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ABSTRACT: The spleen is an infrequent metastatic organ of solid tumours, the prevalence of which ranges between 2.3% and 7.1% in populations with cancer as determined through autopsy. The most common sources of metastasis are breast, lung, colorectal and ovarian carcinoma and melanoma. Isolated metastasis of the spleen is rarely reported with only 93 cases from all sources having been reported up to 2007. Therefore, isolated splenic metastasis from primary lung cancer is exceedingly rare with only 11 cases reported to date. Herein, we report a rare case of isolated splenic metastasis in a 49-yr-old female 3 months after lobectomy for an undifferentiated large cell carcinoma in the right lung (pT(2a)N₀M₀). The only symptom the patient presented with was continuous high fever, which had never been previously reported. This patient presented diagnostic challenges due to the presentation of high fever, leukoapenia after chemotherapy and the cystic splenic mass, all of which led to the initial consideration of splenic abscess. The patient's high fever resolved rapidly after splenectomy and splenic metastasis was confirmed by pathological findings. We also reviewed all 11 reported previously cases and summarised the characteristics and appropriate management of isolated splenic metastasis from lung cancer.
European Respiratory Review 09/2010; 19(117):253-6.
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ABSTRACT: The chitinase-like protein YKL-40, which binds chitin but lacks chitinase activity, has been found to be either the cause or a biomarker for asthma. The aim of our study was to investigate whether serum YKL-40 levels are increased in Chinese patients with asthma and identify its correlation to acute exacerbation, total serum immunoglobulin (Ig)E, the percentage of peripheral blood eosinophils and lung function. We quantified serum YKL-40 levels, total IgE levels and peripheral blood eosinophil percentages in patients with asthma, as well as in controls from the communities surrounding our hospital. The lung function of asthma subjects was also measured. Our data showed that the serum YKL-40 levels were significantly elevated in patients with asthma compared with controls and, when the asthma subjects were stratified, serum YKL-40 levels in the exacerbation group were higher than those in the stable and control groups. In addition, serum YKL-40 levels correlated positively with total serum IgE levels and the percentage of peripheral blood eosinophils, but correlated inversely with lung functions. Thus, we conclude that YKL-40 is found in increased quantities in the serum of Chinese patients with asthma, and its level correlates with exacerbation attacks, indicating that high levels of serum YKL-40 may be a biological characteristic of the exacerbation of asthma.
European Respiratory Journal 04/2010; 35(4):757-60. · 5.89 Impact Factor
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ABSTRACT: The aim of this multicenter study was to identify the causative pathogens of community-acquired pneumonia (CAP) in Shanghai, China, and to determine their susceptibility to antimicrobial agents. Pathogens obtained from 389 patients with documented CAP during 2001-2003 were identified by multiple diagnostic tools that included bacterial culture, polymerase chain reaction (PCR), and specific immunological assays. Susceptibility of the bacterial isolates was tested by the broth microdilution method. A specific pathogen was identified in 39.8% (155/389) of the patients: Haemophilus influenzae (n=80), Klebsiella spp. (n=15), Streptococcus pneumoniae (n=12), Staphylococcus aureus (n=6), Moraxella catarrhalis (n=1), other gram-negative organisms (n=9), and atypical pathogens that comprised Mycoplasma pneumoniae (n=42), Chlamydia pneumoniae (n=17), and Legionella pneumophila (n=2). Most H. influenzae isolates were susceptible to ampicillin (88.3%), and all were susceptible to macrolides. Of the S. pneumoniae isolates, 75% (9/12) were susceptible to penicillin, while 25% (3/12) were intermediately susceptible. H. influenzae and atypical pathogens are among the most important pathogens of CAP. Ampicillin, cephalosporins, and the newer fluoroquinolones can be used as empirical therapy for CAP in the Shanghai area. The efficacy of monotherapy with newer macrolides for CAP caused by S. pneumoniae requires further evaluation.
European Journal of Clinical Microbiology 06/2006; · 2.86 Impact Factor
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ABSTRACT: To investigate the effect of tumor antigen-pulsed, interleukin-18 (IL-18) gene-modified dendritic cells in treatment of spontaneous metastatic lung cancer.
3LL Lewis lung cancer cells were injected into the footpads of C57BL/6 mice to establish a spontaneous metastatic lung cancer model. Ninety-six mice with lung cancer were divided into 8 groups, 12 in each. treated differently. One group was treated by subcutaneous vaccination for two times of tumor antigen peptide Mut1-pulsed, IL-18 gene-modified dendritic cells (DC-IL-18/Mut1) that were derived from normal bone marrow. The other groups were treated with other measures. After treatment, the lung weight, number of metastatic nodes on the lung surface, survival time, and NK and CTL activities were examined.
