Effects of alginate oligomer on the expression of cell cycle- and stress-related genes in Chlamydomonas reinhardtii

Enzymatically prepared alginate oligomer (AO) promoted the growth of Chlamydomonas reinhardtii in a concentration-dependent manner. AO at 2.5 mg/mL induced increase in expression levels of cyclin A, cyclin B, and cyclin D in C. reinhardtii. CuSO₄ at 100 μM suppressed the growth of C. reinhardtiin, and AO at 2.5 mg/mL significantly alleviated the toxicity of CuSO₄. Increased intracellular reactive oxygen species level in C. reinhardtii induced by CuSO₄ was reduced by AO. After cultivation with CuSO₄ at 100 μM, expression levels of ascorbate peroxidase and superoxide dismutase in C. reinhardtii were increased, and AO reduced the increased levels of these enzymes. These results suggest that AO exhibits beneficial effects on C. reinhardtii through influencing the expression of various genes not only at normal growth condition but also under CuSO₄ stress.

Intracellular haemolytic agents of Heterocapsa circularisquama exhibit toxic effects on H. circularisquama cells themselves and suppress both cell-mediated haemolytic activity and toxicity to rotifers (Brachionus plicatilis)

A harmful dinoflagellate, Heterocapsa circularisquama, is highly toxic to shellfish and the zooplankton rotifer Brachionus plicatilis. A previous study found that H. circularisquama has both light-dependent and -independent haemolytic agents, which might be responsible for its toxicity. Detailed analysis of the haemolytic activity of H. circularisquama suggested that light-independent haemolytic activity was mediated mainly through intact cells, whereas light-dependent haemolytic activity was mediated by intracellular agents which can be discharged from ruptured cells. Because H. circularisquama showed similar toxicity to rotifers regardless of the light conditions, and because ultrasonic ruptured H. circularisquama cells showed no significant toxicity to rotifers, it was suggested that live cell-mediated light-independent haemolytic activity is a major factor responsible for the observed toxicity to rotifers. Interestingly, the ultrasonic-ruptured cells of H. circularisquama suppressed their own lethal effect on the rotifers. Analysis of samples of the cell contents (supernatant) and cell fragments (precipitate) prepared from the ruptured H. circularisquama cells indicated that the cell contents contain inhibitors for the light-independent cell-mediated haemolytic activity, toxins affecting H. circularisquama cells themselves, as well as light-dependent haemolytic agents. Ethanol extract prepared from H. circularisquama, which is supposed to contain a porphyrin derivative that displays photosensitising haemolytic activity, showed potent toxicity to Chattonella marina, Chattonella antiqua, and Karenia mikimotoi, as well as to H. circularisquama at the concentration range at which no significant toxicity to rotifers was observed. Analysis on a column of Sephadex LH-20 revealed that light-dependent haemolytic activity and inhibitory activity on cell-mediated light-independent haemolytic activity existed in two separate fractions (f-2 and f-3), suggesting that both activities might be derived from common compounds. Our results suggest that the photosensitising haemolytic toxin discharged from ruptured H. circularisquama cells has a relatively broad spectrum of phytoplankton toxicity, and that physical collapse of H. circularisquama cells can lead not only to the disappearance of its own toxicity, but also to mitigation of the effects of other HABs.

