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Background: Mucinous carcinoma of the skin (MCS) is a rare epithelial tumor which arises primarily in the skin. Metastatic MC from extracutaneous sites, especially breast or colon, mimics MCS and cannot be differentiated from MCS by routine histology alone. Methods: Nine cases of MCS were analyzed immunohistochemically using monoclonal antibodies against cytokeratins (CKs) and human milk fat globulin 1 (HMFG) in order to clarify their nature and compare the immunophenotypes with those of other MCs studied in the literature. Results: Expression of simple epithelial CKs in most of the tumor cells of all cases studied and co-expression of simple and stratified epithelial CKs in some tumor cells of two cases were recognized. CK 20 expression could not detected in any tumor cells. Focal HMFG expression in the luminal or outer surface of the nests was observed in three cases. Conclusion: From CKs expression, MCS was speculated to differentiated mainly toward the secretory cells of the sweat glands, and some tumor cells toward the transient portion between the dermal duct and the secretory portion. Focal HMFG expression suggested either a consequence of malignant transformation or apocrine differentiation. No expression of CK 20 in MCS suggests that we may exclude the diagnosis of metastatic colorectal MC which expressed CK 20. [ABSTRACT FROM AUTHOR]

Objective:Epidemiological as well as experimental studies suggest that particulate air pollutants, including diesel exhaust particles (DEP), may play a role in the recent increase of respiratory morbidity and mortality. We studied the effect of DEP on the production of inflammatory cytokines and mediators including IL-8 and granulocyte macrophage colony stimulating factor (GM-CSF) by human airway epithelial cells in vitro. Methodology:Suspended DEP were added to cultured normal human bronchial epithelial cells or transformed BEAS-2B cells. The release of cytokines and mediators was evaluated by enzyme-linked immunosorbent assay. The transcriptional levels of IL-8 mRNA was studied by northern blot analysis and run-on transcription assay. Activation of transcription factors was assessed by electrophoretic mobility shift assay. Results: Non-toxic doses of suspended DEP showed a significant stimulatory effect on IL-8 and GM-CSF production by airway epithelial cells. Diesel exhaust particles increased the steady-state levels of IL-8 mRNA, which was suggested to be largely due to increased transcriptional rates. Electrophoretic mobility shift assay demonstrated that DEP induced increased binding to the specific motif of nuclear factor (NF)-κB, but not of transcription factor AP-1. Both N-acetylcysteine and pyrrolidine dithiocarbamate attenuated the action of DEP on IL-8 mRNA expression, suggesting that oxidant-mediated pathway might be involved in its processes. Transient transfection of airway epithelial cells with wild and NF-κB binding motifs indicated that the activation of NF-κB was essential for IL-8 gene upregulation by reporter gene assay. Conclusions: These results suggested that DEP activate NF-κB, which might be an important pathway for the expression of inflammatory cytokines in vitro. [ABSTRACT FROM AUTHOR]

Abstract: The case of a patient with pulmonary veno-occlusive disease associated with systemic sclerosis is reported. The patient presented with progressive dyspnoea. Echocardiography and cardiac catheterization study demonstrated right-sided heart failure. The CXR suggested pulmonary hypertension and interstitial pulmonary oedema. We suspected pulmonary veno-occlusive disease based on radiological and haemodynamic findings. Treatment with prednisolone resulted in a reduction in pulmonary arterial pressure and CXR findings improved 2 months later, but no further effect was observed. The patient died 7 months later and at autopsy the lungs showed prominent thickening of the interlobular septa and small branches of pulmonary veins showed intimal thickening. [ABSTRACT FROM AUTHOR]

Keywords: asthma; asthma-COPD overlap; COPD; neutrophil; sputum EN asthma asthma-COPD overlap COPD neutrophil sputum 3137 3141 5 09/30/22 20221001 NES 221001 Soluble suppression of tumorigenicity 2 (sST2) is a decoy receptor for interleukin 33 (IL-33). Soluble ST2 enhances IL-33-induced neutrophilic and pro-type 2 inflammation in the lungs (C-E) Scatter plots of sST2 and IL-33 (C), IL-33 and chemokine (D), and sST2 and chemokine (E) levels in sputum from the same patients. [Extracted from the article]

