Vascular supply with angio-CT for superselective intra-arterial chemotherapy in advanced maxillary sinus cancer

Recently popularised, the combined angiography and CT (angio-CT) system is useful for correctly identifying the feeding arteries and their perfusion in various organs. We applied this system for advanced maxillary cancer to expose its feeding arteries and their supplying territories. In addition to the maxillary artery, extramaxillary feeding arteries were usually observed, including the ophthalmic, accessory meningeal, facial, transverse facial and ascending palatine arteries. These extramaxillary feeding arteries exhibited uniform tendencies, depending on the site of extramaxillary tumour extension.

Protein kinase C mRNA and protein expressions in hypobaric hypoxia-induced cardiac hypertrophy in rats

AIM

Protein kinase C (PKC), cloned as a serine/threonine kinase, plays key roles in diverse intracellular signalling processes and in cardiovascular remodelling during pressure overload or volume overload. We looked for correlations between changes in PKC isoforms (levels and/or subcellular distributions) and cardiac remodelling during experimental hypobaric hypoxic environment (HHE)-induced pulmonary hypertension.

METHODS

To study the PKC system in the heart during HHE, 148 male Wistar rats were housed for up to 21 days in a chamber at the equivalent of 5500 m altitude level (10% O(2)).

RESULTS

At 14 or more days of exposure to HHE, pulmonary arterial pressure (PAP) was significantly increased. In the right ventricle (RV): (1) the expression of PKC-alpha protein in the cytosolic and membrane fractions was increased at 3-14 days and at 5-7 days of exposure respectively; (ii) the cytosolic expression of PKC-delta protein was increased at 1-5, 14 and 21 days of exposure; (3) the membrane expressions of the proteins were decreased at 14-21 (PKC-betaII), 14-21 (PKC-gamma), and 0.5-5 and 21 (PKC-epsilon) days of exposure; (4) the expression of the active form of PKC-alpha protein on the plasma membrane was increased at 3 days of exposure (based on semiquantitative analysis of the immunohistochemistry). In the left ventricle, the expressions of the PKC mRNAs, and of their cytosolic and membrane proteins, were almost unchanged. The above changes in PKC-alpha, which were strongly evident in the RV, occurred alongside the increase in PAP.

CONCLUSION

PKC-alpha may help to modulate the right ventricular hypertrophy caused by pulmonary hypertension in HHE.

SPIO Enhanced MR Imaging for the Detection of Metastases in Sentinel Nodes Localized by CT Lymphography in Patients with Breast Cancer

Background: Ultrasonography, magnetic resonance (MR) imaging, and computed tomography (CT) may detect nodal metastases in patients with breast cancer, but there is not sufficient accuracy with the conventional methods. Recently, superparamagnetic nanoparticles-enhanced MR imaging has been reported to be a promising improvement for diagnostic imaging of lymph node metastases from various tumors. Moreover, sentinel nodes have been reported to be well-identified using CT lymphography in patients with breast cancer. This study evaluated MR imaging with superparamagnetic iron oxide (SPIO) enhancement for the detection of metastases in sentinel nodes localized by CT lymphography in patients with breast cancer, with histopathologic findings as the reference standard.Methods: This study included 102 patients with breast cancer with clinically negative nodes. Each contrast agent was injected intradermally into the skin overlying the breast tumor and in the subareolar region. Sentinel nodes were identified by CT lymphography, and SPIO-enhanced MR imaging of the axilla was performed to detect metastases in the sentinel nodes. A node was considered non-metastatic if it showed a homogenous low signal intensity and metastatic if the entire node or a focal area did not show a low signal intensity on MR imaging. Sentinel node biopsy was performed using a combination of dye and radiocolloid. Imaging results were correlated with histopathologic findings.Results: The mean number of sentinel nodes identified by CT lymphography was 1.1 (range 1–3). Twenty-one of 25 patients with positive sentinel nodes definitively diagnosed by pathology demonstrated metastases on SPIO-enhanced MR imaging. Seventy of 77 patients with negative sentinel nodes definitively diagnosed by pathology were non-metastatic on imaging studies. The sensitivity, specificity, and overall accuracy of MR imaging for the diagnosis of sentinel node metastases were 84%, 91%, and 89%, respectively. In four of 10 patients with micrometastases, the metastases were not detected, but all 15 patients with macrometastases were successfully demonstrated. There were no adverse events associated with either CT or MR imaging.Conclusions: SPIO-enhanced MR imaging is a useful method of detecting metastases in sentinel nodes localized by CT lymphography in patients with breast cancer. Patients with clinically negative nodes may be spared sentinel node biopsy when the sentinel node is diagnosed as disease-free using SPIO-enhanced MR imaging.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1010.