Compared with the mice treated with Mut1-pulsed control LacZ gene-modified DC and those treated with untreated DC, the tumor-bearing mice treated with DC-IL-18/Mut1 had the lightest lung weight (215 mg +/- 20 mg Vs 398 mg +/- 23 mg and 987 mg +/- 45 mg, t = 14.7 and 38.4, P < 0.01), the least lung metastatic nodes (0 Vs 7.8 +/- 2.7 and 49, P < 0.01), the longest survival time (chi(2) = 6.78 and 10.49 respectively, P < 0.01), the strongest cytotoxic T cell activity (53.4 +/- 3.1 Vs 41.3 +/- 2.6 and 9.8 +/- 2.1, t = 13.4 and 15, 7 respectively, P < 0.01), and increased proportions of CD4 + Tcells, CD8 + Tcells, and NK cells.
Tumor antigen-pulsed, IL-18 gene-modified dendritic cells have a significant therapeutic effect on spontaneous netastatic lung cancer through induction of anti-tumor immunological responses.
Zhonghua yi xue za zhi 07/2001; 81(13):779-82.
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ABSTRACT: To assess the effect of intratracheally administered IL-12 recombinant adenovirus (Adm IL-12) on ovalbumin (OVA) induced bronchial hyperresponsiveness in mouse model.
C57BL/6 mice were sensitized by ovalbumin. Adm IL-12 with the dose of 10(8)pfu/mouse was administered intratracheally before OVA challenge. IL-4, IL-5 and IFN-gamma in BALF, bronchial responsiveness, eosinophil count in peripheral blood and BALF, serum total IgE and specific IgE were measured.
There was IL-12 gene expression in the lung tissue after Adm IL-12 administration, concentration of IL-12 in sera and BALF were (540 +/- 60) U/ml and (4 700 +/- 800) U/ml respectively, but were unable to be detected in control group (P < 0.01). Compared with the control group, there were significantly lower levels of IL-4 [(3.5 +/- 2.0) ng/ml vs (85.0 +/- 25.0) ng/ml] (t = 27.97, P < 0.01) and IL-5 [(6.5 +/- 4.5) ng/ml vs (54.0 +/- 14.0) ng/ml], (t = 7.92, P < 0.01) in BALF, accompanying with a higher level of IFN-gamma [(690.0 +/- 32.0) ng/ml vs (12.5 +/- 3.2) ng/ml] (t = 51.6, P < 0.01), lower airway resistance [(360 +/- 30) cm H(2)O vs (810 +/- 50) cm H(2)O] (t = 18.9, P < 0.01) and lower eosinophil counts in both peripheral blood [(0.7 +/- 0.1)% vs (9.2 +/- 0.5)%] (t = 47.1, P < 0.01) and in BALF [(3.5 +/- 0.7) x 10(4)/ml vs (21.6 +/- 4.7) x 10(4)/ml)] (t = 9.33, P < 0.01). However, neither serum total IgE [(65 +/- 9) microgram/ml vs (67 +/- 10) microgram/ml], nor specific IgE [(32 +/- 8) microgram/ml vs (33 +/- 8) microgram/ml] showed significant difference (all P > 0.05).
Intratracheally administered Adm IL-12 inhibits ovalbumin induced airway hyperresponsiveness, which may be an effective approach in the management of antigen induced bronchial asthma.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 05/2001; 24(5):298-301.
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ABSTRACT: To investigate extended-spectrum beta-lactamases (ESBLs) production in clinical isolates of the family Enterobacteriaceae in Shanghai, and compare the resistant rates of ESBLs-producing strains and non-ESBLs-producing strains to 11 antibiotics.
Double-disk synergy test was used to detect ESBLs in 1,026 strains of the family Enterobacteriaceae; Kirby-bauer agar diffusion method was used to judge drug sensitivity.
34.31% of strains of the family Enterobacteriaceae were considered ESBLs producers by double-disk synergy test. The prevalences of ESBLs in isolates of Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae were 37.40%, 30.21% and 41.82% respectively. Except Imipinem and Cefmetazole, the resistant rates of ESBLs-producing strains to other 9 antibiotics were much higher than that of non-ESBLs-producing strains(P < 0.01). The resistant rates of Imipinem to ESBLs-producing strains were the lowest.
