Leiomyosarcoma occurring in the ligamentum teres of the liver: a case report and a review of seven reported cases

We treated a 49-year-old male with leiomyosarcoma of the ligamentum teres of the liver. Preoperative hepatic imagings revealed a mass in the median segment of the liver. The patient underwent surgery, and the mass, measuring 6x5cm in size, was pathologically diagnosed as leiomyosarcoma arising from the ligamentum teres. To our knowledge, only eight cases of this rare tumor have been reported to date in the English literature.

Ameloblastoma with prominent ossification in the mandible of a dog

A rare case of ameloblastoma with prominent stromal ossification in an 8-year-old female dog was studied. A bony mass recurred rapidly in the right mandible at the first molar region. Histopathologic examination revealed the lesion to be an atypical variant of ameloblastoma. Epithelial cells showed marked cell atypia, and mitotic figures were rather common. The collagenous stroma was abundant, with prominent formation of bone trabecular rimmed by active osteoblasts. The tumor was highly proliferative and aggressive, and thought to be malignant in nature.

Somatosensory evoked potentials recorded from the posterior pharynx to stimulation of the median nerve and cauda equina

Somatosensory evoked potentials (ppSEPs) in response to stimulation of the median nerve at the wrist and the cauda equina at the epidural space (the L4 level) were recorded from the posterior wall of the pharynx in 15 patients who underwent spinal surgery under general anesthesia, using disc electrodes attached to the endotracheal tube, and compared with segmental spinal cord potentials (seg-SCPs) that were recorded simultaneously from the posterior epidural space (PES). ppSEPs consisted of the initially positive spike (P9) followed by slow positive (P13) and negative (N22) waves. The P13 and N22 of ppSEPs had phase reversal relationship with the P2 and N2 recorded from the PES, respectively. The peak latencies of P9 (9.40 +/- 0.7 ms) (mean +/- SD), P13 (13.1 +/- 0.9 ms), and N22 (22.0 +/- 2.1 ms) of ppSEPs coincided with those of P1, N1 and P2 of seg-SCPs, respectively, ppSEPs were recorded more clearly with a reference electrode on the dorsal surface of the neck than with the reference electrode at the earlobe or back of the hand. The threshold and maximal stimulus intensities were also similar between the ppSEPs and seg-SCPs. Thus, the P9, P13, and N22 components of ppSEPs were thought to have the same origin as the P1, N1 and P2 of seg-SCPs, respectively. Therefore, the P9, P13 and N22 of ppSEPs may reflect incoming volleys through the root, synchronized activities of the interneurons and primary afferent depolarizations (PAD), respectively. ppSEPs in response to cauda equina stimulation showed that the latencies of the two initial components (4.6 +/- 0.4 and 6.4 +/- 0.6 ms) corresponded to those of the SCPs recorded from the PES (4.6 +/- 0.3 and 6.3 +/- 0.5 ms), suggesting that these potentials reflect impulses conducting through the spinal cord, similar to epidurally recorded SCPs.

A developmental defect in Plasmodium falciparum male gametogenesis

Asexually replicating populations of Plasmodium parasites, including those from cloned lines, generate both male and female gametes to complete the malaria life cycle through the mosquito. The generation of these sexual forms begins with the induction of gametocytes from haploid asexual stage parasites in the blood of the vertebrate host. The molecular processes that govern the differentiation and development of the sexual forms are largely unknown. Here we describe a defect that affects the development of competent male gametocytes from a mutant clone of P. falciparum (Dd2). Comparison of the Dd2 clone to the predecessor clone from which it was derived (W2'82) shows that the defect is a mutation that arose during the long-term cultivation of asexual stages in vitro. Light and electron microscopic images, and indirect immunofluorescence assays with male-specific anti-alpha-tubulin II antibodies, indicate a global disruption of male development at the gametocyte level with at least a 70-90% reduction in the proportion of mature male gametocytes by the Dd2 clone relative to W2'82. A high prevalence of abnormal gametocyte forms, frequently containing multiple and unusually large vacuoles, is associated with the defect. The reduced production of mature male gametocytes may reflect a problem in processes that commit a gametocyte to male development or a progressive attrition of viable male gametocytes during maturation. The defect is genetically linked to an almost complete absence of male gamete production and of infectivity to mosquitoes. This is the first sex-specific developmental mutation identified and characterized in Plasmodium.

