Measurement of the CP violation parameter sin2 phi(1) in B(0)(d) meson decays

We present a measurement of the standard model CP violation parameter sin2 phi(1) (also known as sin2beta) based on a 10.5 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric e(+)e(-) collider. One neutral B meson is reconstructed in the J/psiK(S), psi(2S)K(S), chi(c1)K(S), eta(c)K(S), J/psiK(L), or J/psipi(0) CP-eigenstate decay channel and the flavor of the accompanying B meson is identified from its charged particle decay products. From the asymmetry in the distribution of the time interval between the two B-meson decay points, we determine sin2 phi(1) = 0.58(+0.32)(-0.34)(stat)+0.09-0.10(syst).

Stable histone deacetylase complexes distinguished by the presence of SANT domain proteins CoREST/kiaa0071 and Mta-L1

Human histone deacetylases I (HDAC1) and II (HDAC2) are homologous proteins (84% identity) that catalyze release of acetyl groups from modified N-terminal lysines of core histones. Histone deacetylation is correlated with both transient and persistent states of transcriptional inactivity (i.e. silencing) in many eukaryotes. In this study, we analyzed complexes containing HDAC1 and HDAC2 to identify the proteins most stably associated with these deacetylases. Complex cI (9.5 S) contained transcriptional corepressor CoREST/kiaa0071 and a protein homologous to FAD-dependent oxidoreductases, kiaa0601. Complex cII (15 S) contained >/=15 proteins, including CHD3/4 (Mi-2), Mta-L1, RbAp48/46, and MBD3, characteristic of vertebrate nucleosome-remodeling complexes. Under native conditions, cI and cII may contain HDAC1, HDAC2 or both; these can be dissociated to cI and cII core complexes containing only HDAC1 or HDAC2. The (m)CpG-binding protein MBD2 was associated only with the HDAC1 cII core complex. A model is proposed in which HDAC1 core complexes can be targeted to methylated DNA via MBD2 with recruitment of HDAC2 occurring through formation of HDAC1/2 cII dimers. We note that the cI component CoREST/kiaa0071 and the cII component Mta-L1 share a region of homology that includes a SANT domain; this domain may play a role in complex assembly.

Photorearrangement of vinylidenecyclopropanes to 1,2,3-butatriene derivatives

[reaction: see text] Photoirradiation of benzene solutions containing 1-diarylvinylidene-2,2,3,3-tetramethylcyclopropanes (2a--d) afforded rearranged products 1,2,3-butatrienes (3a-d) in good to high yields. Photorearrangement from 2,2,3-trimethyl and 2,2- and 2,3-dimethyl derivatives 2e--g also proceeded, but the rates of the rearrangement were lower than those of 2a--d. A singlet mechanism is proposed for this photorearrangement, where alkyl migration occurs from 1,3-biradical intermediates generated via the homolysis of the C1-C2 bond. Generation of diarylvinylidene carbenes from 1,3-biradicals might be competitive with the formation of 3.

Myocardial lipid metabolism in compensated and advanced stages of heart failure: evaluation by canine pacing model with BMIPP

The normal myocardium uses primarily fatty acid as its energy source, but, as heart failure develops, the myocardial fatty acid metabolism is limited. In this study, impairment of the lipid metabolism in heart failure was serially evaluated with 123I-(rho-iodophenyl)3-(R,S)-methylpentadecanoic acid (BMIPP), a radioiodinated fatty acid analog.

METHODS

Rapid ventricular pacing was introduced in 10 beagle dogs. Dogs were subjected to hemodynamic assessment and measurement of catecholamine before and after pacing. After 1 wk (group A; n = 4) and 4 wk (group B; n = 6) of pacing, BMIPP was injected directly into the left anterior descending artery; its extraction, retention, and washout rate in the early phase were calculated, and the metabolites in the myocardium were evaluated using high-performance liquid chromatography. These factors were compared with those of healthy control animals (group C; n = 6).