The prevalence of ESBLs in clinical isolates of the family Enterobacteriaceae in Shanghai was high; it is necessary for clinical laboratory to detect ESBLs in clinical isolates of the family Enterobacteriaceae routinely. The resistant rates of ESBLs-producing strains to most antibiotics were high. Imipinem and Cefmetazole were the effective antibiotics to infections caused by ESBLs-producing strains.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 07/2000; 23(7):420-2.
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ABSTRACT: To investigate the serotypes of both infectious and carriage strains of Haemophilus influenzae (Hi) and to evaluate the prevalence of beta-lactamase of major serotypes in Shanghai.
The 534 specimens of sputum and swabs from patients with acute upper or lower respiratory tract infection and 255 cases of control group were collected and incubated on improved Collumbia chocolate medium. All isolated Haemophilus influenzae strains were serotyped by slide agglutinating assay or reverse indirect blood agglutinating method. beta-lactamase were measured by iodine test and paper disc method.
In the patient group, of the 164 Hi strains there were 69 Hib strains (42%, 69/164) and 91 NTHi(56%, 91/164). In the control group, there were 14 strains of Hib and 49 strains of NTHi among 66 strains of Hi, which were isolated from 255 specimens(26%, 66/255). 24%(38/160) of Hi in the patient group produced beta-lactamase. In this group, the positive rate of beta-lactamase was 29%(20/69) for Hib strains and 20%(18/91) for NTHi strains. Sixteen strains resisting to ampicillin were beta-lactamase negative.
These results indicate that Hib and NTHi are the major serotypes of Hi in both the patient and control group. The prevalence of Hib is higher in patients than in the control. Hib strains are more likely to produce beta-lactamase than NTHi.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 01/2000; 22(12):713-6.
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ABSTRACT: To investigate the effects of potassium channel activator on allergen-induced bronchoconstriction and airway inflammation and to discuss which role it plays in asthma therapy.
Airway insufflation pressure, examination of inflammatory cells in bronchial alveolar lavage fluid, analysis of airway pathology and airway Evans blue dye extravasation measurement were employed to detect airway resistance and airway inflammatory responses.
[(3s, 4R)-3, 4-dihydro-2, 2-dimethyl-4-(2-oxopiperidin-l-yl)-6-pentafluoroethyl-2H-1-benzopyran-3-ol] (BRL) 55 834 (8 micrograms/kg) inhibited not only ovalbumin-induced airway insufflation pressure increase but also inflammatory cell infiltration (ICI) in sensitized guinea-pigs; moreover, it did not decrease blood pressure; in contrast to BRL 55 834, single dose of BRL 38 227 (200 micrograms/kg) and verapamil (0.5 mg/kg) had a little effect on ICI; single dose of aminophylline (25 mg/kg) and dexamethasone (1 mg/kg) could not inhibit ICI, but the former could inhibit airway insufflation increase; drugs, besides aminophylline, could reduce microvascular leakage; single dose of BRL 38 227, verapamil and dexamethasone had no inhibition of airway insufflation pressure; BRL 38 227 and verapamil decreased blood pressure markedly.
Selective potassium channel activator BRL 55 834 not only decreases airway resistance, but also inhibit airway inflammation, and both of them are of benefit to asthma therapy.
Chinese medical journal 12/1999; 112(11):988-91. · 0.86 Impact Factor
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ABSTRACT: To improve the positive rate of Hi isolation and to study the epidemiology, antibiotic sensitivity and clinical characteristics of the lower respiratory tract infection by Hi.
Modified Columbia chocolate agar(ICCA) was compared with blood agar staphy stick (BASS) for the primary isolation of Hi from sputa. The sensitivities of 20 antibiotics to Hi were determined in vitro by KB method and MICs of 12 antibiotics were determined by broth microdilution method. The clinical characteristics of 92 cases with lower respiratory tract infection by Hi were analyzed.
The isolation rate of Hi by ICCA was 20%, which was higher than 13% of BASS(P < 0.01). The third generation cephalosporins and the quinolones were most active against Hi. The resistant rate against Hi of ampicillin was 21%, however, that of the third generation cephalosporins was 45%-49%. 67(73%) of 92 cases were bronchopneumonia.
The isolation rate of Hi could be improved by ICCA. The clinical characteristic of lower respiratory tract infection by Hi was not specific. There has been a steady increase of antibiotic resistance during these years.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 04/1999; 22(4):208-10.
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ABSTRACT: In order to realize the significance on the isolation and drug susceptibility of S. epidermidis from patients with lower respiratory tract infections.
(1) Qualified sputum specimens from inpatients in general wards with lower respiratory tract infections were cultured for bacteria and identification between 1990 and 1996. (2) Drug susceptibility of commonly used antibiotics against isolated S. epidermidis strains was determined by K-B methods or agar dilution method.