Multi-organ erythrocyte sequestration and ligand expression in rhesus monkeys infected with Plasmodium coatneyi malaria

The pathogenesis of human cerebral malaria is suspected to be caused by blockage of cerebral microvessels by the sequestration of parasitized human red blood cells (PRBC). Examination of infected tissues indicate PRBC sequestration in microvessels is the result of PRBC knob attachment to endothelial cell surface cytoadherence receptors such as CD36, thrombospondin (TSP), and intercellular adhesion molecule-1 (ICAM-1). In lieu of fresh human tissue, several animal models for human cerebral malaria have been developed, the Plasmodium coatneyi-infected rhesus monkey model being the most versatile. To further the understanding of noncerebral malarial complications during disease, we examined noncerebral tissues of infected rhesus monkeys. Our study demonstrated similar microvessel PRBC sequestration and the presence of cytoadherence ligands in noncerebral tissues. Immunohistochemical analysis showed CD36, TSP, and ICAM-1 cytoadherence proteins in several major organs.

Seroprevalence and specificity of human responses to the Plasmodium falciparum rhoptry protein Rhop-3 determined by using a C-terminal recombinant protein

Rhoptry proteins participate in invasion of erythrocytes by malaria parasites. Antibodies to some of these proteins can inhibit invasion and partially protect monkeys from disease. To examine human serological responses to the 110-kDa component (Rhop-3) of the high-molecular-weight rhoptry protein complex, two cDNA clones corresponding to Rhop-3 were identified by immunologic screening. A recombinant protein representing the C-terminal one-third of the Rhop-3 was used to assess the seroprevalence to this protein in geographically isolated populations with different patterns of malaria transmission. The immunoglobulin G (IgG) positivity rate for the recombinant Rhop-3 in an enzyme-linked immunosorbent assay was 30% in an area of Papua New Guinea where malaria is holoendemic. In Kenya, the prevalence rates were 43 and 36%, respectively, in an area of hyperendemicity and an area of seasonal transmission. By contrast, rates of IgG seroprevalence to an extract of Gambian strain of Plasmodium falciparum were 48, 90, and 97% respectively, in these populations. In these areas, the pattern of antibody recognition of Rhop-3 is more similar (1.7-fold maximum difference) than the parasite extract (5-fold difference). The difference in seroresponses may represent antigenic polymorphism in different parasite strains, while their similarity for the Rhop-3 fragment may represent conservation of this protein. Recombinant- and parasite extract-specific IgG was not found in individuals infected only with Plasmodium vivax. Cross-reactivity was seen in the IgM assay. In Mombasa (Kenya), maternal and cord Rhop-3-specific IgG activities were similar. Fetal antigen-specific IgM reactivity was generally undetectable for all antigens.

A correlation of the sequestration rate of Plasmodium coatneyi-infected erythrocytes in cerebral and subcutaneous tissues of a rhesus monkey

Parasitized red blood cells (PRBCs) were sequestered in microvessels of cerebral and subcutaneous tissues of a rhesus monkey infected with Plasmodium coatneyi. A similar sequestration rate (approximately 80%) was observed in both cerebral and subcutaneous microvessels. Electron microscopy showed knobs of the sequestrated PRBCs cytoadhered to endothelial cells. These results are consistent with the finding of PRBC sequestration in subcutaneous tissues in a comatose patient with cerebral malaria. Biopsy specimens of subcutaneous tissue may be useful as indicators of PRBC sequestration in the brain of cerebral malaria patients.