Rationale: Severe eosinophilic asthma is characterized by airway eosinophilia and corticosteroid‐resistance, commonly overlapping with type 2 inflammation. It has been reported that chemokine (C‐C motif) ligand 5 (CCL5) is involved in the exacerbation of asthma by RNA virus infections. Indeed, treatment with a virus‐associated ligand and a T helper type 2 cell (Th2) cytokine can synergistically stimulate CCL5 production in bronchial epithelial cells. We aimed to evaluate the mechanisms underlying CCL5 production in this in vitro model and to assess the potential of Janus kinase 1 (JAK1) as a novel therapeutic target via the use of ruxolitinib. Methods: We stimulated primary normal human bronchial epithelial (NHBE) cells and BEAS‐2B cells with poly(I:C) along with interleukin‐13 (IL‐13) or IL‐4, and assessed CCL5 production. We also evaluated the signals involved in virus‐ and Th2‐cytokine‐induced CCL5 production and explored a therapeutic agent that attenuates the CCL5 production. Results: Poly(I:C) stimulated NHBE and BEAS‐2B cells to produce CCL5. Poly(I:C) and IL‐13 increased CCL5 production. Poly(I:C)‐induced CCL5 production occurred via the TLR3–IRF3 and IFNAR/JAK1–phosphoinositide 3‐kinase (PI3K) pathways, but not the IFNAR/JAK1–STATs pathway. In addition, IL‐13 did not augment poly(I:C)‐induced CCL5 production via the canonical IL‐13R/IL‐4R/JAK1–STAT6 pathway but likely via subsequent TLR3‐IRF3‐IFNAR/JAK1‐PI3K pathways. JAK1 was identified to be a potential therapeutic target for severe eosinophilic asthma. The JAK1/2 inhibitor, ruxolitinib, was demonstrated to more effectively decrease CCL5 production in BEAS‐2B cells than fluticasone propionate. Conclusion: We have demonstrated that JAK1 is a possible therapeutic target for severe corticosteroid‐resistant asthma with airway eosinophilia and persistent Th2‐type inflammation, and that ruxolitinib has potential as an alternative pharmacotherapy. [ABSTRACT FROM AUTHOR]

An 82‐year‐old man was presented to our hospital due to epigastric and right hypochondrial pain 17 weeks after the initiation of intravenous treatment with nivolumab for recurrent lung adenocarcinoma as multiple lung and sternal metastases. Urgent gastroscopy revealed macroscopic duodenitis such as severe erythema, oedema, black‐coloured erosions, and ulcers located throughout the second portion of the duodenum, which was confirmed by abdominal computed tomography as circumferential thickening of the duodenal wall. Those lesions were pathologically considered as non‐specific inflammation and spontaneously disappeared within a month, suggesting nivolumab‐induced immune‐related adverse events. [ABSTRACT FROM AUTHOR]

A 64-year-old man was referred to our hospital because of persistent dyspnoea for the past 1 month. He had recurrent brain anaplastic meningioma after two operations and irradiation. He suffered from right pleural effusion in the previous few months and was diagnosed with malignant mesothelioma via pleural biopsy 1 month prior to coming to our hospital. At his first visit to our hospital, thoracic computed tomography demonstrated rapidly developed large inhomogeneously enhancing pleural thickening up to 3 cm, which surrounded the right hemithorax, together with left-sided pleural effusion. After re-evaluation of the pathological specimens retrieved from the local hospital, he was finally diagnosed with pleural metastasis secondary to anaplastic meningioma (WHO classification, grade 3). Generally, brain meningiomas are believed to be benign and seldom metastasize to other organs. However, the present case clearly demonstrated the unique clinical presentation of anaplastic meningioma, also known as malignant meningioma, which mimicked the pathological and radiological findings of a malignant mesothelioma. [ABSTRACT FROM AUTHOR]

Key Clinical Message It is well-known that the major organisms for mycotic aneurysms are Staphylococcus aureus, Salmonella spp but is extremely rare in Streptococcus pneumoniae in postantibiotic era. We demonstrated the first case with multiple mycotic aneurysms simultaneously generated in the splenic and hepatic arteries in a patient with pneumococcal pneumonia. [ABSTRACT FROM AUTHOR]

Voltage-gated Na+ channel (INa) is expressed under culture conditions in human smooth muscle cells (hSMCs) such as coronary myocytes. The aim of this study is to clarify the physiological, pharmacological and molecular characteristics of INa expressed in cultured hSMCs obtained from bronchus, main pulmonary and coronary artery. INa, was recorded in these hSMCs and inhibited by tetrodotoxin (TTX) with an IC50 value of approximately 10 nM. Reverse transcriptase/polymerase chain reaction (RT-PCR) analysis of mRNA showed the prominent expression of transcripts for SCN9A, which was consistent with the results of real-time quantitative RT-PCR. These results provide novel evidence that TTX-sensitive Na+ channel expressed in cultured hSMCs is mainly composed of Nav1.7. [Copyright &y& Elsevier]

The article presents a letter to the editor about the side effects of macrolide antibiotics given to pulmonary disease patients.

