Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards.

The aim of this study is to compare blinded with partially blinded detection of gastric cancer with multidetector (MD) CT by using surgery and endoscopic submucosal dissection (ESD) as reference standards. 44 patients with gastric cancer underwent MDCT with air as an oral contrast agent. Surgery was performed on 37 patients, ESD on six and surgery after ESD on one. To provide comparison cases of blinded evaluation, 38 MDCT examinations were added for cases where no focal gastric lesion was seen on endoscopy. Two radiologists, blinded to the presence, number and location of the tumours, evaluated axial and axial plus multiplanar reformation (MPR) images of 82 MDCT examinations with or without gastric cancer. For partially blinded evaluation, the same radiologists, blinded to the location and number of tumours, evaluated axial and axial plus MPR images of 44 MDCT examinations of gastric cancer. Differences in assessment were resolved by consensus. 45 gastric cancers were found in surgical and ESD specimens. Detection rates of gastric cancer from axial and axial plus MPR images during blinded evaluation and from axial and axial plus MPR images during partially blinded evaluation were 62% (28/45), 64% (29/45), 64% (29/45) and 71% (32/45), respectively. There was no statistical significance for the comparison between blinded and partially blinded detection rates of gastric cancer. The detection rate of gastric cancer with MDCT during blinded evaluation showed no specific difference compared with the detection rate of gastric cancer with MDCT during partially blinded evaluation.

Gene delivery into ischemic myocardium by double-targeted lipoplexes with anti-myosin antibody and TAT peptide.

The treatment of myocardial ischemia using gene therapy is a rather novel but promising approach. Gene delivery to target cells may be enhanced by using double-targeted delivery systems simultaneously capable of extracellular accumulation and intracellular penetration. With this in mind, we have used low cationic liposomes-plasmid DNA complexes (lipoplexes) modified with cell-penetrating transactivating transcriptional activator (TAT) peptide (TATp) and/or with monoclonal anti-myosin monoclonal antibody 2G4 (mAb 2G4) specific toward cardiac myosin, for targeted gene delivery to ischemic myocardium. In vitro transfection of both normoxic and hypoxic cardiomyocytes was enhanced by the presence of TATp as determined by fluorescence microscopy and ELISA. The in vitro transfection was further enhanced by the additional modification with mAb 2G4 antibody in the case of hypoxic, but not normoxic cardiomyocytes. However, we did not observe a synergism between TATp and mAb 2G4 ligands under our experimental condition. In in vivo experiments, we have clearly demonstrated an increased accumulation of mAb 2G4-modified TATp lipoplexes in the ischemic rat myocardium and significantly enhanced transfection of cardiomyocytes in the ischemic zone. Thus, the genetic transformation of normoxic and hypoxic cardiomyocytes can be enhanced by using lipoplexes modified with TATp and/or mAb 2G4. Such complexes also demonstrate an increased accumulation in the ischemic myocardium and effective transfection of hypoxic cardiomyocytes in vivo.

Superconductivity up to 29 K in SrFe(2)As(2) and BaFe(2)As(2) at high pressures.

We report the discovery of superconductivity at high pressure in SrFe(2)As(2) and BaFe(2)As(2). The superconducting transition temperatures are up to 27 K in SrFe(2)As(2) and 29 K in BaFe(2)As(2), the highest obtained for materials with pressure-induced superconductivity thus far.

Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial.

BACKGROUND: Laparoscopic colorectal resection has become popular. The recently developed da Vinci Surgical System promises to facilitate endoscopic surgery and overcome its disadvantages. This study therefore aimed to compare the short-term results between robotic tumor-specific mesorectal excision (R-TSME) using the da Vinci Surgical System and conventional laparoscopic tumor-specific mesorectal excision (L-TSME) in rectal cancer patients. METHODS: Between April 2006 and February 2007, 36 patients were randomly assigned to receive R-TSME or L-TSME. During the study, 18 patients underwent robotic low anterior resection using the da Vinci Surgical System, and 18 patients had conventional laparoscopic low anterior resection. Patient characteristics, perioperative clinical results, complications, and pathologic details were compared between the two groups. RESULTS: The patient characteristics were not significantly different between the two groups. The mean operating time, hemoglobin change, and conversion rate were not significantly different between the groups. Complications were treated conservatively and did not require surgical intervention in the R-TSME group. The average length of stay was 6.9 +/- 1.3 days in the R-TSME group and 8.7 +/- 1.3 days in the L-TSME group (p < 0.001). The specimen quality of the R-TSME group was acceptable. CONCLUSION: Tumor-specific mesorectal excision was performed safely and effectively using the da Vinci Surgical System and the perioperative outcomes were acceptable.

