Pharmacokinetic studies of 2-amino-9-(3-acetoxymethyl-4-isopropoxycarbonyl-oxybut-1-yl)purine, an oral prodrug for the antiviral agent penciclovir

2-Amino-9-(3-acetoxymethyl-4-isopropoxycarbonyloxybut-1-yl)- purine (SK1899) was tested as an oral prodrug for penciclovir. SK1899 was administered orally to rats and dogs at doses up to 2 and 0.68 mmol/kg, respectively. SK1899 was well absorbed, and the major metabolites detected in plasma and urine were penciclovir, the active antiviral compound, and 6-deoxypenciclovir (M4) in both species. In rats, SK1899 was rapidly and extensively metabolized to penciclovir, which reached the peak plasma concentration (C(max)) of 39.5 microM at 0.5 h after 0.2-mmol/kg dosing. The area under the plasma concentration-time curve (AUC) for penciclovir was 57.5 microM x h. After an oral dose of 0.034 mmol/kg to dogs, extensive conversion of SK1899 to penciclovir also occurred with slower rate of formation of penciclovir from M4 than in rats. The mean C(max) and AUC for penciclovir were 4.5 microM at 2.7 h and 28.2 microM x h, respectively. The 0- to 24-h urinary recovery of penciclovir represented 36.1 and 36.3% of dose to rats and dogs, respectively. Radioactivity was found in fetuses following an oral administration of [(14)C]SK1899 to pregnant rats, but no significant accumulation was observed. Although substantial milk transfer of [(14)C]SK1899 occurred in rats, the radioactivity in milk was rapidly cleared. The values of C(max), AUC, and urinary recovery of penciclovir after dosing with SK1899 to rats and dogs were similar or slightly higher than those from famciclovir. These data indicate that introduction of an isopropoxy carbonate group into one of the two hydroxyl groups of M4 did not significantly alter the oral bioavailability of penciclovir compared with famciclovir.

Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features

PURPOSE

To assess the computed tomographic (CT) features of abdominopelvic actinomycosis involving the gastrointestinal tract.

MATERIALS AND METHODS

CT scans were analyzed in 18 patients with pathologically proved abdominopelvic actinomycosis involving the gastrointestinal tract. Eight patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness, length, bowel involvement patterns, inflammatory infiltration, and features of peritoneal or pelvic mass, if present, were evaluated at CT.

RESULTS

Of the gastrointestinal tract, the sigmoid colon was most commonly involved (50%). All patients showed concentric (n = 15) or eccentric (n = 3) bowel wall thickening, with a mean thickness of 1.2 cm and a mean length of 8.3 cm. The thickened bowel enhanced homogeneously in nine patients and heterogeneously in the other nine. Inflammatory infiltration was mostly diffuse and severe. In 17 patients, a peritoneal or pelvic mass (mean maximum diameter, 3.2 cm) was seen adjacent to the involved bowel and appeared to be heterogeneously enhanced in most cases; infiltration into the abdominal wall was seen in four patients.

CONCLUSION

Actinomycosis should be included in the differential diagnosis when CT scans show bowel wall thickening and regional pelvic or peritoneal mass with extensive infiltration, especially in patients with abdominal pain, fever, leukocytosis, or long-term use of intrauterine contraceptive devices.

Synthesis and phosphodiesterase 5 inhibitory activity of new 5-phenyl-1,6-dihydro-7H-pyrazolo[4,3-d]pyrimidin-7-one derivatives containing an N-acylamido group phenyl ring

New sildenafil analogues with an N-acylamido group at the 5'-position of the phenyl ring, 6a--e, were prepared from the readily available starting compound 2 in four straightforward steps. Enzyme assays demonstrated that all the target compounds 6a-e showed higher PDE5 inhibitory activities than sildenafil. It was observed that the PDE5 inhibitory activity was enhanced as the chain length of R group increased, but introduction of the branched alkyl groups such as isopropyl (6d) and cyclohexyl (6e) resulted in the drop of potency compared with 6c. In particular the N-butyrylamido derivative 6c exhibited the highest PDE5 inhibitory activity, and was about 6-fold more potent than sildenafil. However, all the compounds exhibited somewhat weak selectivity (1--3-fold) over PDE6, indicating that the compounds 6a--e have intrinsically lower selectivity than sildenafil.

Synthesis and phosphodiesterase 5 inhibitory activity of novel phenyl ring modified sildenafil analogues

New sildenafil analogues containing an ether ring fused into the phenyl moiety, 6a--d and 7a--d, were efficiently synthesized from the readily available starting materials, 1a--d and 2, in five steps. Ab initio calculations indicated that introduction of a cyclic ether to the phenyl group might enhance the co-planarity of the molecule. The torsional angles were calculated to be 2--3 degrees for the 5-membered cyclic ether derivatives, 6a, 6c, 7a, and 7c, and 12--16 degrees for the 6-membered ones, 6b, 6d, 7b, and 7d. On the other hand, sildenafil showed the least co-planarity with the torsional angle of 23 degrees compared with the target compounds, 6a--d and 7a--d. In the enzyme assay, however, the in vitro PDE 5 inhibitory activity was found out to be inversely related to the degree of co-planarity. In other words, the least planar sildenafil showed the highest activity, and the most planar 5-membered cyclic ether derivatives were least active by 100--200-fold compared with sildenafil. Our study clearly demonstrated that the open chain 2'-alkoxy group of the phenyl ring, although less effective for inducing the co-planarity, seemed to act as a much better lipophilic requirement than the cyclic alkoxy moiety.

Synthesis and biological evaluation of novel A-ring modified hexacyclic camptothecin analogues

Eleven A-ring modified hexacyclic analogues of camptothecin (CPT) containing a 1,4-oxazine ring were synthesized from 10-hydroxycamptothecin (11a) and 7-ethyl-10-hydroxycamptothecin (3) (SN-38) in four to five steps and were subjected to the biological tests such as cytotoxicity, topoisomerase I (Topo I) inhibitory activity, acetylcholinesterase (AChE) inhibition, and stability in human plasma. Four compounds 15a, 15b, 16a, and 16c were about 2-fold more potent than topotecan and as potent as CPT toward human cancer cell lines A549, H128, WiDr, MKN45, SK-OV-3, and SK-BR-3 in vitro, even though the most active compound 15b was slightly less potent than SN-38. The potency of Topo I inhibition of these compounds showed relatively good correlation with their cytotoxicity. Most of the compounds exhibited AChE inhibitory activity weaker (9 +/- 2 to 20 +/- 3%) than CPT (23 +/- 5%) or topotecan (20 +/- 4%) and similar to SN-38 (13 +/- 2%), indicating that they might have little effect on causing early diarrhea. The stability of lactone forms of these compounds in human plasma seemed to be much higher than that of CPT and similar to that of topotecan but lower than that of SN-38. Among the new hexacyclic CPT analogues, compound 15b showed higher antitumor activity against human tumor xenograft, WiDr, in nude mice compared to that of SN-38. The most promising compound 15b has been selected for further development.