Salivary duct carcinoma of the parotid gland: clinical and MR features in six patients

This study reports the clinical and MR features of salivary duct carcinoma (SDC) of the parotid gland, which is a rare and highly malignant tumour. We assessed retrospectively the clinical and MR features of six patients with histologically proven SDC of the parotid gland. The five men and one woman, ranging in age from 65-71 years (mean, 67 years), had undergone MRI before surgery. All patients presented with parotid masses and four patients had facial paralysis. Two had been aware of the parotid mass for more than 10 years. On MRI, all of the tumours had an ill-defined margin along either the entire circumference or part of the circumference. Four tumours showed infiltration into the subcutaneous or parapharyngeal space. Two tumours showed a wholly solid internal content, and four tumours had varying proportions of cystic content. The signal intensity of the solid portion was low to intermediate on both T(1) weighted and T(2) weighted images. Three patients showed multiple cervical lymph node swellings. Although SDC can show non-specific MRI findings, the combined findings (e.g. low-to-intermediate signal intensities on T(2) weighted images, ill-defined boundaries, infiltration into the surrounding fat space, facial nerve paralysis and associated cervical lymphoadenopathy, seem to suggest a high-grade malignancy.

Verification of the FEFF simulations to K-edge XANES spectra of the third row elements

Availability of the FEFF simulations to K-edge x-ray absorption near-edge structure (XANES) spectra of the third row elements has been investigated. The FEFF simulations reproduce the spectra from simple substances (Al, Mg, Si, P and S) well, but do not always reproduce those from chemical compounds containing the third row elements. The FEFF simulation has a tendency to underestimate the white line intensity of the XANES spectra in these compounds. This situation is much improved by the Z+1 approach, in which the central atom is replaced by an atom with the atomic number larger by one.

Association of serum interleukin-33 level and the interleukin-33 genetic variant with Japanese cedar pollinosis

BACKGROUND

IL-33, an IL-1-like cytokine, is a ligand for IL1RL1, which is an important effector molecule of type 2 T helper responses. Although IL-33/IL1RL1 interaction has been suggested to be important in induction of allergic airway inflammation, serum levels of IL-33 and the genetic influences of the polymorphisms of IL-33 in human allergic diseases are unclear.

OBJECTIVE

The aim of this study was to examine whether the serum IL-33 level and polymorphisms in IL-33 are associated with Japanese cedar (JC) pollinosis, the most common form of allergic rhinitis, and a major public health problem, in Japan.

METHODS

We performed linkage disequilibrium (LD) mapping of the gene using the HapMap database, and two selected tag single nucleotide polymorphisms were genotyped. We conducted an association study of IL-33 (JC pollinosis, n=170; normal controls, n=100) and measured the IL-33 levels in sera of the 270 subjects by ELISA.

RESULTS

Serum levels of IL-33 were significantly higher in patients with JC pollinosis (P=0.0018) than in controls. In genetic association analysis, we found a positive association between the polymorphism and JC pollinosis (P=0.048).

CONCLUSION

Our results support a role for IL-33 in the pathogenesis of JC pollinosis.

Osteopontin expression in normal and hypobaric hypoxia-exposed rats

AIM

Experimental pulmonary hypertension induced in a hypobaric hypoxic environment (HHE) is characterized by structural remodelling of the heart and pulmonary arteries. Osteopontin (OPN) has emerged as a key factor in cardiovascular remodelling in response to pressure or volume overload. We studied the possible effects of HHE on the OPN synthesis system.

METHODS

One hundred and forty-eight male Wistar rats were housed in a chamber with conditions equivalent of an altitude of 5500 m for up to 21 days.

RESULTS

Plasma OPN protein level was found to be significantly decreased on day 0.5 of exposure to HHE, as was the level in the adrenal gland (which secreted highest levels of OPN protein). In the right ventricle of the heart (mRNA) and the lung (protein), OPN expression was found to be significantly increased only on day 1 and day 5, respectively, of exposure to HHE. By immunohistochemistry, the distribution and intensity of OPN protein in several organs were found to alter during exposure to HHE. However, these changes in OPN synthesis did not coincide with the moderate increase in pulmonary arterial pressure (PAP) (maximal mean PAP, 24.5 mmHg) during HHE.

CONCLUSION

Pulmonary hypertension in HHE with conditions equivalent of an altitude of 5500 m may induce little or no OPN in heart and lung. Sustained induction may require a more severe PAP overload.

Measurement of human and mouse interleukin 18

IL-18, originally designated as interferon-gamma (IFN-gamma)-inducing factor (IGIF), is a pleiotropic cytokine secreted by activated macrophages and Kupffer cells. The major activity associated with this cytokine is induction of IFN-gamma production from T cells, B cells, and NK cells, especially in collaboration with IL-12. IL-18 is synthesized without a signal peptide and must be enzymatically cleaved to become active. Therefore, it is important to determine whether the produced IL-18 is an active or precursor form. This unit describes functional assays for measurement of bioactive human and mouse IL-18 and ELISAs for measurement of murine and human IL-18 proteins. The functional assays are based on the induction of IFN-gamma production by IL-18. The ELISA measures the concentration of human or mouse IL-18. Using a combination of monoclonal antibodies against human or mouse IL-18, the proform and/or mature form of IL-18 can be detected by ELISA.

