Meticillin-resistant Staphylococcus aureus and meticillin-susceptible S. aureus pneumonia: comparison of clinical and thin-section CT findings

OBJECTIVES

The purpose of this study was to compare the clinical and thin-section CT findings in patients with meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-susceptible S. aureus (MSSA).

METHODS

We retrospectively identified 201 patients with acute MRSA pneumonia and 164 patients with acute MSSA pneumonia who had undergone chest thin-section CT examinations between January 2004 and March 2009. Patients with concurrent infectious disease were excluded from our study. Consequently, our study group comprised 68 patients with MRSA pneumonia (37 male, 31 female) and 83 patients with MSSA pneumonia (32 male, 51 female). Clinical findings in the patients were assessed. Parenchymal abnormalities, lymph node enlargement and pleural effusion were assessed.

RESULTS

Underlying diseases such as cardiovascular were significantly more frequent in the patients with MRSA pneumonia than in those with MSSA pneumonia. CT findings of centrilobular nodules, centrilobular nodules with a tree-in-bud pattern, and bronchial wall thickening were significantly more frequent in the patients with MSSA pneumonia than those with MRSA pneumonia (p = 0.038, p = 0.007 and p = 0.039, respectively). In the group with MRSA, parenchymal abnormalities were observed to be mainly peripherally distributed and the frequency was significantly higher than in the MSSA group (p = 0.028). Pleural effusion was significantly more frequent in the patients with MRSA pneumonia than those with MSSA pneumonia (p = 0.002).

CONCLUSIONS

Findings from the evaluation of thin-section CT manifestations of pneumonia may be useful to distinguish between patients with acute MRSA pneumonia and those with MSSA pneumonia.

[Evaluation of a new compact prothrombin time-international normalized ratio measurement device in pediatric management]

BACKGROUND

In a pediatric setting, the need for lifetime oral anticoagulation is increasing because of currency of extracardiac total cavo-pulmonary connection (TCPC) and pediatric valve surgery. We evaluated a new compact device "CoaguChek XS" for measuring prothrombin time-internatinal normalized ratio (PT-INR).

METHODS

The international normalized ratio (INR) values obtained from 71 patients (223 samples) by a CoaguChek XS were compared with those obtained by a laboratory-based coagulation analyzer.

RESULTS

The values from the CoaguChek XS had a significant correlation with the laboratory based results. (r2 = 0.92, p < 0.01, regression line y = 1.05 x -0.02).

CONCLUSION

The CoaguChek XS will be useful in pediatric management.

Establishment of pure NOTES procedure using a conventional flexible endoscope: review of six cases of gastric gastrointestinal stromal tumors

An increasing number of reports have recently been published on hybrid natural orifice transluminal endoscopic surgery (NOTES). These reports do not address how to complete an operation with a flexible endoscope alone (pure NOTES), but rather how to combine use of an endoscope and a laparoscope. Surgical procedures using flexible and rigid endoscopes have been developed using different processes and concepts. Recognizing this conceptual difference, we conducted a study to address how to establish a pure NOTES procedure. Six patients with gastric gastrointestinal stromal tumors (GISTs) underwent hybrid NOTES. Each case was retrospectively reviewed to determine the appropriateness of the treatment and the usefulness of the endoscopic submucosal dissection (ESD) method, double-scope method, spaced perforation method, duodenal balloon occlusion method, and loop clip technique. The development of operative procedures that take advantage of the characteristics of flexible endoscopes, even with conventional flexible endoscopic devices and conventional endoscopes alone, may contribute to the realization of pure NOTES.

A case of pneumonitis and encephalitis associated with human herpesvirus 6 (HHV-6) infection after bone marrow transplantation

Human herpesvirus 6 (HHV-6)-associated encephalitis or pneumonitis has been reported in immunocompetent and immunosuppressed individuals. Several MRI studies in patients with HHV-6-associated encephalitis have been presented. However, to the best of our knowledge, no studies describing thin-section CT imaging in patients with HHV-6-associated pneumonitis have been reported. Here we describe a case of HHV-6-associated encephalitis and pneumonitis that developed after bone marrow transplantation. Thin-section CT images of the chest revealed ground-glass attenuation, consolidation and centrilobular nodules in both lungs.

