, then declined until day 21. DNA fragmentation analysis revealed that a DNA ladder pattern was detectable from day 3, persisted until day 10, and disappeared after day 14. The major cell types expressing Fas ligand are macrophages and neutrophils. Western blot analysis showed that Fas ligand, both membrane-bound form and soluble form, was present from day 1 to day 21 after acute lung injury, with highest level occurring during the first week of acute lung injury. Fas expression in type II pneumocytes reached its maximum on days 3-5 and then gradually declined until day 21. Fas and Fas ligand expression appeared to proceed type II pneumocyte apoptosis. After the acute stage, Fas and Fas ligand expression declined, and type II pneumocyte apoptosis also decreased. These findings correlate with histologic resolution of type II pneumocyte hyperplasia.
Our results confirm that type II pneumocyte proliferation in response to acute lung injury is mainly a reparative phenomenon. During the resolution phase of acute lung injury, extensive apoptosis of type II pneumocytes is the main cellular mechanism that accounts for the disappearance of these cells, and Fas/Fas ligand is involved in the resolution of type II pneumocytes. Our model may provide a useful tool to assess the mechanisms of tissue remodeling after acute lung injury.
Critical Care Medicine 08/2002; 30(7):1528-34. · 6.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The global gene expression profiles of the decidua and chorionic villi of early human pregnancies were analysed by using cDNA microarray technology. Decidual and villous placental tissues were obtained from first trimester abortus and mRNA was extracted for cDNA microarray analysis. The human cDNA microarray [9600 clones, including known regulatory genes and expressed sequence tags (EST)] with colorimetric detection was used to identify differentially expressed genes between early gestational decidua and villi. According to cDNA microarray analysis, we have identified 641 genes with highly expressed mRNA in both decidua and villi, 49 genes with higher expressions in decidua, and 75 genes with higher expression in chorionic villi. These differentially expressed genes were further grouped into categories by their putative functions, including: cell growth-related factors, hormones/cytokines, cell adhesion molecules, signal transduction molecules, apoptosis-related factors, cytoskeleton/extracellular matrix proteins, and EST. Immunohistochemical stainings of cathepsin L, leukaemia inhibitory factor-receptor, and proliferative cell nuclear antigen showed results consistent with the microarray data. Identification of the differentially expressed genes between decidua and villi by microarray provide a global profiling of the gene expression pattern. This work adds to our understanding of placentation by reporting the gene expression profiles during first trimester human pregnancies using cDNA microarray.
Molecular Human Reproduction 06/2002; 8(5):475-84. · 3.85 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The use of lung grafts from non-heart-beat donors (NHBDs) is one way of solving the critical donor organ shortage. Inhaled nitric oxide (NO) and gabexate mesilate (FOY), a protease inhibitor, can attenuate some types of neutrophil-mediated tissue injury. Using an isolated lung ventilation and perfusion model, we studied the effects of these agents on reperfusion injury following lung transplantation from NHBDs.
Five groups of minipigs were studied. In group 1(n = 6), the lungs were flushed and harvested after cardiac arrest, and were reperfused for 2 hours after 2 hours of cold ischemia. In group 2 (n = 6), the lungs were harvested after 2 hours of in situ warm ischemia, followed by 2 hours of cold ischemia and 2 hours of reperfusion. In groups 3 (n = 7), 4 (n = 7), and 5 (n = 6), the procedure was the same as in group 2, except in group 3, NO was inhaled before and after ischemia, in group 4, FOY was given intravenously, and in group 5, a combination of inhaled NO and intravenous FOY were administered.
Compared with group 1, group 2 had higher mean pulmonary arterial pressure, vascular resistance, and lower arterial blood oxygen tension. Furthermore, these negative effects of warm ischemia were also reflected in the contents of bronchoalveolar lavage fluid, tissue myeloperoxidase (MPO) activity, histology, and permeability change. Either FOY or NO administration (groups 3 or 4) ameliorated the associated injury. A combination of FOY and NO use (group5) decreased the parameters of lung reperfusion injury measurement to a larger degree than either agent individually.