Molecular analysis of digenic inheritance in Bartter syndrome with sensorineural deafness

BACKGROUND

Bartter syndrome (BS) is a genetic disorder accompanied by hypokalaemic metabolic alkalosis. BS with sensorineural deafness (SND, OMIM602522) is a newly identified phenotype caused by mutations in the BSND gene that encodes barttin, a beta-subunit for chloride channel ClC-Ka and ClC-Kb and classified as type IV BS. Type IV BS features the most severe phenotype entailing life-threatening neonatal volume depletion and chronic renal failure developing during infancy. A recent report described a case of BS with SND from a consanguineous family who showed homozygous mutations in the CLCNKA and CLCNKB genes. This case indicated the possibility of the occurrence of digenic inheritance in BS with SND resulting from double mutations in the CLCNKA and CLCNKB genes.

SUBJECT AND RESULTS

The current report concerns a 2-year-old girl from a non-consanguineous family with BS accompanied by SND. In our case, four loss-of-function mutations, consisting of mutations in both parental alleles in both CLCNKA and CLCNKB, were identified. The paternal allele had a nonsense mutation (Q260X) in CLCNKA and a splicing site mutation (IVS17+1 g>a) in CLCNKB. The maternal allele had a large deletion mutation (about 12 kbp) extending from CLCNKA to CLCNKB. Our case provides clear evidence that loss-of-function alleles in both alleles of both CLCNKA and CLCNKB results in a phenotype indistinguishable from that of mutations in BSND (type IV BS).

CONCLUSIONS

Recent advances in genetics have resulted in a better understanding of many human inherited diseases, but most of them are monogenic disorders and more complex inheritance patterns remain unresolved. Our case provides clear evidence of digenic inheritance outside the scope of Mendelian inheritance disorders.

Extraction of weak transition strengths via the (3He, t) reaction at 420 MeV

Differential cross sections for transitions of known weak strength were measured with the (3He, t) reaction at 420 MeV on targets of 12C, 13C, 18O, 26Mg, 58Ni, 60Ni, 90Zr, 118Sn, 120Sn, and 208Pb. Using these data, it is shown that the proportionalities between strengths and cross sections for this probe follow simple trends as a function of mass number. These trends can be used to confidently determine Gamow-Teller strength distributions in nuclei for which the proportionality cannot be calibrated via beta-decay strengths. Although theoretical calculations in the distorted-wave Born approximation overestimate the data, they allow one to understand the main experimental features and to predict deviations from the simple trends observed in some of the transitions.

Isotopic dependence of the giant monopole resonance in the even-A 112-124Sn isotopes and the asymmetry term in nuclear incompressibility

The strength distributions of the giant monopole resonance (GMR) have been measured in the even-A Sn isotopes (A=112-124) with inelastic scattering of 400-MeV alpha particles in the angular range 0 degrees -8.5 degrees . We find that the experimentally observed GMR energies of the Sn isotopes are lower than the values predicted by theoretical calculations that reproduce the GMR energies in 208Pb and 90Zr very well. From the GMR data, a value of Ktau = -550 +/- 100 MeV is obtained for the asymmetry term in the nuclear incompressibility.

Salivary gland scintigraphy in gastro-esophageal reflux disease

Gastro-esophageal reflux disease (GERD) is associated with a decreased salivary flow as well as gastric acid production. This study therefore aimed to investigate functional disorders of salivary glands in patients with GERD.

METHODS

Thirty-one consecutive patients with GERD underwent salivary gland scintigraphy.

RESULTS

If the results defined the optimal cutoff point for determining the decreased salivary secretion as 51 % in parotid glands and 36 % in submandibular glands, a decreased salivary secretion of right parotid gland, left parotid gland, right submandibular gland, and left submandibular gland was found in 39 %, 32 %, 36 %, and 58 %, respectively. Overall, salivary function disorder of at least one major salivary gland was found in 24 patients (78 %) with GERD. There was no difference in the incidence of impaired salivary function between GERD patients with and without erosive esophagitis. Salivary gland function was more frequently diminished than expected in GERD. We concluded that the presence of impaired salivary gland function was considered to be one of risk factors for developing GERD symptoms.

Gamow-Teller strength in the exotic odd-odd nuclei 138La and 180Ta and its relevance for neutrino nucleosynthesis

The Gamow-Teller strength distributions below the particle threshold in 138La and 180Ta, deduced from high-resolution measurements of the (3He,t) reaction at 0 degrees, allow us to evaluate the role of charged-current reactions for the production of these extremely rare nuclides in neutrino-nucleosynthesis models. The analysis suggests that essentially all 138La in the Universe can be made that way. Neutrino nucleosynthesis also contributes significantly to the abundance of 180Ta but the magnitude depends on the unknown branching ratio for population of the long-lived isomer.

