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Aims: Alterations in microenvironments are a hallmark of cancer, and these alterations in germinomas are of particular significance. Germinoma, the most common subtype of central nervous system germ cell tumours, often exhibits massive immune cell infiltration intermingled with tumour cells. The role of these immune cells in germinoma, however, remains unknown. Methods: We investigated the cellular constituents of immune microenvironments and their clinical impacts on prognosis in 100 germinoma cases. Results: Patients with germinomas lower in tumour cell content (i.e. higher immune cell infiltration) had a significantly longer progression‐free survival time than those with higher tumour cell contents (P = 0.03). Transcriptome analyses and RNA in‐situ hybridization indicated that infiltrating immune cells comprised a wide variety of cell types, including lymphocytes and myelocyte‐lineage cells. High expression of CD4 was significantly associated with good prognosis, whereas elevated nitric oxide synthase 2 was associated with poor prognosis. PD1 (PDCD1) was expressed by immune cells present in most germinomas (93.8%), and PD‐L1 (CD274) expression was found in tumour cells in the majority of germinomas examined (73.5%). Conclusions: The collective data strongly suggest that infiltrating immune cells play an important role in predicting treatment response. Further investigation should lead to additional categorization of germinoma to safely reduce treatment intensity depending on tumour/immune cell balance and to develop possible future immunotherapies. [ABSTRACT FROM AUTHOR]

Summary [ABSTRACT FROM AUTHOR]

Exteroceptive suppression (ES) periods in human jaw-closing muscles can be conditioned by a wide range of somatosensory stimuli and cognitive states. The aim of this study was to examine the effects of subanaesthetic doses of midazolam, ketamine and propofol on the short latency (ES1) and long latency (ES2) reflex in the jaw-closing muscles. First, we tried to evaluate the various methodological criteria for ES recording. We then examined the effect of subanaesthetic doses of midazolam (0·035 mg kg), ketamine (0·30 mg kg) and propofol (0·35 mg kg) on these reflexes of recording left masseter and temporalis muscle. ES duration did not differ greatly in the present study, recorded with the correct adjustment of stimulating and recording conditions. None of the subanaesthetic doses of the agents influenced ES1, and no significant effects on ES2 were observed with midazolam and ketamine. However, significant inhibitory change was observed in ES2 with propofol. ES2 is thought to be mediated by afferents, which descend in the spinal trigeminal tract and connect with a polysynaptic chain of excitatory interneurones located in the lateral reticular formation. Our observations indicate that propofol is uniquely effective not only through involvement of the gamma-aminobutyric acid type A receptor, but also through a range of other effects. [ABSTRACT FROM AUTHOR]

We applied a combination technique using the EndoFlex® tube with fiberoptic bronchoscopy for a 69-year-old man presenting with limited mouth opening and neck movement. Awake nasotracheal intubation was performed under conscious sedation with propofol and fentanyl. After positioning the tip of the EndoFlex® tube in the oropharynx, the fiberoptic bronchoscope was inserted into the tube until the tip reached the bevel of the tube. Anterior flexion of the distal tip of the EndoFlex® tube facilitated uncomplicated insertion of the tube into the trachea without impingement on the arytenoids. Fiberoptic visualization confirmed that the distal-tip flexing mechanism of the EndoFlex® tube corrected the direction of the tube tip anteriorly, allowing entry into the trachea. We present a case where this technique proved valuable for tracheal intubation in a patient with limitations of mouth opening and neck movement. [ABSTRACT FROM AUTHOR]

Cecal amounts of mucin and immunoglobulin A (IgA) were examined through the cecal fermentation pattern in Wistar (WS) or Sprague–Dawley (SD) rats fed inulin-type fructans differing in their degree of polymerization (DP). The animals were fed a control diet or a diet containing one of the fructans with an average DP of 4, 8, 16, or 23, at 60 g/kg diet for 10 d. Cecal fermentation products substantially differed between WS and SD rats fed DP8 fructan, with short-chain fatty acids (SCFAs) as the major organic acids in the former but lactate predominating in the latter. Cecal fermentability of fructans in both strains generally decreased with increasing DP of fructans, and this was especially manifest in reduction of the amounts of lactate in DP16 and 23. In WS rats, cecal mucin and IgA were greater in all fructan groups than in the control group. In SD rats, cecal mucin was greater only in the DP8, 16, and 23 groups as compared to the control group, while IgA was greater in the DP4 and 8 groups. In both strains, cecal mucin correlated with the sum of cecal SCFAs, but not with lactate, succinate, or total organic acids. In contrast, only cecal lactate correlated with cecal IgA in both strains. The present study shows that the different fermentation patterns of fructans affect cecal mucin and IgA; mucin is likely to respond to cecal SCFA production, whereas IgA increases when fermentation occurs rapidly and lactate is a major fermentation product. [ABSTRACT FROM AUTHOR]

Aims: To facilitate the understanding and correct diagnosis of the anaplastic variant of pleomorphic xanthoastrocytoma (PXA). Methods and results: Twelve cases of PXA were divided into six conventional and six anaplastic types. Three anaplastic PXAs developed in recurrent tumours and three occurred as the primary tumour. Anaplastic PXAs were microscopically characterized by monotonous proliferation of atypical cells, increased mitotic activity, necrosis and microvascular proliferation. Characteristic features of conventional PXA are also variously included in all anaplastic PXAs. No remarkable differences were detected in the immunohistochemical profiles including the neuronal phenotype between the conventional and anaplastic types. Ki67 labelling indices of the anaplastic type were significantly higher than those of the conventional type, whereas p53 showed no difference. Immunohistochemical and fluorescence in situ hybridization analyses on epidermal growth factor receptor did not demonstrate overexpression or gene amplification. Conclusions: The anaplastic PXA, which occurs de novo or through recurrence, should be distinguished from glioblastoma by identifying the salient microscopic features of conventional PXA even in the anaplastic areas; and by demonstrating the expression of neuronal markers, in that the former is expected to have longer survival. [ABSTRACT FROM AUTHOR]