RESULTS

The left ventricular ejection fraction and cardiac output decreased significantly in groups A and B after pacing. The pulmonary capillary wedge pressure did not change in group A but increased significantly in group B. Plasma norepinephrine increased progressively as heart failure developed but did not reach statistical significance. The washout rate in the early phase increased, significantly in groups A and B compared with that of group C. Extraction and retention of BMIPP did not change in group A. In group B, extraction tended to decrease and retention decreased significantly compared with that of group C. The levels of full metabolite formed by complete oxidation of BMIPP decreased, and backdiffusion of BMIPP increased significantly in groups A and B compared with that of group C. Myocardial blood flow did not change among the three groups.

CONCLUSION

Our study indicates that myocardial fatty acid oxidation begins to be inhibited and that washout of BMIPP increases in the compensated stage of left ventricular dysfunction but that myocardial extraction and retention of fatty acid are definitely impaired in the advanced stage of heart failure. Therefore, as assessed by BMIPP, the myocardial lipid metabolism is related to the pathophysiology of the development and worsening of heart failure.

Relation of Fibrillatory Wave Amplitude With Hemostatic Abnormality and Left Atrial Appendage Dysfunction in Patients With Chronic Nonrheumatic Atrial Fibrillation

Large left atrium (LA) and LA appendage (LAA) dysfunction are known to relate to cardiogenic thromboembolism, so the present study investigated the relation of the atrial fibrillatory wave (F wave) amplitude to hemostatic markers and LAA function. Transthoracic and transesophageal echocardiographic studies were performed in 82 consecutive patients with chronic, nonrheumatic atrial fibrillation (AF). Patients were divided into 2 groups according to F wave amplitude in lead V1 on the 12-lead ECG: coarse AF (the greatest amplitude of F wave > or =1 mm, n=44) and fine AF (<1 mm, n=38). Plasma levels of thrombin-antithrombin III complex, D-dimer, platelet factor 4 and beta-thromboglobulin were determined. Compared with patients with coarse AF, those with fine AF had lower LAA peak flow velocity (p<0.05) and higher prevalence of embolic cerebral infarction (50% vs 27%, p<0.05). Platelet activity did not differ between the 2 groups; however, plasma levels of thrombin-antithrombin III complex and D-dimer were significantly higher in patients with fine AF than in those with coarse AF (p<0.05). Multiple logistic regression analysis showed that fine AF was independently associated with cerebral embolism. Therefore, the presence of fine F wave in V1 would be a useful marker of LAA dysfunction and hypercoagulability, and indicate a risk for cerebral embolism in patients with chronic, nonrheumatic AF.

Effect of hydrogen peroxide on guinea pig nasal mucosa vasculature

The effect of hydrogen peroxide (H2O2) on guinea pig nasal mucosa vasculature was studied by in vitro assay. H2O2 elicited relaxation of guinea pig nasal mucosa strips precontracted with phenylephrine in a concentration-dependent manner. The relaxant response to H2O2 was abolished in the presence of catalase. Preincubation of the strips with N(G)-nitro-L-arginine methyl ester or methylene blue significantly attenuated the relaxant responses elicited by H2O2. Fluorescence caused by DAF-2 DA, a fluorescence indicator for nitric oxide, was observed along the nasal mucosa vasculature in response to H2O2. These results suggest that H2O2 induced relaxation of the guinea pig nasal mucosa vasculature and that this relaxation is mediated by the NO/cGMP pathway.

Management of ipsilateral intrapulmonary metastases in the new TNM system for non-small cell lung cancer

BACKGROUND

Recently, the Union Internationale Contre le Cancer and American Joint Committee on Cancer reclassified not only TNM staging but also ipsilateral intrapulmonary metastases (PM) as T4 in a same lobe or M1 in different lobes. To determine whether the new PM staging is appropriate, we studied the prognosis of PM.

METHODS

From January 1981 to October 1997, we performed a lobectomy or pneumonectomy with mediastinal lymph node dissection, and had 42 patients with PM. We analyzed the postoperative prognosis of the patients with ipsilateral PM compared with the same stage group without PM (the non-PM).