The inhaled NO and FOY can protect NHBD lung grafts at an early reperfusion period. Their use in combination has an additive protective effect that might be applied to the protection of NHBD grafts from preservation and reperfusion injury.
The Journal of Heart and Lung Transplantation 03/2002; 21(2):251-9. · 4.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It has been frequently reported that culture-expanded mesenchymal stem cells from bone marrow of healthy donors can be induced to differentiate to osteocytic lineage. This study examined the potential for osteogenic differentiation of mesenchymal stem cells obtained from two patients with myeloproliferative disorders.
Mesenchymal stem cells were derived from bone marrow aspirates obtained in an outpatient clinic from two patients, one with polycythemia vera and the other with essential thrombocythemia. Nucleated bone marrow cells were directly cultured in flasks. Adherent fibroblastic cells in monolayers were isolated by removing nonadherent cells during medium changes. Osteogenic differentiation was induced in expanded adherent cells for 2 weeks in osteogenic medium containing 100 nmol/L dexamethasone, 10 mmol/L beta-glycerophosphate, and 0.05 mmol/L L-ascorbic acid-2-phosphate. Osteogenic differentiation was evaluated by alkaline phosphatase staining and determination of calcium in deposited minerals on culture plates. The expression of osteopontin mRNA was determined by reverse transcription-polymerase chain reaction.
After induction in osteogenic medium, the expression of alkaline phosphatase in mesenchymal stem cells became more intense. Induced alkaline phosphatase-positive cells assumed an irregular shape with multiple spiculate projections, while uninduced alkaline phosphatase-positive cells had a flattened polygonal shape or were elongated. Calcium deposition on the plates of induced cells was 0.39 +/- 0.03 mumol/well in cells from the patient with polycythemia vera and 0.54 +/- 0.03 mumol/well in cells from the patient with essential thrombocythemia, but was not detectable in uninduced cells from either patient. Induction by osteogenic medium markedly increased the expression of osteopontin mRNA in stem cells derived from both patients.
In this study, mesenchymal stem cells obtained from aspiration of bone marrow in patients with myeloproliferative disorders were expanded by culture. After osteogenic induction, these cells were shown to be able to differentiate into osteocytic lineage in vitro.
Journal of the Formosan Medical Association 03/2002; 101(2):124-8. · 1.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate interactions between expressions of tumor suppressor gene p53 and angiogenic factors vascular endothelial cell growth factor (VEGF) and interleukin-8 (IL-8) and their effect on tumor angiogenesis and patient prognosis in non--small-cell lung cancer (NSCLC).
p53, VEGF, IL-8, and the microvessel endothelium were immunostained, and VEGF and IL-8 mRNA expression were quantified using the real-time quantitative reverse-transcription polymerase chain reaction in 65 NSCLC surgical specimens. Aberrant p53 expression was correlated with VEGF and IL-8 mRNA expression, microvessel count (MVC), other clinical-pathologic variables, and patients' survival.
Tumors with high aberrant p53 expression showed significantly higher VEGF and IL-8 mRNA expression and MVC than those with low aberrant p53 expression (P <.001). When tested as a continuous variable, aberrant p53 expression correlated strongly and positively with VEGF and IL-8 mRNA expression and MVC (P <.0001). Tumors with high aberrant p53 expression were associated with mediastinal or distant lymph node metastasis (P =.006). Survival and postoperative relapse time were significantly shorter in patients with high aberrant p53 expression tumors than in those with low aberrant expression tumors (P <.0001). A significant difference in survival was also seen between patients with high and low tumoral VEGF mRNA expression and between those with high and low tumoral IL-8 mRNA expression (P <.0001).
We report here for the first time that aberrant p53 expression is strongly positively correlated with VEGF mRNA and IL-8 mRNA expression in NSCLC. This result indicates that aberrant p53 expression may play a significant role in regulation of VEGF and IL-8 expression and be involved in controlling angiogenesis and explains the adverse prognosis of cancers with high aberrant p53 expression.
