Serum VEGF increases in diabetic polyneuropathy, particularly in the neurologically active symptomatic stage.

AIM: To identify the relationship between vascular endothelial growth factor (VEGF) and diabetic polyneuropathy (DPN). METHODS: Two hundred and twenty diabetic patients participated, 113 with DPN and 107 without DPN. All patients were also classified according to the four stages of DPN (no neuropathy: stage 0; asymptomatic neuropathy: stage 1; symptomatic neuropathy: stage 2; disabling neuropathy: stage 3). Serum VEGF concentration was measured using an enzyme-linked immunosorbent assay (ELISA) and levels between the patients with and without DPN and also between the different stages of DPN, were compared. RESULTS: The mean serum VEGF level in all patients was 264.6 +/- 218.8 pg/ml. The mean serum VEGF level was higher in patients with DPN (310.1 +/- 224.3 pg/ml) than in the patients without DPN (216.5 +/- 204.0 pg/ml, P = 0.0014). Serum VEGF was higher in the 'symptomatic' stage (stage 2, 364.8 +/- 225.9 pg/ml) in comparison with the 'asymptomatic' (stage 1, 256.7 +/- 224.4 pg/ml, P = 0.015) and 'disabling' (stage 3, 180.3 +/- 109.4 pg/ml, P = 0.042) stages. The mean serum VEGF level in patients with diabetic retinopathy (261.1 +/- 210.6 pg/ml) and in patients with diabetic nephropathy (241.5 +/- 185.7 pg/ml) was not increased. CONCLUSIONS: The serum VEGF level is increased in patients with DPN, particularly in patients in the neurologically active 'symptomatic' stage.

Optimal MR cholangiopancreatographic sequence and its clinical application.

PURPOSE: To determine the appropriate acquisition parameters for magnetic resonance cholangiopancreatography (MRCP) with a half-Fourier rapid acquisition with relaxation enhancement (RARE) sequence; to determine the optimal MRCP technique by comparing half-Fourier RARE, steady-state free precession (SSFP) two-dimensional (2D) fast spin-echo (SE), and three-dimensional (3D) fast SE sequences; and to clarify the usefulness and limitations of MRCP in diagnosing pancreatic abnormalities. MATERIALS AND METHODS: Half-Fourier RARE MRCP images with varying parameters were compared by using a phantom. Duct conspicuity and contrast-to-noise ratios (C/Ns) were compared for the four MRCP techniques in a phantom and healthy volunteers. The optimal MRCP technique was used to study healthy volunteers and clinical cases. Receiver operating characteristic (ROC) curves were created for data analysis. RESULTS: A 5-mm-thick section without intersection gap was appropriate for half-Fourier RARE MRCP. Only half-Fourier RARE MRCP could depict a 1-mm duct. C/N was the highest with half-Fourier RARE, followed by 3D fast SE, 2D fast SE, and SSFP sequences. ROC curve analysis revealed no interobserver differences, and the area under the curve for detection of strictures of the main pancreatic duct was as high as 0.89. CONCLUSION: Half-Fourier RARE MRCP has the highest contrast and spatial resolution among the four techniques studied and may play an important role in diagnosing pancreatic abnormalities.

[Early HCC and adenomatous hyperplasia: evaluation of arterial and portal blood flow with CTA, CTAP, and pathologic correlation].

In order to analyze the hemodynamic properties of early hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH), three lesions (two HCCs, one AH) depicted as hypoattenuating at CTA and iso attenuating at CTAP were correlated with the histopathological findings. The number of normal hepatic arteries in the tumor was lower than in the liver. Degeneration and narrowing of the lumens were also seen microscopically. All tumors showed the replacing growth pattern and had similar numbers of the portal tracts in the tumor to the liver. The decreased number of intratumoral normal arteries is suspected to be a characteristic finding of the early stage of HCC.

Hypervascular renal transitional cell carcinoma with extension into the renal vein and inferior vena cava.

A rare case of transitional cell carcinoma (TCC) with extension into the renal vein and inferior vena cava (IVC) is presented. Computed tomography, magnetic resonance imaging, and angiography successfully delineated tumor thrombus in the right renal vein and IVC. TCC should be included in the differential diagnosis of renal tumors that can cause IVC thrombosis.

Human pancreatic adenocarcinoma-associated antigens defined by novel murine monoclonal antibodies Pak-1 and Pak-2.

Two murine monoclonal antibodies (MoAbs) Pak-1 and Pak-2 were established by immunizing Balb/c mice with human pancreatic adenocarcinoma xenografts, previously established in mice. Pak-1 showed a strong positive immunostaining to well- and moderately-differentiated tubular duct cell carcinoma of the pancreas but neither to poorly-differentiated nor to other non-tubular pancreatic carcinomas. Pak-2 showed a wide spectrum of immunostaining to ductal and islet cell carcinomas of the pancreas, revealing less reactivity to well-differentiated tubular duct cell carcinomas than Pak-1. The broad specificity of Pak-2 was similarly observed with extrapancreatic tumor tissues. Neither normal pancreatic tissues nor those with chronic pancreatitis were stained with Pak-1 and Pak-2, whereas the islet cells of normal pancreas were stained by both of them. Western blot analysis revealed that Pak-1 recognized two distinct glycoprotein molecules of ductal adenocarcinoma, 100K dalton molecular weight (MW) and pH6-7 isoelectric points (IP) on two dimensional electrophoresis, and that Pak-2 recognized three glycoprotein molecules, 35K dalton MW and pH7-10 IP. The treatment with periodic acid, neraminidase, trypsin and pronase revealed that antigenic epitopes of Pak-1 and Pak-2 may be composed of complex polysaccharide structure rather than terminal sialic acid residues.