RESULTS

In the previous classification of PM (the old PM), 2 patients were categorized as stage IIA, 9 as IIB, 17 as IIIA, and 14 as IIIB. After reclassification (the new PM), 37 patients were categorized as stage IIIB, and 5 as IV. The old PM stage IIIA group had a significantly poor prognosis compared with the non-PM stage IIIA. However, the prognosis of the new PM group was compatible with that of the non-PM. None of the other staging group had a significant difference in the prognosis.

CONCLUSIONS

The management of PM in the new TNM system for non-small cell lung cancer is appropriate.

Effects of slow tempo exercise on respiration, heart rate, and mood state

The purpose of this study was to investigate psychophysiologic responses to slow movement tempo exercise in three experiments. Exps. 1 and 2 were designed to compare slow with preferred movement tempos chosen freely by the subjects. The task movements in Exp. 1 were repetitive Arm Swinging, Stepping, and Body Swaying, performed by 14 female undergraduate students, while in Exp. 2, Body Swaying and Arm Winding were performed by 10 female undergraduate students and 13 boys and girls junior high school students. Respiration, heart rate, and scores on the State-Trait Anxiety Inventory were measured. Analysis showed respiration rates were lower during slow tempo conditions than preferred conditions. Exp. 3 was designed to compare very slow with slow movement tempos, using a Tai Chi-type of movement performed by 6 female undergraduate students. The subjects were required to synchronize the task movement with auditory stimuli, during which respiration and heart rate were measured, and a UWIST Mood-Adjective Checklist was utilized. Under the very slow movement conditions, Energetic Arousal scores were lower than those for the slow movement and the variation of respiration between rest and task conditions corresponded inversely with the Tense Arousal scores. Together, our results suggest that slow tempo exercise does not increase physiological or psychological arousal.

The three-dimensional map of microsomal glutathione transferase 1 at 6 A resolution

Microsomal glutathione transferase 1 (MGST1) is representative of a superfamily of membrane proteins where different members display distinct or overlapping physiological functions, including detoxication of reactive electrophiles (glutathione transferase), reduction of lipid hydroperoxides (glutathione peroxidase), and production of leukotrienes and prostaglandin E. It follows that members of this superfamily constitute important drug targets regarding asthma, inflammation and the febrile response. Here we propose that this superfamily consists of a new class of membrane proteins built on a common left-handed four-helix bundle motif within the membrane, as determined by electron crystallography of MGST1 at 6 A resolution. Based on the 3D map and biochemical data we discuss a model for the membrane topology. The 3D structure differs significantly from that of soluble glutathione transferases, which display overlapping substrate specificity with MGST1.

Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer

BACKGROUND

Curativity and indications for limited resection of small peripheral lung cancer remain controversial.

METHODS

Pathologic investigations of segmental lymph node metastases and intrapulmonary metastases in the resected lobe were performed for 94 small peripheral lung cancers (3.0 cm or less in diameter).

RESULTS

Nine patients had segmental lymph node metastases, 1 had intrapulmonary metastases, and 1 had both. Of these 11 patients, 5 had metastases limited to the primary tumor-bearing segments, 2 had metastases in nonprimary tumor-bearing segments, and 4 had metastases in both. Of the 10 patients with segmental lymph node metastases, 7 had metastases in both lobar-hilar and mediastinal lymph nodes, and 3 of 8 with adenocarcinoma had a tumor 2.0 cm or less.

CONCLUSIONS

Segmentectomy seems more favorable than wedge resection, but the risk of remnant tumor remains as compared with lobectomy. Evaluation of lobar-hilar or mediastinal lymph nodes is helpful to determine the presence or absence of segmental lymph node metastases. Limited resection can be undertaken with smaller tumors to allow preservation of more lung function while accepting a somewhat enhanced risk of recurrence.