Macrophage polarization and MRSA infection in burned mice

Mortality associated with Staphylococcus aureus infection remains high during the sub-acute phase of burn injury. In this study, we aimed to improve antibacterial resistance of sub-acutely burned mice through macrophage polarization. Sepsis did not develop in mice at the sub-acute phase of 5% total body surface area (TBSA) burn after being infected with methicillin-resistant S. aureus (MRSA), and M1 macrophages (interleukin (IL)-10^-IL-12⁺ inducible nitric oxide synthase⁺ Mφ) were isolated from these mice. In contrast, predominantly M2b macrophages (C-C motif chemokine ligand 1 (CCL1)⁺IL-10⁺IL-12^- Mφ) were isolated from mice with >15% TBSA burn, and all of these mice died after the same MRSA infection. Comparing NOD scid gamma mice inoculated with Mφ with 25% TBSA burns, all mice treated with CCL1 antisense oligodeoxynucleotide (ODN) survived after MRSA infection, whereas all untreated mice given the same infection died within 4 days. CCL1 antisense ODN has been characterized as a specific polarizer of M2bMφ. M1Mφ were isolated from MRSA-infected mice with 25% TBSA burn after treatment with CCL1 antisense ODN, and these mice were shown to be resistant against a lethal dose of MRSA infection. M1Mφ were also isolated from 25% TBSA-burned mice infected with MRSA when the ODN was administered therapeutically, and subsequent sepsis was effectively controlled in these mice. These results indicate that the M2bMφ polarizer is beneficial for controlling MRSA infection in mice at the sub-acute phase of severe burn injury.

The Polarization of M2b Monocytes in Cultures of Burn Patient Peripheral CD14+ Cells Treated with a Selected Human CCL1 Antisense Oligodeoxynucleotide

M2b macrophages (Mφ) play a major role in the increased susceptibility of subacutely burned patients, to sepsis stemming from enterococcal translocation. Certain opportunistic infections in severely burned mice have been controlled by murine CCL1 antisense oligodeoxynucleotide (ODN), a specific polarizer of mouse M2bMφ. In the present study, we have screened CCL1 antisense ODN, which is active against human M2bMφ. Among the 20 CCL1 antisense ODNs synthesized in our laboratory, HCA-11 was shown to be the most active polarizer for human CCL1⁺CD163⁺CD14⁺ cells. Burn patient CCL1⁺CD163⁺CD14⁺ cells (3 × 10⁵ cells/mL) switched to quiescent CCL1^-CD163^-CD14⁺ cells within 48 h in cultures supplemented with 100 μg/mL of HCA-11. After treatment with a 25 μg/chimera dose of HCA-11, the bacterial growth was not observed in various organs of patient chimeras (γNSG mice inoculated with burn patient WBCs) infected with a lethal dose of Methicillin-resistant Staphylococcus aureus. The host antibacterial defenses against certain opportunistic pathogens should be improved in severely burned patients treated with a human CCL1 antisense ODN, HCA-11.

The Strategy of Dural Arteriovenous Fistula with Isolated Sinus

We treated 7 cases of dural arteriovenous fistulas (dAVF) with isolated sinus by transvenous direct embolization.

The fistulas located in the transverse-sigmoid sinus in 5 cases, superior sagittal sinus in 1 case and transverse-sigmoid and superior sagittal sinus in 1 case.

The initial symptoms were generalized convulsion in 2 cases, disturbed consciousness in 1 case, tinnitus in 2 cases and transient ischemic attack in 2 cases. We performed sinus packing with coils in all cases following transarterial embolization.

All patients improved neurologically after the treatments and AVFs completely disappeared in all cases.

Comparative studies on the fish-killing activities of Chattonella marina isolated in 1985 and Chattonella antiqua isolated in 2010, and their possible toxic factors

Chattonella antiqua isolated in 2010 showed extremely more potent fish-killing activities against red sea bream, Japanese horse mackerel, and blue damselfish than those of Chattonella marina isolated in 1985. Chemiluminescence and electron spin resonance (ESR) analyses suggested greater reactive oxygen species (ROS)-producing activity of C. antiqua than that of C. marina. Sodium benzoate, a hydroxyl radical scavenger, significantly suppressed the fish-killing activity of C. antiqua on blue damselfish. The chlorophyll level in the gill tissue of blue damselfish exposed to flagellate cells increased along with the exposure time, and the cell count of gill-associated C. antiqua estimated with chlorophyll level was higher than that of C. marina. These results suggest that the ROS-producing activity and affinity of Chattonella cells to the gill surface may be important factors influencing the fish-killing activity of Chattonella species.

