MRI features of extraocular muscle metastases compared to those of other extraocular muscle diseases of non-thyroid origin.

AIM: To identify the magnetic resonance imaging (MRI) features of metastases to the extraocular muscles (EOM metastases). MATERIAL AND METHODS: The MRI features of 19 patients with EOM metastases were compared with those of 24 patients with EOM diseases of non-thyroid origin. MRI was used to assess the number of tumours, morphology, signal intensity on T2-weighted images, enhancement patterns, and apparent diffusion coefficient (ADC) values. RESULTS: Single muscular involvement was observed in 10 patients, and multiple muscular involvement was observed in nine patients. The morphology was focally discrete in nine patients, and diffuse infiltrative in 10 patients; all the nine patients with focal discrete morphology presented with single muscular lesions. On T2-weighted images, the signal intensities were intermediate or low in 15 patients and a mixture of high and intermediate in four patients. In 14 patients for whom contrast-enhanced images were available, ring enhancement (n=5), heterogeneous diffuse enhancement (n=5), and homogeneous enhancement (n=4) were seen. The mean ADC value was 0.98 × 10-3 mm2/s. Compared to other EOM diseases of non-thyroid origin, single muscular presentation, focal discrete morphology, the presence of hyperintensity on T2-weighted images, and ring or heterogeneous enhancement were significantly more frequent in EOM metastases. CONCLUSION: The MRI features of EOM metastases showed two main patterns: a single discrete mass and multiple infiltrative masses. In addition to the presentation as a single discrete mass, the presence of hyperintensity on T2-weighted images and ring or heterogeneous enhancement can aid in the differentiation of EOM metastases from other EOM diseases.

Synchrotron Radiation Fourier Transform Infrared (SR-FTIR) spectroscopy in exploring ancient human hair from Roman period Juliopolis: Preservation status and alterations of organic compounds.

We explore the preservation status and alterations of organic compounds in Roman period human hairstrandsfrom a specific individual (M196) excavated at Juliopolis (JP). How do these organic compounds present in this c. 2000-year-old human hair compare to those present in modern hair? Alterations to organic compounds in archaeological human hair are caused by biological degradative processes dependent on multifactorial processes acting on the hair since the deposition of a body in a mortuary context. We investigate the type of organic compounds present using Synchrotron Radiation Fourier Transform Infrared (SR-FTIR). Juliopolis (Iuliopolis) is an ancient multiperiod city, located in the Çayirhan district of Nallihan, northwest of Ankara. The Juliopolis necropolis from which M196 was recovered was in use throughout the Hellenistic, Roman, and Byzantine periods, and yielded over 700 tombs with numerous human remains. One tomb (M196) contained human remains of exceptional preservation status, including substantial amounts of hair. Human hair from archaeological contexts is not only extremely rare, but importantly, has high analytical value, with potential for analysis of diet, geographical origins, ancient DNA, metal exposure, and other aspects of life in a time-resolved manner. These data make significant contributions to the life history of the individual (osteobiography), as well as contribute towards key archaeological questions. As these analyses are in their majority destructive, prior evaluation of the preservation of sufficient amounts of the organic compounds on which many such analyses rely upon is crucial, to avoid unnecessary loss of precious ancient samples. The results of our SR-FTIR analyses at SESAME synchrotron show that keratin in the JP M196 is more degraded in comparison to the modern reference sample. However, the results also point to clear potential for further analyses with techniques relying on organic compound preservation, such as C and N isotopic analyses for diet, and aDNA.

Case Report of Living Kidney Transplantation Using Ectopic Pelvic Kidney Harvested by Reduced Port Laparoscopic Donor Nephrectomy.

A 28-year-old woman was diagnosed as having an ectopic kidney in adolescence. She desired to donate her ectopic kidney to her mother, who was diagnosed as having renal failure. The ectopic kidney was located behind the sigmoid colon with 3 renal arteries and 3 renal veins. Laparoscopic donor nephrectomy was performed by reduced port surgery using the GelPOINT access platforms at a midline incision below the umbilicus with 1 accessory port. A thin artery of the donated kidney was ligated. An artery of the upper pole was anastomosed to the internal iliac artery, and a second artery was anastomosed directly to the inferior epigastric artery. Three veins were anastomosed to the external iliac vein: 1 anastomosed directly, 1 interposed by saphenous vein graft, and 1 interposed by harvested ovarian vein. To our knowledge, this is the first successful case of transplantation using an ectopic pelvic kidney by reduced port laparoscopic donor nephrectomy.