Three-dimensional spiral CT cholangiography with minimum intensity projection in patients with suspected obstructive biliary disease: comparison with percutaneous transhepatic cholangiography

BACKGROUND

To evaluate the diagnostic potential of spiral computed tomographic (CT) cholangiography with minimum intensity projection (minIP) in the diagnosis of patients with suspected biliary obstruction.

METHODS

Nine consecutive patients with obstructive biliary disease were enrolled in this study. Spiral CT data (3-mm slice thickness, pitch 1-2:1) obtained 65 s after the start of contrast medium injection (150 mL Ultravist 370, 3 mL/s) were reconstructed at 1-mm intervals. Three-dimensional (3D) CT cholangiography with minIP (3D CTC) was generated with a Siemens software package. The quality of 3D CTC in its ability to demonstrate the anatomic detail, the level of obstruction, and the presence or absence of isolated hepatic segments was evaluated using percutaneous transhepatic cholangiography as a gold standard.

RESULTS

In all patients, 3D CTC demonstrated dilated intrahepatic ducts up to tertiary branches. 3D CTC correctly diagnosed the level of biliary obstruction and demonstrated isolated segments in all patients. In determining the cause of biliary obstruction, one patient with hilar cholangiocarcinoma was misdiagnosed as having biliary invasion by hepatocellular carcinoma.

CONCLUSION

3D CTC with minIP can determine the level and cause of biliary obstruction. 3D CTC can be obtained from regular thin-section helical CT data and may be a strong competitor against diagnostic magnetic resonance cholangiography because of its superior resolution and information on adjacent soft tissues and the duct itself.

Peripheral T-cell lymphoma of the colon: double-contrast barium enema examination findings in six patients

PURPOSE

To evaluate radiologic findings of peripheral T-cell lymphoma (PTCL) of the colon at double-contrast barium enema examination.

MATERIALS AND METHODS

Double-contrast barium enema findings in six patients with pathologically proved PTCL of the colon were retrospectively evaluated and compared with colonoscopic and histopathologic findings.

RESULTS

There was a diffuse involvement of almost all segments of the colon in four patients and a focal segmental involvement in two. Frequent findings at double-contrast barium enema examination included geographic ulcerations (n = 6), aphthous ulcerations (n = 4), pseudopolyps (n = 4), circumferential luminal narrowing (n = 4), and ileocecal deformity (n = 4).

CONCLUSION

PTCL of the colon manifested as either a diffuse or a focal segmental lesion and showed extensive mucosal ulceration at double-contrast barium enema examination. These findings are similar to those of inflammatory bowel disease and are different from those of colorectal lymphoma with the B-cell phenotype.

Quantitative comparison of tumor vascularity of hepatocellular carcinoma after intravenous contrast agent: conventional versus harmonic power Doppler US

BACKGROUND

The purpose of this study was to make a quantitative comparison between conventional and harmonic power Doppler (PD) ultrasound (US) in depicting vascularity of hepatocellular carcinoma (HCC).

METHODS

Ten nodular HCCs in 10 patients were prospectively examined using a 2-4-MHz convex transducer and a standardized examination protocol. Serial US images were obtained before and 20, 30, 40, 50, 60, 90, 120, 150, 180, 240, and 300 s after intravenous injection of 2 g of contrast agent using conventional and harmonic PD US. The percentage of area with Doppler signal within each HCC nodule (%PDA) was calculated in each image with a PC-based image analysis program, and the results with both US techniques were compared.

RESULTS

In the majority of cases, %PDA was greater on conventional PD US than on harmonic PD US. Mean %PDA of 10 HCCs was significantly higher on conventional PD US than on harmonic PD US except at 20 s after injection. The highest values of mean %PDA were 34.9% in conventional PD US and 19.5% in harmonic PD US at 60 s after injection.

CONCLUSION

Area with PD signals within the HCC is smaller and the duration of effective enhancement is shorter in harmonic PD US than in conventional PD US.

Castleman disease of the abdomen: imaging spectrum and clinicopathologic correlations

PURPOSE

The purpose of this work was to define the imaging spectrum of Castleman disease of the abdomen and to correlate the results with clinicopathologic findings.

METHOD

Seventeen patients (male/female 7:10; mean age 35.6 years) with pathologically proved Castleman disease in the abdomen were included in this study. Radiologic findings (CT, n =17; US, n =10; MR, n =1) were retrospectively reviewed by two readers and were correlated with clinical and pathologic findings.

RESULTS

Subjects were divided into those with localized (n = 11) and disseminated (n = 6) disease. In localized disease, the pathologic subtypes were hyaline vascular type in eight and plasma cell type in three. Radiologic studies showed a single large mass in six and a single dominant mass with small satellite nodules in five. Central low attenuation was seen in two cases, and calcification was seen in three cases. Regional lymphadenopathy was found in five cases. In disseminated disease, there were three hyaline vascular types and three plasma cell types. Radiologic findings included diffuse lymphadenopathy (n = 6), hepatosplenomegaly (n = 5), ascites (n = 3), and thickening of the retroperitoneal fascia (n = 3). Disseminated disease revealed symptoms and abnormal laboratory findings (anemia, hypoalbuminemia, elevated erythrocyte sedimentation rate/C-reactive protein, etc.) more frequently than localized disease and showed poor prognosis.

CONCLUSION

There are two distinctive types of radiologic manifestations in Castleman disease of the abdomen: localized and disseminated. The localized type usually shows single or multiple discrete masses, and the disseminated type frequently shows nonspecific organomegaly and lymphadenopathy.

Alteration of cell growth and morphology by overexpression of transforming growth factor beta type II receptor in human lung adenocarcinoma cells

TGF-beta is a potent inhibitory regulator of cell growth, which is transduced through interaction between type I (RI) and type II (RII) receptors that form heteromeric kinase complexes. Abnormal expression of these receptors has been identified in several human epithelial cancers and has been shown to be highly associated with resistance to TGF-beta. In this study, we investigated the expression of RI and RII in 13 human non-small cell lung cancer cell lines (NSCLCs) and demonstrated decreased or loss of RII expression in five lung cancer cell lines, but not of RI. Of these cell lines, the role of RII in NCI-H358 adenocarcinoma, which lacks RII and is insensitive to TGF-beta, was investigated by transducing this cell line with a recombinant retrovirus expressing full-length TGF-beta RII. Stably transfected cells showed significant increase in RII mRNA and protein expression. These cells responded to exogenous TGF-beta1 with suppressed proliferation in a dose-dependent manner and G1 arrest accompanied by morphological change distinct from control cells. We also investigated whether overexpression of dominant-negative RII (dnRII) in NCI-H441 adenocarcinoma, which is sensitive but expresses low levels of RII, could block signaling through the receptor complex. The overexpression of this kinase-domain-truncated RII by expressing the retroviral dnRII construct led to loss of the ability to respond to TGF-beta1 and an exhibition of uncontrolled growth. These results suggest a close association between the loss of the expression of wild-type TGF-beta RII and carcinogenesis in human lung cancer cells.