M2b Monocytes Provoke Bacterial Pneumonia and Gut Bacteria-Associated Sepsis in Alcoholics

Chronic alcohol consumption markedly impairs host antibacterial defense against opportunistic infections. γ-irradiated NOD-SCID IL-2Rγ(null) mice inoculated with nonalcoholic PBMCs (control PBMC chimeras) resisted Klebsiella pneumonia and gut bacteria-associated sepsis, whereas the chimeras created with alcoholic PBMCs (alcoholic PBMC chimeras) were very susceptible to these infections. M1 monocytes (IL-12(+)IL-10(-)CD163(-)CD14(+) cells), major effector cells in antibacterial innate immunity, were not induced by a bacterial Ag in alcoholic PBMC cultures, and M2b monocytes (CCL1(+)CD163(+)CD14(+) cells), which predominated in alcoholic PBMCs, were shown to be inhibitor cells on the Ag-stimulated monocyte conversion from quiescent monocytes to M1 monocytes. CCL1, which functions to maintain M2b macrophage properties, was produced by M2b monocytes isolated from alcoholic PBMCs. These M2b monocytes reverted to quiescent monocytes (IL-12(-)IL-10(-)CCL1(-)CD163(-)CD14(+) cells) in cultures supplemented with CCL1 antisense oligodeoxynucleotide, and the subsequent quiescent monocytes easily converted to M1 monocytes under bacterial Ag stimulation. Alcoholic PBMC chimeras treated with CCL1 antisense oligodeoxynucleotide were resistant against pulmonary infection by K. pneumoniae and sepsis stemming from enterococcal translocation. These results indicate that a majority of monocytes polarize to an M2b phenotype in association with alcohol abuse, and this polarization contributes to the increased susceptibility of alcoholics to gut and lung infections. Bacterial pneumonia and gut bacteria-associated sepsis, frequently seen in alcoholics, can be controlled through the polarization of macrophage phenotypes.

Development of red-shifted mutants derived from luciferase of Brazilian click beetle Pyrearinus termitilluminans

Luciferase, a bioluminescent protein, has been used as an analytical tool to visualize intracellular phenomena. Luciferase with red light emission is particularly useful for bioluminescence imaging because of its high transmittance in mammalian tissues. However, the luminescence intensity of existing luciferases with their emission over 600 nm is insufficient for imaging studies because of their weak intensities. We developed mutants of Emerald luciferase (Eluc) from Brazilian click beetle (Pyrearinus termitilluminans), which emits the strongest bioluminescence among beetle luciferases. We successively introduced four amino acid mutations into the luciferase based on a predicted structure of Eluc using homology modeling. Results showed that quadruple mutations R214K/H241K/S246H/H347A into the beetle luciferase emit luminescence with emission maximum at 626 nm, 88-nm red-shift from the wild-type luciferase. This mutant luciferase is anticipated for application in in vivo multicolor imaging in living samples.

Mitigation of bacterial translocation and subsequent sepsis in γ-irradiated mice treated with CCL1 antisense ODN (INC4P.331)

Gut bacteria-associated sepsis is a serious concern in persons who have radiation-induced injuries in the gastrointestinal system. Such infection does not normally occur in healthy hosts with M1Mϕ. However, M1Mϕ are not generated in γ-irradiated mice (WBI-mice), even though Mϕ are still present. WBI-mice are carriers of M2bMϕ, which inhibit Mϕ conversion from resident Mϕ to M1Mϕ. We have previously reported that sepsis stemming from Enterococcus faecalis oral infection is markedly mitigated in 5 Gy WBI-mice after M2bMϕ polarization using CCL1 antisense ODN. In this study, we examined the effect of CCL1 antisense ODN on spontaneous bacterial translocation and subsequent sepsis in 8 Gy WBI-mice. The ODN was administered (s.c., twice daily) to 8 Gy WBI-mice for 1 week starting 3 days after γ-irradiation. The efficacy of the treatment was evaluated by an increase in the percentage of survival in test groups, as compared with that of control groups. All control mice died within 22 days of γ-irradiation. However, 70% of the WBI-mice treated with 25 to 125 μg/mouse of the ODN survived more than 30 days after γ-irradiation. Severe bacteremia and bacterial growth in MLNs were not seen in WBI-mice treated with the ODN. M1Mϕ were isolated from MLNs of these mice, while M2bMϕ were not. These results indicate that the Mϕ polarization therapy using CCL1 antisense ODN is effective to mitigate spontaneous bacterial translocation and subsequent sepsis in mice exposed to 8 Gy of γ-irradiation.