Impact of FOLFOXIRI plus bevacizumab on resectability and survival in patients with initially unresectable liver metastases from colorectal cancer

621

Background: Prognosis in patients with unresectable liver metastases from colorectal cancer is known to be very poor. However, thanks to progress of chemotherapy including molecular-target agents, “conversion” (from unresectable to resectable) has been sometimes seen. The aim of this preliminary study is to clarify the impact of FOLFOXIRI plus bevacizumab (Bev) on conversion and prognosis in patients with initially unresectable liver metastases from colorectal cancer.

Methods: Seven patients with initially unresectable liver metastases from colorectal cancer, who received FOLFOXIRI (LOHP 85mg/m2 D1, CPT-11 150mg/m2 D1, LV 200mg/m2 D1, and 5FU 2,400mg/m2 infusion over 46 hours, D1) plus Bev 5mg/kg bolus every 2 weeks, were included in this study. Resectability, disease-free survival (DFS), and overall survival (OS) after hepatic resection were investigated in detail. In addition, completeness and adverse effects were examined in this regimen.

Results: All 7 patients tolerated the regimen well, and no adverse effect of grade 3-4 was observed. Five out of 7 patients (71%) became resectable (conversion), except for 2 with multiple lung metastases and bone metastasis prior to chemotherapy. Our historical conversion rates were, 0% (0/7) in 5FU/LV regimen from 1994 to 2003, 25% (7/27) other regimens such as FOLFIRI and FOLFOX except for FOLFOXIRI plus Bev from 2004. In 5 patients who became resectable, CR was not observed, however, all had PR after 6 cycles of chemotherapy (RR 100%). All 5 patients could undergo curative (R0) hepatic resection, furthermore, all had pathological major response (grade 2). Follow-up period ranged from 8 to 18 months, with a median period of 14 months, and 2 patients relapsed (lung recurrence and peritoneal dissemination), and one died of lung metastases (1.5-year OS and DFS are 80 % and 60%).

Conclusions: Our preliminary data suggested the feasibility of this new therapeutic combination in patients with initially unresectable liver metastases from colorectal cancer, and a high conversion rate and better prognosis.

[Table: see text]

The impact of bevacizumab on liver regeneration following hepatectomy in rats

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Background: In our clinical data, we had the interesting findings that the pathologic sinusoidal obstruction syndrome and serum hyaluronic acid after neoadjuvant oxaliplatin-associated chemotherapy for liver metastatic colorectal cancer with bevacitumab (Bev) was ameliorated compared to those without Bev. The purpose of this study was to investigate the influence of bevacizumab administration on regenerating liver in rat 70% and 90% hepatectomy (Hx) model as a surrogate model of human massive hepatectomy for liver metastatic colorectal cancer.

Methods: Male Wister rats weighing 180-230g were divided into the following four groups: 70%Hx, 70%Hx + Bev, 90%Hx and 90%Hx+Bev group. The rats were pretreated with intraperitoneal administration of bevacizumab (5mg/kg) 7 days before hepatectomy. The remnant liver and blood samples were taken one day after hepatectomy, and the following parameters were evaluated: blood analysis (AST, ALT, LDH, T- Bil, and hyaluronic acid), liver weight to body weight (Lw/Bw) ratio, and postoperative survival rate for three days.

Results: In the 70%Hx model, there was no significant difference between the 70%Hx group and 70%Hx + Bev group in blood analysis one day after hepatectomy; AST (1928 vs. 923 IU/L), ALT (1282 vs. 670 IU/L), T-Bil (0.17 vs. 0.19 mg/dl), LDH (3822 vs. 2967 U/L) and hyaluronic acid (995.7 vs. 1026.6 ng/ml) and in Lw/Bw ratio (1.78 vs. 1.84). In 90%Hx model, AST and ALT of blood analysis in 90%Hx+Bev group significantly decreased compared to those in 90%Hx group; AST (3428 vs. 4995 IU/L, P<0.05), ALT (1471 vs. 2287 IU/L, P<0.05), T-Bil (1.94 vs. 2.57 mg/dl), LDH (3229 vs. 5351 U/L) and hyaluronic acid (3865.7 vs. 7862.2 ng/ml). The Lw/Bw ratio in 90%Hx+Bev group significantly increased compared to that in 90%Hx group (0.80 vs. 0.67, P<0.05). The postoperative survival rate in 90%Hx+Bev group showed tendency to improve compared to that in 90%Hx group (75% vs. 50%, P=0.19).

