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PubMed2002

Tissue engineering of the lymphatic system.

The field of tissue engineering has seen tremendous expansion in the last decade. In the last several years, tissue-engineering strategies to treat diseases of skin, cartilage, bone, bladder, blood vessel, tendon, and other tissues have been described. However, tissue-engineering approaches to treat diseases of the lymphatic system are currently nonexistent. We propose that acellular tissues, either native or engineered, could be exploited as a platform for the study of lymphatic biology, and for lymphatic tissue engineering. While speculative, this type of experimental model system could prove powerful for dissecting molecular and cellular events surrounding tumor invasion of lymphatics, as well as lymphangiogenesis. Scaffolds seeded with genetically engineered lymphatic cells could also be implanted to repopulate lymphatic vasculature. In the future, the lymphatic system will surely be added to the list of tissues and organs that prove amenable to tissue-engineering therapies.

Animals↗
PubMed1989

Extrahepatic malignancy following long-term immunosuppressive therapy of severe hepatitis B surface antigen-negative chronic active hepatitis.

To determine the frequency, predisposing factors and consequences of extrahepatic malignancy following long-term immunosuppressive therapy of severe HBsAg-negative chronic active hepatitis, 149 patients who had received prednisone (20 mg daily) or prednisone (10 mg daily) in combination with azathioprine (50 mg daily) for at least 6 months were evaluated systematically for 109 +/- 5 months (range: 7 to 223 months). Seven neoplasms involving cervix (2), lymphatic tissue (1), breast (1), bladder (1), soft tissue (1) and unknown site (1) developed in seven patients after 116 +/- 23 months (range: 18 to 164 months). The incidence of extrahepatic neoplasm was 1 per 194 patient-years of surveillance, and the probability of tumor occurrence was 3% after 10 years. Tumor frequency was similar in men and women and the risk was 1.4-fold greater than that in an age- and sex-matched normal population (95% confidence interval, 0.6- to 2.9-fold normal). Patients with extrahepatic malignancy were not distinguished by age, sex, treatment regimen, cumulative duration of treatment (42 +/- 9 vs. 60 +/- 4 months, p = 0.7) or individual features of the liver disease. Five of the seven patients survived during 48 +/- 25 months of follow-up, including two patients who have lived for at least 5 years after the diagnosis of malignancy. We conclude that extrahepatic malignancy develops infrequently during long-term immunosuppressive therapy. Its occurrence is not related to the type or duration of treatment, and long-term survival after tumor detection is possible. The low but probably increased risk of extrahepatic neoplasm does not militate against the use of immunosuppressive therapy in these patients.

Azathioprine↗
PubMed1999

Leukemias and lymphomas: time trends in the UK, 1984-93.

OBJECTIVE: To investigate recent time trends of some selected and common neoplasms of the blood and lymphatic tissues. METHODS: A specialist population-based register of hematological and related neoplasms was set up in parts of the UK in 1984. Secular changes over the first 10 years were investigated using log-linear Poisson modeling. The results are presented in tabular and graphical form. RESULTS: The analyses of 26,899 cases revealed a decline in incidence of acute myeloid leukaemia (AML), the myeloproliferative disorders (MPD) including chronic myeloid leukaemia (CML) and, in males only, Hodgkin's disease (HD). No secular trends for acute lymphoblastic leukaemia (ALL) were observed at any age. A marked increase in incidence in non-Hodgkin's disease (NHL) and the pre-leukemia group of myeloid dysplasias (MDS) was found. CONCLUSIONS: The rise in MDS and decline in AML and related conditions are most likely to reflect diagnostic changes. Changes in NHL may reflect, in part, a similar phenomena, but an underlying upward trend cannot be excluded. The decline in HD is in one gender only and the significance of this remains to be investigated.

Adolescent↗
PubMed1997

The extension of Gompertz law's validity.