Marginal ulcer on the jejunum after proximal gastrectomy by jejunal interposition

Marginal ulcer after proximal gastrectomy has never been previously reported, despite that this procedure preserves the fundic gland area of the stomach, which secretes gastric acid. In this report, we describe a patient who developed a marginal ulcer on the oral side of the gastrojejunal anastomosis after proximal gastrectomy by jejunal interposition. This case serves as a reminder that gastric acid secretion of the remnant stomach must be carefully monitored after proximal gastrectomy in gastric cancer surgery.

Structural determinants of water permeation through aquaporin-1

Human red cell AQP1 is the first functionally defined member of the aquaporin family of membrane water channels. Here we describe an atomic model of AQP1 at 3.8A resolution from electron crystallographic data. Multiple highly conserved amino-acid residues stabilize the novel fold of AQP1. The aqueous pathway is lined with conserved hydrophobic residues that permit rapid water transport, whereas the water selectivity is due to a constriction of the pore diameter to about 3 A over a span of one residue. The atomic model provides a possible molecular explanation to a longstanding puzzle in physiology-how membranes can be freely permeable to water but impermeable to protons.

Alpha-fetoprotein producing uterine corpus carcinoma: A hepatoid adenocarcinoma of the endometrium

A case of alpha-fetoprotein (AFP) producing endometrial carcinoma in a 60-year-old Japanese woman is presented. The patient complained of abnormal vaginal bleeding of 10 days' duration. On admission a uterine corpus mass and high serum AFP concentration (31950 ng/mL) was noted. There was no tumorous lesion in any other organ radiographically and endoscopically. Histologically, the biopsy specimen taken from the uterine mass showed a poorly differentiated endometrial carcinoma and a radical hysterectomy was subsequently performed. The postoperative serum AFP value transiently decreased with chemotherapy, however, lung metastases were found and the patient died 12 months following surgery. The resected uterus had a necrotic tumor, 6 x 5 x 4 cm in size, filling the endometrial cavity, characterized by exophytic growth with infiltration in the myometrium. Histologically, the tumor was composed of the main medullary carcinoma area with microcysts and admixed small areas of well-differentiated endometrioid adenocarcinoma, accompanied by a smooth transition with one another. In both the areas, the tumor cells had immunoreactive AFP, alpha-1-antitripsin, albumin, transferrin, carcinoembryonic antigen, CA19-9, and epithelial membrane antigen. There was no histologic evidence for a germ cell tumor. Based on these findings, this uterine corpus tumor was regarded as hepatoid variant of endometrial carcinoma. Although the histogenesis remains controversial, we assume the hypothesis that the tumor may arise in the endometrium per se in association with abnormal differentiation of muellerian duct elements.

Cloning, functional characterization, and expression of thyrotropin receptors in the thyroid of amago salmon (Oncorhynchus rhodurus)

Two thyrotropin receptor cDNAs (sTSH-Ra and sTSH-Rb) were cloned from thyroid tissue of the amago salmon, Oncorhynchus rhodurus. sTSH-Ra and sTSH-Rb showed the highest degrees of sequence homology to mammalian TSH receptors. Functional characterization in COS-7 cells transiently transfected with sTSH-Ra or sTSH-Rb showed the largest increase in cAMP when exposed to bovine TSH. RT-PCR analysis demonstrated that sTSH-Ra and sTSH-Rb were expressed in the basibranchial region, but not in the ovary, testis, liver, kidney or brain. In situ hybridization revealed that sTSH-Ra and sTSH-Rb were exclusively expressed in thyroid follicular epithelial cells of amago salmon undergoing smoltification. These results indicated that the cloned cDNAs encode functional TSH receptor proteins. This is the first report of isolation of TSH receptor molecules from nonmammalian vertebrates.