Hyperprolactinaemia among infertile patients and its effect on sperm functions

The effects of hyperprolactinaemia on sperm function were investigated in 264 men with oligozoo-, asthenozoo-, or teratozoospermia and who were attending a male infertility clinic. None of the patients exhibited galactorrhea or complained of impotence. There was no correlation between abnormal values in spermiogram and hyperprolactinaemia. After multiple measurements of serum prolactin concentration, 15 cases (5.7%) were diagnosed as hyperprolactinaemic (> or = 10 ng ml-1). Six of these patients were taking cimetidine and six were taking anti-anxiety drugs. Serum prolactin returned to the normal level after discontinuation of these drugs; thus these 12 cases were considered as drug-induced hyperprolactinaemia. The other three patients were diagnosed as having pituitary microadenomas and received bromocriptine treatment; the serum prolactin levels normalized within 1 month. No changes in sperm concentration, motility or morphology were found after normalization of serum prolactin levels. Sperm fertilizing ability was monitored by the hamster test for 10 months in the three patients with pituitary microadenoma, and no improvement was observed. Results suggest that hyperprolactinaemia, which does not cause symptoms, has little effect on the impairment of sperm functions. Measurement of serum prolactin in infertile men could be justified, however, for early detection of pituitary adenomas.

[Clinical evaluation of 201TI single photon emission computed tomography in patients with large opacities due to silicosis with bronchogenic carcinoma]

201T1 single photon emission computed tomography (201T1 SPECT) was used to evaluate 18 patients with large opacities due to silicosis and 22 others with bronchogenic carcinoma. An early scan and a delayed scan were obtained and the retention index was calculated from the early ratio and the delayed ratio. In patients with silicosis, the retention index and the two ratios were significantly lower than in the patients with bronchogenic carcinoma (p < 0.01). In patients with stable shadows on chest X-ray films due to large opacities of silicosis, the delayed ratio was the same as or lower than the early ratio. However, in patients with silicosis who had high activity in large opacities, the delayed ratio was higher than the early ratio. These results suggest that 201)T1 SPECT is useful for evaluating the activity of large opacities in patients with silicosis and for differentiating large opacities caused by silicosis from those caused by bronchogenic carcinoma.

Stage-specific processing of Pfs230, a Plasmodium falciparum transmission-blocking vaccine candidate

During Plasmodium falciparum gametocytogenesis, Pfs230, a malaria transmission-blocking vaccine candidate, is expressed as a 360 kDa protein localized to the parasitophorous vacuole/parasite plasma membrane. When gametocytes emerge from red blood cells, as they do when taken up in a blood meal by a mosquito, Pfs230 is processed from a 360 kDa form to a 310 kDa form the latter of which is exposed on the exterior surface of gametes. The 50 kDa portion of Pfs230, removed from the amino-terminus of the 360 kDa form, contains 25 contiguous glutamates and an EEVG16 repeat. Analogous to other P. falciparum proteins, the repeat region appears to be immunodominant. As the gamete emerges from the red blood cell and is exposed to the antibodies in the blood meal, cleavage of the immunodominant region of Pfs230 may contribute to an immune evasion strategy by the parasite.

A mouse model for cerebral babesiosis

Clinical symptoms and pathology observed in the cattle infected with Babesia bovis are quite similar to those of human cerebral malaria. Mechanisms involved in the pathogenesis of cerebral babesiosis, however, are still poorly understood because of the lack of a suitable experimental animal model. In this report, Masayoshi Tsuji and his colleagues describe B. bovis infection in severe combined immunodeficiency (SCID) mice, whose circulating red blood cells (RBCs) have been substituted with bovine RBCs (Bo-RBC-SCID mice). The infected mice not only develop a substantial level of parasitemia, but also show nerve symptoms and pathology similar to those observed in infected cattle.