Tissue factor expression as a possible determinant of thromboembolism in ovarian cancer

Ovarian cancer, and clear cell carcinoma in particular, reportedly increases the risk of venous thromboembolism (VTE). However, the mechanisms remain unclear. Tissue factor (TF) supposedly represents a major factor in the procoagulant activities of cancer cells. The present study examined the involvement of TF expression in VTE for patients with ovarian cancer. Subjects comprised 32 consecutive patients (mean age 49.8 years) with histologically confirmed ovarian cancer. Presence of VTE was examined using a combination of clinical features, D-dimer levels and venous ultrasonography. Immunohistochemical analysis was used to evaluate TF expression into 4 degrees. Venous thromboembolism was identified in 10 of the 32 patients (31%), including five of the 11 patients with clear cell carcinoma. Tissue factor expression was detected in cancer tissues from 24 patients and displayed significant correlations with VTE development (P=0.0003), D-dimer concentration (P=0.003) and clear cell carcinoma (P<0.05). Multivariate analysis identified TF expression as an independent predictive factor of VTE development (P<0.05). Tissue factor (TF) expression is a possible determinant of VTE development in ovarian cancer. In particular, clear cell carcinoma may produce excessive levels of TF and is more likely to develop VTE.

An accessory chromophore in red vision

In the absence of a red-sensitive visual pigment, some deep-sea fish use a chlorophyll derivative in their green-sensitive rod cells in order to see deep-red light. Here we show that living rods extracted from a salamander can also accumulate an exogenous chlorophyll derivative, chlorin e6, that renders them as sensitive to red light as they are to green. This vision enhancement by an unbleachable chlorophyll derivative might therefore be a general phenomenon in vertebrate photoreception.

Gamow-Teller strengths in the A = 14 multiplet: a challenge to the shell model

A new experimental approach to the famous problem of the anomalously slow Gamow-Teller (GT) transitions in the beta decay of the A=14 multiplet is presented. The GT strength distributions to excited states in 14C and 14O were studied in high-resolution (d,2He) and (3He,t) charge-exchange reactions on 14N. No-core shell-model calculations capable of reproducing the suppression of the beta decays predict a selective excitation of Jpi=2+ states. The experimental confirmation represents a validation of the assumptions about the underlying structure of the 14N ground state wave function. However, the fragmentation of the GT strength over three 2+ final states remains a fundamental issue not explained by the present no-core shell model using a 6homega model space, suggesting possibly the need to include cluster structure in these light nuclei in a consistent way.

Management and algorithm for focal nodular hyperplasia of the liver in children

PURPOSE

The aim of this study was to determine an appropriate management plan for childhood and adolescent FNH, in particular to establish an algorithm for preoperative diagnosis and treatment.

PATIENTS AND METHODS

Between 1985 and 2003, 4 children with FNH were diagnosed. Of these 4 patients, 3 (Group A) underwent tumor resection, and 1 (Group B) was treated by conservative management. Clinical data, pathological findings and follow-up were evaluated retrospectively.

RESULTS

The 3 patients in Group A were symptomatic, while the 1 patient in Group B was asymptomatic. In 3 of 4 patients, a homogeneous tumor with a central stellate area was noted on abdominal ultrasonography, CT scan and MR imaging. In case 2, SPIO-enhanced MR imaging was useful for differentiating FNH from hepatocellular carcinoma. Though percutaneous needle biopsy was performed in case 3, a pathologically definitive diagnosis was impossible. An open biopsy was performed in case 4 and FNH was diagnosed. In case 4 treated by conservative management, the tumor size did not change during the 7 years after the diagnosis of FNH.

CONCLUSION

FNH is usually treated conservatively because of the good evolutionary outcome of the lesion. Surgery is indicated in cases of complications, compressed adjacent organs, lesion progression, or for symptomatic patients. We advocate the use of less invasive SPIO-enhanced MR imaging instead of open biopsy when the diagnosis of focal liver lesions is not clear after contrast-enhanced CT scan and non-enhanced MR imaging.

Topical suplatast tosilate (IPD) ameliorates Th2 cytokine-mediated dermatitis in caspase-1 transgenic mice by downregulating interleukin-4 and interleukin-5

BACKGROUND

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by elevated serum levels of IgE. AD is associated with Th2 cytokines including interleukin (IL)-4, IL-5, IL-13 and IL-10. Systemic administration of suplatast tosilate (IPD) is currently used to treat Th2 cytokine-mediated AD.

OBJECTIVES

To evaluate the effect of topical IPD on skin lesions of AD using a genetically engineered AD mouse model (K14/caspase-1 transgenic mouse: KCASP1Tg).