Intranasal sensitization of Japanese cedar pollen by the co-administration of low doses of cholera toxin but not its recombinant B subunit to mice

We evaluated the effects of cholera toxin (CT) and the B subunit of cholera toxin (CTB) on the intranasal sensitization of Japanese cedar pollen (JCP) in mice. JCP suspended in phosphate-buffered saline was administered into the nostrils of mice in combination with varying doses of CT or recombinant CTB(r-CTB) once a week for 5 weeks. Antibody responses specific to sugi basic protein (SBP) were monitored by ELISA for seven weeks. The sensitization of JCP alone did not induce IgG1, IgG2b, IgG2a, IgE or IgA. In contrast, sensitization of JCP in combination with CT (JCP/CT) elicited the prominent production of SBP-specific IgG1 and low levels of IgG2b and IgG2a on Day 49. IgE production was detected only in the serum of mice which were treated with JCP/CT, and not under any other protocol. Using spleen cells from these mice, cytokine production was examined by ELISA in culture supernatants after they had been stimulated in vitro with major cedar pollen allergens, Cry j 1, Cry j 2 or SBP. Notable responses were an increase of IFN-gamma as well as IL-4 in JCP/CT-sensitized cells stimulated with Cry j 2, but not in those stimulated with Cry j 1. No significant differences were detected in IL-5 production among the experimental groups. Histopathological examination, however, showed that eosinophil infiltration was evident in the nasal mucosa of the JCP/CT-sensitized mice following challenge with JCP/CT, but weak with BSA/CT or CT alone. Thus, the immunological and histological analyses indicated that the co-administration of a low dose of CT in combination with JCP allows the induction of pollen-allergic states in mice.

Computed tomographic measurements of airway dimensions and emphysema in smokers. Correlation with lung function

Chronic obstructive pulmonary disease (COPD) is characterized by the presence of airflow obstruction caused by emphysema or airway narrowing, or both. Low attenuation areas (LAA) on computed tomography (CT) have been shown to represent macroscopic or microscopic emphysema, or both. However CT has not been used to quantify the airway abnormalities in smokers with or without airflow obstruction. In this study, we used CT to evaluate both emphysema and airway wall thickening in 114 smokers. The CT measurements revealed that a decreased FEV(1) (%predicted) is associated with an increase of airway wall area and an increase of emphysema. Although both airway wall thickening and emphysema (LAA) correlated with measurements of lung function, stepwise multiple regression analysis showed that the combination of airway and emphysema measurements improved the estimate of pulmonary function test abnormalities. We conclude that both CT measurements of airway dimensions and emphysema are useful and complementary in the evaluation of the lung of smokers.

Exercise capacity of thoracotomy patients in the early postoperative period

OBJECTIVE

We investigated the mechanism involved with the initial drop and subsequent recovery of exercise capacity in the early postoperative period of thoracotomy patients.

METHODS

Sixteen patients (13 who had undergone lobectomy, 3 who had undergone pneumonectomy) underwent a routine pulmonary function test (PFT) and a cardiopulmonary exercise test preoperatively, within 14 postoperative days (POD; post-1; mean +/- SD, 9 +/- 2 POD), and after 14 POD (post-2; mean, 26 +/- 12 POD).

RESULTS

After surgery on post-1, PFT results of FVC, FEV(1), and maximum ventilatory volume (MVV) significantly decreased. Oxygen uptake (VO(2)) at a venous blood lactate level of 2.2 mmol/L (La-2. 2), which was adopted as the empirical anaerobic threshold, and maximum V O(2) (VO(2)max) decreased significantly to 88.2 +/- 7.9% and 73.1 +/- 15.4% of the preoperative values, respectively. La-2.2 min ventilation (VE)/ MVV and maximum VEmax)/MVV increased significantly from 0.36 +/- 0.08 to 0. 66 +/- 0.20 and from 0.58 +/- 0.14 to 0.80 +/- 0.09, respectively. On post-2, though La-2.2 VO(2) did not change, VO(2)max improved significantly to 81.5 +/- 19.7% of the preoperative values, in association with significant increases in maximal tidal volume and VEmax, which were produced by significant increases in the PFT results. La-2.2 VE/MVV also decreased significantly to 0.49 +/- 0.13, which indicated a sufficient recovery of respiratory reserve at submaximal exercise.

