Reconstruction for the brilliance-upgrading project of the Photon Factory storage ring

Reconstruction of the Photon Factory storage ring (PF ring; 2.5 GeV) is now in progress to provide very brilliant synchrotron radiation to users, i.e. the emittance is being reduced by a factor of five. Components, such as the quadrupole and sextupole magnets, vacuum chambers, beamlines and beam-position monitors, are being replaced by new ones in 16 normal-cell sections of the PF ring. The accelerating cavities, injection systems and control systems are also being replaced. Operation will commence when the improvements are completed on 1 October 1997.

New beam-position monitor system for upgraded Photon Factory storage ring

Accompanying the brilliance-upgrading project at the Photon Factory storage ring, the beam-position monitor (BPM) system has been renovated. The new system was designed to enable precise and fast measurements to correct the closed-orbit distortion (COD), as well as to feed back the orbit position during user runs. There are 42 BPMs newly installed, amounting to a total of 65 BPMs. All of the BPMs are calibrated on the test bench using a coaxially strung metallic wire. The measured electrical offsets are typically 200 micro m in both directions, which is 1/2-1/3 of those of the old-type BPMs. In the signal-processing system, PIN diode switches are employed in order to improve reliability. In the fastest mode, this system is capable of measuring COD within about 10 ms; this fast acquisition will allow fast suppression of the beam movement for frequencies up to 50 Hz using a global feedback system.

[Methodological study of hemodynamic analysis of lung mass by contrast enhanced dynamic CT]

We investigated a method of analyzing the hemodynamics of the lung mass by contrast enhanced dynamic computed tomography (dynamic CT) to determine the difference in vascular supply between the pulmonary artery and bronchial artery using an experimental model. Our experimental model consisted of two injectors connected to two tubes, representing the pulmonary artery and bronchial artery, which were further connected to a chamber representing the lung mass. Following infusion of contrast medium into each tube with some delay time, dynamic CT scans were performed to obtain time density curves of the two tubes and the chamber. Using the time-density curve of contrast passage, flow rates from the two tubes into the chamber were calculated by the curve fitting method. Calculated values correlated well with the adopted flow rates of fluid from the injectors (r = 0.893) in the experiment. The results indicate our method of individually measuring flow rates of dual-input blood flow, i.e., from the pulmonary artery and bronchial artery, into the lung mass is applicable clinically to determine blood flow by the two arteries supplying the lung mass.

Digital tomosynthesis imaging of the lung

We report our preliminary results of pulmonary imaging by digital tomosynthesis, and describe some advantages of these digitally processed longitudinal tomographic images. Digital tomosynthesis of the lung was performed in 60 subjects, including 56 patients with a localized lesion or diffuse disseminated lesions, with a fluororadiographic TV unit with linear tomographic capability, in conjunction with an image processing unit. Dual energy subtraction digital tomosynthesis was also available in our system. Multiple longitudinal tomographs of the lung, which were reconstructed from a single set of tomographic image data, facilitated easy evaluation of the morphology of pulmonary abnormalities together with related broncho-vascular structures located in the same longitudinal plane as the lesion, and were immune from any problem caused by inconsistent depth of respiration. The image quality of the reconstructed tomographs was greatly improved by digital image processing to reduce tomographic blur and enhance image clarity. Dual energy subtraction digital tomosynthesis was effective in clearly showing the size, configuration, and distribution of calcification in the lesion. Digital tomosynthesis provided useful information in making the roentgenologic diagnosis of pulmonary lesions.

Heterogeneity in intergenic regions of the ribosomal repeat of the pine-blister rusts Cronartium flaccidum and Peridermium pini

Mixed aeciospore isolates of Cronartium flaccidum and Peridermium pini were obtained from single-tree infections in Britain, Italy and Greece. The 5.8s ribosomal RNA gene and flanking intergenic transcribed spacer regions ITS1 and ITS2 were found to be highly similar between C. flaccidum and P. pini. Within samples heterogeneity was detected at three nucleotide loci in the ITS1 and at four loci in the ITS2 suggesting that several fungal genotypes may occur at a single infection court. The heterogeneity was confirmed by heteroduplex polymorphism analysis of mixed aeciospore products. RFLP of the ribosomal intergenic spacer region 1 (IGS1) amplified from the same templates indicated limited sequence polymorphism in some copies of this repeated locus. Both the sexual and asexual forms of C. flaccidum show evidence of sequence polymorphism in two independent, non-coding regions of the ribosomal gene array. Variation appears to be greater in the sexual form C. flaccidum, than in the monoaecious form P. pini.

[123I-MIBG myocardial SPECT in two patients with familial amyloid polyneuropathy]

201T1C1 SPECT and 123I-MIBG SPECT were performed in two patients with familial amyloid polyneuropathy (FAP). Both patients showed normal accumulation of 201T1C1 and no accumulation of 123I-MIBG in the myocardium at the early and delayed images. These results indicate that the patient with FAP-related myocardial change accompanies sympathetic nerve dysfunction. The dysfunction is supposed to be caused by disturbance of re-uptake of MIBG by the terminal ending of the sympathetic nerve (uptake-1) through the amyloid-deposited connective tissue.

Interaction between the short-wavelength cone and rod systems in the electroretinogram of the cynomolgus monkey

We recorded electroretinograms from anesthetized cynomolgus monkeys by means of three monochromatic (435, 524 or 579 nm) full-field stimuli presented with a monochromatic background light. The color of the background light was changed with 29 interference filters (400-700 nm). Waveforms were analyzed by means of principal component analysis to investigate interaction between the short-wavelength cone and other systems. With the same test lights, responses were also recorded during dark adaptation after 20,000-lux full bleach. The shape of the short-wavelength cone electroretinogram changed as a function of the wavelength of monochromatic background light. The change was clearer around 500-nm background light, to which the rod system is highly sensitive. Further, short-wavelength cone responses developed during the first 15 min in the dark; however, they became smaller with the recovery of the rod system. These findings suggest that there is interaction between the short-wavelength cone and rod systems. In addition, the results of waveform analysis confirmed the interaction between the long-wavelength and middle-wavelength cone systems.