METHODS

IPD ointment (3%) and white petrolatum (WP) were applied to KCASP1Tg mice every other day from 6 to 14 weeks after birth. Histopathological analysis of skin lesions and measurement of mRNA expression of cytokines in skin lesions and spleen cells were carried out. We also compared changes in serum parameters between IPD-treated and WP-treated KCASP1Tg mice.

RESULTS

WP-treated mice developed dermatitis at 8 weeks after birth. However, skin lesions in IPD-treated mice were limited. Histopathologically, skin lesions in WP-treated KCASP1Tg mice showed marked inflammatory changes with increased mast cell infiltration. However, mice treated with IPD showed minimum skin lesions with scarce mast cell infiltration. WP-treated KCASP1Tg mice had significant elevation in the serum levels of histamine, IgE and IL-18 as compared with IPD-treated KCASP1Tg mice. mRNA expression of IL-4 and IL-5 in the skin lesions from WP-treated KCASP1Tg mice was significantly higher than in those from IPD-treated mice. In the spleen, the expression of IL-4, IL-5 and interferon-gamma was significantly increased in WP-treated KCASP1Tg mice as compared with their IPD-treated counterparts.

CONCLUSIONS

This study shows that topical therapy with IPD inhibits the expression of IL-4 and IL-5 and ameliorates skin manifestations in an AD mouse model, suggesting the potential usefulness of topical IPD for the treatment of AD.

Fine structure of the Gamow-Teller resonance in 90Nb and level density of 1+ states

The fine structure of the Gamow-Teller resonance in a medium-heavy nucleus is observed for the first time in a high-resolution 90Zr(3He,t)90Nb experiment at the Research Center for Nuclear Physics, Osaka. Using a novel wavelet analysis technique, it is possible to extract characteristic energy scales and to quantify their relative importance for the generation of the fine structure. This method combined with the selectivity of the reaction permits an extraction of the level density of 1+ states in 90Nb.

Thrombotic thrombocytopenic purpura associated with polyarteritis nodosa

We present a case of classical polyarteritis nodosa (PN) overlapping thrombotic thrombocytopenic purpura (TTP). A 70-year-old woman was transferred to our hospital because of general fatigue and fever. On admission, laboratory findings revealed leukocytosis, normochromic normocytic anemia and renal dysfunction. About one week later, she developed disturbance of consciousness, and laboratory findings revealed rapidly progressive thrombocytopenia and renal dysfunction. We suspected the presence of microscopic polyangiitis (MPA), based on mild elevation of myeloperoxidase (MPO) anti-neutrophil cytoplasmic antibody (ANCA). On post-admission Day 11, renal biopsy was performed but the diagnosis of MPA could not be confirmed because of the absence of glomerular crescent formation or vasculitis. However, the biopsy specimen showed many collapsed glomeruli and interstitial inflammation, indicating the presence of occlusive lesions, such as vasculitis in larger arteries. We instituted methylprednisolone pulse therapy, cyclophosphamide and plasma exchange, because the clinical symptoms also satisfied the criteria of TTP. Despite the intensive treatment, the patient died on 43rd day of hospitalization due to thalamic hemorrhage. Autopsy showed typical findings of classical PN including disruption of arterial walls and fibrinoid necrosis in the medium-sized arteries of the kidneys and colon. We detected reduced activity of von Willebrand factor-cleaving protease (VWF-CP) and the presence of plasma inhibitory IgG against VWF-CP. A better understanding of the mechanisms would be useful.

Extraskeletal mesenchymal chondrosarcoma: an imaging review of ten new patients

OBJECTIVE

Extraskeletal mesenchymal chondrosarcoma (EMC) is a rare soft-tissue tumor that most arises in young adults. Because of its rarity, few imaging studies have been reported to date. The purpose of this study was to elucidate the imaging features of this tumor.

DESIGN

We conducted a multi-institutional study in cooperation with five referral cancer centers in Japan. Imaging findings of ten new EMC cases, including conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI), performed at each institute, were reviewed along with clinical features.

PATIENTS

Ten patients with EMC, who had been treated at each hospital from 1990 to 2001, participated in this study.

RESULTS AND CONCLUSIONS

Soft-tissue masses with well-demarcated, dense and granular calcification were most frequently observed on plain radiographs and CT scans. T2-weighted MR images most clearly depicted a two-component structure composed of calcified and uncalcified areas, and enhanced MRI showed inhomogeneous enhancement in both areas. Although the sensitivity and specificity of these findings are unknown, they might be characteristic and have diagnostic value for this rare tumor.

Gamow-teller strengths in proton-rich exotic nuclei deduced in the combined analysis of mirror transitions

Isospin symmetry is expected for the T(z)=+/-1-->0 isobaric analogous transitions in isobars with mass number A, where T(z) is the z component of isospin T. Assuming this symmetry, strengths of analogous Gamow-Teller (GT) transitions within A = 50 isobars were determined from a high energy-resolution study at 0 degrees in combination with the decay Q value and lifetime from the beta decay. This method can be applied to other pf-shell nuclei and can be used to study GT strengths of astrophysical interest.