Cholesterol displacement from membrane phospholipids by hexadecanol.

Adding cholesterol to monolayers of certain phospholipids drives the separation of liquid-ordered from liquid-disordered domains. The ordered phases appear to contain stoichiometric complexes of cholesterol and phospholipid. Furthermore, it has been suggested that the cholesterol in these complexes has a low chemical activity compared to that of the free sterol; i.e., that in excess of the phospholipid binding capacity. We have now tested the hypothesis that the membrane intercalator 1-hexadecanol (HD) similarly associates with phospholipids and thereby displaces the complexed cholesterol. HD introduced into monolayers of pure dimyristoylphosphatidylcholine generated highly condensed (stable and solid) domains. In contrast, the phase behavior of mixed monolayers of the phospholipid, sterol, and alcohol suggested that HD could substitute for cholesterol mole for mole in promoting liquid-ordered domains. We also found that the transfer of cholesterol from mixed monolayers to aqueous cyclodextrin was greatly stimulated by the presence of HD, but only at levels sufficient to competitively displace the sterol from the phospholipid. This enhanced efflux was interpreted to reflect an increase in uncomplexed cholesterol. We conclude that HD forms complexes with dimyristoylphosphatidylcholine that are surprisingly similar to those of cholesterol. HD competitively displaces cholesterol from the phospholipid and thereby increases its chemical activity.

Dielectric behaviour of graded spherical cells with an intrinsic dispersion.

The dielectric properties of single-shell spherical cells with an intrinsic dielectric dispersion have been investigated. By means of the dielectric dispersion spectral representation (DDSR) for the Clausius-Mossotti (CM) factor, we express the dispersion strengths as well as the characteristic frequencies of the CM factor analytically in terms of the parameters of the cell model. These analytic expressions enable us to assess the influence of various model parameters on the electrokinetics of cells. Various interesting behaviours have been reported. We extend our considerations to a more realistic cell model with a graded core, which can have spatial gradients in the conductivity and/or permittivity. To this end, we address the effects of a graded profile in a small-gradient expansion in the framework of DDSR.

Effect of endotoxin on expression of TNF receptors and transport of TNF-alpha at the blood-brain barrier of the rat.

The transport mechanism mediating brain uptake of tumor necrosis factor (TNF)-alpha has been studied. When (125)I-labeled rat TNF-alpha was used in internal carotid artery perfusions in rats, the cytokine showed transcytosis through the blood-brain barrier in intact form (permeability-surface area product 0.34 +/- 0.13 microl. min(-1). g(-1)). Uptake was inhibited by low nanomolar concentrations of unlabeled rat TNF-alpha. Human TNF-alpha, which does not interact with the p80 TNF receptor in rodents, showed no brain uptake. mRNA expression of both p60 and p80 receptors could be demonstrated in native brain microvessel preparations. These transcripts increased to 149% (p60) and 127% (p80) of control 4 h after a systemic immune stimulation (2 mg/kg bacterial endotoxin ip). Lipopolysaccharide treatment did not alter the rate of brain uptake of TNF-alpha measured between 4 and 24 h later. In conclusion, a receptor-mediated mechanism is responsible for the transcytosis of TNF-alpha. Saturable transport, requiring the p80 receptor, occurs at concentrations encountered under pathophysiological conditions and therefore constitutes a relevant mechanism of communication between the immune system and the brain.

Comparison of hydro-US and spiral CT in the staging of gastric cancer.

