Renal leiomyoma: a case report

We report a case of renal leiomyoma. A 46-year-old woman was found incidentally to have a solid and cystic renal mass on computerized tomography. The angiogram revealed no neovascularity. Nephrectomy was performed. Histologically, it was diagnosed as renal leiomyoma of vascular type. Although preoperative diagnosis of renal leiomyoma is difficult due to the various radiological findings, we should always consider this tumor in the differential diagnosis of renal tumors.

Free radical-independent protection by nerve growth factor and Bcl-2 of PC12 cells from hydrogen peroxide-triggered apoptosis

To investigate the mechanism of oxidative stress induced death of PC12 cells, we performed confocal and flow cytometric analysis with a reactive oxygen species (ROS)-specific fluorogen, 6-carboxy-2',7'-dichlorodihydrofluorescein diacetate, di(acetoxymethyl ester) (C-DCDHF-DA). Hydrogen peroxide significantly decreased the number of viable PC12 cells after 24 h. Hydrogen peroxide caused membrane blebbing, nuclear condensation and DNA fragmentation, indicating that the PC12 cells died due to apoptosis. The hydrogen peroxide-triggered apoptosis of PC12 cells was associated with enhanced ROS production in a dose-dependent manner by measuring with C-DCDHF-DA. Nerve growth factor (NGF) and Bcl-2 inhibited the hydrogen peroxide-induced apoptosis of PC12 cells. Neither of them, however, reduced the ROS production in PC12 cells. These data suggest that NGF or Bcl-2 protects PC12 cells from hydrogen peroxide-triggered apoptosis independently from ROS production.

[Assessment of thalamic regional cerebral blood flow in patients with cerebrovascular disease]

The thalamus is believed to play an integrative role in the central nervous system. In the present study, thalamic rCBF was measured in 65 CVD patients and 15 normal volunteers by stable Xe/CT scanning. ROIs were chosen in the thalamic slice at a level 5cm over the OM line, and mean CBF was 7 cm over the OM line. The clinical factors focused on in multiple regression analysis were: age (A), sex (Se), stage from onset (St), lesion side (Sd); unilaterality or bilaterality, size (Sz) thalamic lesion (Tl). GCS (G), HDS-R (H); Hasegawa dementia score (revised), symptoms (Ss) such as anxiety, dizziness, head-headed feeling and headache, and neurological deficits (N). Each factor was graded and scored. Statistically, there was a significant correlation between thalamic rCBF (Y) and mean CBF (X) in the less affected hemisphere: Y = 1.82X + 2.2, r = 0.801, p < 0.001, n = 65. Multiple regression analysis of the thalamic rCBF revealed that the Sz factor was significant (p < 0.0001) on the lesion side: Y = 76.7-10.2Sz, r = 0.644, p < 0.001, n = 51, while the Se, Sd and St factors were significant (p < 0.005) on the less affected side: Y = 71.9 + 9.7Se-6.8Sd-5.0St, R = 0.585, p < 0.001, n = 65. The thalamic index (X), an indicator of thalamic atrophy, and thalamic rCBF were significantly correlated: Y = 28.7X + 10.2, r = 0.386, p < 0.001, n = 80. In conclusion, thalamic rCBF appeared to reflect the degree of organic changes and time course in the cerebral hemisphere, because factors such as size, sex and stage were statistically significant.

Dome formation induced by v-H-ras oncogene in a human choriocarcinoma cell line

To investigate the role of ras genes in trophoblastic cell lineage, we transfected the viral H- or K-ras oncogene into a human choriocarcinoma cell line, CCI, and analysed the biological properties of CCI cells expressing an activated ras oncogene. All v-H-ras-expressing clones distinctively formed the hemispherical domes, which represents an in vitro morphological expression of vectorial transport function and are characteristic of the polarized epithelial cells, but none of v-K-ras-expressing clones and control clones did. Microscopic observation demonstrated that those domes were cavities filled with fluid which accumulated between the cell layer and the surface of culture dish. Scanning electron microscopy revealed that the domes were aggregates of round cells with long numerous microvilli and were morphologically similar to a blastocyst. Furthermore, Na(+)-K(+)-ATPase activity, which is associated with the vectorial fluid transport in transporting epithelial cells, was significantly higher in the v-H-ras-expressing clones than that in the v-K-ras-expressing clones and the parental cells. Those domes flattened within 24 h after treatment with a specific inhibitor of Na(+)-K(+)-ATPase, ouabain, and the number of domes decreased in dose-dependent manner, indicating that Na(+)-K(+)-ATPase activity was required for maintainance of domes. These results suggest that up-regulated activity of H-ras but not of K-ras facilitates the vectorial fluid transport through a chorionic cell layer and leads to the dome formation. The function of II-ras in trophoblasts, may therefore, be essential for embryogenesis, especially for supplying the nutrients.