CONCLUSIONS

The initial drop of exercise capacity after lung resection seems to be derived from both circulatory and ventilatory limitations. Further, the subsequent recovery within 1 month seems to be produced by an improvement in ventilatory limitation, which was caused by the surgical injury to the chest wall.

Primary gastric B cell lymphoma: audit of 82 cases treated with surgery and classified according to the concept of mucosa-associated lymphoid tissue lymphoma

There has been a trend toward stomach conservation during treatment for primary gastric lymphoma, but surgery ensures accurate pathologic diagnosis through the examination of resected specimens. A histopathologic classification for primary gastric lymphoma had been established with the knowledge that the low grade and high grade components occasionally coexist in a single lesion. Efficacy of this classification as an indicator of biologic behavior and prognosis was evaluated. The classification was performed by reexamining surgically resected specimens from 82 patients with stage IE and IIE gastric lymphoma. Clinical characteristics of the low grade and high grade lymphomas were then evaluated and the survival data analyzed. Despite the larger tumor diameter, the depth of invasion for the low grade type was mostly submucosal, and none had serosal invasion. In contrast, 50% of the high grade type had serosal involvement and were also found to have a higher incidence of node metastasis. Prognosis of the low grade type, a 10-year survival rate exceeding 90%, was significantly better than that of the high grade type. Multivariate analysis revealed that curability of the operation followed by the histopathologic grade were significant independent prognostic factors. Some characteristics of the low grade lymphoma were not consistent with what has been reported in the studies involving stomach-conserving strategies. Investigators are advised to note that the histopathologic grade determined with biopsy specimens alone could be misleading.

Relation of transesophageal echocardiographic findings to subtypes of cerebral infarction in patients with atrial fibrillation

BACKGROUND

Transesophageal echocardiography (TEE) has been used to identify the potential risk for cardiogenic embolism in patients with atrial fibrillation (AF). However, ischemic stroke in patients with AF is not always attributable to embolism. Identification of the risk of embolic versus atherothrombotic stroke should lead to the optimal individualized management of patients with AF.

HYPOTHESIS

The goal of the study was to determine the relation between cortical infarction and perforating infarction and TEE findings in patients with AF.

METHODS

We investigated the clinical usefulness of TEE in the risk stratification of clinical subtyping of the cerebral infarctions which were divided into two territories of the cortical branch (cortical infarction due to embolism) and deep perforators (perforating infarction due to atherothrombosis). Left atrial spontaneous echo contrast, peak flow velocity in the left atrial appendage, and generalized atherosclerosis as estimated by the intima-media wall thickness of the thoracic aorta were assessed by TEE in 118 consecutive patients with either paroxysmal (n = 44) or chronic (n = 74) AF. All patients underwent either brain computed tomography or magnetic resonance imaging.

RESULTS

Cortical and perforating infarction was found in 39 and 18% of patients, respectively. The grade of spontaneous echo contrast was higher in patients with than in those without cortical infarction (p < 0.05). In contrast, patients with perforating infarction showed significant increase in the aortic wall thickness when compared with patients without perforating infarction (p < 0.05). In addition, multivariate logistic analysis revealed that spontaneous echo contrast was an independent predictor of cortical infarction, while intima-media wall thickness of the aorta, hypertension, and age were useful in predicting the risk of perforating infarction.

CONCLUSIONS

Transesophageal echocardiography has a potential role in the risk stratification for cortical and perforating infarction in patients with AF.

[The clinical effect of low-dose FP (5-FU + low-dose CDDP) in patients with far advanced gastric cancer, and their quality of life]