To examine the specificity of monoclonal antibody A2B5, four A2B5-reactive gangliosides (designated as G-1, G-2, G-3 and G-4) were purified from bonito fish brain. Ganglioside-1, -2, and -3 migrated above GD1b, below GQ1b, and far below GQ1b on thin-layer chromatography. Ganglioside-4 had the slowest chromatographic mobility and migrated below G-3. The structures of these gangliosides were characterized by overlay analysis with glycolipid-specific ligands, product analysis after sialidase or mild acid treatment, and electrospray ionization-mass spectrometry (ESI-MS). Accordingly, G-1, G-2 and G-3 were identified to be GT3, GQ1c and GP1c, respectively. The ganglioside G-4 was shown to have the following structure: NeuAc-NeuAc-NeuAc-Galβ1-3Gal NAcβ1-4(NeuAc-NeuAc-NeuAcα2-3)Galβ1-4Glcβ1-1′Cer. The antibody A2B5 reacted with these c-series gangliosides, but not with GD3 and other gangliosides and neutral glycosphingolipids. The antigenic epitope for A2B5 was assumed to include the trisialosyl residue connected to the inner galactose of the hemato- or ganglio-type oligosaccharide structure of gangliosides. Phylogenetic analysis of brain gangliosides using the A2B5 preparation demonstrated that c-series gangliosides are enriched in lower animals, especially bony fish of different species. The monoclonal antibody A2B5 would be a useful tool for examining the distribution and function of c-series gangliosides. [ABSTRACT FROM AUTHOR]

Abstract: This report describes a successful renal Tx in a patient with chronic renal failure, caused by dysplastic kidneys, who received a cadaveric kidney with post‐infectious glomerulonephritis. Sequential renal biopsies were performed at 12 h before Tx, and at 1 h and on days 8 and 58 post‐Tx. Post‐operative hematuria disappeared on day 9 and proteinuria on day 13. Normal graft function was observed within 1 month, with histologic resolution. Our study suggests that while the donor kidney facilitates deposition of certain immune reactants, this is a host (environmental) problem and when transplanted into a new host (new environment), the problem is no longer sustained. [ABSTRACT FROM AUTHOR]

To determine the importance of silkworm moth allergens, we tested 267 patients with allergic rhinitis with CAP-RAST® a new assay system for detecting specific IgE in sera. We used the following allergen sources: house-dust mite, Candida, Alternaria, cat dander, orchard grass, ragweed, mugwort,. Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid nudge, adult chironomid midge, and silkworm moth. As axpected, the highest positive rate of reaction, as determined by CAP-RAST, was 73.8°c for Japanese cedar, followed by 53.2% for mite and 50.6% for Japanese cypress. Although the positive rate for silkworm. moth was not as high as for cedar pollen, one-third of patients had specific IgE against silkworm moth. The positive rate of reaction to silkworm moth was much higher than that to chironomid. It was interesting to note that the patients reported had not been documented as having frequent contact with silkworm moth allergen. Correlations between silkworm moth and silk, and silkworm moth and chironomid nudge were found to be significant (P < 0.001). Silkworm moth allergen showed the third highest reaction rate in patients with severe symptoms. These results suggest that silkworm moth allergen should be considered to be important in patients with allergic rhinitis in Japan. [ABSTRACT FROM AUTHOR]

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The effects of minor-component phospholipids, sterols, trimethylamine oxide (TMAO) and tri-n-octylamine (TOA) on the stabilization of γ-tocopherol (γ-Toc) were investigated during the autoxidation of methyl linoleate (ML). On autoxidation of lard containing γ-Toc and TMAO, γ-Toc was rapidly oxidized and decreased to the 50-60% level in the initial stage of reaction. After that, the total amounts of γ-Toc and its reducing dimers, γ-Toc diphenyl ether dimer, γ-Toc biphenyl dimer (H), and γ-Toc biphenyl dimer (L), formed from oxidized γ-Toc, were maintained at a higher level for a longer time. These results indicate the presence of minor components contribution to the stability of γ-Toc. Therefore, three-component synergism involving γ-Toc, TMAO and each phospholipid was tested using ML as substrate. Accordingly, phosphatidyl ethanolamine (PE), phosphatidyl serine (PS), phosphatidyl inositol and phosphatidic acid showed a marked synergistic effect: PS especially inhibited the oxidation of γ-Toc. More than 0.02% of PE was found to keep a constant level of the residual amount of γ-Toc and to retared the formation of γ-Toc biphenyl dimers, which are perferential in the presence of TMAO. Phosphatidyl choline (PC), phosphatidyl glycerol and sterols did not show such an effect. However, PC synergized with TOA for stabilizing γ-Toc in autoxidizing ML. [ABSTRACT FROM AUTHOR]

A response by K. Sugiyama, N. Takahashi, and A. Kohjitani to a letter to the editor about their article focusing on nasotracheal intubation technique, is presented.