Differential mRNA expression of phospholipase D (PLD) isozymes during cAMP-induced differentiation in C6 glioma cells

GTP gamma S-dependent phospholipase D (PLD) activity time-dependently increased during differentiation of rat C6 glioma cells to astrocytic phenotypes induced by dibutyryl cyclic AMP (dbcAMP)/theophylline. The changes in PLD mRNA level were examined by reverse transcriptase-polymerase chain reaction (RT-PCR) method using the degenerate primers designed based on two conserved amino acid sequences in PLDs of human and yeast. The amplified three DNA fragments (tentatively termed as rPLDa, b, and c) contained the conserved regions present in PLDs of various organisms. RT-PCR using non-degenerate primers showed that rPLDa mRNA increased within 12h following treatment with dbcAMP, reaching a broad plateau and then returned to the initial level at 48h. In contrast, the level of rPLDb mRNA showed a concurrent decrease. rPLDc decreased in a time-dependent manner. These results suggest that the expression of PLD mRNAs are differentially regulated during differentiation in C6 glioma cells.

An experience of the usage of electrical tinnitus suppressor

An electrical tinnitus suppressor based on the use of an extracochlear stimulator has been developed at Hokkaido University, Sapporo, Japan, and was implanted in 2 male and 2 female patients. Tinnitus improved in all patients because the auditory nerve was able to be stimulated at home whenever patients wanted treatment. Additional benefits reported after electrical stimulation of the cochlea included sound sleep, relaxation in all cases, and improved hearing acuity in Cases 1, 2, and 4. Minimal temporary complications, including habituation and ear drum perforation, were observed.

Late onset diabetes mellitus in patients with hereditary aceruloplasminemia

Aceruloplasminemia is a systemic degenerative disorder characterized by mutations in the ceruloplasmin gene, the absence of serum ceruloplasmin, and iron accumulation in the brain, liver, and other tissues. Iron is an important catalyst of oxyradical-mediated cellular and tissue injury, and beta-cells in the pancreatic islets are susceptible to the cytotoxic effects of oxidative stress. We report three patients with aceruloplasminemia who have late-onset diabetes mellitus (DM) and impaired glucose tolerance (IGT) as well as neurologic symptoms. Their basal lipid peroxide levels, measured as thiobarbituric acid-reactive products, in plasma samples were three times the values for the controls. This increased susceptibility to lipid peroxidation in patients with aceruloplasminemia suggests that free-radical-mediated tissue injury plays a role in the occurrence of DM and IGT.

Surgical results of tympanoplasty with hokudai-shaped partial and total ossicular replacement prostheses

The surgical results of tympanoplasty using a ceramic partial ossicular replacement prosthesis (PORP) or a ceramic total ossicular replacement prosthesis (TORP) were analyzed. The present study included 25 ears in 22 patients who underwent tympanoplasty between December 1986 and September 1994 and were followed up for more than 6 months postoperatively. Because the ceramic prosthesis was extruded from 2 of the 25 ears, the surgical results in the other 23 ears were analyzed, Surgical results were assessed according to a criterion that permits comparison with data from around the world. The criterion considers a postoperative airbone gap within 20 dB as a success. According to this criterion, the success rate was 90.9% for PORP, 50.0% for TORP, and 69.6% in total. These results are comparable with those found at other centers.

Thyroplasty type I with ceramic shim

To prevent side effects from a silicone shim in Isshiki thyroplasty type I, we used a ceramic shim in 10 patients with unilateral recurrent laryngeal nerve paralysis. No published reports have described the use of ceramic in this type of surgery. According to the degree of glottic insufficiency, ceramic shims of various heights were inserted into the fenestration made in the thyroid ala. All patients experienced subjective improvement of voice postoperatively. Laryngoscopies in most cases showed that glottic insufficiency improved postoperatively. In the postoperative examination, the maximum phonation time improved an average of 3.7 s, and the mean flow rate improved an average of 331 ml/s. We have analyzed the relationship of these improvements to the degree of glottic insufficiency and have compared our results with those of other investigators.