Conclusions: The administration of bevacizumab seven days before hepatectomy did not significantly affect the liver functions and liver regeneration rate. These findings suggest that hepatectomy might be safe and feasible after the use of bevacizumab.

No significant financial relationships to disclose.

Effect of a histone deacetylase inhibitor on antitumor effect of gemcitabine to focus the gene network of ingenuity pathways analysis

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Background: Histone deacetylase (HDAC) is strongly associated with epigenetic regulation and carcinogenesis, and its inhibitors induce the differentiation or apoptosis of cancer cells. Valproic acid (VPA) is one of the clinically available HDAC inhibitors. We previously showed that VPA augmented antitumor effect of GEM in choalngiocarcinoma cell line (2010 GI Symposium); this time, we performed microarray analysis and Ingenuity Pathways Analysis (IPA) to identify the systematic mechanism of the augmentative effect of VPA.

Methods: Human cholangiocarcinoma cell line (HuCCT1) was used. The anticancer effects of VPA or gemcitabine (GEM), and the effects of VPA combined with GEM were studied by MTT assay. We divided the following four groups: control group, VPA group, GEM group, VPA plus GEM combination group. The gene expressions of p21, HDAC, VEGF, and HIF-1 were evaluated by RT-PCR. And, the microarray analysis was performed, the genes were picked up using Gene Spring GX10, and then IPA was performed.

Results: In GEM alone group, no effect of GEM was observed in dose of 5 mm, and 16% of proliferation-inhibitory effects were observed in dose of 10 nm. In VPA alone group, no effect of VPA was observed in dose of 0.5 mm, and 12%, 35%, and 67% of proliferation-inhibitory effects were observed in dose of 1.0, 5.0, and 10mm, respectively. GEM (5 nm) and VPA (0.5 mm) reduced by 23%, which significantly augmented the anticancer effect of GEM alone or VPA alone (p<0.01). Furthermore, GEM combined with VPA upregulated the p21 expression compared with single agent (p<0.05). And, in regard to microarray analysis, we analyzed in 28,869 genes. The 24 genes were picked up with the comparison between VPA group and VPA plus GEM combination group using Gene Spring GX10, and the gene network of the cellular development containing the gene relevant to the differentiation of cancer cell, HLA-DR, was formed with IPA.

Conclusions: VPA augmented the effects of anticancer agents in a cholangiocarcinoma cell line. Such effects may be owing to the gene network of the cellular development. HDAC inhibitor may have the effect of the differentiation of cancer cell.

No significant financial relationships to disclose.

Role of histone deacetylase expression on regulating cancer stem cells in intrahepatic cholangiocarcinoma

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Background: Histone deacetylase (HDAC) modulates gene expressions by chromatin remodeling during malignant transformation, and showed malignant behavior in intrahepatic cholangiocarcinoma (IHCC) (ASCO GI 2008). HDAC inhibitors have recently been found to repress the function of hypoxia inducible factors (HIF) through inducing hyperacetylation of histones. We also reported that the correlation between the expression of CD133, which was one of the cancer stem cell marker, and HIF-1α in IHCC (J Gastroenterol. 2010), and hypothesized that the cancer stem cell could be regulated by histone acetylation through the HIF-1α pathway. The aim of this study was to elucidate the potential mechanism of HDAC for the regulation of malignant behavior including the cancer stem cell in IHCC.

Methods: Thirty-five patients with IHCC who underwent hepatic resection were evaluated. The expressions of HDAC1 (sc-6298 Santa Cruz Biotechnology, USA), HIF-1α (NB100-105 Novus Biologicals, USA) and CD133 (Ab27699 Abcam Inc, UK) were determined immunohistochemically, and the patients were divided into two groups: HDAC1 positive group (n=21); and negative group (n=14). Clinicopathological variables including HIF-1α and CD133 expressions were analyzed according to these expressions.

Results: The HDAC1 expression correlated significantly with higher stage, lymph node metastasis, and vascular invasion. The prognosis in the HDAC1 positive group was poorer than in the HDAC1 negative group (5-year survival: 77.9% vs. 7.9%, p=0.001). In the multivariate analysis, HDAC1 positive expression was identified as the only independent prognostic factor for disease free survival (Hazard Ratio: 7.194, p=0.0018). There was a significant correlation between HDAC1 expression and HIF-1α expression (p=0.007), and also between HIF-1α expression and CD133 expression (p=0.10). Furthermore, co-expressions of these markers in same cancer cells were proven by immunofluorescent staining in the serial section.

