Efficacy of Diluted NBCA Mixture for Embolization of Arteriovenous Malformations

The purpose of this study is to evaluate the efficacy and problems of the embolization for cerebral arteriovenous malformations (AVMs) with diluted cyanoacrylate adhesives.

Twelve consecutive AVM cases were treated with N-butyl-2-cyanoacrylate (NBCA) glues between January 1997 and July 1998. The mean age of the patients was 37 years old. Intracerebral hemorrhage was the presenting symptom in seven cases, seizure in three, headache in one and mental deterioration in one. According to the classification of Spetzler and Martin, seven were Grade 11, five were Grade III. We used a mixture of NBCA (normally 25% Histoacryl, 75% Ethidol) for embolization. Microcatheter was navigated into the nidus and the tip of the catheter was set in a wedged position. Then the glue was injected using complete column technique.

Nineteen sessions of embolization were performed in 12 patients. The mean volume of each nidus was reduced from 22.5 ml to 3.4 ml (85%) after embolization. Four cases were cured by embolization alone. Surgical resection was performed after embolization without any residual nidus in three cases. Five were treated with stereotactic radiosurgery following embolization. One was completely cured in 18 months after and the other four have been decreasing their sizes of nidus. One case was suffered from delayed intracerebral hemorrhage three days after embolization, and resulted in mild hemiparesis and memory disturbance. The others had no complications and were clinically improved or unchanged after embolization.

It is possible to embolize the nidus of AVMs more accurately and safely with diluted mixture of NBCA, compared with the method using relatively higher concentration of NBCA glues. This technique is useful and effective method for the treatment of AVMs.

Human induced pluripotent stem cell-derived fiber-shaped cardiac tissue on a chip

We propose a method for the production of a fiber-shaped three-dimensional (3D) cellular construct of human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs) for the quantification of the contractile force. By culturing the cardiomyocytes in a patterned hydrogel structure with fixed edges, we succeeded in fabricating hiPS-CM fibers with aligned cardiomyocytes. The fiber generated contractile force along the fiber direction due to the hiPS-CM alignment, and we were able to measure its contractile force accurately. Furthermore, to demonstrate the drug reactivity of hiPS-CM fibers, the changes in the contractile frequency and force following treatment with isoproterenol and propranolol were observed. We believe that hiPS-CM fibers will be a useful tool for pharmacokinetic analyses during drug development.

Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma

BACKGROUND

To examine the effect of the histology of carcinoma and sarcoma components on survival outcome of uterine carcinosarcoma.

PATIENTS AND METHODS

A multicenter retrospective study was conducted to examine uterine carcinosarcoma cases that underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating to clinico-pathological demographics and outcomes.

RESULTS

Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma) with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%), low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous (5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%, P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrial invasion, lymphovascular space invasion, and advanced-stage disease were independently associated with decreased PFS (all, P < 0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P < 0.001) and radiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis. However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improved PFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P < 0.001]. On univariate analysis, significant treatment benefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum for high-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017), and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, and anthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared with non-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI 0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P < 0.001), and anthracycline for high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improved PFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, while sarcoma components tended to spread loco-regionally (P < 0.001).

CONCLUSION

Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.

Nucleus ^{26}O: A Barely Unbound System beyond the Drip Line

The unbound nucleus ^{26}O has been investigated using invariant-mass spectroscopy following one-proton removal reaction from a ^{27}F beam at 201  MeV/nucleon. The decay products, ^{24}O and two neutrons, were detected in coincidence using the newly commissioned SAMURAI spectrometer at the RIKEN Radioactive Isotope Beam Factory. The ^{26}O ground-state resonance was found to lie only 18±3(stat)±4(syst)  keV above threshold. In addition, a higher lying level, which is most likely the first 2^{+} state, was observed for the first time at 1.28_{-0.08}^{+0.11}  MeV above threshold. Comparison with theoretical predictions suggests that three-nucleon forces, pf-shell intruder configurations, and the continuum are key elements to understanding the structure of the most neutron-rich oxygen isotopes beyond the drip line.

Candidate Resonant Tetraneutron State Populated by the ^{4}He(^{8}He,^{8}Be) Reaction

A candidate resonant tetraneutron state is found in the missing-mass spectrum obtained in the double-charge-exchange reaction ^{4}He(^{8}He,^{8}Be) at 186  MeV/u. The energy of the state is 0.83±0.65(stat)±1.25(syst)  MeV above the threshold of four-neutron decay with a significance level of 4.9σ. Utilizing the large positive Q value of the (^{8}He,^{8}Be) reaction, an almost recoilless condition of the four-neutron system was achieved so as to obtain a weakly interacting four-neutron system efficiently.

