Three cases of intracystic papillary neoplasm of gallbladder.

Intracystic papillary neoplasm (ICPN) of gallbladder is a comparatively new concept and is described as pre-malignant lesions in Nakanuma et al. (In: Bosman et al. (eds) WHO Classification of Tumours of the Digestive System, World Health Organization of Tumours, IARC, Lyon, 2010). ICPN with high-grade intraepithelial neoplasia is understood to include intraepithelial carcinoma or noninvasive carcinoma. And lesions with invasive cancer components are classified as ICPN with an associated invasive carcinoma [1]. According to Adsay et al., more than half of patients diagnosed with ICPN have invasive cancer components (Adsay et al., Am J Surg Pathol 36:1279-1301, 2012).Polypoid masses in the gallbladder including benign, malignant, and non-neoplastic lesions have been called gallbladder polyps, and ICPN is also a polypoid lesion in the gallbladder. However, it is difficult to differentiate between them. In the literature, it is said that the possibility of malignancy is high in lesions exceeding 1 cm (Terzi et al., Surgery 127:622-627, 2000). And there are few reports on characteristic imaging findings of ICPN.We have experienced three cases (two females and one male) of ICPN and report our imaging findings. Contrast-enhanced computed tomography revealed large papillary polypoid lesions approximately 2-4 cm in size in the gallbladder. Findings suggestive of deformation of the gallbladder wall and extrinsic progression were absent in all cases. T2-weighted magnetic resonance imaging revealed intense signals and diffusion-weighted imaging showed high intensity. Expanding of the gallbladder was seen in case 1, and a tumor stalk-like appearance was seen in the papillary mass in cases 2 and 3. Surgery was performed in all three cases and ICPN was diagnosed pathologically. The cancer was localized to the mucosa, with no infiltration of surrounding tissue in all three cases.

CT features for diagnosing acute torsion of uterine subserosal leiomyoma.

PURPOSE: To evaluate the usefulness of computed tomographic (CT) features for identifying acute torsion of uterine subserosal leiomyoma (USL). SUBJECTS AND METHODS: We analyzed contrast-enhanced CT examinations of 7 USLs with torsion and 44 USLs without torsion. Two radiologists evaluated the CT features, which consisted of poor contrast enhancement inside the USL, thin rim enhancement around the USL, calcification within the USL, a beak sign between the uterus and USL, fan-shaped poor contrast enhancement in the uterus area adjacent to the USL (dark fan sign), and ascites. We analyzed the frequencies of these CT features in the USLs with versus without torsion using Fisher's exact test. RESULTS: The respective frequencies of CT features in USLs with and without torsion were as follows: poor contrast enhancement, 86 and 5% (P = 0.001); thin rim enhancement, 71 and 9% (P = 0.001); calcification, 29 and 18% (P = 0.61); beak sign, 57 and 86% (P = 0.10); dark fan sign, 57 and 0% (P = 0.001); and ascites, 100 and 20% (P = 0.01). CONCLUSIONS: The CT features of poor contrast enhancement, thin rim enhancement, and dark fan sign are valuable for identifying acute torsion of USL.

Radiation-induced temporary hair loss as a radiation damage only occurring in patients who had the combination of MDCT and DSA.

As imaging technologies become increasingly advanced, it is possible to obtain detailed morphological information as well as functional imaging data. In some imaging technologies, the radiation dose increases with the ability to obtain better images or more detailed information. We encountered three cases of temporary bandage-shaped hair loss, which was caused by perfusion studies of the head by multi-detector row computed tomography (MDCT) for evaluation of cerebral blood flow in patients with vascular disorders. In all three patients with temporary hair loss, two angiographies of the head had been performed in the period of serial CT examinations. This suggested the possibility that radiation exposure from angiography performed in serial examinations, combined with the perfusion studies of the head with MDCT, played an important role in this temporary, bandage-shaped hair loss. Radiologists should be aware that a cumulative or multiplier effect of radiation exposure from multiple diagnostic techniques may result in hair loss and other types of radiation complications.

Structures of oligosaccharides derived from Cladosiphon okamuranus fucoidan by digestion with marine bacterial enzymes.

A fucoidan-utilizing marine bacterium, Fucophilus fucoidanolyticus, was cultivated in medium containing fucoidan from Cladosiphon okamuranus. The C. okamuranus fucoidan was digested into oligosaccharides with the intracellular enzymes of F. fucoidanolyticus, and their structures were determined by nuclear magnetic resonance analyses. Some of their structures are represented by one general structural formula, (-3 L-Fuc palpha1-3 L-Fuc p(4- O-sulfate)alpha1-3 L-Fuc p(4- O-sulfate)alpha1-3( D-Glc pUAalpha1-2) L-Fuc palpha1)(m)-3 L-Fuc palpha1-3 L-Fuc p(4- O-sulfate)alpha1-3 L-Fuc p(4- O-sulfate) alpha1-3 L-Fuc p ( m = 0, 1, 2, or 3). We concluded that all oligosaccharides obtained were derived from a sulfated-fucose-containing polysaccharide of C. okamuranus, which has a repeating unit of (-3 L-Fuc palpha1-3 L-Fuc p(4- O-sulfate)alpha1-3 L-Fuc p(4- O-sulfate)alpha1-3( D-Glc pUAalpha1-2) L-Fuc palpha1-).

Isolation and characterization of a fucoidan-degrading marine bacterium.

Fucoidan, a mixture of sulfated fucose-containing polysaccharides, was prepared from the algal bodies of Cladosiphon okamuranus (class Phaeophyceae, order Chordariales, family Chordariaceae) with a yield of 2.0% of the wet weight of the alga. To obtain enzymes that digest the fucoidan, we screened bacteria in the guy contents of the sea cucumber Stichopus japonicus for their ability to decrease the fucoidan in their culture media, and successfully isolated one bacterial strain that could decrease it. The bacterial strain was gram-negative and possessed menaquinone 7 as the predominant respiratory quinone, and the GC content of its genomic DNA was 52%. The results of the phylogenetic analysis of its 16S ribosomal DNA sequence indicated that the bacterial strain was a member of the division "Verrucomicrobia." However, as the bacterial strain is phylogenetically and phenotypically distinct from verrucomicrobial species described previously, the strain was assumed to be a new member of the division "Verrucomicrobia." When the bacterial strain was cultivated in an algal fucoidan-containing medium, the strain decreased fucoidan from C. okamuranus (44%), Nemacystus decipiens (19%), Laminaria japonica (31%), Kjellmaniella crassifolia (23%), sporophyl of Undaria pinnatifida (22%), Fucus vesiculosus (42%), and Ascophyllum nodosum (61%).