The purpose of this study was to compare the diagnostic accuracy of hydro-ultrasonography (US) and spiral computed tomography (CT) in the staging of gastric cancer. Forty-three patients with gastric cancers confirmed at surgery underwent hydro-US and spiral CT on the same day prospectively. Hydro-US and spiral CT were done after ingestion of water. US and CT images were independently analyzed. After surgery, pathological findings according to TNM classification were compared with US and CT findings. The detection rate for T1 tumors was 75% (12/16), and all T2-T4 tumors were detected (27/27). In the T class, good correlation with pathology occurred in 55.8% of cases for US and 58.1% for CT, and there was no difference in staging accuracy between US and CT (P=.7667). Overstaging occurred in 14% for US and CT. Understaging occurred in 30.2% for US and 27.9% for CT. In the N class, good correlation with pathology occurred in 60.5% for US and 55.8% for CT, and there was no difference in staging accuracy between US and CT (P=.0949). Overstaging occurred in 4.7% for US and 18.6% for CT, and understaging occurred in 34.9% and 25.6%, respectively. The diagnostic accuracy of hydro-US and spiral CT in the staging of gastric cancer was between 55.8% and 60.5%, and there was no significant difference in staging accuracy between hydro-US and spiral CT, except for a tendency to overstaging by CT and understaging by US in the N class (P<.05).

Spiral CT of the gastric carcinoma: staging and enhancement pattern.

The purpose of this study was to correlate the preoperative staging of gastric carcinoma using spiral computed tomography (CT) with pathologic staging and to correlate the enhancement pattern of advanced gastric carcinoma (AGC) on spiral CT with histological type. A total of 180 patients with gastric carcinomas confirmed at surgery underwent spiral CT. After surgery, pathologic findings were compared with CT findings. The detection rate for T1 tumors was 81.4% (57/70), and all T2-4 tumors were detected (110/110). In the T class, good correlation with pathology occurred in 47.8%. In the N class, good correlation with pathology occurred in 52.2%. The rate of understaging in the N class (31.7%) was higher than that of overstaging (16.1%) (P<.001). In AGC, the tumor mass showed delayed enhancement, regardless of Borrmann's type. By histological pattern, good and delayed enhancement was seen in 2/3 (66.7%) with signet ring cell type, but 4/5 (80%) with mucinous type were poorly enhanced (P=.019). Spiral CT for determining the preoperative staging of gastric carcinoma was not accurate. However, the enhancement pattern of AGC correlated with histological type.

Radiologic anatomy of the rabbit liver on hepatic venography, arteriography, portography, and cholangiography.

UNLABELLED: Seo TS, Oh JH, Lee DH, et al. Radiologic anatomy of the rabbit liver on hepatic venography, arteriography, portography, and cholangiography. Invest Radiol 2001;36:186-192. RATIONALE AND OBJECTIVES: The radiologic anatomy of rabbit liver has received little study but is important in many experimental investigations. METHODS: Twenty-four rabbits were studied by using hepatic venograms, aortograms, hepatic arteriograms, cholangiograms, and portograms. RESULTS: In all cases, the right, middle, and left hepatic veins drained into the inferior vena cava just below the diaphragm, and the caudate lobe hepatic vein drained more inferiorly. The proper hepatic artery was a branch of the common hepatic artery in 96%. The first branch of the proper hepatic artery was the caudate lobe artery. The remaining main hepatic artery was divided into the right and left hepatic arteries. The left hepatic artery was further divided into the medial and lateral segmental branches in 95%. The anatomy of the portal vein or bile duct was the same as the hepatic artery in 100% of cases. CONCLUSIONS: Knowledge of the normal patterns and variations of the vessels and bile duct will be helpful for experiments of the rabbit liver in future studies.

Sonographic findings of solid and papillary epithelial neoplasm of the pancreas.

OBJECTIVE: To evaluate the sonographic findings of solid and papillary epithelial neoplasm of the pancreas, a rare tumor occurring in young women. METHODS: The sonographic findings of 11 cases of pathologically proven solid and papillary epithelial neoplasm of the pancreas were retrospectively evaluated. RESULTS: In 6 cases (55%), combined cystic and solid portions of the masses were observed, whereas only solid-looking masses without anechoic cystic portions were seen in 4 cases (36%). One case (9%) had marginal calcification, consequently, the internal architecture was not evaluated by sonography. Internal echoes were seen in 3 of 6 cystic and solid masses. Septa were seen in 3 cases. Among 11 cases of solid and papillary epithelial neoplasm, tumor margins were well defined in 10, and tumor capsules were detected in 9 (echogenic in 7 and hypoechoic in 2). Calcifications were seen in 3 cases (27%). CONCLUSIONS: The characteristic sonographic findings of solid and papillary epithelial neoplasm were well-encapsulated, cystic, and solid masses, but sometimes the mass was seen as a pure solid-looking mass or had internal septations or calcifications.