On the adsorption of proteins on solid surfaces, a common but very complicated phenomenon

Adsorption of proteins on solid surfaces and their interaction are major concerns in a number of fields such as biology, medicine, biotechnology and food processing, and play an important role from various points of view. Based on practical viewpoints, information on the conformation of the adsorbed protein as well as adsorption characteristics is essential for a system's performance. Although there are still many problems to be solved, extensive studies in recent years, owing to the development in instrumentation and instrumental techniques, reveal the adsorption behavior of proteins in detail. Here, we stress the importance and interesting aspect of protein adsorption on solid surfaces by reviewing findings that have been obtained in recent years.

Importance of early repair of isolated abdominal aortic dissecting aneurysm

BACKGROUND

Since the available information on isolated abdominal aortic dissecting aneurysm (AADA) is mainly related to case reports or reports of small groups of patients, its natural history remains undetermined and there is no agreement on its optimal management. The purpose of this study is to define the features and pattern of development of this unusual entity as well as to propose criteria for treatment based on our own experience and previously published data.

PATIENTS AND METHODS

We retrospectively evaluated the history of 6 patients diagnosed with AADA. The patients were 5 males and 1 female. The mean age was 71 +/- 8 years (range: 61-80 years), and the mean aneurysm diameter was 54 +/- 14 mm (range: 35-70 mm). All of these patients were hypertensive (100%). History of cerebrovascular accident, ischemic heart disease, peripheral arterial disease, or diabetes mellitus was present in 1 patient, respectively. Two patients developed mycotic AADA.

RESULTS

Emergency operations had been performed in 3 cases, and scheduled surgical reconstruction in the remaining 3 cases. Operation consisted of aneurysmectomy and graft replacement of the diseased aortic segment in all cases. One patient treated in an emergency setting died subsequently of multisystem organ failure, but the others did well.

CONCLUSION

Symptomatic patients or patients at good risk should undergo surgical repair earlier than in the case of abdominal aortic aneurysm without dissection (AAA). Dissection in addition to an AAA will further increase the weakness of the aortic wall and the possibility of aortic rupture will become higher.

Prognostic factors and a scoring system for patients with skeletal metastasis

Between 1992 and 1999, we treated 350 patients with skeletal metastases. A multivariable analysis of the patients was conducted using the Cox proportional hazards model. We identified five significant prognostic factors for survival, namely, the site of the primary lesion, the performance status (Eastern Cooperative Oncology Group status 3 or 4), the presence of visceral or cerebral metastases, any previous chemotherapy, and multiple skeletal metastases. The score for each significant factor was derived from the corresponding estimated regression coefficients (natural logarithm of the hazard ratio). The prognostic score was calculated by adding all the scores for individual factors.

The rate of survival was 31% at six months and 11% at one year for the patients with a prognostic score of 6 or more. By contrast, patients with a prognostic score of 2 or less had a rate of survival of 98% at six months and 89% at one year. This scoring system can be used to determine the optimal treatment for patients with pathological fractures or epidural compression.

Topical Application of Ionic Polymers Affects Skin Permeability Barrier Homeostasis

We previously demonstrated that the external electric potential affected skin barrier homeostasis. On the other hand, topical application of an ionic polymer formed a diffusion electric double layer on the surface of the skin. Thus, we evaluated effects of topical application of ionic polymers on the damaged skin barrier. Application of a nonionic polymer did not affect barrier recovery. Application of sodium salts of anionic polymers accelerated barrier recovery, while that of cationic polymers delayed it. Topical application of a sodium-exchange resin accelerated barrier recovery, but application of a calcium-exchange resin had no effect even when the resins had the same structure. Application of a chloride-exchange resin delayed barrier recovery. Topical application of ionic polymers influenced skin barrier homeostasis.

IL-18 gene therapy develops Th1-type immune responses in Leishmania major-infected BALB/c mice: is the effect mediated by the CpG signaling TLR9?

IL-18 regulates either Th1 or Th2 responses depending on the cytokine microenvironment. Administration of recombinant IL-18 (rIL-18) alone does not promote Th1 response, but rather induces Th2 response and exacerbates Leishmania major infection in susceptible BALB/c mice. Here, we treated BALB/c mice with an IL-18-expressing plasmid by using a gene gun weekly after L. major infection. This gene therapy resulted in improved pathogenic process and preferential induction of Th1 responses by inducing the expression of IL-12 p40, but treatment with rIL-18 did not. Notably, simultaneous administration of rIL-18 with an empty plasmid vector rendered BALB/c mice resistant to the infection, despite the fact that treatment with either rIL-18 alone or the plasmid vector alone did not influence the susceptibility. The synergistic role of the vector with rIL-18 was found to depend on CpG motifs, which enhanced expression of proinflammatory cytokines, especially IL-12, from APCs through Toll-like receptor (TLR) 9 ligation. Treatment with methylated plasmid vector in which CpG was disrupted could no longer prevent the disease development in coadministration with rIL-18. Taken together, IL-18 gene therapy was shown to develop Th1-type protective immunity in L. major-infected BALB/c mice without the requirement of exogenous IL-12, probably via CpG-TLR9 signaling pathway.