Structural study of epitaxial LiCoO2 films grown by pulsed laser deposition on single crystal SrTiO3 substrates

Epitaxial LiCoO₂ (LCO) thin films of different orientations were fabricated by pulsed laser deposition (PLD) in order to model single-crystal behavior of intercalation cathodes during electrochemical reactions. This paper demonstrates that (1) epitaxial growth of LCO on a single crystal Nb-doped SrTiO₃ (Nb:STO) of different orientations occurs with a single orientation relationship; (2) surface morphology of the LCO films is established by the morphology of coalescing grains during island growth mode, whereas morphology of the grains can be visualized as different cuts from a cube with low-energy {104}_R-LCO surfaces; (3) the films consist of predominately trigonal R-LiCoO₂ phase, with a small fraction of the occasionally present cubic c-Li_xCoO₂ phase; (4) cyclic voltammetry measurements have determined rectification at interface between LCO and Nb:STO causing bias on the oxidation part of cycling, thus preventing full cycling.

Effect of oxygen pressure on structure and ionic conductivity of epitaxial Li0.33La0.55TiO3 solid electrolyte thin films produced by pulsed laser deposition

We report on the ionic conductivity of Li_0.33La_0.55TiO₃ (LLTO) epitaxial films grown on the (100) and (111) surfaces of single crystal SrTiO₃ (STO) substrates at different oxygen partial pressures (from 1.33 to 26.66 Pa).

Extension of the N=40 Island of Inversion towards N=50: Spectroscopy of (66)Cr, (70,72)Fe

We report on the measurement of the first 2(+) and 4(+) states of (66)Cr and (70,72)Fe via in-beam γ-ray spectroscopy. The nuclei of interest were produced by (p,2p) reactions at incident energies of 260  MeV/nucleon. The experiment was performed at the Radioactive Isotope Beam Factory, RIKEN, using the DALI 2γ-ray detector array and the novel MINOS device, a thick liquid hydrogen target combined with a vertex tracker. A low-energy plateau of 2(1)(+) and 4(1)(+) energies as a function of the neutron number was observed for N≥38 and N≥40 for even-even Cr and Fe isotopes, respectively. State-of-the-art shell model calculations with a modified Lenzi-Nowacki-Poves-Sieja (LNPS) interaction in the pfg(9/2)d(5/2) valence space reproduce the observations. Interpretation within the shell model shows an extension of the island of inversion at N=40 for more neutron-rich isotopes towards N=50.

Percutaneous radiofrequency ablation for hepatocellular carcinoma located in the caudate lobe of the liver

AIM

This study aimed to evaluate the effectiveness and safety of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) located in the caudate lobe of the liver.

PATIENTS AND METHODS

Between 2012 April and 2014 February, 142 patients with HCC meeting the Milan criteria were enrolled in this study. Of these patients, nine patients had HCC located in the caudate lobe (caudate group). Six of the nine cases were located in the Spiegel lobe, two cases were located in the paracaval portion and one case was located in the caudate process. We evaluated the local recurrence rate and RFA-related complications in the caudate group and non-caudate group.

RESULTS

The local recurrence rate in the caudate group was 12.5% at 1 year and 12.5% at 2 years, while the local recurrence rate in the non-caudate group was 14.9% at 1 year and 29.0% at 2 years; there were no significant differences between the groups. No complications were observed in the caudate group, and minor complications were observed in six patients (4.5%) in the non-caudate group. No major complications or mortalities were observed in either group, and the complication rates were not significantly different between the groups (P = 1).

CONCLUSIONS

RFA for HCC in the caudate lobe and the non-caudate lobe has equivalent effectiveness and safety. RFA is a promising treatment option for HCC arising in the caudate lobe.

Hashimoto's disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria

BACKGROUND

The precise pathogenesis of chronic spontaneous urticaria (CSU) remains unknown. However, an important association between CSU and autoimmune disorders such as Hashimoto's disease (HD) has been reported. We investigated the frequency of HD as a comorbidity of CSU and the prevalence rate of autoreactivity among CSU patients with HD.

PATIENTS AND METHODS

The presence of thyroid autoantibodies and the levels of thyroid hormones were examined in 40 CSU patients who showed urticaria symptoms for >4 weeks. Patients who were diagnosed with HD, including subclinical ones, and were in need of treatment received thyroid therapy, and the changes in their urticarial symptoms were observed. An autologous serum skin test (ASST) was also performed to examine the relation of CSU with autoreactivity.