Treatment of prostatic abscess: value of transrectal ultrasonographically guided needle aspiration.

The purpose of this study was to assess the effectiveness of transrectal ultrasonographically guided needle aspiration in the treatment of prostatic abscess. Fourteen patients with prostatic abscess were evaluated with this technique and treated with sonographically guided needle aspiration. Using this technique, all cases (100%) had one or more hypoechoic areas within the prostate that contained inhomogeneous materials; in 10 patients (71.0%), the lesion showed internal septa or solid portion. The margins of the hypoechoic area were well defined and thick in 11 patients (79.0%) and poorly defined in 3 patients (21.0%). The estimated volume of the prostatic abscess ranged between 2 and 28 ml (mean, 12.0 ml). The presence of a pus collection within the prostate was confirmed by transrectal ultrasonographically guided aspiration in all patients. However, successful treatment of prostatic abscess with transrectal needle aspiration was done in 12 (86.0%) of 14 patients; the treatment failed in 2 (14.0%) of 14 patients. One patient was treated with perineal incision and drainage and the other with transurethral resection. The amount of pus drained ranged between 1 and 39 ml (mean, 12.0 ml). On follow-up transrectal ultrasonographic examination, no remaining abscess pocket was found within the prostate in any of the cases. One year later, the prostatic abscess recurred in one case. In conclusion, transrectal ultrasonographic guidance is useful in the diagnosis of prostatic abscess as well as in the guidance for aspiration and the drainage of such abscesses. Transrectal ultrasonographically guided needle aspiration could be an effective method for treating prostatic abscess.

Survival of Pseudomonas fluorescens and Salmonella typhimurium after electron beam and gamma irradiation of refrigerated beef.

The radurization effects of gamma ray and electron beam irradiation at 1.5 and 3.0 kGy on beef steaks inoculated with Salmonella Typhimurium and Pseudomonas fluorescens were investigated during 8 days of storage at 5 degrees C. Total bacterial counts and numbers of Salmonella Typhimurium and P. fluorescens were analyzed at 2-day intervals. Total bacterial counts of samples irradiated by both gamma rays and electron beam were significantly (P < 0.05) reduced by 3.8 to 5.3 log CFU/g. Salmonella Typhimurium was not detectable during the experimental period. P. fluorescens counts of beef samples irradiated by gamma rays at both 1.5 and 3.0 kGy were not detected; however, P. fluorescens in samples irradiated by electron beam at 1.5 and 3.0 kGy was recovered after 2 days, and bacterial counts reached 7.8 and 6.9 log CFU/g, respectively. Both gamma ray and electron beam irradiation reduced total bacterial counts initially, possibly extending shelf life. Irradiation was very effective in destroying Salmonella Typhimurium; however, P. fluorescens was not completely eliminated by electron beam irradiation. Consequently, gamma ray irradiation was more effective than electron beam irradiation in the destruction of P. fluorescens.

Bone bruises: MR characteristics and histological correlation in the young pig.