Formulation and release characteristics of poly(lactic-co-glycolic acid) microspheres containing chemically modified protein

Chemical modification of proteins may influence their formulation into and release from polymeric microspheres. Three chemical modifications of rat serum albumin (RSA) were effected on the amine groups of this protein: conjugation with a polyanion using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, intermolecular cross-linking using glutaraldehyde, and reductive alkylation using propyl aldehyde. The modified proteins had different physicochemical properties as well as improved encapsulation efficiencies compared with native RSA microspheres. The microspheres were incubated at 37 degrees C for over one month to investigate the influence of protein modification on the release profiles. Microsphere degradation accelerated from the ninth day of the release studies and this coincided with an increase in the release rates. The degradation rates of poly(lactic-co-glycolic acid) microspheres containing either native or cross-linked RSA were more rapid than those containing either heparin conjugated or propylated RSA. This was in agreement with the release data, since the release of the native and cross-linked RSA were more rapid than those of the other modified proteins. The release profiles of the RSA-heparin conjugates and the propylated RSA were approximately zero rather than first order between the tenth and thirtieth day of study. Chemical modification of protein may be a useful method to increase encapsulation efficiency and to decrease release rates of proteins that are to be used in microsphere formulations of potent therapeutic proteins.

Ultrasonographic evaluation of the gallbladder: comparison of fundamental, tissue harmonic, and pulse inversion harmonic imaging

The purpose of our study was to compare pulse inversion harmonic imaging, tissue harmonic imaging, and fundamental imaging in the evaluation of normal and diseased gallbladder. Gallbladders in 170 patients were examined with fundamental imaging, tissue harmonic imaging, and pulse inversion harmonic imaging using a 2- to 5-MHz curved array transducer. Images were divided into normal and abnormal groups. The sharpness of the wall and degree of internal artifact were evaluated in normal groups, and lesion conspicuity and internal artifact were evaluated in abnormal groups. In images of both normal and abnormal gallbladder, significant differences were demonstrated among the 3 imaging methods (P < .001), and pulse inversion harmonic imaging provided the best image quality and the least artifact. Tissue harmonic imaging was the next best, providing better image quality and less artifact than fundamental imaging. In conclusion, pulse inversion harmonic imaging provided the best image quality and the least artifact among the 3 ultrasonographic methods in the evaluation of both normal and abnormal gallbladder.

Biliary ascariasis: MR cholangiography findings in two cases

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.

Improved imaging of hepatic metastases with delayed pulse inversion harmonic imaging using a contrast agent SH U 508A: preliminary study

To investigate the feasibility of delayed pulse-inversion harmonic imaging (PIHI) with the SH U 508A to improve imaging of hepatic metastases, we evaluated 20 patients with known hepatic metastases. Conventional ultrasound (US) was performed before administration, and PIHI was performed 5 min after a bolus injection of 4 G of microbubble contrast agent (300 mg/mL of SH U 508A). Intense, homogeneous enhancement in the liver parenchyma was seen in all patients on delayed PIHI. In 10 patients (50%), 1 or more focal liver lesions that were not seen on unenhanced imaging were detected on delayed PIHI. When comparing 55 lesions that were seen on both techniques, delayed PIHI was superior to unenhanced imaging in terms of lesion conspicuity and lesion-to-liver contrast (p < 0.001, respectively). Delayed PIHI with SH U 508A can improve conspicuity of hepatic metastases and reveal focal liver lesions that are not detected on unenhanced imaging.

Neoplasms containing normal hepatic vessels: imaging features

BACKGROUND

We investigated the incidence and imaging features of hepatic neoplasms containing normal hepatic vessels.

METHODS

Among 3183 patients with various hepatic neoplasms, we found nine patients with normal hepatic vessels traversing hepatic neoplasms. The presence of mass effect on the vessel traversing hepatic neoplasms was evaluated. Other suggestive findings of neoplasms such as altered hepatic contour, portal vein thrombosis, mass effect on extratumoral vessel, and bile duct dilatation were analyzed.

RESULTS

Thirteen hepatic vessels (nine hepatic veins and four portal veins) extended through hepatic neoplasms in nine patients. Undisturbed hepatic vessels within the neoplasms were found in five patients with either primary or metastatic hepatic neoplasm. In one patient with undisturbed hepatic vessels within the neoplasm, there were no associated abnormal findings such as biliary dilatation, change of hepatic contour, or any changes involving the vessels external to neoplasms.

CONCLUSION

Although rare, various primary and secondary hepatic neoplasms can have normal hepatic vessels passing through them without mass effect. However, correct diagnosis in most neoplasms would be possible with careful examination of associated findings.

Fat replacement with absence of acinar and ductal structure in the pancreatic body and tail

We report an unusual case of fat replacement of the pancreatic body and tail. Findings on contrast-enhanced computed tomography and ERCP could be confused with dorsal pancreas agenesis. Histopathologic examination of the resected specimen revealed massive fat replacement with complete absence of the acinar and ductal tissue and scattered islets of Langerhans.

Osmoprotective effect of glycine betaine on foreign protein production in hyperosmotic recombinant chinese hamster ovary cell cultures differs among cell lines

When three recombinant Chinese hamster ovary (rCHO) cell lines, CHO/dhfr-B22-4, CS13-1.00*, and CS13-0.02*, were cultivated in hyperosmolar media resulting from NaCl addition, their specific foreign protein productivity increased with medium osmolality. However, due to a simultaneous suppression of cell growth at elevated osmolality, no enhancement in the maximum foreign protein titer was made in batch cultures. To test the feasibility of using glycine betaine, known as a strong osmoprotective compound, for improved foreign protein production in hyperosmotic rCHO cell cultures, hyperosmotic batch cultures were carried out in the presence of 15 mM glycine betaine. Glycine betaine was found to have a strong osmoprotective effect on all three rCHO cell lines. Inclusion of 15 mM glycine betaine in hyperosmolar medium enabled rCHO cell lines to grow at 557 to 573 mOsm/kg, whereas they could not grow in the absence of glycine betaine. However, effect of glycine betaine inclusion in hyperosmolar medium on foreign protein production differed among rCHO cell lines. CHO/dhfr-B22-4 cells retained enhanced specific human thrombopoietin (hTPO) productivity in the presence of glycine betaine, and thereby the maximum hTPO titer obtained at 573 mOsm/kg was increased by 72% over that obtained in the control culture with physiological osmolality (292 mOsm/kg). On the other hand, enhanced specific antibody productivity of CS13-1.00* and CS13-0.02* at elevated osmolality was decreased significantly in the presence of glycine betaine. As a result, the maximum antibody titer at 557 mOsm/kg was similar to that obtained in the control culture with physiological osmolality. The mRNA contents per cell determined by northern blot hybridization correlated with q in all three rCHO cell lines, indicating that transcriptional regulation is responsible in part for q enhancement at hyperosmolality in the absence as well as the presence of glycine betaine. Taken together, efficacy of the simultaneous use of hyperosmotic pressure and glycine betaine as a means to improve foreign protein production was variable among different rCHO cell lines.