[Clinical application of digital TV tomosynthesis to disorders of the wrist and their post-operative evaluation]

The clinical utility of digital TV tomosynthesis was assessed in 13 patients with chronic disorders of the wrist and the first carpometacarpal joints, and a post-operative evaluation was carried out. The disorders included nonunion of the scaphoid in five patients, Kienböck's disease in four, subluxation of the distal radioulnar joint in two, and osteoarthrosis of the first carpometacarpal joint in two. The total time needed to obtain two sets of tomographs of a wrist by digital TV tomosynthesis was about 10 minutes, or approximately one third of the time required with conventional methods. The total radiation exposure in obtaining all tomographs of one direction with digital TV tomosynthesis was less than that in obtaining only one tomograph with conventional methods. Digital TV tomosynthetic images were judged superior to conventional tomographs by four orthopedic surgeons and four radiologists, because tomographic blur was reduced in part by a spatial frequency filter processing. Clinically, digital TV tomosynthesis was very helpful in evaluating nonunion of the scaphoid and Kienböck's disease, especially in their post-operative conditions with metallic fixative devices. Digital TV tomosynthesis was found to be a fast, feasible and inexpensive method with low radiation exposure for evaluating disorders of the wrist.

[Trial of a small image network system in a radiology department of an university hospital]

This paper describes the construction of an image network system in Shinshu University Hospital, and some of its current issues and advantages. Our discussion is based on our experience with a PACS system. SAIPACS, which was installed in 1990 for use in clinical conferencing and pre- and post-graduate education, and with a new CT and MRI network, which was subsequently introduced in 1993. The SAIPACS interconnects eight digital imaging modalities, including CT, MRI, XTV-DR (including digital tomosynthesis), FCR, nuclear medicine (RI), DSA, US, and a film digitizer (FD), with a workstation. Transmission time from the magnetic disk of each imaging modality to the SAIPACS image disk is not rapid enough. Therefore, we need to select images for transfer that are pertinent to our specific purpose, to complete image transmission within a practically acceptable period of time. The new CT/MRI network is composed of two CT units, two MRI systems, an image processing unit and a Universal Gateway. It provides faster image transmission than the SAIPACS system, because there is no need to reform image data to send them in a reversible compressed form. A versatile network system connected to the SAIPACS and CT/MRI network enables digital image data to be processed and edited and images to be transferred back to SAIPACS for clinical or educational use.

Long wavelength-middle wavelength cone interaction under no background in the electroretinogram of the cynomolgus monkey

We recorded electroretinograms from anesthetized cynomolgus monkeys for 30 monochromatic (400-700 nm) full-field stimuli with five different stimulation levels presented without a background light. Waveforms were analyzed by means of principal component analysis to investigate the influence of stimulus intensity on long- and middle-wavelength cone interaction. With increasing levels of stimulus intensity, the middle-wavelength cone system showed a slight peak shift and a noticeable increase in response, while the long-wavelength cone system showed an obvious change in peak wavelength rather than response. In addition, spectral responses in the long-wavelength cone system increased over the red region, whereas they decreased over the yellow region. On the other hand, responses in the middle wavelength cone system increased over the yellow region much more than over the green region. These complicated changes are thought to indicate the induction of long- and middle-wavelength cone interaction by stimulus light.

Metastable single-strand DNA conformational polymorphism analysis results in enhanced polymorphism detection

Single-strand DNA conformational polymorphism (SSCP) makes use of sequence-dependent folding of single-stranded DNA (ssDNA), which alters the electrophoretic mobility of the fragments, to detect sequence differences between closely related molecules. In this study ssDNAs were purified by depletion of the complementary strand and PCR reactants on magnetic M-280-strepavidin beads. It was found that SSCP profiles created by purified ssDNAs differ from the profiles created by more usual SSCP methods. Under some conditions, SSCP profiles using whole PCR reaction products may result from the interaction between residual PCR primers and ssDNAs. We observed that the ratio of conformers revealed by band position and band intensity may vary between the assay techniques and misinterpretation of sequence variants may result. Another observation of this study was the formation of metastable conformational isomers with bead-purified ssDNAs by eliminating the thermal treatment used in conventional SSCP methods. The metastable SSCP (mSSCP) represents a novel and sensitive system for detection of sequence variation between closely related DNAs. The technique used here for the preparation of the purified ssDNAs is potentially useful for automated PCR-SSCP analysis using capillary electrophoresis or other methods.

[Study of X-ray filter and peak kilovoltage in film-screen chest radiographs in regard to detection of simulated pulmonary nodules: comparison between film-screen combination and FCR]

We compared the ability of standard film-screen chest radiographs to detect simulated pulmonary nodules. The radiographs were taken with different X-ray filters and tube voltages. Detection capability was analyzed utilizing receiver operating characteristic (ROC) curves formed from the interpretation of six readers. Nodule detection was slightly better in images obtained with a tube voltage of 135 kVp than with one of 100 kVp (not statistically significant). Approximately equal detection performance was shown by a conventional film-screen system and FCR with three X-ray filter sets: a copper filter backed by aluminium, a tungsten filter backed by yttrium and aluminium, and a lead filter backed by yttrium and aluminium. Results showed less X-ray exposure with the two latter filter sets. Unenhanced FCR images taken with approximately the same X-ray exposure as conventional radiographs showed nearly equal ability to detect the simulated nodules.

[Study of X-ray filter and peak kilovoltage in Fuji Computed Radiography in regard to the detection of simulated pulmonary nodules]

To determine a suitable combination of X-ray filter and tube kilovoltage for Fuji Computed Radiography (FCR), to provide better detection of pulmonary nodules and reduce patient exposure, we compared observer performance with different X-ray filters and tube voltages. Radiographs were obtained with a copper filter backed by aluminium, with a tungsten filter backed by yttrium and aluminium, and with a lead filter backed by yttrium and aluminium, at both 100 kVp and 135 kVp. Observer performance in detecting simulated lung nodules, which were placed on the posterior aspect of a chest phantom, was compared using receiver operating characteristic (ROC) techniques for each combination of the X-ray filter and tube voltage. The results of the study indicated that 1) nodule detection was superior for the images obtained with 135 kVp as compared with 100 kVp; 2) approximately equal detection rates were obtained for the three X-ray filter sets, although results with the tungsten filter were slightly inferior to the other two filters; and 3) the absorbed dose may be reduced by 30% with the use of a lead filter backed by yttrium and aluminium compared with a copper filter backed by aluminium. We conclude that chest radiography with FCR should preferably be conducted with a higher kilovoltage, e.g., 135 kVp rather than 100 kVp, to ensure a higher detection rate of pulmonary nodules and in conjunction with a lead filter backed by yttrium and aluminium to reduce X-ray exposure to the patient.