Resistance of subacutely burned mice (SAB-mice) therapeutically treated with CCL1 antisense ODN against infections with MRSA or enterococci (INC4P.344)

In previous studies, sepsis stemming for E. faecalis translocation and MRSA local infection has been greatly controlled in SAB-mice prophylactically treated with CCL1 antisense ODN. Effector cells (M1Mφ) in host antibacterial immunities are isolated from the infected SAB-mice after treatment with the ODN. In this study, the antibacterial resistance of SAB-mice therapeutically treated with the ODN was examined against infections with E. faecalis and MRSA. Mice 2 weeks after flame burn injury (3rd degree 25% TBSA) were infected with MRSA (106 CFU/mouse, i.v.). Decontaminated mice 2 weeks after burn injury were infected with E. faecalis (8 x 106 CFU/mouse, p.o.). These mice were therapeutically treated with the ODN (s.c., 10 mg/mouse) at various schedules starting 12 h after the infection. The antibacterial efficacies of the ODN were evaluated by reducing bacterial growth in blood and organs as compared to those of control mice. In the results, bacteria grew in the blood (>105 CFU/ml), liver (>106 CFU/gram), spleen (>105 CFU/gram), and kidneys (>107 CFU/gram) of control mice 3 to 5 days after MRSA infection. However, significant growth of the pathogen in their organs was not demonstrated in SAB-mice treated with the ODN 12, 24, and 36 h after the infection. Similar results were obtained in SAB-mice orally infected with E. faecalis. These results indicate that infections with MRSA and E. faecalis in SAB-mice are controllable by the therapeutic treatment with CCL1 antisense ODN.

Human CCL1 antisense oligodeoxynucleotide (ODN) screened as a potent inhibitor of M2b monocytes (INC6P.322)

In a murine model of γ-irradiation, bacterial translocation and subsequent sepsis have been effectively controlled by CCL1 antisense ODN, a M2b macrophage reverter. In the present study, we tried to obtain human CCL1 antisense ODN which is inhibitory on human M2b macrophages. Twenty human CCL1 antisense ODNs were synthesized based on the prediction of CCL1 mRNA secondary structure, calculation of GC content, and binding energy of ODNs. To evaluate the activity of these ODNs, an amount of CCL1 in culture fluids of M2b monocytes cultured with the ODNs was determined by ELISA. M2b monocytes were generated in vitro from healthy donor peripheral blood monocytes after stimulation with IL-1β and IgG in combination. In the results, 2 ODNs (HCA-15 ; CAACATCTGGAGAAGGGT : HCA-17 ; GGGCTGTGGTGATGATC), at doses of 20 and 100 µg/ml, suppressed 70-80% or more of CCL1 production by M2b monocytes. Also, decreased expression of IL-10 and CD163 was shown in M2b monocytes cultured with HCA-15 and HCA-17. The other 18 ODNs were not significantly active on the M2b macrophage reversion. These results suggest that HCA-15 and HCA-17 may be beneficial in controlling bacterial translocation and subsequent sepsis in patients with γ-irradiation.