[Evaluation of thoracography for secondary pneumothorax in elderly people].

The thoracoscopic surgery for patient with pneumothorax has been considered to be safe and easy. In recent years, there is a growing number of secondary pneumothorax due to advanced pulmonary emphysema in elderly patients. To confirm the existence of adhesion and the site of air leakage are important prior to surgery. In our institution, thoracography was performed before surgery in 9 cases of emphysema and secondary pneumothorax over 60 years old patients. The mean age was 72.2 years old and all patients were male. Air leakage and its site could be identified in 6 cases by thoracography. In the remaining 3 cases, adhesion sites were identified. There were no complications in all cases. The operation time was 117 minutes, and blood loss was 9.9 ml in average. The mean postoperative drainage period was 1.6 days and total hospital stay was 5.9 days. We conclude that the thoracoscopic surgery can be performed more safely by obtaining information of thoracic cavity using thoracography before surgery.

Prostaglandin receptors EP2 and IP are detectable in atherosclerotic arteries and plaques.

AIM: Prostaglandin (PG) receptor agonists are frequently used for the pharmacological treatment of arteriosclerosis obliterans (ASO). In particular, the PG receptors EP2 and IP stimulate vasodilation and inhibit platelet aggregation, biological processes thought to be protective against ASO and important for physiological homeostasis. However it is uncertain whether EP2 and IP exist in diseased arteries, or what their distribution within the artery might be. In this study, we analyzed the distribution of these PG receptors in patients with severe ASO to determine the potential application of stimulation of these receptors as targets for pharmacological treatment. METHODS: We collected segments of atherosclerotic femoral arteries during femoropopliteal bypass surgery and determined the expression levels of EP2 and IP receptors by western blotting. Immunofluorescence was used to observe receptor localization. RESULTS: Findings of western blotting showed an increased Cox-2 expression in patients with ASO. The EP2 as well as IP receptors were each induced approximately 3-fold in comparison to normal samples. The expression of these receptors was increased in the intimal layer as well as the medial layer; their expression was also detectable within the atherosclerotic plaque. CONCLUSION: We observed induction of the PG receptors EP2 and IP in atherosclerotic femoral arteries in the arterial intima, medial layer, as well as the associated atherosclerotic plaque. These results suggest that receptor-selective PG agonists specifically target atherosclerotic arteries and therefore, may find potential application in the pharmacological management of patients with ASO.

Latitudinal variation in egg size and number in anadromous masu salmon Oncorhynchus masou.

Latitudinal variation in egg size and number in anadromous masu salmon Oncorhynchus masou was examined. Relatively greater variation in egg size occurred among rivers than among females within rivers or within females. Egg size was generally greater and egg number generally lower at more northerly latitudes.

Presence of prostacyclin receptor in arteriosclerotic human femoral artery.

AIM: Prostacyclin, which is mainly synthesized by vascular endothelial cells, exerts antiplatelet and smooth-muscle-relaxant effects, thereby maintaining cardiovascular homeostasis. Prostacyclin analogues have been clinically proven to improve ischemic symptoms and prevent the occurrence of vascular events in the lower extremities of patients with arteriosclerosis obliterans. We examined the presence of prostacyclin receptor (IP receptor) in an arteriosclerotic human femoral artery. METHODS: Specimens of the femoral artery were obtained at the time of limb amputation from an 83-year-old woman. Atherosclerotic lesions and associated changes such as calcification were evident. The specimens were stained with hematoxylin and eosin, and processed for immunohistochemistry. RESULTS: A monolayer of cells was observed on the luminal side of the femoral artery. Single immunohistochemistry showed the presence of the IP receptors on cells of the luminal side of the femoral artery. Triple-immunofluorescence staining revealed colocalization of IP-receptor-positive cells and cells positive for von Willebrand factor, a marker of vascular endothelial cells. CONCLUSIONS: We investigated the presence of the IP receptor in the human femoral artery immunohistochemically, and demonstrated their strong expression in endothelial cells. This finding suggests that prostacyclin or prostacyclin analogues may act on their receptors on endothelial cells in patients with arteriosclerosis obliterans.

Changes in the fluorescence spectrum of individual single-wall carbon nanotubes induced by light-assisted oxidation with hydroperoxide.