Conclusions: The findings suggested that histone acetylation regulated cancer stem cell through the HIF-1α pathway; therefore, HDAC1 might be a possible promising molecular target in IHCC.

No significant financial relationships to disclose.

Radiological findings in acute Haemophilus influenzae pulmonary infection

OBJECTIVE

The aim of this study was to assess pulmonary thin-section CT findings in patients with acute Haemophilus influenzae pulmonary infection.

METHODS

Thin-section CT scans obtained between January 2004 and March 2009 from 434 patients with acute H. influenzae pulmonary infection were retrospectively evaluated. Patients with concurrent infection diseases, including Streptococcus pneumoniae (n=76), Staphylococcus aureus (n=58) or multiple pathogens (n=89) were excluded from this study. Thus, our study group comprised 211 patients (106 men, 105 women; age range, 16-91 years, mean, 63.9 years). Underlying diseases included cardiac disease (n=35), pulmonary emphysema (n=23), post-operative status for malignancy (n=20) and bronchial asthma (n=15). Frequencies of CT patterns and disease distribution of parenchymal abnormalities, lymph node enlargement and pleural effusion were assessed by thin-section CT.

RESULTS

The CT findings in patients with H. influenzae pulmonary infection consisted mainly of ground-glass opacity (n=185), bronchial wall thickening (n=181), centrilobular nodules (n=137) and consolidation (n=112). These abnormalities were predominantly seen in the peripheral lung parenchyma (n=108). Pleural effusion was found in 22 patients. Two patients had mediastinal lymph node enlargement.

CONCLUSION

These findings in elderly patients with smoking habits or cardiac disease may be characteristic CT findings of H. influenzae pulmonary infection.

Localised right upper-lobe pulmonary oedema caused by extension of giant cell carcinoma to the mitral valve

Giant cell carcinoma of the lung is a very rare primary malignant tumour and localised right upper-lobe pulmonary oedema is also unusual. We report a case of giant cell carcinoma, which invaded the left atrium through the left pulmonary vein and caused localised right upper-lobe pulmonary oedema.

Persistence of the single lineage of transmissible 'social cancer' in an asexual ant

How cooperation can arise and persist, given the threat of cheating phenotypes, is a central problem in evolutionary biology, but the actual significance of cheating in natural populations is still poorly understood. Theories of social evolution predict that cheater lineages are evolutionarily short-lived. However, an exception comes from obligate socially parasitic species, some of which thought to have arisen as cheaters within cooperator colonies and then diverged through sympatric speciation. This process requires the cheater lineage to persist by avoiding rapid extinction that would result from the fact that the cheaters inflict fitness cost on their host. We examined whether this prerequisite is fulfilled, by estimating the persistence time of cheaters in a field population of the parthenogenetic ant Pristomyrmex punctatus. Population genetic analysis found that the cheaters belong to one monophyletic lineage which we infer has persisted for 200-9200 generations. We show that the cheaters migrate and are thus horizontally transmitted between colonies, a trait allowing the lineage to avoid rapid extinction with its host colony. Although horizontal transmission of disruptive cheaters has the potential to induce extinction of the entire population, such collapse is likely averted when there is spatially restricted migration in a structured population, a scenario that matches the observed isolation by distance pattern that we found. We compare our result with other examples of disruptive and horizontally transmissible cheater lineages in nature.

Pulmonary thin-section CT findings in acute Moraxella catarrhalis pulmonary infection

OBJECTIVE

Moraxella catarrhalis is an important pathogen in the exacerbation of chronic obstructive pulmonary disease. The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute M. catarrhalis pulmonary infection.

METHODS

Thin-section CT scans obtained between January 2004 and March 2009 from 292 patients with acute M. catarrhalis pulmonary infection were retrospectively evaluated. Clinical and pulmonary CT findings in the patients were assessed. Patients with concurrent infection including Streptococcus pneumoniae (n = 72), Haemophilus influenzae (n = 61) or multiple pathogens were excluded from this study.

RESULTS

The study group comprised 109 patients (66 male, 43 female; age range 28-102 years; mean age 74.9 years). Among the 109 patients, 34 had community-acquired and 75 had nosocomial infections. Underlying diseases included pulmonary emphysema (n = 74), cardiovascular disease (n = 44) or malignant disease (n = 41). Abnormal findings were seen on CT scans in all patients and included ground-glass opacity (n = 99), bronchial wall thickening (n = 85) and centrilobular nodules (n = 79). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 99). Pleural effusion was found in eight patients. No patients had mediastinal and/or hilar lymph node enlargement.