Journal of Clinical Oncology 03/2002; 20(4):900-10. · 18.37 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Poland's syndrome is an uncommon congenital anomaly of the chest wall characterized by the absence of the pectoralis major muscle and other nearby musculoskeletal components. Many associated aberrations over the thoracic cage, intrathoracic organs, and upper limbs have been reported. However, spontaneous pneumothorax in these patients has not been reported. Here, we describe two patients with both Poland's anomaly and spontaneous pneumothorax. One patient was a 16-year-old boy with left chest wall hypoplasia and pneumothorax on the right side. The other was a 27-year-old man with right chest wall hypoplasia, hand brachydactyly, and pneumothorax. Pneumothorax in both patients was treated with bullectomy and mechanical pleurodesis with the aid of videothoracoscopy, and the postoperative courses were smooth. Blood supply disruption has been hypothesized as a pathogenic mechanism of both spontaneous pneumothorax and Poland's syndrome, suggesting an association between these two diseases.
Journal of the Formosan Medical Association 03/2002; 101(2):148-51. · 1.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report the successful application of high-frequency oscillatory ventilation in a patient with tension pneumatocele (TP). The proposed check-valve mechanism for the development of pneumatoceles predicts that positive-pressure ventilation could lead to distension of these airspaces and formation of TPs. Therefore, high-frequency ventilation could be more applicable in conditions, such as massive air leak due to bronchopleural fistula, that are difficult to manage by conventional ventilator modes.
Chest 02/2002; 121(1):284-6. · 5.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Two diabetic patients with primary liver abscess, who initially responded unsatisfactorily to intravenous ceftriaxone or cefoxitin treatment and had abscess drainage, were found to be infected with a single clone of Klebsiella pneumoniae with two different colonial morphotypes and resistotypes. Primary liver abscess caused by second-generation cephalosporin-resistant K. pneumoniae strains may be an emerging problem in Taiwan.
Emerging infectious diseases 02/2002; 8(1):100-2. · 6.17 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A total of 394 nonduplicate isolates of Streptococcus pyogenes collected from 1979 to 1998 and 267 nonduplicate isolates of Streptococcus pneumoniae collected from October, 1998, to May, 1999, in Taiwan were evaluated. Among the 220 erythromycin-resistant (MIC, > or =1 microg/ml) S. pyogenes isolates, 35% had an M phenotype and 65% had an ML phenotype (inducible resistance [iML], 0.5%, and constitutive resistance [cML], 64.5%). Among the 243 erythromycin-resistant S. pneumoniae isolates, the majority (65.4%) had an ML phenotype (iML, 0.4%, and cML, 65%) and 34.6% had an M phenotype. A substantial upsurge in the incidence of M-phenotype erythromycin-resistant isolates was found with time for S. pyogenes (0% in 1979-1984 and 100% in 1997-1998), and an increasing incidence of M-phenotype among erythromycin-resistant S. pneumoniae was also noted (<20% before 1994 and 45.4% in 1999). All S. pyogenes and all but four S. pneumoniae isolates exhibiting a cML or iML phenotype had harbored the ermAM gene. The presence of the mefA gene was demonstrated in all isolates of S. pyogenes and the mefE gene in all but four S. pneumoniae isolates exhibiting the M phenotype. Due to the increasing susceptibility of S. pyogenes and S. pneumoniae isolates to clindamycin, susceptibility tests of these two organisms to macrolides and clindamycin should be performed simultaneously in the clinical microbiology laboratory, particularly in areas with high rates of macrolide resistance.