Morphological selection of parental Chinese hamster ovary cell clones exhibiting high-level expression of recombinant protein

To facilitate the establishment of recombinant Chinese hamster ovary (rCHO) cell lines with dihydrofolate reductase (dhfr)-mediated gene amplification, a primary selection method based on morphology of parental CHO clones has been developed. Morphology of parental clones that were made by transfecting various plasmids encoding thrombopoietin (TPO) and its analogs and humanized antibodies into dhfr-deficient (dhfr-) CHO cells was not uniform. Morphology of many parental clones exhibiting high-level expression of the introduced gene was similar to that of nontransfected dhfr- CHO cells. On the other hand, most parental clones with low-level expression experienced noticeable morphological changes such as bipolar fibroblast-like morphology. In case of selection of parental clones with TPO expression level higher than 200 ng/mL, morphological selection improved selection efficiency by 3.5-fold compared with random selection. Furthermore, when subjected to methotrexate for gene amplification, parental clones that were selected based on morphology elevated the expression level as much as those that were selected randomly. Taken together, morphological selection of parental clones can facilitate the establishment of rCHO cell lines expressing recombinant proteins.

CT features of intraductal intrahepatic cholangiocarcinoma

OBJECTIVE

The objective of this report was to describe the CT features of intraductal intrahepatic cholangiocarcinoma.

CONCLUSION

Segmental or lobar dilatation of the intrahepatic bile ducts associated with or without intraductal polypoid mass, amorphous structures, or both with slight hyperattenuation are common CT findings of intraductal intrahepatic cholangiocarcinoma. The size of the intraductal mass determines the visibility on CT.

Preoperative evaluation of Klatskin tumor: accuracy of spiral CT in determining vascular invasion as a sign of unresectability

BACKGROUND

To assess the accuracy of spiral computed tomography (CT) in predicting the resectability of Klatskin tumor as determined by vascular invasion.

METHODS

Twenty-one consecutive patients with Klatskin tumor who had undergone laparotomy were included in this study. The preoperative thin-section (5-mm-thick) spiral CT scans of these patients were assessed for the surgical resectability of tumor by evaluating the vascular invasion. The criterion for vascular invasion indicating unresectability was the tumoral invasion of the proper hepatic artery or main portal vein or simultaneous invasion of one side of the hepatic artery and the other side of the portal vein.

RESULTS

All nine patients with tumors thought to be unresectable on the basis of CT findings had tumors that were unresectable at surgery (positive predictive value, 100%). Of 12 patients with tumors thought to be resectable, six had resectable tumors (negative predictive value, 50%). Spiral CT failed to detect small hepatic metastasis (n = 1), lymph node metastasis (n = 1), extensive tumor (n = 2) and variation of bile duct (n = 2), which precluded surgical resection.

CONCLUSION

Spiral CT is a reliable method for detecting vascular invasion and unresectable tumors. However, it has limitations in detecting variations of the bile duct or the intraductal extent of tumor.

Lactobacillus kimchii sp. nov., a new species from kimchi

A bacteriocin-producing lactic acid bacterium, which was isolated from the Korean fermented-vegetable food kimchi, was subjected to a polyphasic taxonomic study using phenotypic characterization and phylogenetic and genetic methods. This organism (MT-1077T) has phenotypic properties that are consistent with the description characterizing the genus Lactobacillus. Phylogenetic analysis based on 16S rDNA sequences showed clearly that strain MT-1077T is a member of the genus Lactobacillus. The closest phylogenetic relatives are Lactobacillus alimentarius KCTC 3593T and Lactobacillus farciminis LMG 9200T, with levels of 16S rDNA similarity of 98.4 and 98.2%, respectively. Levels of 16S rDNA similarity between strain MT-1077T and other Lactobacillus species were less than 93.0%. Differences in some phenotypic characteristics and DNA-DNA relatedness data indicated that strain MT-1077T should be distinguished from L. alimentarius KCTC 3593T and L. farciminis LMG 9200T. On the basis of the data presented, it is proposed that strain MT-1077T should be placed in the genus Lactobacillus as a new species, Lactobacillus kimchii sp. nov. The type strain of the new species is strain MT-1077T (= KCTC 8903PT = JCM 10707T).

Osmoprotective effect of glycine betaine on thrombopoietin production in hyperosmotic Chinese hamster ovary cell culture: clonal variations

When 23 recombinant Chinese hamster ovary (rCHO) cell clones were cultivated in hyperosmolar medium resulting from NaCl addition (533 mOsm/kg), their specific thrombopoietin (TPO) productivity (q(TPO)) was increased. However, due to depressed cell growth at elevated osmolality, no enhancement in the maximum TPO titer was made in batch cultures of all 23 clones. To test the feasibility of using glycine betaine, known as a strong osmoprotective compound, for improved TPO production in hyperosmotic rCHO cell cultures, hyperosmotic batch cultures of 23 clones were performed in the presence of 15 mM glycine betaine. Glycine betaine was found to have a strong osmoprotective effect on all 23 clones. Inclusion of 15 mM glycine betaine in hyperosmolar medium enabled 22 clones to grow at 542 mOsm/kg, where most clones could not grow in the absence of glycine betaine, but at a cost of reduced q(TPO). However, the relative decrease in q(TPO) varied significantly among clones. Thus, efficacy of the simultaneous use of hyperosmotic pressure and glycine betaine as a means to improve foreign protein production was variable among clones. Six out of 23 clones displayed more than a 40% increase in the maximum TPO titer in the hyperosmolar medium containing glycine betaine, compared with that in the standard medium with a physiological osmolality. Taken together, the results obtained here emphasize the importance of selection of clones for the successful use of hyperosmotic pressure and glycine betaine as an economical means to improve TPO production.

A case of chronic cerebral paragonimiasis westermani

We report a chronic cerebral paragonimiasis from a 41-year-old Korean man who complains a headache and weakness of left motor neuron components. Magnetic resonance images of the brain revealed conglomerates of multiple ring-like enhancements in temporo-occipital and frontal lobes of the right hemisphere. An intradermal test for paragonimiasis westermani was positive. The patient was born near an endemic area of paragonimiasis and used to eat boiled or grilled freshwater crayfish in his childhood. Nodules in the brain were resected through craniotomies. The eggs of P. westermani were identified pathologically and parasitologically in the calcified necrotic lesions. Examinations on sputum and fecal specimens for the eggs of P. westermani were shown to be negative and a chest radiograph was normal. It is presumed that the brain lesions were formed by P. westermani approximately 30 years ago.

Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US

PURPOSE

To evaluate contrast agent-enhancement patterns in hepatic hemangiomas, hepatic metastases, and hepatocellular carcinomas (HCCs) at pulse-inversion harmonic ultrasonography (US) with a microbubble contrast agent.

MATERIALS AND METHODS

Twenty hepatic hemangiomas in 20 patients and 41 malignant hepatic tumors in 23 patients (33 metastases and eight HCCs) were evaluated with pulse-inversion harmonic US. US images were obtained before injection and every 10-15 seconds after injection of a 4-g bolus (300 mg/mL) of SH U 508A (a microbubble contrast agent) for 5 minutes. The contrast-enhancement patterns of 61 hepatic lesions were assessed.