[Micro-wave local area network for radiological image transmission]

Shinshu University consists of five campuses in different locations, a situation that presents some problems in communication. To solve this problem, the Shinshu University Video and Data Network System (SUNS), which includes a high-speed audio-visual transfer function, has been developed and utilized for pre- and postgraduate education, administrative teleconferences, and local telephone (PBX) and Fax services. In 1988, a cooperative group for the study of radiographic image processing was organized, consisting of staff members of Shinshu University Hospital in Matsumoto, the Faculty of Engineering in Nagano (75 km from Matsumoto) and the Faculty of Textile Science and Technology in Ueda (45 km from Matsumoto). The system has been developed with a pair of personal computer (PC)-based interactive image workstations and high-speed digital telecommunication interfaces to the SUNS. A transmission time of 878 kbps has been attained, including the time needed for read/write onto the PC hard disk. Image data thus transferred from the hospital have been utilized for the study of image processing by researchers in the Faculty of Engineering, and the processed images have been sent back to the hospital for evaluation of clinical efficacy of the processing by diagnostic radiologists. This kind of microwave network is a promising alternative for high-speed data transmission for radiological images and their processing.

[Cerebral digital tomosynthetic angiography for planning stereotactic biopsy of brain tumor]

We used cerebral digital tomosynthetic angiography for planning the probe trajectory of stereotactic biopsy of brain tumors in four patients. The probe trajectory was basically planned by MRI examinations. However, cerebral digital tomosynthetic angiography demonstrated detailed three-dimensional vascular anatomy around the brain tumors, and therefore was very helpful in revising the planned trajectory when there was a fairly large vessel likely to cross with it.

Polymerase chain reaction heteroduplex polymorphism analysis by entangled solution capillary electrophoresis

Heteroduplex DNA polymorphism analysis (HPA) makes use of conformational polymorphisms to alter electrophoretic mobility of fragments and can be used to detect non-restrictable loci. We have developed a novel application of entangled solution capillary electrophoresis (ESCE) to separate heteroduplex and homoduplex DNA molecules. The addition of ethidium bromide and glycerol to the free solution sieving buffer resulted in the improved peak resolution and good reproducibility. Reannealed polymerase chain reaction products could be used directly for mutation screening and with fully automated ESCE the entire HPA may be completed in less than 30 min including sample handling. This technology could provide a rapid and highly efficient way for screening rare mutations among large numbers of individuals.

Digital angiotomosynthesis for preoperative evaluation of cerebral arteriovenous malformations and giant aneurysms

PURPOSE

To evaluate the clinical utility of the digital angiotomosynthesis technique for giving additional information regarding critical anatomy of cerebrovascular lesions before surgical intervention.

METHOD

Seven arteriovenous malformations and three giant aneurysms were examined with digital angiotomosynthesis; these images were compared with conventional angiograms.

RESULTS

1) Detailed recognition of three-dimensional vascular structures of the arteriovenous malformation and giant aneurysm was facilitated by the cine mode of digital angiograms and angiotomograms. 2) Reconstructed angiotomograms could show clear separation of overlapping vessels and demonstrate fine vasculature. 3) Fine feeders, which were difficult to trace on the conventional angiogram, were more easily recognized in all cases of arteriovenous malformation. 4) Small arteries passing in close proximity to the arteriovenous malformation nidus were identifiable. 5) Fine arterial branches, being obscured by big shadows of giant aneurysms on the conventional angiograms, were well identified. 6) The anatomic relationship of bone structures to the giant aneurysm was clearly shown.

CONCLUSIONS

Digital angiotomosynthesis is helpful for recognizing the three-dimensional and detailed vascular anatomy of arteriovenous malformations and giant aneurysms and provides neurosurgeons with useful information for preoperative evaluation.

Specific expression of the neurofibromatosis type 1 gene (NF1) in the hamster Schwann cell

The gene responsible for neurofibromatosis type 1 (NF1) has sequence homology to the GTPase-activating protein (GAP) and demonstrates GAP activity against ras p21. To study tissue-specific and/or tumor-specific expression of the NF1 gene product, now called neurofibromin, immunostaining and immunoblotting were applied to the N-nitroso-N-ethylurea (ENU)-induced Syrian hamster neurofibromatosis model using polyclonal antibodies against the NF1 fusion protein and a synthetic peptide. Strong expression was observed specific to the Schwann cells of the normal peripheral nerves by immunostaining. Neoplastic Schwann cells showed specific binding of anti-NF1; however, the frequency of positive cells was diminished. Immunoblotting also revealed positive expression of the 250-kd NF1 gene product in the brain, the normal peripheral nerves, and 7 of 14 ENU-induced neurofibromas. Although ENU-induced melanoma and Wilms' tumor were negative for neurofibromin, foci of Schwannian differentiation in both primary and transplanted melanomas were positive. These results suggest that neurofibromin plays some role in differentiation and growth regulation of the Schwann cell.

Three cone systems under white background in the electroretinogram of the cynomolgus monkey

We recorded electroretinograms for 31 monochromatic (400-700 nm) full-field stimuli at five different adaptation levels from anesthetized cynomolgus monkeys. These waveforms were analyzed by means of a principal component analysis to discuss the relationship between three cone systems with a white background. Under no background, spectral response curves of middle-, long- and short-wavelength cone showed peaks at 517, 579 and 435 nm, respectively, which are in agreement with those of the three cone types. Spectral responses of the middle- and long-wavelength cone systems were increased and decreased, respectively, at the region of 530-590 nm as the level of white background light increased. These opposite changes resulted in the shift of the middle- and long-wavelength cone spectral response peaks to 546 and 609 nm, respectively, which suggests interaction between long- and middle-wavelength cone systems. The peak of the short-wavelength cone system shifted to 452 nm because of decreased responses at the region of 400-450 nm. Therefore, the short-wavelength cone system seems to be mediated by a different mechanism from that involving long- and middle-wavelength cone interaction.