Microbial Drug Resistance 02/2002; 8(1):27-33. · 2.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The incidence of nosocomial Candida fungemia increased 36-fold from 1981 (0.8/10,000 discharges) to 2000 (28.8/10,000 discharges) at the National Taiwan University Hospital, a 2000-bed teaching hospital in northern Taiwan. To understand the current status of resistance to available antifungal agents among Candida species causing invasive infections, the in vitro susceptibilities of 222 isolates (collected from July, 1999-June, 2001) were determined. Among all of the Candida species tested, 6% and 7% were resistant to fluconazole and itraconazole, respectively. The MIC90 values of voriconazole and amphotericin B were 0.5 and 1 microg/ml, respectively, although some isolates of C. krusei (amphotericin B and voriconazole MIC, >64 microg/ml) and C. tropicalis and C. glabrata (voriconazole MICs, >64 microg/ml) were less susceptible to voriconazole or amphotericin B. About one-half of the C. glabrata isolates belonged to susceptible dose-dependent (SDD, 36%) or resistant (12%) categories for fluconazole and 96% belonged to SDD (56%) or resistant (40%) category for itraconazole. When compared with fluconazole susceptibility data of blood Candida isolates recovered from patients treated at the same hospital (NTUH) from two different time periods (January, 1994, to June, 1995, and January, 1997, to June, 1999 described in previous reports), the incidence of increased susceptibility of non-krusei Candida isolates to fluconazole was evident. This trend of increasing susceptibility for fluconazole did not correlate to the increasing use of this agent in the hospital. None of the random amplified polymorphic DNA patterns generated by arbitrarily primed PCR using four random oligonucleotide primers for 14 isolates, which exhibited fluconazole MICs of > or = 16 microg/ml, were identical, indicating an absence of clonal dissemination among these isolates in the hospital.
Microbial Drug Resistance 01/2002; 8(4):311-9. · 2.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cyclooxygenase 2 (COX-2) has been reported to be commonly expressed in advanced stages of human lung adenocarcinoma. In this
study, the COX-2 constitutive expression vector was transfected into a human lung adenocarcinoma cell line CL1.0 and several
clones were obtained which stably expressed COX-2. These COX-2-overexpressed clones demonstrated remarkable resistance to
apoptosis induced by Ultraviolet B (UVB) irradiation, vinblastine B (VBL) cell lymphoma-2 (Bcl-2), or other anti-cancer drugs.
To understand how COX-2 prevents apoptosis, the investigators examined the expression level of Bcl-2 family members. Mcl-1,
but not other Bcl-2 members, was significantly up-regulated by COX-2 transfection or prostaglandin E2 (PGE2) treatment. Treatment of COX-2-overexpressed cells (cox-2/cl.4) with two specific COX-2 inhibitors, NS-398 and celecoxib,
caused an effective reduction of the increased level of Mcl-1. These data suggest that the expression level of Mcl-1 is tightly
regulated by COX-2. Moreover, transfection of cox-2/cl.4 cells with antisense Mcl-1 enhanced apoptosis induced by UVB irradiation,
revealing that Mcl-1 plays a crucial role in cell survival activity mediated by COX-2. Furthermore, COX-2 transfection or
PGE2 treatment evidently activated the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. Inhibition of the PI3K pathway by LY294002
or wortmannin effectively attenuated the increased level of Mcl-1 induced by COX-2 or PGE2. Blocking the PI3K activity with a dominant-negative vector, DN-p85, also greatly diminished the level of Mcl-1 and enhanced
UVB-elicited cell death in cells transfected by COX-2. In a similar way, LY294002 inhibited cell survival and Mcl-1 level
in PGE2-treated CL1.0 cells. These findings suggest that COX-2 promotes cell survival by up-regulating the level of Mcl-1 by activating
the PI3K/Akt-dependent pathway.