(1) Two thousand and six hundred sixty strains of various kinds of bacteria were isolated from 6228 sputum specimens, 257 strains (9.66%) of which were S. epidermidis (ranking the forth). The isolating rate of S. epidermidis was 4.13%. (2) By determining the drug susceptibility of S. epidermidis to 21 commonly used antibiotics, it was found that this bacterium was resistant to all the agents except vancomycin in different levels, and the resistant rate ranged from 15.2% to 98.1%, of which many strains showed multidrug resistance. Vancomycin, imepinem, cefocefin and cefoperazone were relatively sensitive agents tested, the resistant rates being 0, 17.1%, 18.7% and 30.0%, respectively. The resistant rates of all other agents were higher than 48.5%, some of which higher than 80%. The resistant rate of penicillin G was nearly 100%.
Attention should be paid to the high isolating rate of S. epidermidis in the respiratory tract infections and the high drug resistance in some strains, and the role of this bacterium in the lower respiratory tract infections needs to be studied.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 10/1998; 21(9):535-7.
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ABSTRACT: Repeated intranasal administration of interleukin 8 (IL-8) induces bronchial hyperresponsiveness (BHR) accompanied by lower airway neutrophil accumulation (ANA) in guinea-pigs. Leukotriene B4 (LTB4) is a chemotactic factor for neutrophils. To elucidate whether LTB4 and neutrophil elastase are involved in the IL-8-induced BHR and ANA, the effects of a LTB4 antagonist (ONO-4057) and a neutrophil elastase inhibitor (ONO-5046) on the responses were examined. IL-8 (5 microg x kg[-1]) was administered intranasally to guinea-pigs twice weekly for 3 weeks. One day after the last administration, animals were anaesthetized and artificially ventilated through tracheal cannulae, and lateral pressure at the tracheal cannula (Pao) was measured as an overall index of airway responses to inhaled histamine. ONO-4057 (2 or 20 mg x kg[-1]) or ONO-5046 (30 or 300 mg x kg[-1]) was administered intraperitoneally 24 and 1 h before anaesthesia. ONO-4057, but not ONO-5046, significantly inhibited the IL8-induced BHR and ANA, assessed by bronchoalveolar lavage, in a dose-dependent manner. These findings suggest that interleukin 8 causes bronchial hyperresponsiveness and airway neutrophil accumulation in guinea-pigs in vivo. In part this appears to be due to release of leukotriene B4, whereas it may not be mediated by neutrophil elastase.
European Respiratory Journal 02/1998; 11(2):306-11. · 5.89 Impact Factor
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ABSTRACT: Interleukin-8 (IL-8) has been shown to be a chemotactic factor for neutrophils, T-lymphocytes and eosinophils, but it is unknown whether the IL-8-induced inflammatory cell accumulation into the airways can cause the bronchial hyperresponsiveness (BHR) characteristic of asthma. IL-8 at a dose of 0.5 or 5 micrograms/kg was administered intranasally to guinea-pigs twice a week for 3 weeks. One day after the last administration, animals were anesthetized and artificially ventilated through tracheal cannula and lateral pressure at the cannula (Pao) was measured as an overall index of airway responses to increasing concentrations of inhaled histamine (25, 50, 100, and 200 micrograms/ml). The IL-8 treatment significantly enhanced bronchial responsiveness to histamine in a dose-dependent manner (ANOVA P < 0.01). The provocative concentration of histamine causing a 100% increase in Pao (PC100) at a dose of 0.5 and 5 micrograms/kg of IL-8 was 68.1 (GSEM 1.12) and 35.6 (GSEM 1.25) micrograms/ml, respectively. The latter was significantly (P < 0.01) lower than that in control animals treated with PBS (93.3 [GSEM, 1.14] micrograms/ml). The IL-8 treatment also induced a significant influx of neutrophils, but not eosinophils, in bronchoalveolar lavage (BAL) fluid (18.3 +/- 8.8 and 30.6 +/- 8.3% in animals treated with 0.5 and 5 micrograms/kg, respectively, of IL-8 vs 3.6 +/- 0.7% in phosphate buffered saline-(PBS)-treated animals). Furthermore, we examined the effect of the thromboxane receptor antagonist S-1452 (0.01 or 0.1 mg/kg, i.p. 24 and 1 h before anesthesia) on this IL-8 induced BHR. S-1452 significantly inhibited the BHR dose-dependently (ANOVA P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Clinical & Experimental Allergy 02/1995; 25(1):51-9. · 5.03 Impact Factor
