A case report of benign metastasizing leiomyoma of the lung: FDG-PET-CT findings and the utility of uterine needle biopsy.

Benign metastasizing leiomyoma (BML) is a rare condition that affects other organs out of the uterus. Recently, a few case reports in which 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been used to distinguish the malignancy have been published. Here, the authors present a case of BML with metabolic activity on PET, in which needle biopsy of the uterus was efficient to make diagnosis.

Complete remission of primary retroperitoneal transitional cell carcinoma after radiotherapy and oral chemotherapy: a case report.

Primary retroperitoneal transitional cell carcinomas (TCCs) are extremely rare neoplasms for which prognosis is very poor. We present a case that underwent complete remission after radiotherapy and concurrent oral chemotherapy. A 68-year-old woman presented with acute onset of bloody stool. Urgent colonoscopy only detected haemorrhoids. Subsequent abdominal ultrasonography revealed a mass of 7 cm in maximal diameter in the left iliac fossa. Laparotomy disclosed a retroperitoneal mass that could not be dissected and therefore only incision biopsy was performed. After a final diagnosis of primary retroperitoneal TCC, chemotherapy with tegafur-uracil (UFT) was initiated but was not effective. Subsequently, radiotherapy was initiated concurrently with UFT at a total dose of 50 Gy in 25 fractions. At 20 months after radiotherapy, the tumour seemed to have completely remitted. At the last follow-up, ten years from radiotherapy, computed tomography revealed no recurrence. We identified only three single case reports regarding primary retroperitoneal TCC over the last five decades. All patients died from the tumour 8-24 months after diagnosis or treatment. Based on the success of our case, radiotherapy with concurrent oral chemotherapy should be considered as an option for unresected cases.

Neuropeptide Y loses its orexigenic effect in rats with lesions of the hypothalamic paraventricular nucleus.

BACKGROUND: Both neuropeptide Y (NPY) and ghrelin can enhance the feeding behavior. The purpose of this study was to determine whether NPY and ghrelin are involved in hyperphagia and obesity induced by lesions of the hypothalamic paraventricular nucleus (PVN). METHODS: Sham-operated control rats and rats subjected to bilateral electrolytic lesions of the PVN were administered NPY (5 µg/rat) by intracerebroventricular infusion or ghrelin (20 µg/kg) by intraperitoneal (i.p.) injection. Control rats were administered the appropriate vehicle by the same route as the drug. We measured the cumulative food intake (FI) for 2 h after infusion of NPY and for 4 h after ghrelin injection. RESULTS: NPY significantly increased the cumulative FI in sham-operated rats. In PVN-lesioned rats, however, the cumulative FI at each time point (15 min, 30 min, 1 h, and 2 h) after NPY infusion was not significantly different from vehicle infusion, showing that NPY lost its orexigenic effect in PVN-lesioned rats. Following ghrelin injection, the cumulative FI was greater in PVN-lesioned rats than sham-operated rats, indicating that PVN lesions enhanced the orexigenic effects of ghrelin. CONCLUSION: These results suggest that the hyperphagia and obesity induced by PVN lesions may be related to an increased orexigenic action of ghrelin, but not NPY.

Effects of ghrelin, corticotrophin-releasing hormone, and melanotan-II on food intake in rats with paraventricular nucleus lesions.

Bilateral lesions of the hypothalamic paraventricular nuclei (PVN) induce hyperphagia and obesity, and ghrelin stimulates appetite in rodents and humans. Conversely, corticotrophin-releasing hormone (CRH) and melanotan-II (MT-II, a synthetic structural homologue of alpha-melanocyte-stimulating hormone, alphaMSH) inhibit feeding behavior. The purpose of the present study was to determine whether these peptides are involved in the hyperphagia and obesity induced by PVN lesions. After bilateral electrolytic lesions of the PVN, rats were given ghrelin intraperitoneally (i. p.), or intracerebroventricular (i. c. v.) infusion of CRH or MT-II. We measured the cumulative food intake (FI) for 4 h after ghrelin injection in rats fed AD LIB, and the changes in FI at 15 min, 30 min, 1 h, and 2 h after infusion of CRH and MT-II in rats fasted for 24 h. Ghrelin significantly increased cumulative FI, with maximal response 3 h and 4 h after injection, and at these times, the FI of PVN-lesioned rats was greater than that of sham-operated rats. CRH significantly decreased FI in all experimental animals, but at 1 h, there was a more powerful inhibitory effect on FI in the PVN-lesioned group than in the sham-operated group. MT-II decreased FI in sham-operated, but not in PVN-lesioned rats. Thus, ghrelin and CRH showed more potent orexigenic and anorectic effects in PVN-lesioned rats, respectively, but MT-II lost its inhibitory action on feeding behavior. These results suggest that the hyperphagia and obesity induced by PVN lesions may be related to an increased orexigenic action of ghrelin due to the destruction of endogenous CRH and alphaMSH receptors.