[Recurrence of the acute respiratory distress syndrome in a patient with liver cirrhosis and diabetes mellitus]

The acute respiratory distress syndrome developed twice within 4 months in a patient with liver cirrhosis and diabetes mellitus. The diagnosis was made from the diffuse alveolar shadows seen on a chest X-ray film and a lung injury score of 3.3. The initial episode resolved quickly with steroid pulse therapy. The second episode resolved to some extent after the same therapy, but the patient died of hepatic and renal failure followed by acute pneumonia. The causes of the first and second episodes were considered to be different and the outcome depended on liver and kidney function. We report this case because the acute respiratory distress syndrome rarely occurs within 4 months.

Effect of low dietary calcium intake on blood pressure and pressure natriuresis response in rats: a possible role of the renin-angiotensin system

Dietary Ca is an important modulator of blood pressure in humans and rats. Since the kidney plays a key role in the pathogenesis of hypertension, the effects of a low Ca diet (0.01% Ca) on blood pressure and pressure natriuresis response were studied in normotensive Sprague-Dawley rats. In addition, a possible role of the renin-angiotensin system in the development of hypertension and an altered pressure natriuresis response resulting from low dietary Ca intake was examined. In the low Ca diet group, systolic blood pressure measured by the tail-cuff method was significantly higher than in the normal Ca diet group (1,1% Ca) 1 week after the diet (1 13.0 +/- 7.1 vs. 105.0 +/- 9.5mmHg, p < 0.05). After 4 weeks, the hypertension was more pronounced. Low dietary Ca intake significantly inhibited the water and sodium excretory responses to acute elevation of renal perfusion pressure by tightening an infrarenal aortic constriction. Treatment with an inhibitor of angiotensin-converting enzyme, captopril (30 mg/kg/day), completely abolished the elevation of blood pressure and attenuated the reduced pressure natriuresis response observed in Ca-deficient rats. Although plasma renin activity was not different between the low and normal Ca diet groups after the 2-week dietary regimen, the pressor response to angiotensin II was enhanced by 30% in the low Ca diet group and there was a significant difference in the pressor response between the two groups. These results suggest a possible involvement of the renin-angiotensin system in the development of hypertension and an inhibitory effect on the pressure natriuresis response caused by low dietary Ca intake, via an enhanced sensitivity to angiotensin II.

Differential contribution of metal complexation and dimerization to the chemotherapeutic potential of bicyclen-Zn2II complex against human immunodeficiency virus

1,1'-(m-Xylenediyl)-bis(1,4,7,10-tetraazacyclododecane)-Z n2II complex (m-xylenediyl-bicyclin-Zn2II), a potent inhibitor of human immunodeficiency virus (HIV), was obtained from cyclin by a combination of dimerization and metal complexation. The ratio of median cytotoxic concentration against host cells (CC50) and median effective concentration against HIV cytopathogenicity (EC50), referred to as the selectivity index (SI), was regarded to be a measure of anti-HIV activity. These two chemical modifications contributed to a potent, in vitro anti-HIV activity of m-xylenediyl-bicyclin-Zn2II by respectively increasing the CC50 and decreasing the EC50 in comparison with those of cyclin.

Release profiles of recombinant human tumor necrosis factor from Ca(2+)-triggering liposome in vivo

After the administration of the recombinant human tumor necrosis factor (rHuTNF), plasma concentration could be controlled from egg yolk phosphatidylcholine (eggPC)-egg yolk phosphatidic acid (eggPA) liposome (EggPA liposome). The plasma concentration was highest after the rHuTNF solution administration. Although the concentration after the 30% EggPA liposome administration was much lower than that after the solution administration, the antitumor effect against Meth A sarcoma was equal to that of the rHuTNF solution. Non-linear elimination of rHuTNF in rat could explain these phenomena. First, to evaluate the intact absorption profile, we developed a non-linear absorption calculating program (NLAP). The calculation revealed little difference in the total absorption amounts between the solution and liposomes. The absorption rate from the liposomes was lower than that from the solution, and finally, the control of rHuTNF release from liposomes was also confirmed in vivo. These findings suggested that the sustained release of rHuTNF from liposomes maintained high drug concentration in the injected site and decreased the systemic drug concentration.