PURPOSE: To correlate magnetic resonance (MR) signal characteristics of bone bruises with histological findings. MATERIALS AND METHODS: In 14 tibiae of young pigs, bone bruises were created in the proximal tibial metaphysis. The signal intensity seen on the MR images were correlated with histological findings. The following findings were evaluated: (a) changes of signal intensity on the tibiae; (b) changes of histology on the tibiae; and (c) changes of (a) and (b) on follow-up examinations. RESULTS: We observed three types of injuries on T1-weighted images: focal or diffuse low signal, normal signal and linear low signal intensities. Severe hemorrhagic areas showed low signal intensities on all sequences of MR imaging. Fast spin-echo (FSE) T2-weighted images showed a more distinct low signal intensity than T1-weighted images. FSE short tau inversion recovery (STIR) and FSE fat saturated (FSE-FS) T2-weighted images showed similar signal intensities with FSE T2-weighted images. FS T1-weighted enhanced images showed low signal intensities with variable enhancements. Upon histological examination, hemorrhages and edemas were prominent at the subcortical areas of the contusion sites. The areas of dense, low signal intensities in all imaging sequences showed signs of severe hemorrhage. The areas of diffuse low signal and enhanced areas showed mixed areas of hemorrhages and edemas. Follow-up MR imaging showed evolution of the processes of hemorrhages and edemas with fatty marrow changes. CONCLUSIONS: MR imaging can depict changes in the bone marrow resulting from direct injury to the bone. MR imaging is a useful tool for evaluating the evolution of bone bruises.

Potentiation of hydrogen peroxide, nitric oxide, and cytokine production in RAW 264.7 macrophage cells exposed to human and commercial isolates of Bifidobacterium.

Bifidobacteria have been previously shown to stimulate immune function and this may be mediated by macrophages. The RAW 264.7 cell line was used here as a macrophage model to assess the effects of human and commercial Bifidobacterium isolates on the production nitric oxide (NO), hydrogen peroxide (H2O2) and the cytokines IL-6 and tumor necrosis factor (TNF)-alpha. Thirty three Bifidobacterium strains differentially stimulated the production of H2O2 NO, TNF-alpha, and IL-6 in a dose-dependent manner in 24-h cultures. In the presence of lipopolysaccharide (LPS) the effects of bifidobacteria on NO and H2O2 were masked and were less pronounced at the later stage of incubation. Co-stimulation of macrophages with both LPS and Bifidobacterium increased the production of IL-6 synergistically. In contrast, LPS reduced the ability of the bifidobacteria-induced macrophages to produce TNF-alpha. Our results demonstrated that both human and commercial Bifidobacterium strains can stimulate H2O2, NO, TNF-alpha, and IL-6 production, and this effect was strain-dependent. The in vitro approaches employed here should be useful in further characterization of the effects of bifidobacteria on gastrointestinal and systemic immunity.

Advanced gastric carcinoma: the role of three-dimensional and axial imaging by spiral CT.

BACKGROUND: The purpose of this study was to assess the role of three-dimensional (3D) and axial imaging by spiral computed tomography (CT) in the evaluation of advanced gastric carcinoma (AGC). METHODS: Sixty patients with AGC underwent 3D and axial imaging by spiral CT. Among them, 40 cases were confirmed by surgery. The remaining 20 cases showed typical findings of AGC with upper gastrointestinal series and gastroscopy that were proved by endoscopic biopsy. Spiral CT was performed with 3-mm collimation, 4. 5-mm/s table feed, and 1.5-mm reconstruction interval in the supine position after ingestion of gas. Three-dimensional images using the shaded surface display (SSD) technique were analyzed and graded (excellent, good, or poor). A second dual-phase spiral CT scan was performed with 5-mm collimation, 7-mm/s table feed, and 5-mm reconstruction interval in the prone position after ingestion of water. RESULTS: Among 60 cases of AGC, there were two cases (3.4%) of Borrmann type 1, 12 cases (20.0%) of Borrmann type 2, 32 cases (53.3%) of Borrmann type 3, 11 cases (18.3%) of Borrmann type 4, and three cases (5.0%) of Borrmann type 5. Of the 60 cases of AGC, excellent 3D images were obtained in nine patients (15.0%), good 3D images in 39 (65.0%), and poor 3D images in 12 (20.0%). Among the 12 patients with poor images, cancers were located at the pyloric antrum in eight cases (66.7%), were AGC Borrmann type 4 in three cases (25.0%), and early gastric carcinoma (EGC)-mimicking lesion (AGC Borrmann type 5) in one case (8.3%). Cancers involving the antrum tended to show poor images (p < 0.05). Using axial images, Borrmann's classification based on tumor morphology was accurately identified in 41 cases (68.3%); however, using 3D imaging, 52 cases (86.7%) were accurately classified (p < 0.05). In 40 cases receiving surgery, good correlation between axial CT image and pathology occurred in 70.0% of T class and 72.5% of N class. CONCLUSIONS: Three-dimensional images of AGC by spiral CT data were good or excellent in 80%, and combining 3D images with axial CT imaging improved the accuracy in classifying Borrmann type and tumor staging.