[A case study of immunohistochemical findings of rheumatic pseudocystic lesions in the femoral lateral condyle and tibial plateau--the comparison with synovial lesions]

Rheumatoid pseudocysts of which pathogenesis are not well known, are commonly observed in the major joints of the body, especially knees in rheumatoid patients. This report investigated the pseudocysts in the knee of a rheumatoid patient radiologically and immunohistochemically. A sixty-three-year-old woman with rheumatoid arthritis who had pseudocysts in the femoral lateral condyle and tibial plateau was hospitalized to have the lesions surgically removed. The MRI findings showed a connection between the pseudocysts and the joint cavity. A window of 1 x 1 cm2 was made at the tibial anterior cortex and the contents of the pseudocyst were resected and hydroxyapatite granules were inserted into the lesion after the removal of the pseudocyst tissue. In the histological findings, the specimen from the tibial pseudocyst revealed fibrous connective tissue with a few inflammatory cells, while the synovial specimen revealed the fibrous tissue with intense inflammatory cells infiltration forming lymphoid follicules. In immunohistochemical findings, both specimens showed positive with anti-HLA class I, anti-HLA DR, anti-CD44 and anti-HSP70 antibodies. The pathological findings of the pseudocystic lesion were similar to those of synovia, and it was considered that the synovia had invaded into the bone and formed the pseudocystic lesion. The MRI findings also support this hypothesis. The pseudocystic lesion was surrounded by bone and it was isolated from cytokain-rich joint effusion. This isolation from rheumatic joint effusion may explain the weaker inflammation of the pseudocystic lesion than that of synovia.

Influence of baseline airway calibre and pulmonary emphysema on bronchial responsiveness in patients with chronic obstructive pulmonary disease

STUDY OBJECTIVE

Bronchial hyper-responsiveness (BHR) is widely observed in patients with chronic obstructive pulmonary disease (COPD). However, its clinical significance in COPD has not yet been established. To determine the factors that influence BHR in COPD, multiple linear regression analysis was used to analyse the relationship between BHR to methacholine and baseline forced expiratory volume in 1 s (FEV1), vital capacity (VC), residual volume (RV)/total lung capacity (TLC), static compliance (Cst), transfer coefficient of the lung (Kco), and the percentage of low attenuation area (%LAA) determined by computed tomographic (CT) scan.

METHODS

Bronchial responsiveness to methacholine was determined in 63 patients with COPD by the dosimeter method and expressed as PD20FEV1. Residual volume and TLC were determined by body plethysmography. The percentage of low attenuation area was defined as the percentage of area less than -960 Hounsfield unit on a CT scan of the thorax.

RESULTS

Forced expiratory volume in 1s (%predicted) and %LAA correlated with BHR (P = 0.023 and 0.020, respectively), while VC (%pred), RV/TLC, Cst and Kco did not. The coefficient of determination was 0.43. The regression analysis showed that a 10% increase in FEV1 (%pred) and a 10% decrease in %LAA would increase log(PD20FEV1) by 0.145 and 0.117, respectively.

CONCLUSIONS

A considerable proportion of the BHR in COPD is related to functional abnormalities and morphologic changes of emphysema, such as decreased baseline airway calibre and destruction of the lung parenchyma.

Site-directed mutagenesis of hamster complement C1S: characterization with an active form-specific antibody and possible involvement of C1S in tumorigenicity

We have previously shown that non-transformed mouse A31 cells became tumorigenic when they were transfected with hamster C1s cDNA expression plasmid BCMGSNeoCS. In the present study, mutations were introduced into the cDNA at the activation cleavage site, Arg423(AGG) and the active center Ser617(AGC). These amino-acids were replaced by His423(CAC) and Thr617(ACC), respectively. The mutated cDNAs were inserted into BCMGSNeo and transfected to A31 and its polyoma-virus-transformed SEA7 cells. C1s produced from these transfectants lost their enzyme activity. Transfectants of these mutated C1s cDNA did not form tumors in nude mice, To distinguish between active and inactive C1s in situ, we have developed novel antibodies, one directed to the NH2-terminal neoepitope of the L chain and the other specific for uncleaved inactive C1s. These antibodies were used to characterize C1s produced by transfectants, so as to determine whether or not it was cleaved at the right position.

Suppressed expression of CD44 variant isoforms during human glioma A172 cell differentiation induced by cyclic AMP

CD44 is a major receptor for hyaluronic acid, which is the most frequent route of malignant glioma invasion. Multiple isoforms of CD44 are generated by alternative mRNA splicing. We have examined differential expression of CD44 variant isoforms (CD44vs) during dibutyryl cyclic AMP (dbcAMP)/theophylline-induced differentiation of human glioma A172 cells using reverse transcriptase-polymerase chain reaction (RT-PCR). Treatment of cells with dbcAMP and theophylline caused decreased expression of all CD44 isoforms after 24 h. The CD44 standard form was observed to return to the unstimulated level after 72 h, whereas the variant isoforms, CD44 8v-10v and 10v, remained at the low level after 24-72 h. Changes of CD44vs were correlated with the level of expression of c-jun. These results suggested that the expression patterns of CD44vs might correlate with cellular differentiation in human glioma cells.).

