The distribution of serum C-reactive protein (CRP) levels and their association with age, sex, and atherosclerotic risk factors were studied in a large Japanese population between 1992 and 1995. The subjects consisted of 2,275 males and 3,832 females aged 30 years and over. CRP was measured by nephelometry. The distribution of CRP was highly skewed toward a lower level than that of previous studies and seemed to be a combination of two separate distribution curves. The increase in CRP with age was statistically significant, and males had higher CRP levels than did females. Males who were current smokers had higher CRP levels than did nonsmokers. Age, systolic blood pressure, diastolic blood pressure, triglycerides, fibrinogen, and body mass index were all positively associated with CRP in both sexes, while total cholesterol and blood glucose were positively related in females only. High density lipoprotein cholesterol was inversely related in both sexes. Multiple logistic regression analysis showed that sex, age, systolic pressure, high density lipoprotein cholesterol, triglycerides, fibrinogen, and body mass index were significant independent variables. In conclusion, the distribution of CRP among the Japanese was quite different from that among Westerners, although CRP levels correlated with other atherosclerotic risk factors, similar to those in Westerners.

Bacterial 16S ribosomal RNA genes (rDNA) were detected in blood samples from two healthy individuals by PCR under conditions involving 30 cycles that did not produce any visible products from negative control saline. Even from control samples, PCR involving 35-40 cycles yielded visible bands. Major clones detected in the blood samples, but not in control, were the Aquabacterium subgroup, Stenotrophomonas subgroup, Budvicia subgroup, Serratia subgroup, Bacillus subgroup and Flavobacteria subgroup. No clone was located within the bacteroides-clostridium-lactobacillus cluster, which is indigenous to gastrointestinal flora.Key words bacteremia, blood, polymerase chain reaction, 16S ribosomal RNA.Diagnosis of bacterial infection and identification of the agent responsible is essential in clinical medicine, and has been traditionally carried out by inoculating blood or infected tissues into a liquid or solid nutrient medium. This approach has a limitation in that it can detect only bacteria and fungi that are culturable in a laboratory. Recently, PCR using species-specific primers (1-5) and nucleic acid sequence-based amplification (NASBA) (6) have also been used as an alternative approach for detecting agents that are responsible for infection.These techniques can also be used for detailed analysis of microbial biota in the oral cavity and gastrointestinal tract, using universal primers that anneal to conserved regions in the 16S ribosomal RNA gene (rDNA) or gyr B gene (7-9). It is reported that half of the bacteria comprising the oral and intestinal flora have not been previously identified by in vitro culture procedures (10). Moreover, recent studies using PCR have raised the possibility that bacterial DNA may be present in the human bloodstream (11-13). Our ultimate objective is to elucidate the role of such subclinically infecting unculturable or latent bacteria in the pathogenesis of chronic vascular diseases (14-16). As a first step, we investigated whether bacteria can translocate in some way from the oral and intestinal flora to the blood stream in 'healthy' humans. In this preliminary study, blood specimen-specific bacterial sequences were detected by PCR of rDNA. However, they were not representative of sequences found in human intestine.PCR was done with a REDExtract-N-Amp Blood PCR kit (Sigma-Aldrich Japan, Tokyo, Japan) using broadrange 16S ribosomal RNA gene (rDNA)-specific oligonucleotide primers. The PCR kit does not require any type of purification, organic extraction, centrifugation or alcohol precipitation, and can be used with whole blood.For blood sampling, the skin was first sterilized with a cotton swab moistened with popidone iodide, the anterior brachial median vein was punctured using a sterile 21-gauge needle (Terumo Corporation, Tokyo, Japan),

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BackgroundPulmonary epithelial-myoepithelial carcinoma (P-EMC) is a rare subset of salivary gland-type tumors of the lung. Because of its rarity and unproven malignant potential, the optimal therapy for P-EMC has not been defined. Here, we report a typical case of P-EMC and a review of the literature to consider appropriate treatment.Case presentationA 54-year-old woman presented with an abnormal lung shadow on a routine chest X-ray. A chest computed tomography (CT) scan verified an 18-mm endobronchial nodule on the middle lobe. We performed a bronchoscopic biopsy, and the patient was diagnosed with P-EMC. After confirming the absence of tumors in the salivary glands, she underwent a right middle lobectomy along with hilar and mediastinal lymph node dissections. Currently, the patient is doing well, without any sign of recurrence 3 years after surgery.ConclusionsAlthough a majority of P-EMC cases, as in our case, behave indolently, several poor progression cases have been reported. For distinguishing the minor malignancy cases from others, histological findings such as myoepithelial anaplasia could be a predictive factor. Complete resection is needed to evaluate the whole tumor, because P-EMCs often show histological heterogeneity. Moreover, incomplete excision may be a poor prognostic factor. Although lobectomies as well as lymph node dissections, sleeve lobectomies, or pneumonectomies are routinely performed for complete resection, further investigation is required to establish the optimal treatment strategy.

A surgical case of pulmonary metastases of polymorphous low-grade adenocarcinoma (PLGA) originating from the minor salivary gland in the soft palate in a 62-year-old woman is reported. PLGA has been to be a locally invasive carcinoma without distant metastases; thus our case is the first reported case with histologically-proven distant metastases to the lung. We emphasise that attention should be paid to distant metastases especially to the lung even in case of PLGA.

Background The incidence of postoperative atrial fibrillation (POAF) after pulmonary lobectomy ranges from 6.4 to 12.6%. This study aimed to analyze the postoperative risk factors and prognosis for POAF in lobectomy for lung cancer. Methods Data were collected from patients undergoing pulmonary lobectomy from April 2010 to March 2019. We analyzed risk factors for POAF among perioperative factors and compared postoperative complications or overall survival between POAF and non‐POAF groups. We classified POAF as either the temporary or non‐temporary type and compared perioperative factors, postoperative complications, and overall survival. Results POAF was identified in 49 (5.2%) of the 947 lobectomies. The POAF group included more males, patients with poor performance status (PS), history of paroxysmal atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), and intraoperative blood transfusions. Poor PS, COPD, previous paroxysmal AF, and intraoperative blood transfusion were independent risk factors for POAF in multivariate analysis. The POAF group had a poorer prognosis than the non‐POAF group (p = 0.0045). POAF was divided into 29 temporary and 20 non‐temporary types. The onset date of non‐temporary‐type POAF was significantly later than that of the transient type (P < 0.01), and diabetes mellitus was significantly higher in non‐temporary‐type POAF. Non‐temporary‐type POAF had a significantly poorer prognosis in terms of overall survival (p = 0.005). Conclusions Poor PS, COPD, history of PAF, and intraoperative blood transfusion were independent risk factors for POAF. Non‐temporary‐type POAF occurred significantly later than transient type and caused poorer prognosis after lobectomy for lung cancer.