RESULTS

Of 20 hemangiomas, 19 revealed peripheral enhancement, which was globular in 14 (70%) and rimlike in five (25%), with centripetal fill-in; the remaining one (5%) showed homogeneous enhancement. In 33 metastases, the enhancement was rimlike in 16 (48%), homogeneous in seven (21%), and stippled in two (6%); in the remaining eight metastases (24%), no enhancement was seen. Of eight HCCs, four (50%) showed homogeneous enhancement and the remaining four (50%) showed heterogeneous enhancement. Centripetal fill-in of lesions with intratumoral enhancement was not seen in any malignancy.

CONCLUSION

Pulse-inversion harmonic US with a microbubble contrast agent is potentially useful for the specific diagnosis of hemangiomas that demonstrate characteristic enhancement features.

Gadolinium mesoporphyrin as an MR imaging contrast agent in the evaluation of tumors: an experimental model of VX2 carcinoma in rabbits

OBJECTIVE

We determined the enhancement features of experimentally induced malignant tumors on MR imaging with the use of gadolinium mesoporphyrin, a recently developed MR contrast agent that may be necrosis-specific.

MATERIALS AND METHODS

VX2 carcinoma was inoculated into 24 rabbit thighs. T1-weighted contrast-enhanced MR imaging with IV gadopentetate dimeglumine (2-min delay) and gadolinium mesoporphyrin (20-hr delay) was performed 3-4 days (n = 6), 6-7 days (n = 6), 10-11 days (n = 5), and 13-14 days (n = 7) after the implantation of VX2 carcinoma. All tumors were sectioned along the same plane of MR images, and a detailed MR imaging-histopathologic correlation was performed.

RESULTS

Pathologically, areas enhanced with gadolinium mesoporphyrin included necrotic tissue, viable tumor, inflammatory granulation tissue, hemorrhage, and fibrosis. On gadopentetate dimeglumine-enhanced MR images, unenhanced areas of the tumor corresponded with intratumoral necrosis and hemorrhage.

CONCLUSION

Gadolinium mesoporphyrin enhances tumor necrosis on delayed phase MR imaging; however, it is impossible to specifically depict necrosis with gadolinium mesoporphyrin because it also enhances other parts of lesions, including viable tumor.

A downstream element in the human beta-globin promoter: evidence of extended sequence-specific transcription factor IID contacts

We describe here the identification and characterization of a functional downstream element in the human adult beta-globin promoter. The existence of this element was indicated by two mutations at +22 and +33 downstream of the beta-globin transcriptional start site in humans with beta-thalassemia. In vitro transcriptional analysis of these mutants, plus a third at +13, indicates that all three decrease transcription from the beta-globin promoter. Scanning mutagenesis from +10 to +45 indicates that this region contains a functional cis element(s) in vitro, and we designated this element the DCE (downstream core element). The DCE functions in concert with the beta-globin CATA box and initiator element, as well as in a heterologous, TATA-less context. A second set of mutants indicates that a particular geometry of the DCE and core promoter is necessary for promoter function. Lastly, DCE mutants show reduced affinity for transcription factor IID (TFIID). These data indicate that TFIID makes sequence-specific contacts to the DCE and that TFIID binding is necessary for DCE function.

Signaling pathways to the assembly of an interferon-beta enhanceosome. Chemical genetic studies with a small molecule

Small molecules that modulate specific protein functions are valuable tools for dissecting complex signaling pathways. Here, we identified a small molecule that induces the assembly of the interferon-beta (IFN-beta) enhanceosome by stimulating all the enhancer-binding activator proteins: ATF2/c-JUN, IRF3, and p50/p65 of NF-kappaB. This compound stimulates mitogen-activated protein kinase kinase kinase 1 (MEKK1), which is a member of a family of proteins involved in stress-mediated signaling pathways. Consistent with this, MEKK1 activates IRF3 in addition to ATF2/c-JUN and NF-kappaB for the assembly of the IFN-beta enhanceosome. MEKK1 activates IRF3 through the c-JUN amino-terminal kinase (JNK) pathway but not the p38 and IkappaB kinase (IKK) pathway. Taken together with previous observations, these results implicate that, for the assembly of an IFN-beta enhanceosome, MEKK1 can induce IRF3 and ATF2/c-JUN through the JNK pathway, whereas it can induce NF-kappaB through the IKK pathway. Thus, specific MEKK family proteins may be able to integrate some of multiple signal transduction pathways leading to the specific activation of the IFN-beta enhanceosome.

Mechanism of ATP-dependent promoter melting by transcription factor IIH

We show that transcription factor IIH ERCC3 subunit, the DNA helicase responsible for adenosine triphosphate (ATP)-dependent promoter melting during transcription initiation, does not interact with the promoter region that undergoes melting but instead interacts with DNA downstream of this region. We show further that promoter melting does not change protein-DNA interactions upstream of the region that undergoes melting but does change interactions within and downstream of this region. Our results rule out the proposal that IIH functions in promoter melting through a conventional DNA-helicase mechanism. We propose that IIH functions as a molecular wrench: rotating downstream DNA relative to fixed upstream protein-DNA interactions, thereby generating torque on, and melting, the intervening DNA.

MRI in staging advanced gastric cancer: is it useful compared with spiral CT?

PURPOSE

During the last decade, rapid progress has been made in MR technology. Our objective was to evaluate the role of MRI in staging advanced gastric cancer (AGC; gastric cancer invading the muscularis propria) and to compare it with that of spiral CT.

METHOD

We prospectively performed both MR and CT examinations on 26 patients with AGC proven by endoscopic biopsy. Contrast-enhanced CT and nonenhanced MRI with a 1.0 T scanner using FLASH, HASTE, and true-FISP sequences were obtained in each patient after injection of antiperistaltic drug and ingestion of 1 L of tap water. Fifty-two sets of CT and MR images were analyzed by two radiologists in consensus without any information from other images. T and N staging of AGC was determined according to the TNM classification. All patients underwent surgery within 1 week after both examinations. Diagnostic accuracy of each staging of AGC on CT or MRI was evaluated by comparison with the pathologic results.

RESULTS

MRI was slightly superior to CT in T staging (81 vs. 73%, respectively; p < 0.05). Although MRI had a tendency to overstage the pathologic T2 cancer, positive predictability of T2 stage and sensitivity of T3 stage were high (100%, respectively). Regarding the N staging, CT was slightly superior to MRI (73 vs. 65%; p > 0.05). However, both CT and MRI demonstrated the tendency of understaging in N staging.

CONCLUSION

Although MRI was superior to spiral CT in T staging, MRI cannot completely replace spiral CT in staging AGC because of its limitation in N staging.

Factors influencing vascular and hepatic enhancement at CT: experimental study on injection protocol using a canine model

PURPOSE

The purpose of this work was to evaluate the effects of contrast medium injection parameters on aortic, portal vein, and hepatic enhancement at spiral CT and to assess optimal injection protocol for hepatic CT.