Effects of a six-week exposure to excess iodide on thyroid glands of growing and nongrowing male Fischer-344 rats

A 6-wk exposure to excess iodide intake (EII) via drinking water (260 mg potassium iodide/L) demonstrated different effects on growing (4-wk old) and nongrowing (45-wk old) male Fischer-344 rats. In growing rats, EII induced a significant increase in thyroid weight, pituitary weight, serum thyroid-stimulating hormone (TSH), and thyroxine (T4). The labeling index (LI) of thyroid follicular cells was slightly increased, although not statistically significant. Histologically, an increase in follicular cell height, an increase in colloid accumulation, and evidence of colloid absorption were noted. The effect of bovine TSH (bTSH) and protirelin tartrate (TRH-t) on LI was significantly augmented by EII. In nongrowing rats, EII induced a significant increase in thyroid weight and serum T4 but no increase in pituitary weight, serum TSH, and the LI of follicular cells. Histologically, an increase in colloid accumulation was found in small follicles. EII did not augment the effect of bTSH and TRH-t on the LI of follicular cells. This study suggests that growing rats are still susceptible to acute hypothyroidism even after 6 wk of continuous exposure to excess iodide, whereas nongrowing rats are refractory within an equivalent treatment period.

Heterobasidion annosum 5.8s ribosomal DNA and internal transcribed spacer sequence: rapid identification of European intersterility groups by ribosomal DNA restriction polymorphism

Using conserved fungal ribosomal gene sequences the internal transcribed spacer (ITS) regions one and two (ITS1, ITS2) and the 5.8s ribosomal RNA gene (rRNA) of Heterobasidion annosum were amplified by the polymerase chain reaction (PCR). The nucleotide sequence was determined in three European intersterility groups (ISG-S, -F and -P). Three sequence variants of the ITS were found in ISG-S isolates. The sequence of the ITS of ISG-F differed by two residues from the major ISG-S sequence variant. The ISG-P sequence differed from ISG-S and ISG-F at 15-16 and 16 residues, respectively. Amplified intergenic spacer elements were informative for ISG fingerprinting following digestion with various 4-cutter restriction endonucleases. All differences in the restriction fragments between the ISGs were because of sequence differences in the ITS regions. The fingerprint patterns of isolates from the same intersterility group but from different European localities were identical. These results show that ribosomal DNA fingerprinting is a rapid technique to identify ISGs in Heterobasidion annosum.

Regressive and non-regressive thyroid lesions of the rat induced by single injection of N-bis(2-hydroxypropyl)nitrosamine and iodine deficient diet

Six-week-old male F344 rats were divided into 4 groups. Rats in Groups 1 (n = 16) and 3 (n = 14) received a s.c. injection of N-bis(2-hydroxypropyl)nitrosamine (DHPN) (2800 mg/kg) in experimental week 1 while rats in Groups 2 (n = 5) and 4 (n = 5) received saline. From weeks 2-20, all rats were given an iodine deficient (I-def) diet and tap water. Groups 1 and 2 were killed for the measurements of thyroid-stimulating hormone (TSH), thyroxine (T4), the maximum thyroid width (MTW), thyroid weight, morphology, morphometrics and proliferating cell nuclear antigen (PCNA) labeling index (LI). The thyroids of the rats in Group 3 and 4 were surgically exposed and the MTWs were measured. These latter rats were given basal diet for 6 weeks to recover from iodine deficiency, and then killed for the same measurements. Thyroid nodular lesions in Group 1 rats were classified into five categories (NL0, NL1, NL2, NL3 and NL4) based upon incremental cellular and structural atypia. Two types of regressive nodules (NL'0 and NL'1+2) were identified in the recovered rats as the regressed form of NL0, NL1 and NL2 lesions. NL3 and NL4 nodules were seen in Groups 1 and 3. The mean number of combined NL0, NL1 or NL2 lesions was 28.44 +/- 6.12 nodules per rat (NPR) in Group 1 rats and the mean number of NL'0 and NL'1+2 lesions was 28.07 +/- 13.05 NPR in Group 3 rats. The mean number of NL3 or NL4 lesions was 1.70 NPR in Group 1 rats and 3.42 NPR in Group 3 rats. The LIs were NL0 (6.4 +/- 2.5%), NL1 (7.7 +/- 4.4%), NL2 (0.7 +/- 0.3%), NL3 (7.5 +/- 1.3%) and NL4 (14.4 +/- 5.3%) in Group 1 rats and NL'0 (< 0.001%), NL'1 + 2 (< 0.01%), NL3 (9.0 +/- 4.4%) and NL4 (23.3 +/- 17.8%) in Group 3 rats. The thyroid weights of Group 4 rats were 41% of Group 2 rats. The volume fraction (VF) of the non-NL3, non-NL4 areas in Group 3 rats was 40% of that in Group 1 rats. However, the VF of NL3 or NL4 lesions in Group 3 rats was 520% of that of Group 1 rats. In summary, the growth of the NL0, NL1 and NL2 lesions was TSH-dependent, whereas NL3 and NL4 lesions were TSH-independent.(ABSTRACT TRUNCATED AT 400 WORDS)

Proliferative activity of primary cutaneous melanocytic tumours

The expression of proliferating cell nuclear antigen (PCNA) was examined in formalin-fixed paraffin-embedded tissue sections from 41 lesions (27 melanocytic nevi, 3 atypical nevi and 11 malignant melanomas) to determine the proliferative activity of primary cutaneous melanocytic tumours. Most of the malignant melanomas had more than 7% PCNA-positive cells (9.2 +/- 0.5%), while the melanocytic nevi manifested less than 1% PCNA-positive cells (0.4 +/- 0.1%). Atypical nevi exhibited an intermediate, but still significantly lower, labelling ratio when compared with malignant melanomas (0.8 +/- 0.2%). The proliferative activity of the lesions was compared between portions at different depths in the skin (epidermal, upper dermal and lower dermal location). In cases of malignant melanoma, the proliferative activity was higher in the deeper portion of dermis whereas PCNA-positive cells in melanocytic nevi were located in the upper dermis predominantly. Thus the PCNA labelling ratio of malignant melanoma and/or melanocytic nevus cells located in the epidermodermal junction was not necessarily higher than that of malignant melanoma and/or melanocytic nevus cells in the dermis. These results indicate that staining with PCNA would be very useful in the differentiation of malignant melanoma from melanocytic nevi manifesting cellular and/or structural atypia by virtue of a significant difference in the proportion of PCNA-positive cells. Although malignant melanomas have higher proliferative activity than melanocytic nevi in the deeper dermis, junctional activity in melanocytic tumours does not indicate cell proliferation.

