Miliary tuberculosis with indeterminate interferon gamma release assay results.

Recently, interferon gamma release assays (IGRAs) have become an important clinical tool for detecting latent tuberculosis. However, IGRA results may impede making a diagnosis. We herein present an interesting case of miliary tuberculosis with a nonspecific IGRA reaction due to hemophagocytosis.

Improving in the fasting, but not the postprandial, glucose level is associated with reduction of plasma d-ROMs level in patients with type 2 diabetes.

AIMS: This study aimed to evaluate the relationship between improvement of glucose metabolism and plasma levels of diacron-reactive oxygen metabolites (d-ROMs) in patients with type 2 diabetes. METHODS: As the first daily profile, the plasma levels of glucose and d-ROMs were determined on admission. Then, after treatment to lower plasma glucose levels, the second daily profile of these levels was evaluated. Fasting plasma glucose (FPG), the total area under the curve (AUC) of the daily plasma glucose profile (AUCDP), the AUC of the postprandial plasma glucose levels (AUCPP), the AUC of the daily plasma d-ROMs profile (AUCd-ROMs), the coefficient of variation (CV) of plasma glucose (CVPG), and the mean amplitude of glycemic excursions (MAGE) were calculated. The relationship between the improvement of glucose metabolism and that of oxidative stress in patients with type 2 diabetes was evaluated. RESULTS: The second determinations of FPG, AUCDP, AUCPP, MAGE, and AUCd-ROMs were significantly lower than those of the first determinations, but no significant difference was observed in CVPG. Linear regression analysis demonstrated significant associations between the changes in AUCd-ROMs and the changes in both FPG and AUCDP, whereas no significant association was observed between the change in AUCd-ROMs and the change in AUCPP, CVPG, or MAGE. CONCLUSIONS: This study has demonstrated that improvement of the FPG level, but not of the postprandial glucose level, is associated with a reduction of the plasma level of d-ROMs in patients with type 2 diabetes.

Metastatic ovarian tumors: a review of 64 cases.

OBJECTIVE: The goal was to review cases of metastatic ovarian tumor with respect to their clinical features. METHODS: Sixty-four patients with pathologically confirmed metastatic ovarian carcinoma, who were treated between 1978 and 2002 at Osaka Medical Center for Cancer and Cardiovascular Diseases (OMCC), were reviewed and the clinical features examined. RESULTS: We found that metastatic tumors accounted for 21.1% (64/304) of malignant ovarian tumors. Of 64 metastatic ovarian tumors, 26 originated from gynecologic organs, and 38, from nongynecologic organs. Gynecologic primary sites were the uterine body (23%), uterine cervix (14%), and fallopian tube (3%). Eight of nine cervical cancers with ovarian metastases were adenocarcinomas. Adenocarcinoma of the uterine cervix metastasized to the ovaries more frequently than squamous cell carcinoma (5.6% vs 0.1%, respectively; P < 0.01). Among 38 cases of metastatic ovarian tumors from nongynecologic organs, Krukenberg tumors, pathologically characterized by the presence of typical signet-ring cells, were found in 11 patients (29%). Most (8/11) had originated in the stomach. Half (19/38) were preoperatively diagnosed as metastases. The 5-year survival rate after resection of metastatic ovarian tumors from gynecologic organs was significantly higher than the rate after resection of such tumors from nongynecologic organs (47% vs 19%, respectively; P = 0.026). CONCLUSIONS: Metastatic ovarian tumors are likely to be relatively common in Japan because of the high incidence of gastric cancer. In cases of pelvic tumor, metastatic ovarian tumor should always be included in the differential diagnoses. As the 5-year survival after resection of metastatic ovarian tumor is 19%, even for tumors from nongynecologic organs, it seems worthwhile to consider tumorectomy as the second cytoreduction.

Expression of platelet-derived endothelial cell growth factor/thymidine phosphorylase in cervical intraepithelial neoplasia.

Angiogenesis contributes to the growth and secondary spreading of solid tumors. Platelet-derived endothelial cell growth factor (PD-ECGF)/thymidine phosphorylase (TP) has been identified as such an angiogenic factor. In this study, the expression of PD-ECGF/TP and VEGF was evaluated by immunohistochemical staining of tumor specimens from 40 patients with cervical intraepithelial neoplasia (10 with moderate dysplasia; 10 with severe dysplasia; 10 with carcinoma in situ; 10 with invasive carcinoma). The microvessel density was assessed by immunostaining for factor VIII-related antigen in the most highly neovascularized area. In both the nucleus and cytoplasm, the intensity of PD-ECGF/TP expression in carcinoma in situ and invasive carcinoma was significantly stronger than that in moderate dysplasia. However, the intensity of VEGF expression was not significantly different in the various specimens. The microvessel density in mild dysplasia was significantly different from that in carcinoma in situ (p<0.05), and that in invasive carcinoma (p<0.05). There was no significant relationship between the microvessel density and the expression of PD-ECGF/TP or that of VEGF. These results show that the expression of PD-ECGF/TP appears to be involved in the promotion of angiogenesis in cervical intraepithelial neoplasia.