Journal of Biological Chemistry 12/2001; 276(52):48997-49002. · 4.77 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The expression pattern of mucin genes was studied in 7 lung adenocarcinoma cell lines (CL1, CL2, CL3, NCL2, PC9, PC13, PC14) and 12 lung adenocarcinoma tissues. CL1 and PC 13 are poorly differentiated cell lines with low mucin glycoprotein production. The other 5 cell lines are well differentiated and produce a higher amount of mucins. Total RNA was extracted from these cell lines. Northern blot analysis was performed by hybridization with specific antisense oligonucleotide probes recognizing mucin-specific tandem repeats of 4 mucin genes (MUC1, MUC2, MUC3, MUC4). RT-PCR was carried out to amplify the 3′ and 5′ nonrepetitive coding regions of MUC1 and the 5’ nonrepetitive coding region of MUC2. All these cell lines expressed MUC1, MUC2, MUC3, and MUC4 mRNA but in variable mounts. The poorly differentiated cell lines (CL1 and PC 13) had a relatively low level of expression of MUC1, MUC2, MUC3 and MUC4. RT-PCR, with primers amplifying the MUC1 nonrepetitive coding region 5′ end, 293 bp, and the 3′ end, 522 bp, as well as the MUC2 nonrepetitive 5′ coding region, 308 bp, revealed the presence of MUC1 and MUC2 mRNA in all the cell lines. Sequence analysis of the PCR products were very homologous, similar to previously published MUC1 and MUC2 cDNA sequences. The expression pattern of mucin genes is consistent with that of mucin glycoproteins as studied using biochemical and immunological methods. Northern blotting and RT-PCR analysis in 12 lung adenocarcinoma tissues with various grades of differentiation (6 poorly differentiated adenocarcinomas and 6 moderately to well-differentiated adenocarcinomas) showed heterogeneous expression of the 4 mucin genes in tissues without clear correlation with the differentiation grade. Therefore the clinical implications of the differential expression of the mucin genes need further investigation.
Oncology 08/1970; 53(2):118-126. · 2.27 Impact Factor
-
William Travis,
Elisabeth Brambilla,
Masayuki Noguchi,
Andrew Nicholson,
Kim Geisinger,
Yasushi Yatabe,
David Beer,
Charles Powell,
Gregory Riely,
Paul Van Schil, [......],
Keiko Kuriyama,
Jin Soo Lee,
Vincent Miller,
Iver Petersen,
Victor Roggli,
Rafael Rosell,
Nagahiro Saijo,
Erik Thunnissen,
Ming Tsao,
David Yankelewitz
[show abstract]
[hide abstract]
ABSTRACT: : This new classification strategy is based on a multidisciplinary approach to diagnosis of lung adenocarcinoma that incorporates clinical, molecular, radiologic, and surgical issues, but it is primarily based on histology. This classification is intended to support clinical practice, and research investigation and clinical trials. As EGFR mutation is a validated predictive marker for response and progression-free survival with EGFR tyrosine kinase inhibitors in advanced lung adenocarcinoma, we recommend that patients with advanced adenocarcinomas be tested for EGFR mutation. This has implications for strategic management of tissue, particularly for small biopsies and cytology samples, to maximize high-quality tissue available for molecular studies. Potential impact for tumor, node, and metastasis staging include adjustment of the size T factor according to only the invasive component (1) pathologically in invasive tumors with lepidic areas or (2) radiologically by measuring the solid component of part-solid nodules.
J Thorac Oncol.
-
Daniel Wai-Sing Chu,
Shinn-Jang Hwang,
Fong Seng Lim,
Helen May Lin Oh,
Prasert Thongcharoen, Pan-Chyr Yang,
Hans L. Bock,
Mamadou Dramé,
Paul Gillard,
Yanee Hutagalung,
Haiwen Tang,
Yee Leong Teoh,
Ripley W. Ballou
[show abstract]
[hide abstract]
ABSTRACT: The immunogenicity and lot-to-lot consistency of an AS03-adjuvanted H5N1 vaccine were evaluated in 1206 Asian adults, randomised to receive two doses of adjuvanted (3.75 μg haemagglutinin) or diluent-mixed vaccines, 21 days apart. Post-Dose 2, 96.0% of vaccinees in the H5N1-AS03 group demonstrated a four-fold increase in neutralising antibody titres against the vaccine strain A/Vietnam/1194/2004 and 91.4% against strain A/Indonesia/05/2005. Haemagglutination-inhibiting antibodies (titre ≥1:40) against A/Vietnam/1194/2004 and A/Indonesia/05/2005 strains were observed in 94.3% and 50.2% of subjects, respectively. Lot-to-lot consistency of the AS03-adjuvanted vaccine combinations was demonstrated. The AS03-adjuvanted vaccine was well tolerated, induced a high frequency of immune responses to the vaccine strain, allowed antigen sparing and promoted cross-clade immunity. These characteristics make it suitable for presumptive use if an H5N1 pandemic were considered to be imminent.
Vaccine.