METHOD

Ten 15 kg dogs underwent single level dynamic CT through the hepatic hilum at 5 s intervals just after the injection of contrast medium for 3 min. With use of different volumes (1, 2, and 3 ml/kg), injection rates (0.5, 1, and 2 ml/s), and concentrations (150, 200, and 300 mg/ml), a total of 270 spiral CT scans were performed. In each scan, time-attenuation curves of aorta, portal vein, and liver were obtained. The degree of maximum contrast enhancement (Imax), time to maximum enhancement (Tmax), and time to equilibrium phase (Teq) for to each injection protocol were analyzed.

RESULTS

Alterations in contrast material volume, injection rate, and concentration had significant impact on contrast enhancement of the liver. With increasing volume of contrast medium, Imax, Tmax, and Teq of aorta, portal vein, and liver increased (p < 0.005). With increasing rate of injection, on the other hand, Imax of aorta and liver increased (p < 0.05), but Tmax and Teq decreased (p < 0.005). Change of concentration of contrast medium had a significant effect on Imax of vessels (p < 0.05).

CONCLUSION

Maximum contrast enhancement of liver and vessels was influenced mainly by injection volume of contrast medium and the time to peak enhancement by injection rate of contrast medium. Under given amounts of contrast medium, therefore, the strategy of increasing volume by dilution and faster injection might give better Imax values without penalty for the duration of an optimal temporal window (Tmax and Teq).

Identification of Mad as a repressor of the human telomerase (hTERT) gene

Activation of telomerase, which has been frequently associated with cellular immortality, may constitute a key step in the development of human cancer. De-repression in the expression of its catalytic subunit hTERT gene has been proposed to directly link to the telomerase activation in tumor cells. Little is known about the mechanism how the hTERT gene is repressed in telomerase-negative mortal cells. This study was conducted, using an expression cloning approach, with the aim of identifying the gene(s) responsible for repressing the hTERT gene expression. Using this genetic screen, we isolated the transcription factor Mad as a repressor. Mutation of its DNA binding sites caused significant de-repression of hTERT promoter activity in mortal cells. This Mad-mediated repression of the hTERT promoter in mortal cells was counteracted by ectopic expression of Myc. The antagonism between Mad and Myc was also observed with an endogenous hTERT promoter. Their potential roles in differential hTERT promoter activities were further supported by the relative amounts of Mad and Myc proteins detected in immortal and mortal cells. Thus, Mad may be a direct negative regulator of hTERT in mortal cells and this repression mechanism can be inhibited by induction of Myc in immortal cells.

Gastric adenoma with atypical appearance: findings on double-contrast barium study with histopathologic correlation

BACKGROUND

To describe the radiologic findings of nonpolypoid gastric adenomas and to correlate them with pathologic findings.

METHODS

During a 9-year period, we reviewed 49 pure gastric adenomas in 43 patients with positive radiologic findings. Of these adenomas, seven with atypical polypoid appearance were retrospectively included in the study. We reviewed these findings with double-contrast barium study and correlated them with the pathologic findings.

RESULTS

Of seven nonpolypoid adenomas, four were depressed and three were flat at pathologic examination. All were diagnosed as early gastric carcinoma (five as type IIc, one as type IIb, one as type IIa + IIc) in upper gastrointestinal series. Three were located in the gastric angle, two in the lower body, and two in the antrum. Size ranged from 10 mm to approximately 25 mm (mean = 15 mm). Six lesions had nodular surface and five had convergency of the mucosal folds. A shallow depressed area was seen in six lesions.

CONCLUSIONS

A considerable proportion of gastric adenomas presents as a depressed or flat lesion on double-contrast barium study because of histologic characteristics of decreased subjacent mucosa. Because the nonpolypoid adenoma has a greater potentional for malignancy, more precaution is needed during the follow-up of this uncommon lesion.

Chemotherapeutic DNA-damaging drugs activate interferon regulatory factor-7 by the mitogen-activated protein kinase kinase-4-cJun NH2-terminal kinase pathway

Chemotherapeutic drugs and energy-rich radiation cause DNA damage, inducing signaling pathways for apoptotic cell death or cell growth arrest. The tumor suppressor gene p53 plays the critical role in the regulation of these DNA damage responses. Human tumor cells can become resistant to chemotherapy through functional inactivation of p53. Thus, it is important to identify p53-independent DNA damage signaling pathways. Here, treatment of cells with chemotherapeutic drugs or UV irradiation potentiated the transcriptional activity of IFN regulatory factor-7 (IRF7), inducing its phosphorylation and its nuclear translocation. Furthermore, IRF7 was activated by the c-Jun NH2-terminal kinase (JNK) in response to DNA-damaging agents. Activation of JNK by mitogen-activated protein kinase kinase-4 stimulated the transcriptional activity of IRF7 and induced its translocation into the nucleus. Thus, activation of IRF7 through the JNK signaling pathway may play a role in the transcriptional regulation of genes in response to DNA-damaging agents.

Nodular hepatocellular carcinoma: variation of tumor conspicuity on single-level dynamic scan and optimization of fixed delay times for two-phase helical CT

PURPOSE

The purpose of this work was to determine the optimal delay times in two-phase helical CT for nodular hepatocellular carcinoma (HCC).

METHOD

Twenty-four patients with nodular HCC (size 2.1-6.7 cm, mean 4.2 cm) were divided into three groups to undergo single-level dynamic CT with 150 ml of contrast material (iodine load of 45 g) at a rate of 3 ml/s. CT acquisition started 10, 30, or 60 s after the injection for each group, respectively, and lasted for 110 or 120 s. The optimal 20 s windows that allowed a tumor-to-liver contrast of >10 HU were determined in the pooled tumor-to-liver contrast curve.

RESULTS

The determined temporal windows were 36-56 and 130-150 s, respectively. However, each window was not appropriate in seven (33%) and five (36%) patients because of the individual variations of the contrast curve.

CONCLUSION

There is no optimal fixed delay time that is appropriate in all individual patients. The best delay times are 36 and at least 130 s with our injection protocol.

Comparison of harmonic and conventional power Doppler ultrasonography for assessment of slow flow in hyperechoic tissue: experimental study using a Doppler phantom

RATIONALE AND OBJECTIVES

Despite the advantages of depicting slow flow in small vessels, conventional power Doppler ultrasound (US) has a basic limitation, specifically that artifactual power Doppler signals mimic blood flow, especially in hyperechoic tissue. The purpose of this study was to compare harmonic power Doppler US with power Doppler US using a Doppler phantom under various parameter settings, focusing on the assessment of slow flow in the hyperechoic tissue.

METHODS

While controlling the flow velocity (5 and 10 cm/s), pulse repetition frequency (500, 700, and 1,000 Hz), wall filter (low and medium), and Doppler gain (90%, 96%, and 100%), the authors performed both harmonic Doppler US and power Doppler US by using a Doppler phantom/flow control system. We measured and compared the relative intensities of the Doppler signals (0-250 scale) in both the vessels and hyperechoic tissue-mimicking materials with the two different imaging modalities.