RESULTS

Eleven of the 40 CSU patients were diagnosed with HD, and 4 of the 5 patients who received and completed thyroid therapy showed considerable remission of urticarial symptoms during and after treatment. In addition, the rate of positive ASST results tended to be higher in CSU patients with HD (5 of 7) than in those without HD (2 of 6).

CONCLUSIONS

The comorbidity rate of HD in CSU patients was high, and such patients tended to have a positive ASST. Thyroid therapy in CSU patients with HD can lead to a considerable remission of urticarial symptoms, which may suggest that HD is possibly involved in the aetiology of CSU, or is at least a potential exacerbating factor for CSU.

Feasibility and efficacy of intraperitoneal docetaxel administration as salvage chemotherapy for malignant gynaecological ascites

Ovarian and endometrial cancers diagnosed at advanced stages are often associated with malignant ascites. This study aimed to determine the safety, feasibility and efficacy of intraperitoneal (IP) docetaxel (TXT) for the treatment of ascites. A phase I study, including nine patients, was undertaken to determine the maximum tolerable dose. Efficacy was retrospectively assessed in 18 patients treated with 40-70 mg/m(2) IP TXT between 2005 and 2012. In a phase I study, the dose was safely escalated to a maximum of 70 mg/m(2), at which level no patients had grade -3 haematological adverse events. In a retrospective study of 18 patients, seven had an Eastern Cooperative Oncology Group performance status of 3; 16 had prior paclitaxel administration and two, with doses of 40 and 70 mg/m(2), experienced a serological response and a decrease in paracentesis. Thus, palliative treatment of recurrent OC should be further studied with 40 mg/m(2) among more patients, and 70 mg/m(2) could be evaluated for first-line IP chemotherapy.

Observation of a p-wave one-neutron halo configuration in (37)Mg

Cross sections of 1n-removal reactions from the neutron-rich nucleus (37)Mg on C and Pb targets and the parallel momentum distributions of the (37)Mg residues from the C target have been measured at 240  MeV/nucleon. A combined analysis of these distinct nuclear- and Coulomb-dominated reaction data shows that the (37)Mg ground state has a small 1n separation energy of 0.22(-0.09)(+0.12)  MeV and an appreciable p-wave neutron single-particle strength. These results confirm that (37)Mg lies near the edge of the "island of inversion" and has a sizable p-wave neutron halo component, the heaviest such system identified to date.

Notizen: Deoxycyclopaldic Acid and Cyclopaldic Acid, Plant Growth Regulators, Produced by Penicillium sp

Deoxycyclopaldic acid (1) and cyclopaldic acid (2) were isolated from cultures of the fungus Penicillium sp. as plant growth regulators and their structures were established by spectroscopic evidence. Deoxycyclopaldic acid was found in nature for the first time. The biological activities of 1 and 2 have been examined using bioassay methods with lettuce and rice seedlings.

Raised serum levels of interleukins 6 and 8 and antiphospholipid antibodies in an adult patient with Henoch-Schönlein purpura

BACKGROUND

The long-term prognosis of Henoch-Schönlein purpura (HSP) is determined by the severity of renal involvement, known as HSP nephritis, which varies considerably from patient to patient. There is now increasing evidence that dysregulated cytokine production plays a crucial role in human autoimmune and inflammatory processes.

AIM

To explore the possible contributions of serum antistreptolysin O, C-reactive protein, IgA, interleukin (IL)-6, IL-8, tumour necrosis factor (TNF)-α, anticardiolipin antibody (aCL) and antiphosphatidylserine-prothrombin complex antibody (anti-PSPT) in the pathogenesis of HSP, and to evaluate correlations between those biological parameters and the clinical features.

METHODS

Records were reviewed of 58 patients with HSP who presented initially with palpable purpura between 2003 and 2009. Serum IL-6 levels were determined by chemiluminescent enzyme immunoassay, IL-8 levels by ELISA and TNF-α levels by quantitative sandwich enzyme immunoassay. Serum aCL and anti-PSPT levels were measured according to our previously published procedures.

RESULTS

There was a significant correlation between the serum IL-6 and IgA anti-PSPT levels, and also between the serum IL-8 and IgA anti-PSPT levels. Serum IL-8 and IgA aCL levels were both significantly higher in patients with renal involvement than in those without. Serum IL-6 and IgM anti-PSPT levels were also significantly higher in patients with gastrointestinal symptoms than in those without.

CONCLUSIONS

We suggest that serum IL-6 and IL-8 associated with antiphospholipid antibodies play a pivotal role in the induction of HSP. Based on our results, IL-8 and IgA aCL levels could be useful as markers to monitor the development of HSP nephritis, and IL-6 and IgM anti-PSPT levels could be used as markers to monitor the development of gastrointestinal involvement.