-
[show abstract]
[hide abstract]
ABSTRACT: We describe herein a recurrent catheter-related (Port-A-Cath; Smiths Industries Medical Systems [SIMS] Deltec, Inc., St. Paul, Minn.) infection caused by multidrug-resistant Mycobacterium chelonae with two colonial morphotypes in a 53-year-old woman with gastric adenocarcinoma. Four isolates recovered from this patient within a 3-month period were found to belong to a single clone on the basis of the isolates’ identical antibiotypes as determined by the E test and their identical random amplified polymorphic DNA patterns.
-
[show abstract]
[hide abstract]
ABSTRACT: From December 1997 to March 1998, 25 methicillin-resistant Staphylococcus aureus (MRSA) isolates exhibiting negative Staphylase (Oxoid Ltd., Basingstoke, England) reactions were identified from various clinical specimens from 13 patients in six intensive care units (ICUs) or in wards following a stay in an ICU at the National Taiwan University Hospital. The characteristics of these isolates have not been previously noted in other MRSA isolates from this hospital. Colonies of all these isolates were grown on Trypticase soy agar supplemented with 5% sheep blood and were nonhemolytic and unpigmented. Seven isolates, initially reported as Staphylococcus haemolyticus (5 isolates) and Staphylococcus epidermidis (2 isolates) by the routine identification scheme and with the Vitek GPI system (bioMerieux Vitek, Inc., Hazelwood, Mo.), were subsequently identified as S. aureus by positive tube coagulase tests, standard biochemical reactions, and characteristic cellular fatty acid chromatograms. The antibiotypes obtained by the E test, coagulase types, restriction fragment length polymorphism profiles of the staphylococcal coagulase gene, and random amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates disclosed that two major clones disseminated in the ICUs. Clone 1 (16 isolates) was resistant to clindamycin and was susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ) and was coagulase type II. Clone 2 (eight isolates) was resistant to clindamycin and TMP-SMZ and was coagulase type IV. These two epidemic clones from ICUs are unique and underline the need for caution in identifying MRSA strains with colonial morphologies not of the typical type and with negative Staphylase reactions.
-
[show abstract]
[hide abstract]
ABSTRACT: Helicobacter fennelliae (formerly Campylobacter fennelliae) has been reported to cause bacteremia in homosexual men with or without human immunodeficiency virus (HIV) infection. We report here a 48-year-old, non-HIV-infected, heterosexual man with diabetes mellitus and cirrhosis of the liver who developed bacteremia and septic shock due to H. fennelliae. The patient was treated successfully initially with intravenous ampicillin-sulbactam and ceftazidime, followed by ampicillin-sulbactam only. These agents were active in vitro against the isolate by E-test results. To our knowledge, this is the first documented case of septic shock due to H. fennelliae in a non-HIV-infected, heterosexual, immunocompromised patient.
-
[show abstract]
[hide abstract]
ABSTRACT: Enterococcus cecorum (formerly Streptococcus cecorum), originally isolated from poultry intestines, has rarely been encountered in human diseases. A 60-year-old man with liver cirrhosis and hepatocellular carcinoma developed peritonitis on the seventh day of his hospitalization. Cultures of one blood sample and one ascites fluid sample obtained on that day both grew E. cecorum. The patient received intravenous cefoxitin therapy and initially responded well. Unfortunately, another episode of peritonitis associated with septic shock developed 24 days after the start of treatment, and culture of one blood specimen yielded the same organism. The isolates were identified by the conventional biochemical tests, the API Rapid ID 32 Strep system, and the API ZYM system (both systems from bioMerieux, Marcy L'Etoile, France) and were further confirmed by cellular fatty acid chromatography and 16S rRNA gene partial sequencing. The identical biotype, antibiotype, and random amplified polymorphic DNA pattern of the three isolates documented the long-term persistence of this organism in the patient. To the best of our knowledge, this is the first clinical description of recurrent bacteremic peritonitis caused by E. cecorum.