PR3-ANCA-positive crescentic necrotizing glomerulonephritis accompanied by isolated pulmonic valve infective endocarditis, with reference to previous reports of renal pathology.

Patients with infective endocarditis (IE) often have renal complications which may include infarcts, abscesses and glomerulonephritis (GN). Furthermore, it is generally accepted that there is an association between IE and anti-neutrophil cytoplasmic antibody (ANCA). Here, we report the case of a 24-year-old man who developed rapidly progressive GN in the course of IE due to infection with alpha-streptococcus. The initial clinical manifestation of the condition was severe sacroiliitis without fever. Sandwich ELISA showed that the patient was positive for PR3-ANCA at low titer, and the classical complement pathway was also activated. Renal biopsy demonstrated several lesions: focal embolic GN, GN with immune deposits and focal and segmental crescentic necrotizing GN. Treatment with antibiotics and steroids led to eradication of the infection, and resolution of the renal disease was accompanied by immediate disappearance of PR3-ANCA and hypocomplementemia. During a 4-year follow-up period, no recurrence was observed. There have only been 7 case reports of GN associated with IE and PR3-ANCA in which the renal pathology has been described, and the current report is the first to document renal pathology in a patient with isolated pulmonic valve IE and PR3-ANCA. Moreover, this report is the first to show a change in renal biopsy findings in response to treatment. A review of the 7 literature cases and that of our patient showed that none involved pauci-immune GN. Hence, further studies are needed to clarify the prevalence of pauci-immune GN in ANCA-positive IE patients.

Immunotactoid glomerulopathy with microtubular deposits, with reference to the characteristics of Japanese cases.

We present the case of a 69-year-old man with nephrotic syndrome and renal insufficiency, who developed lobular glomerulonephritis. An electron microscopy examination of a renal biopsy showed microtubular structures of 24 nm in diameter in the subendothelial space and the paramesangial area. These deposits were PAS-positive and Congo red-negative, and revealed predominantly positive staining for kappa light chain. There was no evidence of diseases with highly organized glomerular deposits, such as amyloidosis, cryoglobulinemia, systemic lupus erythematosus or paraproteinemia. Therefore, the patient was diagnosed to have immunotactoid glomerulopathy (ITG). During a seven-year course he has not developed any disease known to be associated with organized glomerular immune deposits. Hence, we believe ITG occurred as a primary glomerular disease in this case. We also highlight cases of ITG with microtubular deposits that have been reported in Japan, compare these cases to previous reports, and show that the characteristics of the Japanese cases are male predominance; a high incidence of membranoproliferative glomerulonephritis (MPGN); a low incidence of monoclonal gammopathy and hematological malignancies and a higher incidence of hypocomplementemia.

High-power femtosecond fiber-feedback optical parametric oscillator based on periodically poled stoichiometric LiTaO3.

We demonstrate a synchronously pumped high-gain optical parametric oscillator with feedback through a fiber, using a passively mode-locked Yb:YAG thin-disk laser as a pump source. We obtain as much as 19-W average signal power at a wavelength of 1.45 microm in 840-fs pulses and 7.8 W of idler power at 3.57 microm. The repetition rate of the pulses is 56 MHz, and the transverse beam quality of the generated signal is M2 < 1.6.

A case of renovascular hypertension due to bilateral renal artery microaneurysm who succeeded in baby delivery.