ILC3 detected in intestinal mucosal tissues of mice with chronic alcohol consumption (IRC4P.608)

Bacterial translocation from microbiota causes serious sepsis in mice with chronic alcohol consumption (CAC-mice). Since innate lymphoid cells (ILCs) are cells to be involved in the prosperity and decoy of host antibacterial innate immunities, in this study, we tried to isolate ILCs from intestinal mucosal tissues of CAC-mice with various durations of alcohol consumption. CAC-mice were prepared by an oral gavage of 0.6 ml/day of 20% EtOH for 4 to 14 weeks. Lineage negative (lin-) cells were isolated from the intestinal mucosal tissue of CAC-mice. These cells were stimulated with PMA (50 ng/ml) and ionomycin (500 ng/ml) for 6 hours. Obtained cells were analyzed for ILC2 and ILC3 by flow cytometry, and culture fluids of lin- cells were assayed for IL-22 and IL-17A by ELISA. In the results, the percentage of CD45+CD90+RORγt+ cells (ILC3) in the lin- cell population was gradually increased in mice with alcohol consumption for 10-12 weeks (7.84% in average), as compared to be percentage of ILC3 in normal mice (0.67%). On the other hand, CD127+ICOS+Sca-1+ST2+ cells (ILC2) were minimally isolated from the lin- cell population of 4-12 week CAC-mice. Lin- cells from 12 week CAC-mice produced 400 pg/ml of IL-22 and 1.7 ng/ml of IL-17A. These results indicate that 10-12 week CAC-mice are carriers of ILC3 which play a role in the increased susceptibility of CAC-mice to enterococcal translocation and subsequent sepsis.

Effect of CCL1 antisense ODN on spontaneous bacterial translocation and subsequent sepsis in mice irradiated with whole body 137Cs γ-rays (WBI-mice) (INC7P.412)

Radiation victims who suffer from gastrointestinal injuries are extremely susceptible to gut-associated sepsis. In our previous studies, M1Mφ located in the lamina propria and mesenteric lymph nodes were shown to be major effector cells against bacterial translocation. However, M1Mφ were not generated in these organs of WBI-mice who are carriers of M2bMφ (inhibitor cells for Mφ conversion from resident Mφ to M1Mφ). CCL1 produced by M2bMφ is essential for the maintenance of M2bMφ properties. In this study, we examined the effect of CCL1 antisense ODN on gut-associated sepsis stemming from endogenous intestinal microflora in 9 Gy WBI-mice. CCL1 antisense ODN was administered s.c. to WBI-mice twice a day for 1 week starting 3 days post-exposure to γ-rays. This group of mice was designated as treated mice. The mortality rates and bacterial growth in the organs and blood of treated mice were compared to those of control mice (WBI-mice treated with scrambled ODN). In the results, control mice died within 14 days of γ-irradiation, while 30% of treated mice survived more than 30 days after the irradiation. Bacteria progressively grew in the mesenteric lymph nodes, liver and blood of control mice, while the pathogens were not isolated significantly from these organs of treated mice. These results indicate that sepsis stemming from spontaneous bacterial translocation is noticeably mitigated in WBI-mice treated with CCL1 antisense ODN.

Bactericidal IL-12+ Mφ generation in sub-acutely burned mice infected with MRSA after treatment with CCL1 antisense oligodeoxynucleotides (ODN) (INC7P.415)