RESULTS

Power Doppler US with any combination of the four parameters evaluated depicted strong flow signals (mean, 213) that were superior to harmonic Doppler US (mean, 61). Relatively strong artifactual signals within the hyperechoic tissue-mimicking materials were noted on all power Doppler US studies (mean, 106) but nearly none on harmonic Doppler US (mean, 3). The contrast-to-noise ratio of harmonic Doppler US was significantly greater than that of power Doppler US.

CONCLUSIONS

Harmonic Doppler US is more useful in assessing slow flow in hyperechoic tissue than power Doppler US because it produces fewer artifactual Doppler signals originating from stationary hyperechoic tissues, which can be misjudged as true signals on power Doppler US.

Vascularity of hepatocellular carcinoma: assessment with contrast-enhanced second-harmonic versus conventional power Doppler US

PURPOSE

To compare contrast material-enhanced harmonic power Doppler ultrasonography (US) with conventional power Doppler US in depicting the vascularity of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Twenty patients with nodular HCCs (2.6-13.2 cm in diameter; mean diameter, 4.8 cm) were prospectively examined with both conventional and harmonic power Doppler US. US was performed with a 2-4-MHz curved linear-array transducer according to a standard examination protocol (1,000-Hz pulse repetition frequency, medium wall filter, and power gain of 55%-84% for conventional power Doppler US; 700-Hz pulse repetition frequency, low wall filter, and power gain of 95%-98% for harmonic power Doppler US). Serial, dynamic scans were obtained before intravenous injection of the contrast agent (SH U 508A) and at 30, 60, 90, 120, 180, 240, and 300 seconds after injection with both techniques.

RESULTS

The number of intratumoral power Doppler US signals was similar with both techniques at 30-90 seconds after contrast agent injection; however, after 90 seconds, conventional power Doppler US depicted significantly more signals than did harmonic power Doppler US. Harmonic power Doppler US was superior to conventional power Doppler US in terms of power Doppler artifacts such as "blooming" or motion-related artifacts.

CONCLUSION

Although the effective enhancement duration is relatively short compared with that for conventional power Doppler US, contrast-enhanced harmonic power Doppler US can be effective in evaluating the vascularity of HCCs because of the advantage of fewer power Doppler artifacts.

Involvement of retinoblastoma protein in p27Kip1-induced apoptosis

p27Kip1, a cyclin-dependent kinase (CDK) inhibitor, plays a critical role in cell cycle regulation. Expression of p27Kip1 is shown to increase during apoptosis in mammalian cells. Here, to directly address the role of p27Kip1 in apoptosis, p27Kip1 is overexpressed in human SK-Hep1 hepatoma cells. This leads to apoptotic cell death and this reduces protein, but not mRNA, levels of the retinoblastoma (Rb). Consistently, accumulation of Rb protein blocks p27Kip1-mediated apoptosis. These studies demonstrate an involvement of Rb in the apoptotic cell death which is induced by overexpression of p27Kip1.

MR imaging of advanced gastric cancer: comparison of various MR pulse sequences using water and gadopentetate dimeglumine as oral contrast agents

BACKGROUND

To evaluate clinical usefulness of oral contrast agents (gadopentetate dimeglumine and water) and to assess proper magnetic resonance (MR) imaging in evaluating advanced gastric cancer (AGC) by comparing different MR imaging techniques.

METHODS

Fifteen patients with AGC were imaged with a 1.0-T MR imager and body-array coil. All patients underwent surgery or laparascopic biopsy. Fast low-angle shot (FLASH), half-Fourier single-shot turbo spin-echo (HASTE), and true fast imaging with steady-state precession time (FISP) images were obtained after ingestion of 900 mL tap water in each patient, followed by postcontrast FLASH images after additional ingestion of gadopentetate dimeglumine (Gd-DTPA). Qualitative analysis including T-staging of AGC and scoring of imaging quality and quantitative analysis were performed prospectively.

RESULTS

In image quality and diagnostic accuracy of T-staging, FLASH imaging showed results slightly superior to those of other imaging modalities, and there was no great difference between using water and Gd-DTPA as an oral contrast agent. As for cancer-to-gastric lumen contrast-to-noise ratio (CNR), HASTE and true FISP imaging were superior to FLASH imaging with Gd-DTPA (p < 0.0001). In cancer-to-pancreas CNR, FLASH imaging without Gd-DTPA showed the best result.

CONCLUSIONS

The use of Gd-DTPA as a positive contrast agent may not be imperative, and T1-weighted FLASH imaging in combination with true FISP imaging with ingestion of tap water can be very useful in evaluating AGC with MR imaging.

The Wilms' tumor 1 tumor suppressor gene represses transcription of the human telomerase reverse transcriptase gene

Regulation of the human telomerase reverse transcriptase (hTERT) gene is the primary determinant for telomerase enzyme activity, which is found in tumor cells but is largely absent from normal somatic cells. Recent studies have shown that Myc protein can transcriptionally activate the hTERT gene. However, little is known about the repression mechanism of the hTERT gene and telomerase enzyme. Here, we developed an expression cloning strategy to identify cDNAs whose products can repress hTERT promoter activity in telomerase-positive immortal cells. Using this screen, we isolated the Wilms' tumor 1 suppressor gene (WT1). WT1 can repress hTERT promoter activity in 293 kidney cells. The WT1 binding site on the hTERT promoter was identified by deletional analysis. Alteration of the WT1 binding site markedly derepresses transcription from an isolated hTERT promoter by inhibiting interaction of WT1 with DNA. These specific repression effects of WT1 were not observed in HeLa cells, which express no endogenous WT1. Furthermore, we show that WT1 can repress the endogenous hTERT promoter and telomerase enzyme activities. These results suggest that WT1 may be a transcriptional repressor of the hTERT gene, at least in some specific cells.

Unusual gastric tumors: radiologic-pathologic correlation

The overlap of radiologic findings in many gastric tumors makes differentiation difficult. However, some unusual gastric tumors have characteristic radiologic features that may suggest a specific diagnosis. At barium study, lipomas typically manifest as a smooth submucosal mass or an ulcerated lesion with a "bull's-eye" appearance that is indistinguishable from other mesenchymal tumors. At computed tomography (CT), lipomas usually manifest as well-circumscribed submucosal masses with fat attenuation. At radiology, glomus tumors appear as smooth submucosal masses with or without ulceration and may contain tiny flecks of calcification. These tumors frequently demonstrate strong enhancement on early-phase contrast material-enhanced images. At barium study, lymphangiomas may appear as smooth intramural masses that are indistinguishable from other mesenchymal tumors. At CT, they manifest as non-enhancing extramucosal masses with homogeneous low attenuation. Diffuse lesions in Brunner gland hamartoma manifest as multiple small nodules, producing a characteristic "cobblestone" appearance. Lymphomas may have typical imaging features (eg, more pronounced and homogeneous mural thickening) that can help differentiate them from adenocarcinoma. In addition, adenocarcinomas may demonstrate unusual findings such as transpyloric spread, unusually large polyps, or intratumoral calcifications. Familiarity with these radiologic features of gastric tumors can help ensure correct diagnosis and proper management.