-
[show abstract]
[hide abstract]
ABSTRACT: Long-term colonization of various body sites with a multidrug-resistant Pseudomonas aeruginosa clone (resistant to piperacillin, cefoperazone, ceftazidime, aztreonam, imipenem, cefepime, cefpirome, ofloxacin, ciprofloxacin, minocycline, and aminoglycosides) with subsequent severe infections in burn patients has not been reported previously. Thirty-nine isolates of multidrug-resistant P. aeruginosa (resistant to ceftazidime and at least three of the agents listed above) recovered from various clinical samples from three patients in an intensive care burn unit from April 1997 to May 1997 and seven preserved isolates recovered from six patients in other medical wards at National Taiwan University Hospital from April 1996 to May 1997 were studied for their epidemiological relatedness. The epidemic could be attributed to a multidrug-resistant P. aeruginosa clone belonging to serogroup O:F (serogroup O:4) by means of antimicrobial susceptibility testing, O serogrouping, and analysis of the randomly amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates. The epidemic strain persisted in the three patients for weeks to months; in the meantime, these patients had received multiple antimicrobial agents for the management of intervening episodes of invasive infections (bacteremia, ventilator-associated pneumonia, and/or catheter-related sepsis) caused by this strain, as well as concomitant infections due to other organisms. The strain had been isolated only once previously, from a burn patient who was on the unit in December 1996. The present report, describing a small outbreak due to P. aeruginosa, documents the fact that a single clone of multidrug-resistant P. aeruginosa can cause long-term persistence in different body sites of burn patients and that the colonization can subsequently result in various severe infections.
-
[show abstract]
[hide abstract]
ABSTRACT: Background: Connective tissue growth factor (CTGF) inhibits the metastatic activity of human lung cancer cells in a mouse model; however, the mechanism of this modulation is unclear. We investigated the role of angiogenesis in this process. Methods: CL1-5 and A549 human lung adenocarcinoma cells were stably transfected with vectors containing CTGF or hypoxia-inducible factor (HIF) 1α or with vector controls. Transfected cells were injected into nude mice (n = 10 per group), and tumor growth, metastasis, and mouse survival were measured. Excised xenograft tumors and primary human lung adenocarcinomas (n = 24) were subjected to immunohistochemistry with antibodies to the endothelial cell marker CD31 and to CTGF. Expression of HIF-1α and vascular endothelial growth factor (VEGF) A was assessed in vitro by using reporter gene assays. Cells were transiently transfected with HIF-1α mutant and antisense arrest-defective 1 protein (ARD-1), and HIF-1α acetylation was assayed by immunoprecipitation. All statistical tests were two-sided. Results: Xenograft tumors derived from CTGF transfectants grew more slowly than those from control-transfected cells and had reduced expression of HIF-1α and VEGF-A, vascularization (as assessed by CD31 expression), and metastasis (all P <.001). Xenograft tumors derived from CTGF-overexpressing cells that were transfected with HIF-1α had higher VEGF-A expression than CTGF-overexpressing xenografts. Mice with CTGF/HIF-1α xenografts had lower survival than mice carrying CTGF-overexpressing xenografts (CL1-5/Neo, mean = 69.6 days, 95% confidence interval [CI] = 53.9 to 85.3 days versus CL1-5/CTGF, mean = 102.1 days, 95% CI = 92.1 to 112.1 days; P = .001, CL1-5/CTGF, mean = 102.1 days, 95% CI = 92.1 to 112.1 days versus CL1-5/CTGF/HIF-1α, mean = 81.7 days, 95% CI = 66.5 to 96.9 days; P = .011, CL1-5/Neo, mean = 69.6 days, 95% CI = 53.9 to 85.3 days versus CL1-5/CTGF/HIF-1α, mean = 81.7 days, 95% CI = 66.5 to 96.9 days; P = .122). Tumors of patients with the same disease stage but with high CTGF protein expression had reduced microvessel density compared with tumors with low expression. Transfection with antisense-ARD1 decreased the level of acetylated HIF-1α and restored HIF-1α and VEGF-A expression in CTGF-overexpressing cells. Conclusion: CTGF inhibition of metastasis involves the inhibition of VEGF-A–dependent angiogenesis, possibly by promoting HIF-1α protein degradation.