A 58‐year‐old man presented with a two‐month history of facial erythema and dry cough. Physical examination revealed typical cutaneous manifestations of dermatomyositis (DM), including heliotrope rash and shawl sign. A chest X‐ray revealed a 4‐cm mass in the right middle lung. After bronchoscopy and investigation of auto‐antibodies, he was diagnosed with co‐occurring transcriptional intermediary factor 1‐gamma (TIF1‐γ) positive DM and lung adenocarcinoma. He was administered oral prednisolone for subsequent muscle weakness, but developed TIF1‐γ positive DM‐associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture and died from progression of chemoresistant lung cancer. A 58‐year‐old man presented with a two‐month history of facial erythema and dry cough. After testing he was diagnosed with co‐occurring transcriptional intermediary factor 1‐gamma (TIF1‐γ) positive dermatomyositis (DM) and lung adenocarcinoma. He subsequently developed muscle weakness and was administered oral prednisolone but developed TIF1‐γ positive DM‐associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture. Despite treatment, he gradually deteriorated and died from progression of chemoresistant lung cancer six months later. [ABSTRACT FROM AUTHOR]

A 62‐year‐old healthy man presented to our hospital due to a persistent fever of up to 38°C for one week. Thoracic computed tomography showed right pleural effusion with multiple large nodules up to 7 cm in diameter composed of numerous discrete small nodules like fireworks, the so‐called "cluster" signs. Some of the large nodules had a hyper‐dense portion centrally surrounded by partially discrete small nodules, not as densely assembled, suggestive of the "galaxy" sign. The repeated acid‐fast sputum smears and both bronchial washings were all negative for Mycobacterium tuberculosis, but the acid‐fast culture of sputum taken soon after the first bronchoscopy, and pleural fluid, turned out to be positive for M. tuberculosis at six weeks after admission. The present case clearly demonstrates that the "galaxy" and "cluster" signs are red herring signs of the low rates of isolating M. tuberculosis, which should be differentiated from pulmonary sarcoidosis. In this article, we present a unique case of active pulmonary tuberculosis, with multiple huge "cluster" signs like fireworks, together with multiple "galaxy" signs. The repeated acid‐fast sputum smears and both bronchial washings were all negative for Mycobacterium tuberculosis, but the acid‐fast culture of sputum taken soon after the first bronchoscopy, and pleural fluid, turned out to be positive for M. tuberculosis at six weeks after admission. The present case clearly demonstrates that the "galaxy" and "cluster" signs are red herring signs of the low rates of isolating M. tuberculosis, which should be differentiated from pulmonary sarcoidosis. [ABSTRACT FROM AUTHOR]

A 17‐year‐old woman was referred to our hospital due to cough on exertion and right chest pain over the previous two months, together with bloody sputum over the previous week. Chest X‐ray demonstrated a nodule measuring 3 cm in diameter in the right middle lung field. On repeated bronchoscopy, the tumour was recognized as a rapidly growing intra‐bronchial protruded tumour at the orifice of the right B8. Based on a tentative diagnosis of lung cancer, right lower lobectomy was performed. She was diagnosed with mixed squamous cell and glandular papilloma of the bronchus without smoking history and human papillomavirus infection. Solitary endobronchial papillomas are rare but should be considered a differential diagnosis for solitary lung nodule with the potential to develop into carcinoma. Solitary endobronchial papillomas are extremely rare, accounting for only 0.38% of all lung tumours and approximately 7% of all benign epithelial and mesenchymal lung tumours. Here, we present an unexpected case of mixed papilloma in the youngest known patient to date who suffered from chest pain and bloody sputum. [ABSTRACT FROM AUTHOR]

The article reports on research which investigated social isolation in elderly adults with chronic respiratory failure who were undergoing long term oxygen therapy (LTOT). Researchers evaluated 50 patients undergoing LTOT. They found that LTOT led to social isolation and that support groups could alleviate the problem of social isolation.