Through fluorescence-spectrum measurements, we investigated the effects of light-assisted oxidation with H2O2 (LAOx) on single-wall carbon nanotubes (SWNTs) that were individually dispersed in an aqueous solution of surfactant. The intensities of the fluorescence spectra were decreased remarkably by the LAOx when the light's wavelength was 400-500 nm and a little when 600-700 nm. The spectrum intensity did not recover even when the pH was restored to an original value of 6.5. The spectra changed little when the LAOx wavelength was 500-600 nm or the light was not irradiated. In addition, the effect of LAOx on SWNTs was related to the diameters of SWNTs. We inferred that these phenomena reflected that H2O2 was dissociated by absorbing the fluorescence light emitted from optically excited SWNTs, which, in turn, accelerated the burning out of SWNTs.

Combined use of percutaneous ethanol injection and radiofrequency ablation for the effective treatment of hepatocelluar carcinoma.

Radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) therapy are currently used for the treatment of hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the usefulness of combination therapy of PEI and RFA (PEI-RFA). Seventy-three patients with biopsy-proven HCC and liver cirrhosis underwent RFA after a bolus injection of ethanol into HCC. The volume of coagulated necrosis in the liver caused by PEI-RFA was estimated and compared with that by RFA alone. Coagulated necrosis areas in the liver of patients treated with PEI-RFA were significantly larger than those of patients treated with RFA alone. In PEI-RFA group, the volume of coagulated necrosis was significantly correlated with the amounts of ethanol injected into HCC. No major complications were observed during and after the PEI-RFA treatment. These results indicate that PEI-RFA is more effective than RFA alone and can make dramatic improvement of therapeutic effects in RFA therapy for HCC with fewer sessions of treatments. Therefore, PEI-RFA is considered to be a practical and promising option and may open up new avenues for the treatment of HCC.

Expression of p33(ING1) in hepatocellular carcinoma: relationships to tumour differentiation and cyclin E kinase activity.

BACKGROUND: Inhibitor of growth-1 (ING1) is a new candidate for the tumour suppressor gene that encodes a 33k Da protein (p33(ING1)). While reduction of p33(ING1) is an important event in some human cancers, the expression of p33(ING1) in human hepatocellular carcinoma (HCC) remains to be examined. We evaluated p33(ING1) expression in various liver diseases including HCC. METHODS: Expression of p33(ING1) was evaluated immunohistochemically not only in the normal liver (n = 5), but also in specimens of chronic hepatitis (n = 39) and HCC (n = 86). We also analysed the relationship between p33(ING1) expression and cyclin E kinase activity detected by autoradiography in 29 HCCs. RESULTS: Expression of p33(ING1) was reduced in HCC, especially in moderately and poorly differentiated HCCs, and those at advanced stages. Furthermore, expression of p33(ING1) correlated inversely with cyclin E kinase activity. CONCLUSIONS: These data suggest that reduction of p33(ING1) may contribute to the process of malignant transformation, progression and dedifferentiation of HCC via an increase of cyclin E kinase activity.

Morphometric nerve fiber analysis and aging process of the human inferior alveolar nerve.

We studied morphometric nerve fiber analysis and the aging process of the inferior alveolar nerve (IAN). Human IANs were resected at the mandibular foramen. The preparation of sections involved fixation, washing, dehydration, embedding, sectioning and staining as described in our previous reports. We estimated the total number of myelinated axons in the IAN being average 26,200, the transverse area of those being average 37.1 microns 2, the average perimeter of those being 23.0 microns, the average circularity ratio of those being 0.85, respectively. According to these results, the IAN did not demonstrate notable age-relation change in any measured item. The IAN differed from not only our previous data on the human motor peripheral nerves but also those on the human sensory peripheral nerves. With regard to the aging process, the IAN indicated morphological features compared with other peripheral nerves.

Primary osteogenic sarcoma of a finger proximal phalanx: a case report and literature review.

Osteogenic sarcoma of the small bones of the hand is rare with only 15 cases documented. We describe a 12-year-old boy with an osteogenic sarcoma of the proximal phalanx of the middle finger. Wide excision in the form of ray amputation with a wide surgical margin was performed after neoadjuvant chemotherapy consisting of combined high-dose methotrexate, doxorubicin, ifosfamide, and cisplatin. To restore maximum function the index ray was transferred to the base of the third metacarpal. Adjuvant chemotherapy was administered subsequently. At 28-month follow-up evaluation there was no evidence of local recurrence of disease or distant metastasis and both function and appearance were good.

[A patient with recurrent breast cancer whose liver metastasis regressed following combined use of weekly docetaxel and MPA.5'-DFUR].