In vivo antimelanoma effects of 4-S-cysteaminylphenol, a newly synthesized therapeutic agent specific to melanoma

Antimelanoma effects of 4-S-cysteaminylphenol (4-S-CAP), which is a newly synthesized melanin precursor, as a chemotherapeutic agent specific to malignant melanoma were determined in an in vivo system using mouse B16 melanoma. The intraperitoneal injection of 4-S-CAP induced a slight delay in the growth period of subcutaneous melanoma of C57BL/6 mice. Survival times of mice after treatment with 4-S-CAP were a little longer than those of control mice (P < 0.05), although all mice died from the local growth of tumours. The viable cell ratio of in vivo subcutaneous tumour cells reduced to 52.8% within 24 h after treatment with 4-S-CAP, but the ratio had recovered to the control level 72 h after treatment (> 90%). Similarly, the proliferating-cell-nuclear-antigen-positive cell ratio of melanotic melanoma had reduced 24 h after treatment and recovered within 72 h after treatment, while 4-S-CAP had no effect on amelanotic tumours. The formation of lung colonies by intravenous inoculation of malignant melanoma cells was compared between mice with intraperitoneal injection of 4-S-CAP and phosphate-buffered saline only. The 4-S-CAP-treated mice had significantly fewer lung colonies compared with the control mice (P < 0.01). The results indicate that the agent, 4-S-CAP, would have a therapeutic effect on malignant melanoma for a short time in vivo and therefore the agent can be effective against a small number of tumour cells, such as lung colonies, although it had little effect on the local tumours.

Chest imaging with dual-energy subtraction digital tomosynthesis

Dual-energy subtraction digital tomosynthesis with pulsed X-ray and rapid kV switching was used to examine calcifications in pulmonary lesions. The digital tomosynthesis system used included a conventional fluororadiographic TV unit with linear tomographic capabilities, a high resolution video camera, and an image processing unit. Low-voltage, high-voltage, and soft tissue subtracted or bone subtracted tomograms of any desired layer height were reconstructed from the image data acquired during a single tomographic swing. Calcifications, as well as their characteristics and distribution in pulmonary lesions, were clearly shown. The images also permitted discrimination of calcifications from dense fibrotic lesions. This technique was effective in demonstrating calcifications together with a solitary mass or disseminated nodules.

Friend leukemia virus-induced leukemogenesis in fully H-2 incompatible C57BL/6-->C3H radiation bone marrow chimeras

Resistance and/or susceptibility for Friend leukemia virus (FLV)-induced leukemogenesis was examined in the fully H-2 incompatible C57BL/6 (B6)-->C3H radiation bone marrow chimeras (RBMC). The results indicated that B6-->C3H chimeras never developed FLV-induced leukemias when infected with FLV 4 months after bone marrow transplantation (BMT). Spleen cells from B6-->C3H chimeras that were preimmunized with 100 Gy-irradiated FBL-3 cells (FLV-induced leukemic cell line originated from B6 mice) were shown to generate anti-FBL-3 specific T-cell proliferation as well as cytotoxic T cells. We also found that when bone marrow cells from B6 mice were mixed with those from C3H mice and then grafted into supralethally irradiated C3H mice, resulting chimeras whose peripheral blood contained less than 30% C3H-derived (susceptible) cells were refractory to FLV-induced leukemogenesis. On the other hand, when C3H mice were infected with FLV and then supralethally irradiated 5 days later and grafted with bone marrow from B6 donors, they developed leukemias which were of B6 origin. Athymic nu/nu mice of B6 background were again shown to develop leukemia following infection with FLV. Possible implication of these findings on the role of T cell-mediated immune response in resistance to FLV-induced leukemogenesis and the immunocompetent nature of fully H-2 incompatible RBMC were discussed.

[Noninvasive quantitative measurement of cerebral blood flow with 123I-IMP--lung monitoring method]

In order to perform a less invasive determination of regional cerebral blood flow (rCBF) using I-123-IMP, we used the lung clearance curve as a substitute for the arterial blood activity curve as an input function. We assumed that a major portion of the intravenously injected I-123-IMP initially accumulates in the lung and then is gradually cleared from the lung pool to enter the systemic circulation. In this case lung clearance could be considered nearly equal to the integral of arterial blood activity shown during the examination. We used a single probe detector to obtain the lung clearance curve as the difference between sequential lung activity and peak lung activity. The absolute value of the sequential change in arterial blood activity was estimated from the differentiated lung clearance curve compared with the arterial blood activity that was estimated by actual blood sampling once during the examination. The rCBF was calculated by the thus estimated arterial blood activity curve and brain activity by SPECT image using the microsphere model. The values of rCBF obtained by this method were similar to those obtained by the continuous arterial sampling method, and this lung monitoring method was thought to be applicable to clinical use.

N-nitroso-N-ethylurea-induced hamster melanoma: a new method for efficient induction and schwannian differentiation of melanoma

Melanocytic tumors as well as multiple neurofibromas were induced in 35 of 88 Syrian golden hamsters by a single s.c. administration of 100 mg/kg of N-nitroso-N-ethylurea applied 48 h after birth. The lesions were all observed proliferating in the dermis and demonstrated melanosomes and premelanosomes. High cellularity, nuclear atypia and transplantability of the tumors in outbred hamsters suggested a malignant nature. Some of the melanomas were morphologically heterogenous and contained Schwann-like cells as minor components. In addition, transplantation of the melanomas resulted in increased schwannian differentiation even for primary tumors which did not contain any Schwann-like cell foci. One of the transplanted melanomas mimicked malignant peripheral nervous tumor. Schwannian differentiation was also proved by the fact that glial fibrillary acidic protein was positive in 22.2% of the cases. The present results suggest that the induced hamster melanomas originate from neural crest-derived cells which are able to differentiate into both melanocytes and Schwann cells.

Expression of the proliferating cell nuclear antigen in bone marrow cells from patients with myelodysplastic syndromes and aplastic anemia

To determine the proliferative activity of the hematopoietic cells under nonneoplastic and/or neoplastic conditions, the expression of a cell cycle-related antigen, the proliferating cell nuclear antigen (PCNA), was examined in the bone marrow trephines of 79 individuals, 12 of whom had no hematologic disorder, 32 of whom had a diagnosis of myelodysplastic syndromes (MDSs), 20 of whom suffered from aplastic anemia, and 15 of whom had a diagnosis of acute myeloid leukemia. Most of the patients with MDS had more than 15% PCNA-positive cells (23.5% +/- 1.5%) while patients with no hematologic disorder showed fewer than 15% PCNA-positive cells (11.7% +/- 0.7%). The overall ratio of the PCNA-positive cell fraction in the bone marrow was considered of prognostic value for predicting transition into overt leukemia from MDS. Aplastic anemia cases usually exhibited hypocellular bone marrow and an infrequent labeling with the anti-PCNA antibody (3.3% +/- 0.5%). However, a few aplastic anemia cases showed hypercellular bone marrow and a significantly high PCNA-positive cell ratio (32.0% +/- 4.4%). In the bone marrow of acute myeloid leukemia patients more than 20% of total nucleated cells were positive for PCNA (30.0% +/- 2.2%). The results suggest that the expression of PCNA is associated with the regulation of bone marrow cell proliferation and the bone marrow cellularity, and that these findings would serve as an early indicator of evolution of overt leukemia in MDS and also would be useful in distinguishing MDS cases from aplastic anemia cases when the bone marrow is hypocellular or normocellular.