CONCLUSIONS

M. catarrhalis pulmonary infection was observed in elderly patients, often in combination with pulmonary emphysema. CT manifestations of infection were mainly ground-glass opacity, bronchial wall thickening and centilobular nodules.

Comparison of pulmonary thin section CT findings and serum KL-6 levels in patients with sarcoidosis

OBJECTIVE

This study aimed to compare thin-section CT images from sarcoidosis patients who had either normal or elevated serum KL-6 levels.

METHODS

101 patients with sarcoidosis who underwent thin-section CT examinations of the chest and serum KL-6 measurements between December 2003 and November 2008 were retrospectively identified. The study group comprised 75 sarcoidosis patients (23 male, 52 female; aged 19-82 years, mean 54.1 years) with normal KL-6 levels (152-499 U ml(-1), mean 305.7 U ml(-1)) and 26 sarcoidosis patients (7 male, 19 female; aged 19-75 years, mean 54.3 years) with elevated KL-6 levels (541-2940 U ml(-1), mean 802.4 U ml(-1)). Two chest radiologists, unaware of KL-6 levels, retrospectively and independently interpreted CT images for parenchymal abnormalities, enlarged lymph nodes and pleural effusion.

RESULTS

CT findings in sarcoidosis patients consisted mainly of lymph node enlargement (70/75 with normal KL-6 levels and 21/26 with elevated KL-6 levels), followed by nodules (50 and 25 with normal and elevated levels, respectively) and bronchial wall thickening (25 and 21 with normal and elevated levels, respectively). Ground-glass opacity, nodules, interlobular septal thickening, traction bronchiectasis, architectural distortion and bronchial wall thickening were significantly more frequent in patients with elevated KL-6 levels than those with normal levels (p<0.001, p<0.005, p<0.001, p<0.001, p<0.001 and p<0.001, respectively). By comparison, there was no significant difference in frequency of lymph node enlargement between the two groups.

CONCLUSION

These results suggest that serum KL-6 levels may be a useful marker for indicating the severity of parenchymal sarcoidosis.

Application of a novel combination of near-infrared spectroscopy and a humidity-controlled 96-well plate to the characterization of the polymorphism of imidafenacin

Objectives

This study aimed to apply a currently available chemometric near-infrared spectroscopy technique to the characterization of the polymorphic properties of drug candidates. The technique requires only small quantities of samples and is therefore applicable to drugs in the early stages of development.

Methods

The combination of near-infrared spectroscopy and a patented 96-well plate divided into 32 individual, humidity-controlled, three-well compartments was used in the characterization of a hygroscopic drug, imidafenacin, which has two polymorphs and one pseudo-polymorph. Characterization was also conducted with powder X-ray diffraction and thermal analysis. The results were compared with those from routinely used conventional analyses.

Key findings

Both the microanalysis and conventional analysis successfully characterised the substance (transformation and relative stability among the two polymorphs and a pseudo-polymorph) depending on the storage conditions. Near-infrared spectroscopic analyses utilizing a humidity-controlled 96-well plate required only small amounts of the sample for characterization under the various conditions of relative humidity.

Conclusions

Near-infrared microanalysis can be applied to polymorphic studies of small quantities of a drug candidate. The results also suggest that the method will predict the behaviors of a hygroscopic candidate in solid pharmaceutical preparations at the early stages of drug development.

Multiple lymphadenopathy as an initial sign of extramammary Paget disease

Extramammary Paget disease (EMPD) often develops in external genitalia. Paget cells can, however, adopt an invasive phenotype and metastasize to regional lymph nodes and beyond, leading to poor patient outcomes. Based on this clinical observation, multiple lymphadenopathy may represent an initial sign of EMPD. To address the potential significance of multiple lymph node swelling in EMPD, we report two patients with cutaneous primary EMPD who showed multiple lymphadenopathy as an initial sign during the clinical course of the disease as well as tumour metastasis. Significantly, marked lymphatic vessel growth was observed in regional lymph nodes that underwent massive tumour cell invasion. Therefore, nodal lymphangiogenesis may promote tumour cell invasion and metastasis to distant organs, including the lymph nodes, emphasizing the clinical relevance of multiple lymphadenopathy.