The role of 3D spiral CT in early gastric carcinoma.

PURPOSE: The purpose of this study is to assess the role of 3D imaging using spiral CT for the detection and evaluation of early gastric carcinoma (EGC). METHOD: Thirty-one patients with EGC underwent 3D and axial imaging using spiral CT, and all cases were confirmed at surgery. According to the pathologic specimens, one patient (3.2%) had type I, five (16.1%) had type IIb, 13 (42.0%) had type IIc, three (9.6%) had types IIc + IIb, three (9.6%) had types IIc + III, two (6.5%) had types IIa + IIc, two (6.5%) had types IIb + IIc, and two (6.5%) had types IIb + III. Spiral CT was first performed with 3 mm collimation, 4.5 mm/s table feed, and a 1 mm reconstruction interval in the supine position after intravenous injection of Buscopan and ingestion of gas. The 3D shaded surface display renderings were performed, analyzed, and graded as excellent, good, or poor. Axial CT scanning was performed with 5 mm collimation, 7 mm/s table feed, and a 5 mm reconstruction interval in the prone position after ingestion of water. RESULTS: With use of axial CT images, 20 of 31 tumors (64.5%) were detected. Tumors were suspected in two cases, but nine were not detected. With use of 3D images, 29 of 31 tumors (93.5%) were detected (p < 0.05). Of the 31 cases of EGC, excellent 3D images were obtained in 6 patients (19.3%), good 3D images in 21 (67.7%), and poor 3D images in 2 (6.5%). In the two cases with poor images, the tumor was confined to the mucosal layer and the types were EGC IIc + IIb. In the remaining two cases (6.5%), the tumors were not detected by 3D images. In one case, the tumor was confined to the mucosal layer, and in the other it was located in the pyloric antrum. Both tumors were EGC type IIc. The two cases not detected by 3D imaging were also not detected by axial CT scanning. CONCLUSION: The detection rate of EGC is higher using 3D imaging than axial CT scan alone.

Characterization of the small subunit ribosomal RNA gene of the oyster parasite Haplosporidium costale.

The small subunit ribosomal RNA (SSU rRNA) gene of the oyster parasite Haplosporidium costale was characterized from spore DNA by polymerase chain reaction (PCR) and molecular cloning. Sequence analysis showed that identical clones were obtained from separate batches of spore samples. The gene is 1791 nucleotides in size. It has 84.5% sequence similarity to that of a related oyster parasite, Haplosporidium nelsoni, 71.8% similarity to that of its oyster host, Crassostrea virginica, and 75.4% similarity to that of another oyster parasite, Perkinsus marinus. Among the variable regions of these SSU rRNA genes, H. costale-specific primers were designed and used to confirm parasite identity by the PCR technique. A common 150 base pair amplification product was obtained from DNA samples of H. costale spore DNA, DNA prepared from tissue sections of oysters infected with H. costale plasmodia, and the H. costale SSU rRNA clone. There was no detectable product from DNA samples isolated from tissue sections of oysters infected with H. nelsoni plasmodia.

Bilateral primary pigmented nodular adrenocortical disease--a case of report describing a rare cause of Cushing's syndrome.

A case of Cushing's syndrome due to bilateral pigmented nodular adrenal disease in a 35-year-old male is presented. The adrenals showed multiple, black, variable sized nodules. Histologically the cells contained lipofuscin and either had a clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus. Lymphocytic infiltration and fatty metaplasia within the nodules are two of the prominent histological features. There is extreme internodular atrophy which suggests that primary pigmented nodular adrenocortical disease is a non-adrenocorticotropic hormone dependent condition. Since the disorder appears to involve primarily the cortex of both adrenals, the treatment of choice is bilateral adrenalectomy followed by steroid replacement. The characteristic clinicopathological manifestations that separate this diagnosis from other types of adrenal disease are also discussed. This is the first reported case in Korea to be documented with the pertinent clinicopathological findings.