[HLA antigens in patients with testicular germ cell tumors]

The role of HLA antigens in the etiology of testicular germ cell tumor has been suggested previously. Several attempts have been made to establish associations of HLA antigens in patients with testicular cancers, but have yielded inconsistent results. We studied the frequencies of HLA antigens by serological typing and DNA typing and examined the association between testicular germ cell tumors and HLA antigens. The serological expression of HLA-A, -B, -C, -DR and -DQ antigens was analyzed in 23 patients with germ cell cancers of the testis. The findings indicated a trend towards an increase in the antigen DQ4 (p < 0.05). The 13 patients were typed for HLA DRB1 and DQB1 allele by PCR-RFLP analysis. The findings revealed an increased frequency of DRB1 0405 (p < 0.01) and DQB1 0401 (p < 0.01).

Antineutrophil cytoplasmic antibodies (ANCA)-associated crescentic glomerulonephritis and propylthiouracil therapy

Cutaneous vasculitis is an uncommon complication of propylthiouracil therapy. Although its pathogenesis remains to be established, detection of antineutrophil cytoplasmic antibodies (ANCA) in association with this type of vasculitis has recently been described. We report here 2 patients who developed ANCA-associated crescentic glomerulonephritis without evidence of cutaneous vasculitis during propylthiouracil treatment of hyperthyroidism. Improvement of the renal function and the disappearance of ANCA were correlately found after discontinuation of propylthiouracil and by corticosteroid therapy in both patients.

A correlation between sequestered parasitized erythrocytes in subcutaneous tissue and cerebral malaria

Sequestered parasitized erythrocytes were found in microvessels of subcutaneous tissues in a comatose patient with cerebral malaria even though the blood smears were negative after quinine treatment. This situation reflects the continued presence of sequestered parasites in the brain and suggests that negative parasitemia in peripheral blood does not necessarily mean the end point of malarial treatment has been reached. Our findings suggest that biopsy of subcutaneous tissue from severe malaria patients may be useful for determining the severity and prognosis of malaria patients.

[A time-saving approach for quantifying regional cerebral blood flow and application to split-dose method with 123I-IMP SPECT using a single-head rotating gamma-camera]

We have proposed a modified early method, which can shorten the total time required for the quantitative regional cerebral blood flow (rCBF) measurement with N-isopropyl-p(-)[123I]iodoamphetamine (123I-IMP) using single-head rotating gamma-camera and the continuous arterial sampling method. Between 7 to 25 minutes after the intravenous injection of 123I-IMP, brain activity increases linearly, the SPECT data acquisition is being performed, and during which detector is rotating continuously. Then the rCBF values based on the microsphere model were calculated using the planar images obtained before and after the above acquisition and 5 min after the injection, and input counts obtained by the continuous arterial sampling. A good correlation (r = 0.951) was observed between the rCBF values obtained by this method and the traditional method, in which the SPECT data acquisition started about 30 min after injection. Applying this method to the quantitative rCBF measurements at rest and during stress with Diamox by the split dose method of 123I-IMP, we could evaluate the rCBF at rest and cerebral perfusion reserve in the same day. We conclude that this method can shorten the total time required for the standard normal microsphere method and can be applied to the split dose method, and this method provide the rCBF values not so much affected by washout of the tracer from the brain.

[Silicosis associated with autoimmune hemolytic anemia]

A 60-year-old man with pneumoconiosis complained of general fatigue, exertional dyspnea, and anorexia. The patient had severe anemia, and laboratory examination revealed autoimmune hemolytic anemia with positive direct and indirect Coombs tests. After corticosteroid therapy, the anemia resolved markedly, and the antinuclear antibody test became negative. However, the silicotic shadow on chest X-ray film showed no remarkable change. The autoimmune hemolytic anemia in this case was probably due to an immunological disturbance caused by silicosis.