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Malays J Pathol. 1999 Dec;21(2):87-93.
Pattern of lymph node pathology in a private pathology laboratory.

Kim LH, Peh SC, Chan KS, Chai SP.

Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur.

Lymph node excision biopsy is commonly carried out for the investigation of lymphadenopathy. The objective of this study is to elucidate the pattern of nodal pathology seen in a private pathology practice. A total of 137 nodal biopsies for primary investigation of nodal enlargement were retrieved from the files in a private diagnostic pathology laboratory in the year 1997. Lymph nodes excised for cancer staging were excluded from this study. The histology was reviewed based on H&E stained sections, and with additional histochemical and immunoperoxidase stains when deemed necessary. Cases of malignant lymphomas were sub-classified with the aid of further immunophenotyping using a panel of monoclonal and polyclonal lymphoid antibodies. One case was excluded from this study due to inadequate tissue for further assessment. There were 58 males and 78 females, giving a ratio of 1:1.3 in the remaining 136 cases. They consisted of 13 Malays (M), 108 Chinese (C), 14 Indians (I) and 1 other ethnic group (O). The ratio of M:C:I:O was 1:8.3:1.1:0.1. The majority of the cases were in the age range of 20 to 50 years. The pathology consisted of 17 (12.5%) malignant lymphomas [6 Hodgkin's lymphoma, 11 non-Hodgkin's lymphoma], 35 (25.7%) metastatic carcinomas, 45 (33.1%) reactive hyperplasia, 19 (13.9%) tuberculosis, 11 (8.2%) Kikuchi's disease and 9 (6.6%) others (Castleman's disease 2, cat scratch disease 2, Kimura's disease 1, sarcoidosis 1, non-specific lymphadenitis 3). All categories of nodal disease showed approximately similar ratio of ethnic and gender distribution as above, except for Kikuchi's disease, for which 100% of the patients were female. The most common site of biopsy was from the head and neck region, particularly the cervical group of nodes. The most common nodal pathology seen in the private laboratory was reactive hyperplasia, followed by metastatic carcinoma. Malignant lymphoma constituted only 12.5% of the cases.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11068412&dopt=Abstract

Kekkaku. 2000 Sep;75(9):533-44.
[Factors related to the slowdown in the reduction of the tuberculosis incidence rate in Osaka City--structure of the high incidence rate of tuberculosis in Osaka City analyzed by administrative-ward group, five-year period and age group]

[Article in Japanese]

Takatorige T, Aoki Y, Tanigake C, Ruful A, Tatara K.

Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Japan.

The tuberculosis incidence rate in Osaka City is the highest in Japan. We analyzed the incidence rate in Osaka City in five-year period from 1978 to 1997, namely, 1978-1982 (period I), 1983-1987 (period II), 1988-1992 (period III), and 1993-1997 (period IV). Until the first half of 1980, the tuberculosis incidence rate in Osaka City had been dropping every year, but the rate of decline has been slowed substantially or even stopped since 1983. The incidence rate ratio of Osaka City compared with the national rate was 2.0 to 2.3 from 1970 to 1975, but it has been increasing from 1983 and is now higher than 3. We divided 24 wards of Osaka City into five groups based on selected employment indicators of population 15 years of age and over of 1995 National Census. Group A consists of two wards characterized by extremely high unemployment rate, Group B of four wards by high unemployment rate and high rate of manufacturing workers, Group C of six wards by high rate of non-manufacturing workers (tertiary industry workers), Group D of five wards by high rate of manufacturing workers, and Group E of seven wards by residential areas. The incidence rate of Group A had been declining during periods I and II but started to rise after period III. The rates of Group B and C had been declining from period I to II but the decline slowed down substantially even for every age class in periods III and IV. The incidence rates of Groups D and E have been falling. The incidence rate of the 50-69 year-old age group has been increasing substantially. The proportion of newly registered patients in Group A to all patients of Osaka City increased from 25.2% in period I to 32.7% in period IV. The number of newly registered patients of the 40-69 age class in Group A accounted for 45.1% of that in Osaka City in period IV. The slowdown in the reduction of the tuberculosis incidence rate has occurred not in all, but in only a few wards and it is a typical phenomenon of the middle-aged in those wards. It would be worth investigating whether a substantial decline in the tuberculosis incidence rate in Osaka City cannot be achieved by means of uniform control measures for all wards. Intensified tuberculosis control measures should focus on patients in specific wards and age groups.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11068370&dopt=Abstract

Am J Respir Crit Care Med. 2000 Nov;162(5):1979-82.
Increased levels of interleukin-18 in patients with pulmonary sarcoidosis.

Shigehara K, Shijubo N, Ohmichi M, Yamada G, Takahashi R, Okamura H, Kurimoto M, Hiraga Y, Tatsuno T, Abe S, Sato N.