Model core potential and all-electron studies of molecules containing rare gas atoms

Molecules HRgF (Rg = Ar, Kr, Xe, Rn) were studied at levels of theory that included electron correlation, taking relativistic effects into account either by using the recently developed parametrization of the extended model core potentials and basis sets or by using the Douglas-Kroll method with all-electron basis sets. Charge distributions were calculated according to Mulliken, Lowdin, and natural bond orbital methods of population analysis and the results of these methods were compared, confirming that bonding in these molecules corresponds to interaction between the fluoride anion and the RgH(+) moiety. In contrast to previously reported results, the present calculations show that the radon compound, HRnF, is more stable than compounds of the lighter congeners. Trends in the first ionization energies, bond lengths, energies of formation and decomposition, and harmonic vibrational frequencies were discussed and found to be consistent with the periodic trends of the atomic properties of the rare gas atoms.

Parasellar T2 dark sign on MR imaging in patients with lymphocytic hypophysitis

BACKGROUND AND PURPOSE

MR imaging findings of LYH and pituitary adenomas are similar, but the therapeutic strategies are completely different. The purpose of this study was to evaluate sellar and parasellar MR imaging findings in patients with both diseases, as well as characteristic clinical findings.

MATERIALS AND METHODS

Clinical findings, including endocrinologic study and MR images of 20 patients with LYH and 22 patients with pituitary adenoma, were retrospectively reviewed. We evaluated the MR images in relation to the following: 1) the PPHI on T1-weighted images, 2) thickened stalk (>3.5 mm), 3) pituitary symmetry, 4) pituitary enhancement pattern, 5) a dural tail, and 6) parasellar signal intensity on T2- and T1-weighted images.

RESULTS

Between patients with LYH and those with pituitary adenoma, a significant difference was identified for the number of patients with loss of PPHI, thickened stalk, pituitary symmetry, homogeneous enhancement, and parasellar dark signal intensity on T2-weighted images by statistical analysis (Fisher exact probability test, P < .05). Among them, only parasellar dark signal intensity on T2-weighted images had no false-positive cases.

CONCLUSIONS

The parasellar T2 dark sign can be a specific finding used to distinguish pituitary adenoma from LYH.

Venous structures at the craniocervical junction: anatomical variations evaluated by multidetector row CT

The aim of this study was to evaluate the anatomy of and normal variations in the craniocervical junction veins. We retrospectively reviewed 50 patients who underwent contrast-enhanced CT with a multidetector scanner. Axial and reconstructed images were evaluated by two neuroradiologists with special attention being paid to the existence and size of veins and their relationships with other venous branches around the craniocervical junction. The venous structures contributing to craniocervical junction venous drainage, including the inferior petrosal sinus (IPS), transverse-sigmoid sinus, jugular vein, condylar vein, marginal sinus and suboccipital cavernous sinus were well depicted in all cases. The occipital sinus (OS) was identified in 18 cases, including 4 cases of prominent-type OS. The IPS showed variations in drainage to the jugular vein through the jugular foramen or intraosseous course of occipital bone via the petroclival fissure. In all cases, the anterior condylar veins connected the anterior condylar confluence to the marginal sinus; however, a number of cases with asymmetry and agenesis in the posterior and lateral condylar veins were seen. The posterior condylar vein connected the suboccipital cavernous sinus to the sigmoid sinus or anterior condylar confluence. The posterior condylar canal in the occipital bone showed some differences, which were accompanied by variations in the posterior condylar veins. In conclusion, there are some anatomical variations in the venous structures of the craniocervical junction; knowledge of these differences is important for the diagnosis and treatment of skull base diseases. Contrast-enhanced CT using a multidetector scanner is useful for evaluating venous structures in the craniocervical junction.