Sub-acutely burned mice are shown to be carriers of M2bMφ, these cells are characterized as inhibitor cells for Mφ conversion from resident Mφ to M1Mφ. CCL1 released from M2bMφ has been identified as an essential chemokine for the maintenance of M2bMφ properties, and M2bMφ derived from sub-acutely burned mice have reverted to resident Mφ after cultivation with CCL1 antisense ODN. In this study, we tried to determine the effect of CCL1 antisense ODN on M1Mφ generation in sub-acutely burned mice infected with MRSA. Two weeks after burn injury, the mice were infected i.v. with 105 CFU/mouse of MRSA, and then, treated with the ODN (s.c., twice a day, 10 μg/mouse). Two days after the infection, F4/80+ cells were isolated from the peritoneal cavities of the mice and assayed for IL-12+ cells. Also, the killing activity of these cells against MRSA was tested in vitro. In the results, a majority of Mφ from normal mice infected with MRSA were shown to be IL-12+ cells (>82%), while 10% or less of Mφ from burn mice infected with the pathogen were IL-12+ cells. However, a majority of Mφ isolated from burn mice infected with MRSA and treated with the ODN were shown to be IL-12+ cells. A majority of Mφ from burn mice infected with MRSA were not bactericidal, while Mφ preparations from the same mice additionally treated with the ODN were bactericidal. These results indicate that M1Mφ are induced after treatment with CCL1 antisense ODN in sub-acutely burned mice infected with MRSA.

Effect of CCL1 antisense oligodeoxynucleotides (ODN) on MRSA infection in subacutely burned mice (SB-mice) (MPF3P.810)

Staphylococcus aureus is frequently isolated from subacutely burned patients, and these infections easily develop into severe sepsis. M2bMφ have been characterized as the responsible cells on the increased susceptibility of SB-mice to staphylococcal infections, and SB-mice are carriers of M2bMφ. In this study, we tried to protect SB-mice (mice 10 to 30 days after burn injury) from a lethal dose infection of MRSA using CCL1 antisense ODN (an inhibitor of M2bMφ). Mice, 14 days after burn injury (20% total body surface area 3rd degree burns), were infected with 2 x 106 CFU/mouse of MRSA. Then, these mice were treated s.c. with 10 μg/mouse of CCL1 antisense ODN twice a day for 3 days (treated mice). As control mice, SB-mice were treated with scrambled ODN. The protective effect of the ODN against MRSA infection was evaluated by a reduction in the mortality rates of treated mice as compared with that of control mice. Also, bacterial growth in various organs of treated mice was compared with those of controls. In the results, all control mice died within 7 days of MRSA infection, while all treated mice were still alive after 7 days with the same infection. Bacteria grew in the liver, spleen and kidneys of control mice. However, the pathogen did not grow significantly in these organs of treated mice. These results indicate that sepsis caused by a lethal dose of MRSA infection in SB-mice is controlled by treatment with CCL1 antisense ODN.

Effect of CCL1 antisense ODN on the M2bMφ elimination and subsequent generation of M1Mφ in bacterial translocation sites of mice irradiated with whole body 137Cs γ-rays (WBI-mice) (INC7P.411)

An essential host defense against gut-associated sepsis is a local antibacterial innate immunity mainly expressed by M1Mφ (IL-10-IL-12+ Mφ with marked bactericidal activity). Although Mφ are radioresistant, M1Mφ are not generated in bacterial translocation sites (lamina propria and mesenteric lymph nodes) of WBI-mice. M2bMφ (IL-10+IL-12-CCL1+ Mφ) appearing in response to radiation injuries inhibit Mφ conversion from resident Mφ to M1Mφ. CCL1 has been characterized as an essential chemokine for the maintenance of M2bMφ properties, and M2bMφ are shown to be major CCL1 producer cells. In this study, we tried to eliminate M2bMφ and induce M1Mφ in the bacterial translocation sites of WBI-mice by treatment with CCL1 antisense ODN. The ODN was administered s.c. to WBI-mice twice a day for 1 week starting 3 days after γ-irradiation (8-11 Gy). One day after the final treatment, these mice were stimulated orally with 107 heat-killed E. faecalis. Then, F4/80+ Mφ were isolated from the bacterial translocation sties of these mice and tested for their M1Mφ and M2bMφ properties. In the results, M1Mφ were not detected in the translocation sites of WBI-mice stimulated with the antigen. However, M1Mφ were isolated from WBI-mice treated with the ODN and stimulated with the antigen. M2Mφ were not isolated significantly from these mice. These results indicate that M1Mφ are inducible by the bacterial antigen in 8-11 Gy WBI-mice after treatment with CCL1 antisense ODN.