Third Department of Internal Medicine and First Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido Branch of the Japan Anti-tuberculosis Association, Sapporo, Japan.

Interleukin-18 (IL-18) has recently been identified as an interferon-gamma (IFN-gamma)-inducing factor, and it plays an important role in T helper 1 (Th1) response. We measured the serum levels of IL-18 and IFN- gamma in 37 patients with pulmonary sarcoidosis and 25 healthy control subjects. We also measured the levels of IL-18 and IFN-gamma in 10-fold concentrated bronchoalveolar lavage (BAL) fluids of 19 patients with pulmonary sarcoidosis and 9 healthy control subjects (all lifelong nonsmokers). The levels of serum IL-18 and IFN-gamma were significantly increased in patients with sarcoidosis. The levels of BAL fluid IL-18 were significantly elevated in patients with sarcoidosis, however, the IFN-gamma levels of the patients and control subjects were all below sensitivity. Serum IL-18 levels significantly correlated with serum IFN-gamma levels and lysozyme activity. The patients positive for gallium-67 ((67)Ga) scan had significantly elevated serum IL-18 levels as compared with those of the negative patients. BAL fluid IL-18 levels significantly correlated with serum IL-18 levels in patients with sarcoidosis, and there was a significant correlation between IL-18 levels and lymphocyte proportions in sarcoid BAL fluids. In patients with sarcoidosis, IL-18 seems to induce IFN-gamma production and IL-18 levels in sera may reflect disease activity of sarcoidosis.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11069843&dopt=Abstract

Am J Respir Crit Care Med. 2000 Nov;162(5):1641-7.
Increased cortisol: cortisone ratio in acute pulmonary tuberculosis.

Baker RW, Walker BR, Shaw RJ, Honour JW, Jessop DS, Lightman SL, Zumla A, Rook GA.

Centre for Infectious Diseases and Department of Bacteriology, University College and Royal Free School of Medicine, London, UK.

To evaluate a possible role for altered cortisol metabolism in mediating the immunoparesis associated with progressive tuberculosis (TB), we have studied the hypothalamic-pituitary-adrenal axis, and the activities of the 11beta-hydroxysteroid dehydrogenases (11-HSDs) that interconvert active cortisol and inactive cortisone. In active pulmonary tuberculosis (PTB), the ratio of cortisol/cortisone metabolites in 24-h urine showed a shift towards active cortisol (ratio, 1.19 +/- 0.1, n = 16 versus 0. 89 +/- 0.05 in cured pulmonary tuberculosis (CTB), n = 13, p < 0. 01; and 0.78 +/- 0.04 healthy volunteers (HV), n = 11, p < 0.005). Conversion of cortisone (administered as 25 mg orally) to cortisol in peripheral plasma was higher in PTB (peak 1,157 +/- 55 nM, n = 14 versus 862 +/- 50 nM in CTB, n = 10, p < 0.005, and 882 +/- 73 nM in HV, n = 10; p < 0.005). Cortisol/cortisone ratio was increased in bronchoalveolar lavage fluid in PTB (7.73 +/- 1.48, mean +/- SE, n = 13) compared with HV (4.05 +/- 0.38, n = 11, p < 0.05) but was not different in plasma (PTB, 3.25 +/- 0.68; HV, 4.01 +/- 0.92). Responses of plasma cortisol to dexamethasone, CRH stimulation, and multidose ACTH stimulation were not different. These data suggest that in pulmonary tuberculosis, central control of glucocorticoid production is normal but that peripheral metabolism, in particular in the lung, is deviated in favor of the active metabolite cortisol. This offers a possible mechanism to explain the immunoparesis observed in progressive pulmonary tuberculosis.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11069789&dopt=Abstract

FEMS Microbiol Lett. 2000 Nov 15;192(2):159-62.
Bactericidal and inhibitory effects of azole antifungal compounds on Mycobacterium smegmatis.

Jackson CJ, Lamb DC, Kelly DE, Kelly SL.

Institute of Biological Sciences, University of Wales Aberystwyth, SY23 3DA, Aberystwyth, UK.

Azole antifungals are central to therapy and act by inhibiting a cytochrome P450, sterol 14-demethylase and blocking normal sterol synthesis. Our recent identification of a mycobacterial sterol biosynthetic pathway led us to probe the efficacy of a range of these compounds against Mycobacterium smegmatis. Several showed equivalent or greater inhibitory effects to those against Candida albicans, and bactericidal activity was demonstrated for four compounds, clotrimazole, econazole, miconazole and tebuconazole. The major drug used clinically, fluconazole, was ineffective. The results are discussed in the light of the world-wide spread of tuberculosis, including drug-resistant forms and the requirement for new drugs.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11064188&dopt=Abstract

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