Low-dose FP therapy was carried out in 30 patients with far advanced gastric cancer and assessed according to anti-tumor effect and quality of life (QOL). This therapy consisted of CDDP (3.5-7 mg/m2/day infused on Days 1-5 every week) and continuous infusion of 5-FU (250 mg/m2/day for 28 days). A partial response was observed in 15 cases, so the overall response rate was 50%. The response rates with stomach and lymph node cancers were higher than those of other organs (64.3% and 55.6%). Patients without peritoneal dissemination, with good performance status (PS) (0, 1) and differentiated histologic type showed a significantly higher response rate than patients with peritoneal dissemination, poor PS (2, 3, 4) and undifferentiated histologic type (p = 0.0034, 0.0253, 0.0080). No side effects (> or = WHO grade 3) were observed. The QOL of patients was assessed according to the percentage of patients with an observed improvement of diet, who could be discharged from hospital, and the duration in hospitals in relation to survival time (hospital stay). The QOL of patients with low-dose FP therapy was better than that of patients with usual combination chemotherapy. Low-dose FP therapy is a promising regimen for patients with far advanced gastric cancer.

[Abnormal Q wave in the right precordial leads unmasked during right bundle branch block in a patient with anteroseptal myocardial infarction: a case report]

Electrocardiography in a 77-year-old woman showed small R waves in leads V1-V3 3 hours after the onset of acute anteroseptal myocardial infarction. Abnormal Q waves appeared in leads V1-V3 only during intermittent right bundle branch block. The normal septal force disappeared after transmural septal infarction and a small force of right ventricle origin became apparent as a small R wave in V1. Right bundle branch block delayed activation of right ventricle, and thereby deleted the initial R wave and unmasked the Q wave of the septal infarction. Appearance of a Q wave in leads V1-V3 with right bundle branch block should not be assumed to reflect the extension of myocardial infarction.

A case of cancerous familial adenomatous polyposis in urinary bladder due to migration of colonic mucosa through rectovesical fistula

The patient was a 50-yr-old man who had undergone low anterior resection for rectal cancer at the age of 24 yr in 1966. At that time, gastric and colonic polyposis were indicated. Postoperative anastomotic dehiscence occurred and, by 1985, a rectovesical fistula had formed. In 1986, when the patient was 44 yr old, he was examined at our hospital for constriction of the rectum due to the rectovesical fistula. Abdominoperineal excision of rectum and surgical closure of the fistula were performed, and the patient was kept under observation because of a diagnosis of familial adenomatous polyposis. In 1988, when the patient was 46 yr old, early ascending colon cancer was discovered and total colectomy was performed. Then, in December, 1991, gross hematuria was found. Further examination revealed a tumor on the posterior wall of the urinary bladder lumen, and biopsy showed adenocarcinoma. Pelvic recurrence of the rectal cancer was diagnosed, and total pelvic exenteration was performed. There were no distant metastases; histologically, the tumor of the bladder was thought to be due to colonic mucosa of familial adenomatous polyposis that had migrated to the bladder lumen via the rectovesical fistula and had become cancerous.

Limbic lobe of the human brain: evaluation with turbo fluid-attenuated inversion-recovery MR imaging

PURPOSE

To determine whether brain cortices have different signal intensities on turbo fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images.

MATERIALS AND METHODS

Coronal 5-mm-thick turbo FLAIR MR images in 56 neurologically normal patients (27 male and 29 female patients; age range, 12-73 years; mean age, 47 years) were evaluated retrospectively. Cortical signal intensities in the amygdala, hippocampus, cingulate gyrus, subcallosal area, insula, temporal lobe, parietal lobe, and occipital lobe were graded relative to cortical signal intensity in the frontal lobe. Contrast-to-noise ratios were compared for each cortical area.

RESULTS

Increased signal intensity was frequently seen in the amygdala, hippocampus, cingulate gyrus, and subcallosal area, regardless of patient age. Signal intensities of temporal, parietal, and occipital cortices were similar to that of frontal cortex, and signal intensity of the insula was slightly higher than that of frontal cortex. There were no significant differences with respect to sex and laterality, whereas significant differences were found among cortical regions (P <.01). The contrast-to-noise ratios of the amygdala, hippocampus, cingulate gyrus, and subcallosal area were significantly greater than those of all other gray matter structures (P <.05).

CONCLUSION

On turbo FLAIR images, high signal intensities of cortices of the limbic lobe are frequently seen in neurologically normal brain. These findings should not be considered abnormal.