Importance of sulfate groups for the macrophage-stimulating activities of ascophyllan isolated from the brown alga Ascophyllum nodosum

To investigate the role of sulfate groups on the macrophage-stimulating activities of ascophyllan, we prepared desulfated ascophyllan, and its effects on RAW264.7 cells were compared with native ascophyllan. The chemical structural analysis revealed that nearly 21% of sulfate groups of ascophyllan were removed by desulfation reaction, while no significant changes in the molecular mass and monosaccharide composition occurred after desulfation. NO- and cytokine- (TNF-α and G-CSF) inducing activities of the desulfated ascophyllan on RAW264.7 cells were significantly decreased as compared to native ascophyllan. Furthermore, the activity of desulfated ascophyllan to induce reactive oxygen species (ROS) generation from RAW264.7 cells decreased to almost negligible level. Our results suggest that the level of sulfate groups of ascophyllan is an important structural element responsible for the macrophage-stimulating activities. Probably, even the limited removal of sulfate residues sensitive to desulfation reaction may result in significant decrease in the bioactivities of ascophyllan.

Lumbar vertebral chordoma arising from an intraosseous benign notochordal cell tumour: radiological findings and histopathological description with a good clinical outcome

Benign notochordal cell tumours have recently been described as intraosseous benign lesions of notochordal cell origin. The lesions are found in vertebral bodies in 20% of autopsy studies and are a potential precursor of chordoma. We report a rare case of lumbar vertebral chordoma that was thought to arise from a benign intraosseous notochordal cell tumour and which showed significant osteosclerotic change. Radiologically, the lumbar vertebral mass lesion showed hyperintensity on T2 weighted images, with scanty enhancement on post-contrast T1 weighted MR images. High uptake corresponding to the mass was noted on fluorine-18-fluorodeoxyglucose positron emission tomography. Bone biopsy revealed proliferation of the physaliphorous cells between thickened bone trabeculae; no nuclear mitosis was observed. Although the mass was diagnosed clinically as spinal chordoma, histopathology contained both benign notochordal cell tumour and conventional chordoma. After heavy particle (11C)-charged radiation therapy was applied to the lesion with a sufficient radiation field margin, the tumour volume significantly decreased and there was improvement in the patient's symptoms. On follow-up radiological studies, the tumour had markedly regressed and there was no tumour regrowth or distant metastasis. In this case report, benign notochordal cell tumour and conventional chordoma are histopathologically identified in the L1 vertebral body, which contains osteosclerotic and osteolytic areas. It is suggested that the benign notochordal cell tumour coexists with a conventional chordoma and that this histopathological finding supports a hypothetical relationship between benign notochordal cell tumour and chordoma.

Expansile organized maxillary sinus hematoma: MR and CT findings and review of literature

An organized hematoma is a chronic state of fibrotic tissue surrounding a hemorrhage. A mass lesion resulting from hematoma in the maxillary sinus was first reported in 1917, and the term, "blood boil," was clinically coined from such features as encapsulated blood and locally aggressive behavior. Subsequently, others have reported lesions with a similar appearance and clinical course, and now, in Japan, blood boil is used as a clinical term for such lesions. Factors that may predispose a patient to hematoma formation vary, and the pathogenesis of the mass is still uncertain. The lesions are mainly composed of an organized hematoma, regardless of their origin. We present 2 cases of organized maxillary sinus hematomas that have unusual radiologic findings and correlate these findings with the histopathologic findings.