The interval 35-85 years is mostly considered as the range of Gomperz law's validity. Looking at the spectrum of causes of death for the interval 10-30 years we find that its main share is caused by various accidents independent of age. These accidents result in the increase and following plateau of the total mortality curve over the age of 15 years. When the number of deaths from age independent causes (accidents, violence, suicide, accidental falls, etc.) is subtracted from the total number of deaths the linear area begins before the age of 20 years. The linear regression of the logarithm of mortality without accidents was performed for the age interval 20-84 years for six populations (men and women in the US in 1989, in Japan in 1990 and in former Czechoslovakia in 1990). Furthermore, the mortality curves of some causes important at the interval 0-15 years were inspected. Unlike other causes, births do not affect the disposition of children to die of malignant neoplasm of the brain and malignant neoplasm of lymphatic and haemopoietic tissue.

Adolescent↗
PubMed1979

[Differential diagnosis of facial skin swellings (author's transl)].

Enlargement of the cheeks may be due to a multitude of disorders, congenital, neoplastic, and in particular inflammatory. Congenital facial anomalies include cutaneous (and osseous) hemihypertrophy of the face and unilateral angiomatous malformations (e.g. Sturge-Weber-Krabbe Syndrome). Buccal enlargement due to dermal tumours include localized haemangiomas and lymphangiomas, lipomas and other benign connective tissue neoplasms, generalized disorders of the lymphatic or reticuloendothelial system including mycosis fungoides, reticulum cell sarcoma and other soft tissue malignancies, and cutaneous manifestations of malignant haemoblastoses, in particular chronic lymphatic leukaemia. Within the very large group of inflammatory skin swellings of the face a review is made of some bacterial pyodermias, severe forms of acne vulgaris, herpes zoster, lupus vulgaris, erysipelas, rosacea, steroid dermatitis, lupus erythematosus (discoid and systemic), toxic dermatitis, allergic eczema, urticaria, Quincke's oedema, and the Melkersson-Rosenthal syndrome. The importance of prevention and early detection of steroid-induced dermatitis is emphasized. This disorder, which is a pseudo-inflammatory disfiguring complication of prolonged topical steroid abuse, ranks in frequency with the skin problems most often seen in dermatological practice.

Adult↗
PubMed2000

Mineral dust exposure and systemic diseases.

Based on clinical and immunological studies, we have proposed the hypothesis that occupational dust exposure might cause not only pneumoconiosis but also autoimmune diseases and malignancies of various organs such as neoplasms of lymphatic and hematopoietic tissues and gastric cancer. Evidence from cohort studies of pneumoconiotic patients in Japan, copper miners, and stone masons support our hypothesis. The carcinogenicity and cytotoxic effect of inhaled dust on immune cells are considered to contribute to the development of these diseases.

Aged↗
PubMed1972

Reported influenza in pregnancy and subsequent cancer in the child.

A longitudinal study of 1,959 infants born in the first week of March 1958 to mothers who were reported to have had influenza during pregnancy revealed an incidence of cancer of 4.1 per 1,000 compared with only 0.8 per 1,000 among the 14,791 infants of mothers who had not had influenza.This increase was caused by cases of leukaemia and other neoplasms of lymphatic and haematopoietic tissue (I.C.D. 200-209) (P <0.0001).Data from the reports of the Registrar General for England and Wales were used to estimate the number of infants born in each year from 1955 to 1964 who subsequently died of cancer before 5 years of age. The rates for each year were compared with an estimate of the prevalence of influenza during the preceding winter. After allowing for the overall trend in the cancer death rate, a highly significant correlation was shown with deaths attributed to causes classified as I.C.D. 200-209 (P <0.005), but not with deaths attributed to other cancers. The increase in the risk of developing these neoplasms among children whose mothers had influenza is estimated to be not less than fourfold. Even so the risk remains small (3 to 4 per 1,000).

Child↗
PubMed1972

Incidence of neoplasms in children born after influenza epidemics.