Evidence for the existence of the [2 0 2]3/2 deformed band in mirror nuclei 25Mg and 25Al

After 50 years of its prediction, the highest-lying [2 0 2]3/2 orbit among the six Nilsson single-particle orbits originating from the sd shells in prolately deformed nuclei and the rotational band on this orbit were identified. The band members were observed in 25Al at excitation energies of 6-7.5 MeV in a high-resolution 25Mg(3He,t) charge-exchange reaction at 0 degrees having a strong selectivity for Gamow-Teller transitions. In the comparison with the analogous M1 transitions in 25Mg, the J(pi)=3/2(+) bandhead state and the excited 5/2(+) and 7/2(+) members were clearly assigned.

Cytokine-induced inflammatory liver injuries

IL-18 is a pleiotropic cytokine and is produced by various types of cells including activated macrophages, particularly Kupffer cells. IL-18 has potential to activate inflammatory responses through induction of IFN-gamma production in collaboration with IL-12. Somewhat paradoxically, IL-18 also has the capacity to induce allergic responses via induction of IL-4 production by T helper cells and to activate mast cells and basophils to release atopic effector molecules such as histamine. Indeed, IL-18 is involved in inflammatory tissue injuries, such as Crohn's disease and atherosclerosis, and also in hyper IgE and atopic dermatitis. IL-18 is particularly important for induction of experimental liver diseases. Endotoxin-induced liver injury or Fas ligand-induced hepatitis is caused by endogenous IL-18 in mice. Moreover, patients with liver diseases such as fulminant hepatitis, liver cirrhosis due to hepatitis virus infection and primary biliary cirrhosis show elevation of serum levels of IL-18, that correlates with the corresponding disease severity. Therefore, endogenous IL-18 plays a major role in induction of some types of liver injuries in mice and human. NKT cells that express both T cell receptor and NK cell marker are abundant in the liver of mice and human. Recent studies have revealed that NKT cells participate in some types of liver injuries, such as concanavalin A-induced T cell-mediated hepatitis and malaria hepatitis. In this review article, we focus on IL-18-involving liver damages and NKT-cell-mediated liver injuries.

Development of a quantification system of ionic dissociative metabolites using an FT-IR/ATR method

A simultaneous quantification system of ionic dissociative metabolites was developed using a Fourier transform mid-infrared spectroscopic method by focusing our attention on the enzyme reaction from glucose 6-phosphate to fructose 6-phosphate with phosphoglucose isomerase (PGI). We studied the pH dependency of the infrared spectra of the mixture solution for which the PGI reaction was assumed. The infrared spectra of ionic dissociative components in the mixture solution were extracted by multiple linear regression analysis under the assumption of ionic dissociation equilibrium. Additionally, we constructed a simultaneous quantification system using the extracted spectra of the ionic dissociative components on the basis of the ionic dissociation equilibrium. We could accurately estimate the pH value and the concentrations of the ionic dissociative materials in their mixture solution by using this quantification system. In addition, the stability of quantification results for a pK shift was also verified.

Monolithic silica columns with chemically bonded ?-cyclodextrin as a stationary phase for enantiomer separations of chiral pharmaceuticals

An enantioselective silica rod type chiral stationary phase (CSP) is presented; a novel combination of the well known enantiomer separation properties of beta-cyclodextrin and the unique properties concerning the flow behavior of silica monoliths. Two different synthesis routes are described, and it was found that the in situ modification of a plain silica rod column turned out to be the best. The chromatographic behaviour of the beta-cyclodextrin silica rod was studied and compared with a very similar commercially available beta-cyclodextrin bonded particulate material (ChiraDex). Even if the amount of beta-cyclodextrin bound to the silica rod was only about half of the amount of beta-cyclodextrin bound to ChiraDex) particles, good resolutions were achieved for a set of chiral test components like Chromakalin, Prominal, Oxazepam, Methadone and some other drugs. By taking advantage of the unique features of the silica rods relating to their flat H/u (Van Deemter) curves, fast enantiomer separations could be demonstrated.