Clinical results of stenting for cervical internal carotid stenoses

SUMMARY

Total 89 patients with cervical ICA stenosis were treated by stenting. In 74 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rate was 4.5% and 0%, respectively.Two(3%) of 74 cases showed distal embolism when blocking balloon catheter systems(BBCS) were used, while distal embolism occurred in four (27%) of 15 cases of stenting without BBCS. On diffusion- weighted MRI (DWI), hyperintense areas were detected in seven (47%) of 15 lesions when we used BBCS only during postdilatation. On the other hand, use of BBCS during predilatation as well as postdilatation reduced hyperintense areas on DWI, which were detected in three (25%) of 12 patients. Our blocking balloon catheter system is a useful device to reduce the risk of distal embolism, especially when we use it during not only postdilatation but predilatation.

A case of glassy cell carcinoma of the uterine cervix effectively responding to chemotherapy with paclitaxel and carboplatin

Glassy cell carcinoma (GCC) of the uterine cervix is a highly malignant tumor and has a poor prognosis. As yet, no effective systemic chemotherapy to this tumor has been reported. Here we describe a case of recurrent GCC that responded to paclitaxel and carboplatin combination treatment. The patient, a 32-year-old woman, with clinical staging FIGO IB1 disease had a radical hysterectomy and postoperative radiotherapy. Three months after initial treatment, she had a relapse as peritoneal dissemination, which was confirmed in the second surgery (adnectomy) and which did not respond to platinum-based conventional chemotherapy (cisplatin, adriamycin, cyclophosphamide and carboplatin, etoposide). The recurrent peritoneal tumors responded well to paclitaxel and carboplatin combination treatment. An elevated serum concentration of carcinoembryonic antigen (672 ng/ml) was reduced to 14.4 ng/ml by six such courses. Peritoneal histopathology confirmed a complete response in the third surgery (ileostomy) for adhesive ileus by the radiotherapy. This is the first report of effective systemic chemotherapy with paclitaxel and carboplatin to recurrent GCC of the uterine cervix.

Variation of des-gamma-carboxyprothrombin (PIVKA-II) levels in cord blood throughout gestation

The variation of des-gamma-carboxyprothrombin (PIVKA-II, protein induced by vitamin K absence) levels in umbilical cord blood throughout gestation was examined using a highly sensitive method, electrochemiluminescence immunoassay (ECLIA). PIVKA-II levels in infants without any complications were low, but modestly high, exceeding the normal range of healthy adults during the preterm period, followed by a remarkable increase after the 37th week of gestation. Among infants complicated with severe preeclampsia a marked increase of PIVKA-II levels was observed in preterm infants, showing a good correlation with the existence ofinfarctions on the placenta. On the other hand, among infants complicated with preterm premature rupture of the membranes (PROM) in which antibiotics were administered during the prenatal period, a moderate elevation of PIVKA-II levels was observed. These data suggest that the normal range of PIVKA-II in fetuses is modestly high compared with adults and any deficient status of vitamin K would not exist throughout the preterm period. Nevertheless, the vitamin K status might readily fall into a deficient condition in term infants. Furthermore, it is notable that vitamin K deficiency would be induced in complicated gestation with severe preeclampsia and medication with antibiotics.

Clinical results and complications of endovascular treatment for intracranial aneurysms

SUMMARY

Thirty-two patients with intracranial aneurysm were treated via the endovascular approach and clinical results and complications were accessed. The aneurysms were on the anterior circulation, posterior circulation and feeding artery of AVM in 17, 12 and three patients respectively. In 17 (anterior circulation aneurysm), 12 patients underwent parent artery occlusion. There were two complications: cerebral embolism due to premature detachment of balloons and cerebral infarct due to parent artery occlusion. In 12 (posterior circuration aneurysm), four patients had complications: three infarcts due to parent artery occlusion and one aneurysmal bleeding at the interventional procedure. Coil compactions occurred in four cases. There were no complications in cases associated with AVM. Use of detachable balloons for intra-aneurysmal occlusion and intra-aneurysmal embolisation for partially thrombosed giant aneurysm tends to result in ischemic lesions where patient outcome is poor. We must pay attention to avoid these complications even though intra-aneurysmal embolisation using microcoils is currently performed safely.