Influence of instrument settings on flow signal and background noise in power Doppler US. An experimental study using a flow phantom with hyperechoic background

OBJECTIVE

To determine the influence of various power Doppler instrument settings on intensities of flow signal and background noise in flow with a tissue-equivalent phantom.

METHODS

Power Doppler images were obtained with changing wall filter level (low, medium, high, and maximum), pulse repetition frequency (PRF; 500, 700, 1000, 1500, 3000, and 6000 Hz), and Doppler gain (60%, 70%, 80%, 90%, and 100%) at different flow velocities (13.3, 26.5, and 49.8 cm/sec). To make a quantitative comparison of different settings, the authors measured the intensities of flow signal and background noise in obtained power Doppler images using the scanner and a computer program, calculated signal-to-noise difference (SND; intensity of flow signal--intensity of background noise), and evaluated the relation between SND and power Doppler settings.

RESULTS

The intensities of flow signal and background noise were proportional to flow velocity and power Doppler gain but were inversely proportional to PRF and wall filter level. At constant wall filter level (medium), changes of PRF and Doppler gain to the same directions resulted in a high SND. At constant PRF (1000 Hz), changes of wall filter and Doppler gain to the same directions also resulted in a high SND. However, at constant Doppler gain (80%), a high SND was obtained with changing wall filter level and PRF to the opposite directions.

CONCLUSIONS

Three Doppler instrument settings--wall filter level, pulse repetition frequency, and Doppler gain--have reciprocal influences on SND.

Hepatic changes in benign obstruction of the hepatic inferior vena cava: CT findings

OBJECTIVE

The objective of this study was to describe CT findings of changes in the liver associated with benign obstruction of the hepatic inferior vena cava (IVC).

MATERIALS AND METHODS

For a 10-year period, 35 patients with benign obstruction of the hepatic IVC underwent contrast-enhanced CT of the abdomen. These patients were included in this retrospective study. CT scans were analyzed for morphologic changes and abnormal enhancement of the liver, changes in intrahepatic vessels, and additional findings that might be related to obstruction of the IVC.

RESULTS

Morphologic changes of the liver included hypertrophy of the caudate lobe (91%) and the left lobe (57%), atrophy of the right lobe (49%), and a nodular surface (74%). The most common pattern of attenuation change was areas of linear, irregular, or wedge-shaped hypoattenuation predominantly located in the peripheral portion of the liver (63%). Diffuse hypoattenuation was seen in six patients (19%) and was frequently found in areas in which hepatic veins filled with hypoattenuated thrombosis (67%). On CT, segmental IVC obstruction (80%) was seen as an obliterated segment of the hepatic IVC. However, membranous IVC obstruction (20%) was not seen on CT. The IVC below the level of obstruction was often revealed as rounded (89%) and occasionally contained thrombus (37%) or calcification (26%).

CONCLUSION

CT shows a broad spectrum of morphologic and attenuation changes of the liver and of the hepatic vessels in benign obstruction of the hepatic IVC.

Limitations of characterization of hepatic hemangiomas using a sonographic contrast agent (Levovist) and power Doppler ultrasonography

Power Doppler ultrasonography using a sonographic contrast agent (Levovist) was evaluated in 20 patients with hepatic hemangiomas with a 2-4 MHz convex transducer according to a standardized examination protocol (pulse repetition frequency, 1000 Hz; medium wall filter; power Doppler gain, 50 to 85%). Enhancement patterns were assessed and were compared with those on dynamic magnetic resonance imaging (n = 11) or computed tomography (n = 9). The most common enhancement pattern was dotlike or linear enhancement located predominantly at the periphery of the tumor (15 cases, 75%). Diffuse homogeneous enhancement was seen in one case (5%). No definite contrast enhancement was evident in four cases (20%). The enhanced area on ultrasonograms was smaller than that on dynamic MR images or CT scans in 18 cases (90%). A transient centripetal fill-in pattern was identified in six cases (30%). Persistent enhancement until 300 s was not seen in any case. Therefore, specific diagnosis of hemangioma with power Doppler ultrasonography and contrast agent may not be possible.

Unusual gastric tumors: radiologic-pathologic correlation

The overlap of radiologic findings in many gastric tumors makes differentiation difficult. However, some unusual gastric tumors have characteristic radiologic features that may suggest a specific diagnosis. At barium study, lipomas typically manifest as a smooth submucosal mass or an ulcerated lesion with a "bull's-eye" appearance that is indistinguishable from other mesenchymal tumors. At computed tomography (CT), lipomas usually manifest as well-circumscribed submucosal masses with fat attenuation. At radiology, glomus tumors appear as smooth submucosal masses with or without ulceration and may contain tiny flecks of calcification. These tumors frequently demonstrate strong enhancement on early-phase contrast material-enhanced images. At barium study, lymphangiomas may appear as smooth intramural masses that are indistinguishable from other mesenchymal tumors. At CT, they manifest as non-enhancing extramucosal masses with homogeneous low attenuation. Diffuse lesions in Brunner gland hamartoma manifest as multiple small nodules, producing a characteristic "cobblestone" appearance. Lymphomas may have typical imaging features (eg, more pronounced and homogeneous mural thickening) that can help differentiate them from adenocarcinoma. In addition, adenocarcinomas may demonstrate unusual findings such as transpyloric spread, unusually large polyps, or intratumoral calcifications. Familiarity with these radiologic features of gastric tumors can help ensure correct diagnosis and proper management.

Activation of interferon regulatory factor 3 in response to DNA-damaging agents

Genotoxic stress triggers signal transduction pathways that mediate either the protection or apoptosis of affected cells. The interferon regulatory factors (IRFs) are involved in a wide range of host defense mechanisms against environmental stresses. Treatment with DNA-damaging agents, including doxorubicin and UV radiation, caused phosphorylation of the IRF3 transcription factor. Phosphorylation of IRF3 induced its interaction with the transcriptional co-activator cAMP-response element binding protein-binding protein. Furthermore, genotoxic stress-induced phosphorylation of IRF3 resulted in its movement from the cytoplasm to the nucleus, where it activated transcription from its binding site. These observations suggest that IRF3 plays a role in the defensive responses induced by genotoxic stress.

In vivo and in vitro analyses of Myc for differential promoter activities of the human telomerase (hTERT) gene in normal and tumor cells

Induction of the catalytic subunit of human telomerase, hTERT, plays a critical role in the activation of telomerase during tumorigenesis. Here, we isolate the hTERT gene promoter and define the functional promoter region, which is inactive in normal cells but active in tumor cells. Myc directly interacts with the hTERT promoter and activates its transcription both in vivo and in vitro. Activation or repression of Myc can alter hTERT promoter activities in normal or tumor cells. Furthermore, we detect high levels of Myc protein in tumor cells compared with normal cells. The ability of Myc to modulate the activity of the hTERT promoter and, hence, the telomerase enzyme may contribute to its ability to promote tumor formation.