Association of Sjögren's syndrome with pulmonary hypertension: report of two cases and review of the literature

We report two autopsy cases of Sjögren's syndrome associated with pulmonary hypertension. The pulmonary muscular arteries of both cases showed concentric fibrocellular intimal proliferation, medial hypertrophy, and plexiform lesions. To determine the significance and pathogenesis of this rare association, we carried out morphometric and immunofluorescent studies and reviewed the seven similar cases reported in the literature. Depositions of immunoglobulin G, Clq, C3c, C4, and C5 were observed in the pulmonary arterial walls of both of our cases. Morphometric studies revealed increased medial thickness to radius ratios and intimal thickness to radius ratios of the pulmonary muscular arteries in both cases. Previously reported patients were all female, and those cases were frequently associated with Raynaud's phenomenon. This report provides additional and convincing evidence for an association of Sjögren's syndrome and plexogenic pulmonary hypertension based on a detailed study of two cases and a review of the literature. The significance and pathogenesis of this association were examined, but not clarified. However, our studies add to the accumulating data suggesting a link between autoimmune diseases and chronic pulmonary hypertension.

Coronary artery lesions in Takayasu arteritis: pathological considerations

This communication reviews the clinical and pathological features of coronary artery lesions in Takayasu arteritis. The incidence of coronary artery involvement has been reported to be 9% to 10%, and is observed mainly in autopsy cases because coronary artery disease is usually not evident until the occurrence of angina pectoris or myocardial infarction, or after the onset of congestive heart failure. On the basis of pathological features, the following three types of coronary artery lesions can be distinguished: type 1, stenosis or occlusion of the coronary ostia and the proximal segments of the coronary arteries; type 2, diffuse or focal coronary arteritis, which may extend diffusely to all epicardial branches or may involve focal segments, so-called skip lesions; and type 3, coronary aneurysm. Most of the coronary artery lesions in Takayasu arteritis are of type 1. Narrowing of the coronary arteries is mainly due to the extension of the inflammatory processes of proliferation of the intima and contraction of the fibrotic media and adventitia from the ascending aorta. In some cases, coronary stenosis may be caused by coronary arteritis as skip lesions in Takayasu arteritis, but even in these cases the lesions have been reported to affect mainly the proximal segments of the coronary arteries. Diffuse lesions of the coronary artery and coronary artery aneurysm seem to be very rare in Takayasu arteritis. Other causes of coronary ostial stenosis, coronary arteritis and coronary artery aneurysm are also discussed.

A case of popliteal cystic degeneration with pathological considerations

Adventitial cystic degeneration of the popliteal artery is seldom encountered; only 39 cases have been reported up to now in Japan. The pathogenesis of this disease remains controversial, and the authors describe a case in which the pathological findings differed from cases reported in the previous literature. The subject was a 74-year-old man admitted to our hospital complaining of intermittent claudication. The characteristic findings of cystic degeneration of the popliteal artery were uncovered by contrast-enhanced computed tomography (CT) and duplex sonography. The contrast-enhanced CT showed a low-density area and duplex sonography revealed a multi-lobulated low-echoic lesion. The Doppler signal of the low-echoic lesion could not be detected. While some cysts were found in the adventitia, they were mainly located in the media. The media also showed a remarkable decrease of smooth muscle cells and a prominent mucinous degeneration that had occurred circumferentially. These findings suggest that the medial degeneration noted had occurred prior to cystic formation. Because of this and other findings, we recommend the use of the term cystic degeneration of the popliteal artery in addition to the term cystic adventitial disease of the popliteal artery.

Incidence of atypical bronchioloalveolar cell hyperplasia of the lung: relation to histological subtypes of lung cancer

The incidence of atypical bronchioloalveolar cell hyperplasia (ABH) of the lung was investigated to evaluate the possibility of this lesion being a precancerous stage in the histogenesis of adneocarcinoma. Lobectomy and pneumonectomy specimens of 165 primary and 45 metastatic tumour cases were step-sectioned horizontally and examined histologically. An average of 51 blocks were taken in each case. Sixty-seven ABHs up to 10 mm in diameter were detected, only 2 lesions being associated with scar tissue. Age was one factor apparently related to ABH development, although not the major one. There was no correlation between smoking index and ABH occurrence. In males, the incidence was highest in association with adenocarcinoma (25.5% of cases, 0.8% of sections), followed by large cell carcinoma (25.0% of cases), squamous cell carcinoma (10.5% of cases) and metastatic tumours from other sites (4.8% of cases). In females, ABH was also more common together with adenocarcinoma (8.3% of cases) than with metastatic tumours (4.0% of cases). The differences in male incidences by case and by section between the adenocarcinoma and metastatic tumour categories were statistically significant (P less than 0.05, P less than 0.01 respectively) indicating that ABH may be a precancerous lesion capable of transformation of adenocarcinoma.

Wegener's granulomatosis. Associated with diffuse pulmonary hemorrhage

The authors report a case of Wegener's granulomatosis with the unusual manifestation of diffuse pulmonary hemorrhage. A 58-year-old man complained of bloody sputum and fever. Chest X-ray films showed multiple nodular shadows in both lung fields. He was diagnosed as having Wegener's granulomatosis by transbronchial lung biopsy, which revealed necrotizing granulomatous inflammation with necrotizing vasculitis. Despite treatment with cyclophosphamide and prednisolone, his condition rapidly deteriorated. An extensive diffuse alveolar shadow appeared in both lung fields in chest X-ray films, anemia became worse, and he died of respiratory failure. Autopsy revealed diffuse alveolar hemorrhage with necrotizing capillaritis in addition to the typical pathological findings in Wegener's granulomatosis. The capillaritis was characterized by neutrophilic infiltration of alveolar septa, and fibrin thrombi in alveolar capillaries. Diffuse pulmonary hemorrhage is uncommon in Wegener's granulomatosis. However, once diffuse pulmonary hemorrhage occurs, the respiratory condition rapidly deteriorates and is life-threatening. Therefore, accurate diagnosis and appropriate treatment are required.