Malignant fibrous histiocytoma of the esophagus

A 78-year-old man presented with an esophageal polyp that was confirmed by immunohistochemistry and electron microscopy to be malignant fibrous histiocytoma. The tumor was comprised of a proliferation of spindle-shaped cells admixed with bizarre giant cells. These tumor cells were immunoreactive for smooth muscle actin, vimentin, alpha-1-anti-chymotrypsin and CD68. Electron microscopic examination revealed the myofibroblastic and histiocytic features of the tumor cells. No elements of epithelial or myogenic differentiation were found in the tumor. Malignant fibrous histiocytoma of the esophagus is extremely rare, with 10 cases being documented so far in the literature. The differential diagnosis of pleomorphic tumors of the esophagus is discussed.

Clinoidal meningioma arising from falciforme process of optic canal: case report and review

A 56-year-old female with an initial symptom of unilateral progressive visual disturbance presented with a clinoidal meningioma arising from a falciforme process of the optic canal. Magnetic resonance images with gadolinium-diethylenetriaminepenta-acetic acid demonstrated marked enhancement of a small mass, approximately 1 cm in diameter, roofing the right optic nerve at the intracranial opening of the optic canal. The clinoidal meningioma is rarely reported and the precise originating location of the neoplasm has not been clarified. This is the first case of clinoidal meningioma, which is confirmed by the operative observation as the origin of the neoplasm is a falciforme process of the optic canal. Magnetic resonance images with enhancement are useful for the diagnosis of such a small neoplastic lesion adjacent to bone structure and total removal without a deterioration of visual function is achieved by careful microsurgical procedure.

Selective hypothermic perfusion of canine brain

A method for selective brain cooling by profound hemodilution with cold Ringer's lactate solution was previously reported in 1992. We recently modified this technique by combining it with an ultrafiltration and rewarming circuit between the left jugular vein and the inferior vena cava. We used 12 beagle dogs to study the efficacy of selective cerebral hypothermia induced by this modified technique. The brain temperature decreased to 28 degrees C within 5.4 +/- 2.7 minutes and to 20 degrees C within 15.5 +/- 9.4 minutes. The lowest brain and rectal temperatures were 17.0 +/- 1.8 degrees C and 32.1 +/- 2.2 degrees C, respectively. All animals survived in good condition without evidence of neurological deficits until they were killed at 10 weeks. Histological examination of the brains with 2,3,5-triphenyltetrazolim chloride demonstrated no evidence of ischemic lesions, and even in the hippocampus, there was no evidence of ischemic neuronal damage.

Regional cerebral blood flow in patients with schizophrenia: relevance to symptom structures

Regional cerebral blood flow (rCBF) was measured with technetium-99m hexamethylpropyleneamine oxime single photon emission computed tomography in 38 neuroleptic-treated schizophrenic patients. To improve the validity of the evaluation of symptomatology, we applied findings previously derived in a principal component analysis (PCA) of the Positive and Negative Syndrome Scale. The PCA had disclosed five orthogonal independent symptom structures (i.e., negative, hostile/excited, thought disordered, delusional/hallucinatory, and depressive components), and obtained factor scores for 70 schizophrenic subjects, including the present sample. Stepwise regression analysis elucidated some of the cortical regions in which relative rCBF predicted the severity of symptoms--namely, lateral and orbital prefrontal, lateral temporal, inferior parietal, and medial temporal regions. Findings suggested that symptom structures derived from PCA could prove helpful in elucidating the pathophysiology of neural mechanisms.

Behavioral studies on rats with transient cerebral ischemia induced by occlusion of the middle cerebral artery

The behavioral effects of transient cerebral ischemia in adult Wistar rats were studied. In Experiment 1, rats were subjected to 90-min occlusion of the unilateral, left or right, middle cerebral artery (MCA) followed by recirculation. The locomotor activity had not changed 3 and 30 days after the occlusion, except that the number of rearing was significantly decreased by left MCA occlusion. Rats were examined in a radial maze system for learning and memory ability during 4 weeks from the 3rd day after ischemia (the 3rd day was counted as day 1 of the experiment). Maze performance was slightly disturbed due to focal brain damage by MCA occlusion, but the disturbance was statistically significant only on days 6, 11, and 15 in the right occlusion. In Experiment 2, rats were trained to master a radial maze task completely for 4 weeks, and then subjected to transient unilateral (right) ischemia as described above. These rats showed an increase in incorrect entry in the radial maze task from day 4 to day 14. However, on day 21, the number of incorrect entry decreased to the control level of the sham-operated group. The numbers of correct choice were inversely related with those of incorrect entry, though slightly blunted. Coincidentally, the time required to solve the maze task was also prolonged from day 4 to day 14, but returned to the control time on day 21. These results suggest that unilateral ischemia transiently suppresses both acquiring radial maze performance and maintenance of learned performance and that it is a good model for studying human focal cerebral ischemia.