Life-threatening hemoptysis is one of the most challenging conditions of all respiratory emergencies, and requires prompt and proper treatment. With the advancement of catheter technology, efficacy of bronchial artery embolization (BAE) for hemoptysis has been well established. However, in some cases, recurrent hemoptysis may occur during a short period of time after BAE due to blood supply via missed bronchial arteries or nonbronchial systemic arteries. Therefore, knowledge of anatomical variation of bronchial arteries and nonbronchial arterial supply contributing to hemoptysis is essential to achieve excellent long-term as well as short-term results. Additionally, interventional radiologists should be familiar with proper selection of catheters and embolic materials to increase the technical success rate and to reduce the procedure-related complications. In this article, we illustrate angiographic and computed tomographic anatomy of the bronchial and nonbronchial arterial supply, technical aspects, results, and complications of BAE. We also discuss the risk factors influencing recurrent hemoptysis after BAE.

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We studied the significance of antibodies to bovine serum albumin (BSA) as a biomarker for juvenile idiopathic arthritis (JIA). Sera from 30 children newly diagnosed with polyarticular JIA and sera from 30 healthy children matched for sex and age were tested for IgA, IgG and IgM by ELISA. BSA was used as a target to characterize changes in levels of interacting immunoglobulins. Initial results obtained before removal of antibodies that interacted with BSA suggested that JIA patients had increased levels of IgA in their sera. The serum IgA level was significantly (p<0.0001) higher in JIA children (mean±standard deviation (SD)=2.07±0.089 mg/mL) than in healthy children (1.69±0.109 mg/mL), while there was no significant difference in the levels of serum IgG and IgM between JIA children and healthy children; mean±SD of IgG serum level was 7.31±0.43 mg/mL and 7.39±0.52 mg/mL in JIA and healthy children (p=0.234), respectively, and IgM serum level was 1.22±0.24 mg/mL and 1.27±0.28 mg/mL in JIA and healthy children (p=0.238), respectively. However, the mean±SD of IgA level in JIA sera after purification from antibodies that interacted with BSA was 1.71±0.096 mg/mL, indicating the responsibility of anti-BSA IgA antibodies for increased IgA level in JIA patients. In conclusion, a humoral immune response against this antigen might serve as a diagnostic tool for detection of high-risk patients. Thus, positive BSA titers assist in discriminating children with JIA from healthy children.

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A total of 1,270 nursing students of Nagasaki University School of Health Sciences were examined for serum HBsAg and anti-HBs at their first year between 1990 and 2006. The prevalence of HBsAg was 0.39% (5/1,270); 0.52% (4/762) in 1990-1999, 0.27% (1/368) in 2000-2004, and 0% (0/140) in 2005-2006. The prevalence of anti-HBs was 1.81% (23/1,270); 1.97% (15/762) in 1990-1999, 0.82% (3/368) in 2000-2004, and 3.57% (5/140) in 2005-2006. A total of 650 students who were negative for HBsAg and anti-HBs in 1998-2006 received a primary series of hepatitis B vaccinations. Subsequently, 98.2% (638/650) acquired anti-HBs. The median titer of anti-HBs concentrations at 4 weeks after primary vaccination was 2,145.0 mIU/mL. Eleven among 12 students who did not acquire anti-HBs after a primary vaccination received a second series of vaccinations, after which eight (72.7%) acquired anti-HBs. Overall 99.4% (646/650) of the students vaccinated acquired anti-HBs. Among 286 students who acquired anti-HBs after the primary series of vaccinations, 17 (5.9%) became negative for anti-HBs in their third year. Nursing students should be educated about the risks for and prevention of blood borne infections, including the need to be vaccinated against hepatitis B. Moreover, nursing students who do not acquire anti-HBs after primary vaccination should receive a 3-dose revaccination series.

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A 46-year-old female patient with deep vein thrombosis (DVT) and pulmonary embolism complicated with disseminated intravascular coagulation was admitted to our hospital. She was treated with urokinase and repeated plasma exchange and with the administration of low-molecular-weight heparin coupled with a high dose of glucocorticoid after inferior vena cava (IVC) filter placement. As the etiology of DVT, blood tests showed no evidence of antiphospholipid syndrome or protein S/C deficiency except for hypereosinophilia and obesity with a high body mass index (34 kg/m2). Activated protein C (APC) resistance was not detected. Eosinophilia coupled with remarkable obesity was considered to be the trigger of DVT in this patient. After intensive therapy along with strict anti-coagulant agents, effective reduction of thrombosis in both the IVC and pulmonary arteries was observed along with improvement of the coagulation system.

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Pancreatic islet cell transplantation (IT) has now been a treatment of choice for the type I diabetes mellitus (DM), and the demand for IT is increasing. With the aim to grasp the present state and to survey the prospects of IT management in Nagasaki, we reviewed 75 type I DM patients who had been followed at the First Department of Internal Medicine of Nagasaki University Hospital. Among the 75 patients, 3 cases (4%) were judged to be candidates for IT according to the Japanese Islet Transplant Registry criteria. In addition, the estimated number of newly developing candidate for IT was one per year in Nagasaki prefecture, based on the epidemiologic factors including the annual incidence rate of type I DM patients in Japan, the population of Nagasaki prefecture, and the proportion of IT candidates among the type I DM patients followed at Nagasaki University Hospital. These results indicated that if an institute in Nagasaki newly constructs a standard IT unit and to run it in accordance with the Good Manufacturing Practice (GMP), they should cooperate with other laboratory units operating cell therapy, since GMP entails large amount of running costs.

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