[A new polar map to quantify reversible area by myocardial 201Tl single photon emission computed tomography and clinical application to patients before and after percutaneous transluminal coronary angioplasty]

In the studies of stress 201Tl single photon emission computed tomography, we have developed a computer method to discriminate reversible from irreversible defect, then quantify each area and display the area on the polar map. Initial percent uptake (%Ui) and delayed percent uptake (%Ud) were expressed as percent of the maximum uptake area and were defined as regional myocardial 201Tl uptake in initial and delayed image, respectively. The %Ud/%Ui ratio was defined as redistribution ratio (RD-ratio). The values of %Ui obtained from each pixel of short axis slices were plotted against the values of RD-ratio on XY co-ordinates. In this graphic display, normal area, ischemic viable area and non viable area were separated by the following four lines. A; The straight line (Y = 2.0-0.012X) indicating the relationship between %Ui and RD-ratio for the group with ischemic viable myocardium. B; The parallel line to A and shifted to -1.5 SD from A. C; The vertical line at 67.0% level (ischemic upper level). D; The vertical line at 27.6% level (viable lower level). Each area was discriminated by color display and calculated relative area values were displayed on the polar map. Criteria for discriminating each area were derived from the results of ischemic pre-transluminal coronary angioplasty (PTCA) lesions (n = 21) in which viability was confirmed by successful PTCA and previous results of 66 cases with single vessel disease and 16 cases of control group. This new computerized technique was applied for evaluation of another group with successful PTCA (n = 15).(ABSTRACT TRUNCATED AT 250 WORDS)

[Experimental study on catheter-bypass between superior mesenteric and hepatic hilar portal veins (SMV-HPV bypass)]

Hepatic ischemia is a consequence of concomitant resection of the portal vein and the hepatic artery when it is necessitated in hepatobiliary or pancreatic surgery. We developed an antithrombogenic catheter with a balloon and experimentally evaluated the safety of construction of SMV-HPV bypass using this catheter to simultaneously prevent intestinal vascular congestion and hepatic ischemia. The main portal vein and the hepatic artery were blocked and SMV-HPV shunting was made in five dogs (bypass group); the main portal vein and the hepatic artery were blocked and the SMV was shunted to the femoral vein in others (ischemia group). In the ischemia group, 3 of the 5 dogs died within 5 days, but all animals of the bypass group survived for a long period. In the bypass group, the changes of adenine nucleotide levels, energy charge ratio, liver function, blood coagulation, and fibrinolysis were mild and within physiologic ranges, and none of changes of the hepatic tissue were observed histologically. This bypass procedure is simple and safe to simultaneously prevent hepatic ischemia and intestinal vascular congestion in cases requiring concomitant resection and reconstruction of the portal vein and the hepatic artery.

Cardiac metastasis of lung cancer. A study of metastatic pathways and clinical manifestations

BACKGROUND

Although lung cancer frequently spreads to the heart, details of cardiac metastases of lung cancer have not been fully discussed. The authors attempted to elucidate the relationship between the mechanisms of cardiac metastasis and a variety of clinical manifestations caused by cardiac metastasis.

METHODS

Clinical and autopsy records were reviewed in 74 autopsied cases of lung cancer. In cases with cardiac metastasis, the metastatic pathways to the heart were determined by the macroscopic examinations, and the relationship between the metastatic pathways and the clinical manifestations were studied.

RESULTS

Metastases to the pericardium or heart were seen in 23 cases (31%). A lymphatic metastatic pathway was detected in 18 cases (hilar lymphatic routing in 12 cases, and mediastinal lymphatic routing in 6 cases), and a hematogenous metastatic pathway was detected in 5 cases. Malignant pericardial effusion was documented in 15 of 23 cases. The metastatic pathway in 14 of 15 cases was lymphatic (hilar lymphatic routing in 10 cases, and mediastinal lymphatic routing in 4 cases). Patients showing lymphatic metastasis had higher incidence of malignant pericardial effusion than those with hematogenous metastasis (P less than 0.05). Of 23 cases of cardiac metastasis, myocardial infarction was found in 1 case, resulting from the compression of the coronary arteries by the tumor. Concurrent supraventricular arrhythmias were recorded in eight cases with cardiac metastasis. Patients with cardiac metastasis had higher incidence of arrhythmia than those without cardiac metastasis (P less than 0.05). In cases of cardiac metastasis, patients with arrhythmia were older (P less than 0.01) than those without arrhythmia.

CONCLUSIONS

The authors concluded that the hilar lymphatic pathway is essential for early development of malignant pericardial effusion in lung cancer and that aging and cardiac metastasis may be responsible for arrhythmia in patients with lung cancer.

Cytogenetic studies of human malignant melanoma cell lines

Cytogenetic studies were performed on six cell lines derived from three patients suffering from malignant melanomas. The modal chromosome numbers were in the hypotriploid to hypertetraploid ranges and both the numerical and structural aberrations of chromosomes were found. Aberrations were most frequently observed in chromosomes 1, 6 and 7. Deletion of 1q was consistently present in all cell lines, while loss of 6q was observed in two cell lines of case 1. Translocations t (Y; 6) and t (6;?) occurred in one cell line from case 3. An increased number of copies of chromosome 7 was a characteristic feature of the cell lines from case 2. Since positive correlation between the expression of EGF receptors and an increased dosage of chromosome 7 has been reported for malignant melanomas and the gene for EGFR has been mapped to band 7p12-p13, this phenomenon might be of importance for the proliferation of malignant melanoma. The findings of the present study are generally in agreement with the data previously published in the literature, indicating the existence of specific non-random chromosome lesions during melanoma development.