Following a recent report that neoplasia of the lymphatic and haematopoietic tissues is commoner than average in children whose mothers have had influenza in pregnancy, the incidence of neoplasms in 1954-68 in children of the Manchester Hospital Region was examined in relation to date of birth. There were no significant differences between cohorts born in different quinquennia. Incidence among children born after six influenza epidemics in 1951-68 was no higher than among other children born in these years. It is concluded that if there is an association between maternal influenza and childhood neoplasia it is probably due to factors such as immunological deficiencies which may predispose independently to both conditions.

Adolescent↗
PubMed1980

Host resistance to carcinoma of the breast.

The recent demonstration that tumor cell circulation occurs early in the development of a growing neoplasm allows us to hypothesize that the growth of a primary lesion provides the patient with sufficient exposure to disseminating tumor cells to define the lower limit of her own threshold of host resistance. The biologic behavior of carcinoma of the breast is discussed by examining the significance of local recurrence in the contralateral breast, the residual breast tissue, and adjacent lymphatic tissue.

Breast Neoplasms↗
PubMed1996

Mortality rates for patients with a history of Kawasaki disease in Japan. Kawasaki Disease Follow-up Group.

OBJECTIVE: To determine whether the mortality rate of patients with a history of Kawasaki disease is higher than that of the general population. DESIGN: In a cohort study, 6585 patients with Kawasaki disease were observed from the first medical encounter because of the disease through the end of 1992, or until death. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were calculated with vital statistics data of Japan for the control. RESULTS: Of 6585 patients who met the eligibility criteria, 6550 (99.5%) were followed through either the end of the study or the date of death. Nineteen patients (14 male subjects) died during the study period; an overall SMR of 1.56 (955 CI, 0.94 to 2.43) was calculated for the entire study period. The SMR was 1.78 (95% CI, 0.97 to 2.99) for male subjects and 1.16 (95% CI, 0.38 to 2.71) for female subjects. During the acute phase of the disease (the first 2 months after onset), the SMR was higher, particularly in male subjects (SMR, 10.12; 95% CI, 3.72 to 22.07). After the acute phase, however, both boys and girls had low SMRs. Nine of the 19 deaths were caused by Kawasaki disease; there were 2 deaths as a result of congenital anomalies of the circulatory system and 2 subjects died of malignant neoplasms of lymphatic or hematopoietic tissues. CONCLUSIONS: Although the mortality rate among those with a history of Kawasaki disease was elevated in Japan, many of the deaths that caused the elevation occurred during the acute phase of the disease. The mortality rate was not increased after the acute phase of the disease.

Age Distribution↗
PubMed1998

Mortality among patients with a history of Kawasaki disease: the third look. The Kawasaki Disease Follow-up Group.

BACKGROUND: Long-term prognosis of Kawasaki disease is still unclear. METHODS: In a cohort study, 6576 patients with Kawasaki disease were observed from their first medical encounter because of the disease through the end of 1994, or until death. Standardized mortality ratios (SMR) with 95% confidence intervals (CI) were calculated with vital statistics data of Japan used for the control. RESULTS: Of 6576 patients who met the eligibility criteria, 6550 (99.6%) were followed through either the end of the study or the date of death. Twenty patients (14 male, 6 female subjects) died during the study period; an overall SMR of 1.35 (95% CI 0.82-2.08) was calculated. The SMR was 1.45 (95% CI 0.79-2.44) for male subjects and 1.15 (95% CI 0.42-2.52) for female subjects. During the acute phase of the disease (the first 2 months after the first visit to hospital), the SMR was higher, particularly in male subjects (SMR 10.13, 95% CI 3.72-22.08). After the acute phase, however, both boys and girls had low SMR. Nine of the 20 deaths were caused by Kawasaki disease; there were three deaths as a result of congenital heart diseases and two subjects died of malignant neoplasms of lymphatic or hematopoietic tissues. CONCLUSIONS: Although the mortality rate among those with a history of Kawasaki disease was elevated in Japan, many of the deaths that caused the elevation occurred during the acute phase of the disease. The mortality rate was not increased after the acute phase of the disease.

Adolescent↗