The aurora sign: an ultrasonographic sign suggesting parenchymal lung disease

The objective of this study was to clarify the cause and clinical significance of a large number of ring-down artefact (RA) observed on the dorsal side of the right hepatic lobe on abdominal ultrasound (US). 2000 abdominal US examinations were evaluated to investigate the frequency and number of RA behind the right lobe of the liver. In this study, RA observed by subcostal or intercostal US were described as the "aurora sign" when they were numerous. US findings were correlated with high resolution CT or three-dimensional CT of the right lung base. Experimental study was also performed to investigate the mechanism of the aurora sign. The results were as follows. (1). Aurora sign was noted in 43 patients. In 37 of these 43 patients (86.0%), chest CT or plain radiography revealed diffuse interstitial changes in the right lower lung field. Three-dimensional CT of the lung and the experimental model revealed that the aurora sign derived from the irregularity of air spaces immediately below the pleura associated with interstitial pulmonary disorders. (2). One or more bands of RA were observed in 907 of the 2000 patients (45.4%). Of 177 patients with fatty liver, RA was observed in 14 (7.9%), while of the 1823 patients with no fatty liver, RA was observed in 893 (49.0%). The frequency of RA was significantly different (p<0.001) between the patients with and without fatty liver. In conclusion, parenchymal lung disease should be suspected when the aurora sign is noted on the dorsal side of the right hepatic lobe. However, RAs are rare in patients with fatty liver.

Milrinone improves lung compliance in patients receiving mechanical ventilation for cardiogenic pulmonary edema

BACKGROUND

Cardiogenic pulmonary edema is a frequent cause of respiratory failure. We investigated whether milrinone improved lung compliance.

METHODS

We selected 10 patients with respiratory failure due to severe cardiogenic pulmonary edema to receive mechanical ventilation. Patients were administered a bolus injection of milrinone (50 microg kg-1) over 10 min, followed by continuous intravenous infusion (0.5 microg kg-1 min-1). Lung compliance, blood gas values, hemodynamic parameters, and sample plasma milrinone levels were assessed over 120 min after the onset of the continuous infusion of milrinone.

RESULTS

Ten min following milrinone infusion, dynamic compliance (Cdyn) and static compliance (Cst) increased from 37 +/- 12 to 42 +/- 12 ml cmH2O-1 and from 40 +/- 13 to 45 +/- 12 ml cmH2O-1, respectively (P < 0.01). Plasma milrinone levels reached a therapeutic level for vasodilator and positive inotropic effect at 10 min after milrinone infusion. A significant decrease in mean pulmonary artery pressure and pulmonary artery wedge pressure occurred simultaneously with an increase in respiratory system compliance. However, an increase in cardiac index was observed later than these changes. There were significant correlations between the mean pulmonary artery pressure and Cdyn (r = -0.39, P < 0.01) and Cst (r = -0.38, P < 0.01).

CONCLUSIONS

Milrinone-induced improvement in lung compliance along with an improvement of hemodynamics was found together with an inverse relationship between compliance and mean pulmonary artery pressure.

Excitation and decay of the isovector giant monopole resonances via the 208Pb(3He,t p) reaction at 410 MeV

The excitation and subsequent proton decay of the isovector spin-flip giant monopole resonance (IVSGMR) is studied via the 208Pb(3He,t) reaction at 410 MeV. In the inclusive spectrum (60+/-5)% of the non-energy-weighted sum-rule strength for this 2 variant Planck's over 2h omega resonance was found in the region 29<Ex(208Bi)<51 MeV. The central excitation energy and width of the IVSGMR are 37+/-1 MeV and 14+/-3 MeV, respectively. It is found that the branching ratio for proton decay is (52+/-12)% and that the deep neutron-hole states in 207Pb are strongly fed.

MR-based three-dimensional presentation of cartilage thickness in the femoral head

The purpose of our study was to visualize the hyaline cartilage of the femoral head and to evaluate the distribution of the thickness by three-dimensional reconstruction of MRI data. The MRI was performed in 10 normal volunteers, 1 patient with osteonecrosis and 4 with advanced osteoarthritis. A fast 3D spoiled gradient-recalled acquisition in the steady state pulse sequence (TR 22 ms/TE 5.6 ms/no. of excitations 2) with fat suppression was used for data collection. Coronal and sagittal images were obtained with 3-mm effective slice thickness, 16-cm field of view (FOV) and 256x192 matrix. The MR images were reconstructed in three dimensions for evaluating the distribution of the cartilage thickness. In all normal volunteers, 1 patient with osteonecrosis and three advanced osteoarthritis, 3D reconstruction was successful, but in 1 case of osteoarthritis, 3D reconstruction failed because of the narrow joint space. In normal volunteers, the cartilage thickness is thickest in the central portion around the ligamentum teres (mean 2.8 mm). The medial portion and the lateral portion are almost of the same thickness (medial 1.3 mm, lateral 1.1 mm). In 3 cases of osteoarthritis, the cartilage became thinner in the lateral portions (<0.6 mm), but was unchanged in the central and medial portions. Three-dimensional reconstruction of MRI data is useful for evaluating the distribution of the cartilage thickness of the femoral head objectively.