Pathological features of the pulmonary artery in Takayasu arteritis

Little attention has been paid to the pathological features of the pulmonary artery in Takayasu arteritis. Autopsy specimens of 6 cases of this disease were studied. Lesions were found in the aortic arch and its brachiocephalic branches in all cases and in both the aortic arch and thoracoabdominal aorta in 5 cases. The pathohistologic characters of the pulmonary artery were very similar to those of the systemic artery. Stenosis-recanalization, so-called blood vessels-in-blood vessels, of the pulmonary elastic arteries were found in four cases. These lesions were not observed in the systemic arteries, and most of the newly formed channels in them seemed to be branches of bronchial arteries. Luminal obstruction of pulmonary muscular arteries was observed in 4 cases, cellular arteritis of muscular arteries in 2 cases, and angiomatoid dilatation of small blood vessels in 2 cases. Thus in this study we found peculiar stenosis-recanalization lesions of the pulmonary elastic arteries, and also showed that the pulmonary elastic and muscular arteries are frequently involved in Takayasu arteritis. These findings suggest that pulmonary hypertension could influence morbidity and long-term mortality in this disease.

Tumor-promoting effects of both iodine deficiency and iodine excess in the rat thyroid

Thyroid tumor-promoting effects of iodine deficiency and iodine excess were investigated in a rodent 2-stage model to estimate an optimal iodine intake range that would not effectively promote development of thyroid neoplasia. Six-week-old male F344 rats were given a single subcutaneous injection of 2,800 mg/kg body weight N-bis(2-hydroxypropyl)-nitrosamine (DHPN) or saline vehicle, maintained on Remington's iodine-deficient diet (21 +/- 2 ng/g iodide), and supplemented with various amounts of potassium iodide up to 260 mg/liter in drinking water to generate conditions ranging from severe iodine deficiency to severe iodine excess. In DHPN-treated rats, both conditions significantly increased thyroid follicular tumorigenesis. In DHPN-untreated rats, iodine deficiency produced diffuse thyroid hyperplasia, characterized by small follicles with tall epithelium and reduced colloid, together with a decrease in thyroxine (T4) and an increase in thyroid-stimulating hormone (TSH). On the other hand, iodine excess produced colloid goiter, characterized by large follicles with flat epithelium and abundant colloid admixed with normal or small-sized follicles lined by epithelium of normal height, together with normal serum T4 and slightly decreased TSH. These effects were directly proportional to the severity of iodine deficiency or extent of iodine excess and suggest that each condition has a different thyroid tumor promotion mechanism. Iodine intakes that showed the least tumor promotion were 2.6 and 9.7 micrograms/rat/day in this study. Promoting mechanisms and the problem of statistically estimating recommended daily iodine intake range are briefly discussed.

Malignant melanomas of the oral cavity: heterogeneity of pathological and clinical features

Data on 35 patients with oral malignant melanomas were pooled and the pathological features and the clinical course were examined in detail. Of these 35 cases, 27 (77.1%) showed a two-phase growth pattern, with both a vertical and a radial growth phase. Moreover, these 27 cases were classified into three subtypes according to gross features of the vertical growth phase; nodular, flat elevated and ulcerated types. Almost two-thirds of the cases were of the melanotic type. Malignant melanomas without a radial growth phase were found in 8 instances, all of which showed a nodular growth pattern, 1 being of melanotic type and 7 amelanotic. Mean latent insidious periods were evaluated for the cases with different growth phases. Cases with a radical growth phase exhibited the longest mean latent period (35.7 months), and a median survival time of 23.5 months. Cases without a radial growth phase showed a short mean latent period (2.1 months), and a median survival time of 7.5 months. The thickness of invasion ranged from 2 to 9 mm. Although 77.1% of the cases depicted similar pathological patterns to acral lentiginous melanomas of the skin, oral malignant melanomas demonstrated heterogeneity in morphological features, developmental process and biological behaviour. The histogenesis of oral melanomas is briefly discussed.

Neoplastic argentaffin cells with intracytoplasmic eosinophilic granules in a gastric adenocarcinoma

A case of poorly differentiated adenocarcinoma of the stomach with unique histological features is reported: in addition to characteristic adenocarcinoma cells, a large number of tumor cells contained bright eosinophilic and argentaffin granules in their cytoplasm. On routine histologic examination, the latter cells closely resembled the endocrine cells present in the normal human gastrointestinal tract, although the granules were distributed throughout the cytoplasm and did not show any polarity, which is usually subnuclear in normal endocrine cells. Immunohistochemical studies demonstrated positive staining for lysozyme, CEA, gastrin and HCG. Electron microscopic examination revealed cytoplasmic neurosecretory granules, and some tumor cells were found to contain both secretory granules and mucinous material within the same cytoplasm. These neoplastic endocrine cells presumably originated from primitive digestive system elements capable of differentiating towards both endocrine and mucus-secreting varieties.

[Noninvasive quantitative measurement of cerebral blood flow with 123I-IMP--a study concerning the input function]

For the noninvasive quantitative measurement of cerebral blood flow (CBF) using N-isopropyl-[123I]p-iodoamphetamine (IMP), we studied the usefulness of the lung clearance curve obtained by a single probe detector as the input function for brain as an alternative to arterial blood activity. In four patients, we compared the time-activity curve of the lung and serial arterial blood activity for approximately 20 minutes following an IV bolus injection of IMP. Significant positive correlations were observed between lung clearance and the integral of arterial blood activity of IMP. In addition, a study to identify the best region for monitoring lung activity with the probe detector was performed in six patients using a gamma camera and region of interest (ROI) management. The central region of the right lung was found to be the best position for monitoring lung radioactivity. This study suggests that the lung clearance curve of IMP can be used as the input function for brain in the quantitative assessment of CBF.

Stromal melanocytic foci ("blue nevus") in step sections of the uterine cervix

Stromal melanocytic foci (SMF) of the uterine cervix, which are known as extracutaneous blue nevus, were examined in step sections of the cervix. A total of 189 uterine specimens surgically excised for leiomyoma, adenomyosis etc., were studied. The over-all incidence of SMF of the cervix was 28.6% (54/189 cases). The incidence of these lesions increased with age, and they were most prevalent in the sixth decade of life (12/30 cases, 40%). SMF were presented more often in the anterior wall than in the posterior wall. Most of the lesions were less than 1 mm in size. No case of SMF demonstrated expansive tumorous growth. Six of 54 cases of SMF displayed consecutive spread of SMF in almost all step sections of the cervix. The histological findings confirmed that SMF of the cervix is quite common existence among Japanese women. It is speculated that the mucosal region near the skin and/or cutaneous region near the mucosa may have stromal melanocytosis; malignant melanoma could develop from SMF of the cervix, which did not have junctional activity because of stromal melanocytic origin.