We report the case of a young pregnant woman with bilateral renovascular hypertension due to renal microaneurysms from an unknown cause, who had a successful delivery. Pregnancy did not affect the disease activity even in the postpartum period. Her blood pressure was maintained within the normal range by administration of labetalol. Although the angiographic appearance of the symmetrical aneurysms in both renal artery beds from the interlobular to arcuate artery levels suggested polyarteritis nodosa of multiple microaneurysms in the bilateral interlobular arteries, the clinical features suggested other causes of renovascular hypertension, such as fibromuscular dysplasia and/or congenital microaneurysms. We were thus unable to reach a definitive diagnosis.

Regional variations in the incidence of end-stage renal failure in Japan.

CONTEXT: Despite recent medical advances, the number of patients beginning dialysis annually is increasing in both the United States and Japan. The ethnically homogeneous population of Japan presents an opportunity to study the presence of factors other than race/ethnicity that might contribute to incidence of end-stage renal disease (ESRD). OBJECTIVE: To determine if and where regional differences exist in ESRD in Japan. DESIGN, SETTING, AND SUBJECTS: Analysis of data reported by the Japanese Society for Dialysis Therapy based on the annual number of patients with ESRD beginning maintenance dialysis therapy in all 47 prefectures of Japan from 1982 to 1998. MAIN OUTCOME MEASURES: Mean annual ESRD incidence and increasing rate of ESRD in each of 11 predefined areas making up the entire country. RESULTS: Incidence of ESRD increased approximately 3-fold in Japan during the study years, from 81.3 per 1 million in 1982 to 237.6 per 1 million in 1998. Significant regional differences were found in both measures. The mean (SEM) annual ESRD incidence (P<.01) and increasing rate of ESRD (P<.01), respectively, were significantly different across Japan. Koshinetsu (140 [11] per 1 million and 9.1 [0.6] per 1 million/y) and Hokuriku (141 [12] per 1 million and 9.7 [0.5] per 1 million/y) were the areas with the lowest incidence and increasing rate of incidence, while Okinawa (188 [17] per 1 million and 13.4 [0.6] per 1 million/y) and Kyushu (179 [15] per 1 million and 12.0 [0.6] per 1 million/y) were the areas with the highest incidence and increasing rate of incidence. CONCLUSIONS: We found definite and significant regional differences in incidence and increasing rate of incidence of ESRD in Japan. Further analyses are needed to identify factors that contribute to these regional differences and thereby improve strategies for treatment of renal disease. JAMA. 2000;284:2622-2624.

Generation, Microwave Spectrum, Barrier to Internal Rotation of Methyl Group, and ab Initio MO Calculation of syn-2-Nitrosopropene, syn-CH(2)&dbond;C(CH(3))&bond;N&dbond;O.

syn-2-Nitrosopropene was generated, in the gas phase, by chemical reaction of 1-chloro-2-(hydroxyimino)propane with K(2)CO(3) and identified by microwave spectroscopy. The microwave spectrum of the reaction product was observed in the frequency range from 8.0 to 40.0 GHz. The rotational constants (MHz) were determined as A = 8744.09(6), B = 4846.07(2), and C = 3177.84(3) for CH(2)&dbond;C(CH(3))&bond;(14)NO (normal species) and A = 8664.36(5), B = 4822.15(3), and C = 3157.04(3) for CH(2)&dbond;C(CH(3))&bond;(15)NO ((15)N species) in the ground vibrational state. The values of the planar moment (P(cc) = (I(a) + I(b) - I(c))/2) obtained for the normal and (15)N species were 1.525(1) and 1.526(1) u Å(2), respectively. This suggests that the nitrogen atom lies in or is close to the ab inertial plane of the molecule and shows also that only two hydrogen atoms are located symmetrically out of the symmetry plane. The reaction product was determined to be syn-2-nitrosopropene by comparing the observed and calculated rotational constants, kappa (Ray's asymmetry parameter) and r(s) coordinates of the nitrogen atom. The dipole moments (D) were determined to be µ(a) = 2.43(5), µ(b) = 1.12(7), and µ(total) = 2.67(7). The barrier heights of the internal rotation owing to the methyl group of the normal species in the ground and first excited torsional states were determined to be 1750(50) and 1740(50) cal/mol (1 cal/mol = 4.184 J/mol), respectively. The (14)N nuclear quadrupole coupling constants (MHz) were determined to be chi(aa) = 0.25(21), chi(bb) = -7.11(40), and chi(cc) = 6.85(61). Two vibrational excited states were observed and the vibrational frequencies (cm(-1)) of the C-N and C-C torsional modes were determined to be 160(40) and 175(40), respectively. The lifetime of syn-2-nitrosopropene was found to be ca. 2 min in the waveguide cell. Copyright 2000 Academic Press.