A 28-year-old woman who was 10 months pregnant was diagnosed with left breast cancer. She received preoperative chemotherapy and underwent mastectomy after parturition. Endocrine therapy and adjuvant CMF and CAF was administered, but a bone metastasis appeared 2 years later and a liver metastasis 3 years later. Weekly docetaxel and MPA plus 5'-DFUR combination therapy were successively and simultaneously administered. The liver tumor regressed, and the survival time was prolonged by 1 year and 6 months. This case suggests that the combined use of both therapies was safe for the patient in serious bad condition and had a strong antitumor effect.

A randomized comparison of the straight linear approach with electrogram mapping focal approach in selective slow pathway ablation.

The aim of this study was to evaluate the efficacy and safety of the anatomic linear approach in selective AVN slow pathway ablation, in comparison to the widely used electrogram mapping focal approach. It remains undetermined whether or not anatomic linear ablation has a greater potential for eliminating slow pathway conduction than does focal ablation. Fifty consecutive patients (21 men, 29 women, age 56 +/- 14 years) with common type AVNRT were randomly assigned to the linear approach (25 patients) or local electrogram mapping approach (25 patients). A linear lesion was created between the tricuspid annulus, at the midlevel of the coronary sinus (CS) ostium, and the anterior aspect of the CS infundibulum. In 22 (88%) patients in the linear group, the AVNRT was successfully eliminated by 1.5 +/- 0.8 linear RF applications without any complications. All 25 patients in the focal group satisfied the endpoint criteria after 3.8 +/- 2.4 focal RF deliveries. The success rate did not significantly differ between the two groups. Out of the 22 patients with a successful outcome in the linear group, 17 (77%) attained complete abolition of the slow pathway conduction, whereas this was observed in only eight (32%) patients in the focal group (P < 0.005). The session time was significantly shorter in the linear group. Recurrence of the tachycardia was not documented in any patient during a mean follow-up of 18 +/- 8 months except one with residual slow pathway conduction in the focal ablation group. In conclusion, the anatomic linear approach can be performed safely and possesses a greater potential for slow pathway interruption compared to the electrogram mapping focal approach.

Intraneural median nerve pressure in carpal tunnel syndrome.

In order to determine whether endoscopic carpal tunnel release decompresses the median nerve, we measured the intraneural median nerve pressure pre- and postoperatively in 55 hands. The median nerve pressure was significantly reduced postoperatively.

Case report: pulmonary embolism from thrombosis in a duplicated inferior vena cava developing after an electrophysiologic procedure.

Duplicated inferior cava (IVC) is an anomaly we rarely encounter during electrophysiologic procedures. We report a case with duplicated IVC who developed thrombosis of the left IVC following an electrophysiologic procedure, which resulted in an asymptomatic pulmonary embolism. It is speculated that several catheters placed in the torturous route through the left IVC caused either endothelial damage to the vessel wall, or hemostasis in the relatively narrow portion of the vessel, resulting in thrombus formation. Since the prevalence and characteristics of thrombo-embolic complications during electrophysiologic procedures in patients with a duplicated IVC remain unknown, we believe this case should be reported.

Possible involvement of bcl-2 suppression in wild-type p53 gene-dependent cell growth repression in rat osteosarcoma cells.

We recently obtained 3 cloned cell lines demonstrating the p53 mutation from a lung metastatic nodule of a rat transplantable osteosarcoma. In this study, we applied wild-type p53 gene transfer to the rat osteosarcoma cells by lipofection to investigate the effects on cell growth, expression of genes such as waf1/p21, bcl-2, and bax, and nucleosomal DNA fragmentation due to apoptosis. Reconstitution of the p53 gene inhibits cellular growth, and this growth-suppressive effect is partly due to apoptosis involving bcl-2 gene suppression in this tumor type. This rat osteosarcoma model is similar in biologic behavior to human cases and thus is very suitable for further investigation of tumorigenesis and gene therapy for osteosarcoma.

Analysis of posterior mitral annular activation during entrainment and catheter ablation of mitral isthmus ventricular tachycardia using a coronary sinus catheter.

A detailed analysis of the ventricular activation along the posterior aspect of the mitral annulus was made using a multipolar catheter positioned in the coronary sinus in a patient with mitral isthmus ventricular tachycardia (VT) associated with a remote inferior myocardial infarction and prior cryosurgical ablation for the elimination of a different preexisting VT. A change in the timing and sequence of the ventricular activation along the isthmus could be observed during induction of the VT and entrainment pacing. A radiofrequency (RF) current application directed at the posterolateral region of the isthmus successfully eliminated this tachycardia. During the RF delivery, complete conduction block was confirmed by a sudden change in the activation sequence during sinus rhythm.