Molecular cloning and tissue-specific expression of a gonadotropin-releasing hormone receptor in the Japanese eel.

Gonadotropin-releasing hormone (GnRH) is a key regulatory neuropeptide involved in the control of reproduction in vertebrates. In the Japanese eel, one of the most primitive teleost species, two molecular forms of GnRH, mammalian-type GnRH and chicken-II-type GnRH (cGnRH-II), have been identified. This study has isolated a full-length cDNA for a GnRH receptor from the pituitary of the eel. The 3233-bp cDNA encodes a 380-amino acid protein which contains seven hydrophobic transmembrane domains and N- and C-terminal regions. The exon/intron organization of the open reading frame of the eel GnRH receptor gene was also determined. The open reading frame consists of three exons and two introns. The exon-intron splice site is similar to that of the GnRH receptor genes of mammals reported so far. Expression of the eel GnRH receptor was detected in various parts of the brain, pituitary, eye, olfactory epithelium, and testis. This result suggests that GnRH has local functions in these tissues in addition to its actions on gonadotropin synthesis and release in the pituitary. This tissue-specific expression pattern is similar to that of the eel cGnRH-II. Furthermore, the present eel receptor shows very high amino acid identity with the catfish and goldfish GnRH receptors, which are highly selective for the cGnRH-II. These results suggest that the cGnRH-II acts through binding to the present receptor in the eel.

Microwave Spectrum and Molecular Conformation of (E)-Benzaldehyde Oxime.

The microwave spectrum of (E)-benzaldehyde oxime, C(6)H(5)-CH&dbond;NOH and C(6)H(5)-CH&dbond;NOD, has been observed in the frequency range from 26.5 to 40.0 GHz. The spectrum of the ground vibrational state was assigned and fitted to the Watson's A-reduced Hamiltonian to obtain these rotational and centrifugal distortion constants: A = 5183.13(29) MHz, B = 895.367(3) MHz, C = 763.819(3) MHz, Delta(J) = 0.019(3) kHz, and Delta(JK) = 0.204(7) kHz for the normal species, and A = 5158.4(23) MHz, B = 869.44(2) MHz, C = 744.34(2) MHz, Delta(J) = 0.023(2) kHz, and Delta(JK) = 0.193(7) kHz for the deuterated species. The values of the DeltaI (=I(c) - I(a) - I(b)) obtained for the normal and deuterated species were -0.295(6) and -0.28(5) a.m.u. Å(2), respectively. The molecular conformation of this molecule was a planar one in which the values of the dihedral angles, CCNO and CNOH, were almost 180 degrees and 180 degrees, respectively. Copyright 1999 Academic Press.

Microwave Spectrum and Molecular Conformation of delta-Valerolactam.

Microwave rotational spectra for normal and N-deuterated species of delta-valerolactam (2-piperidinone) were observed in the frequency range from 8 to 40 GHz. The spectra of the ground vibrational states for two isotopic species and the excited vibrational states for normal species were assigned, and the rotational constants (MHz) in ground vibrational state were determined using the Watson A-reduced Hamiltonian: A = 4590.96(11), B = 2495.03(2), C = 1731.06(2) for normal species and A = 4436.79(13), B = 2484.49(1), C = 1703.83(1) for deuterated species, respectively. The comparison of the rotational constants and r(s) coordinates of the imino hydrogen atom with ones from the ab initio MO calculation at the MP2/6-31G(d, p) level of theory led to the conclusion that the spectra assigned were due to a half-chair conformer. One vibrationally excited state was observed and its vibrational frequency was 95(64) cm(-1). Copyright 1999 Academic Press.

A case of IgA nephropathy after ABO-incompatible living kidney transplantation.

A 39-yr-old Japanese man underwent living related kidney transplantation. Because the graft was ABO-incompatible, he was treated with double filtration plasmapheresis before transplantation and his immunosuppressive therapy was stronger than usual. However, immunoglobulin A nephropathy, accompanied by cellular crescents and necrotizing lesions, developed after 18 months. To our knowledge, the association of IgA nephropathy with ABO-incompatible kidney transplantation has not been reported previously.