Acute Klebsiella pneumoniae pneumonia alone and with concurrent infection: comparison of clinical and thin-section CT findings

The purpose of this study was to identify the clinical and thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia (KPP) alone and with concurrent infection. We retrospectively identified 160 patients with acute KPP who underwent chest thin-section CT examinations between August 1998 and August 2008 at our institution. The study group comprised 80 patients (54 male, 26 female; age range 18-97 years, mean age 61.5) with acute KPP alone, 55 (43 male, 12 female; age range 46-92 years, mean age 76.0) with KPP combined with methicillin-resistant Staphylococcus aureus (MRSA) and 25 (23 male, 2 female; age range 56-91 years, mean age 72.7) with KPP combined with Pseudomonas aeruginosa (PA). Underlying diseases in patients with each type of pneumonia were assessed. Parenchymal abnormalities were evaluated along with enlarged lymph nodes and pleural effusion. In patients with concurrent pneumonia, underlying conditions such as cardiac diseases, diabetes mellitus and malignancy were significantly more frequent than in patients with KPP alone. The mortality rate in patients with KPP combined with MRSA or PA was significantly higher than in those with KPP alone. In concurrent KPP, CT findings of centrilobular nodules, bronchial wall thickening, cavity, bronchiectasis, nodules and pleural effusion were significantly more frequent with concurrent pneumonia than in those with KPP alone.

Two-dimensional metallic tungsten nanowire network fabricated by electron-beam-induced deposition

One-dimensional tungsten nanowires and two-dimensional tungsten nanowire networks were fabricated on a tungsten substrate by using electron-beam-induced deposition (EBID) without precursor injection. The as-prepared tungsten nanostructures were studied using a combination of energy-dispersive x-ray spectroscopy and selected area electron diffraction. It was revealed that the tungsten nanostructures were composed of pure metallic tungsten. The WO(3) oxide formed in the chemical preparation of tungsten foils was probably the source of tungsten for the fabrication of tungsten nanostructures by EBID.

Genetic parameters for preweaning and early growth traits in Berkshire pigs when creep feeding is used

The objective of this study was to find optimal traits for inclusion in selection criteria by estimating genetic parameters for direct genetic, maternal genetic, and common environmental effects for growth traits before 60 d of age and for the number of teats under an open breeding population, and to evaluate genetic relationships for traits at 60 d of age. Records of 2,344 male and 2,204 female purebred Berkshire pigs were analyzed. For BW at 14 d of age and for weaning weight, the heritabilities of a direct genetic effect were greater than those of a maternal genetic effect. This result is contrary to previous results showing a gradual decrease in the maternal genetic effect and an increase in the direct genetic effect up to weaning. The positive genetic correlations between direct and maternal genetic effects for BW at 14 d of age and weaning weight are clearly contrary to other reports. This phenomenon seems to be caused by creep feeding begun just after the birth of the piglets and maintained throughout the preweaning period in this Berkshire population.

Silver nanowires with a monoclinic structure fabricated by a thermal evaporation method

Silver nanowires with a monoclinic structure (mono-Ag NWs) were fabricated by a thermal evaporation method for the first time. The crystal lattice parameters of the mono-Ag NWs were calculated using the UnitCell program. They are as follows: a = 0.303 nm, b = 1.140 nm, c = 0.292 nm, and beta = 118.5 degrees. In situ annealing experiments revealed that the as-prepared mono-Ag NWs transited to fcc-Ag NWs during annealing at approximately 1173 K for 60 s.

A delayed response to acute stimulation with human chorionic gonadotropin in scorbutic rats

Since our previous study revealed low basal testosterone (T) levels and a failure in response to an acute stimulation with human chorionic gonadotropin (HCG) despite of a good response to chronic stimulation in scorbutic mutant rats, time course of the response to HCG was studied and plasma LH level was measured in young adult rats deficient in ascorbic acid for 3 weeks. A single subcutaneous injection of HCG (200 IU) elevated T levels only slightly in plasma and not in testicular tissues of scorbutic rats 1 h after the injection when the levels in ascorbutic rats reached a maximum, while it yielded the same response pattern as in ascorbutic rats after 3 h. A pretreatment with HCG to scorbutic rats for 1 or 4 days resulted in the same response of plasma T as in ascorbutic rats. Plasma LH levels in unstimulated scorbutic rats were about 40% of those in ascorbutic rats. These findings indicate that a prolonged deficiency of ascorbic acid decreases plasma LH, and may reduce the sensitivity of testes to LH.

In situ TEM observation of the growth and decomposition of monoclinic W(18)O(49) nanowires

The growth of monoclinic W(18)O(49) nanowires by heat treatment of a tungsten filament at approximately 873 K and the decomposition of these nanowires under 200 keV electron irradiation at approximately 1023 K have been investigated using in situ transmission electron microscopy (TEM). In situ TEM observation of the growth confirmed the vapor-solid growth mechanism of the monoclinic W(18)O(49) nanowires. In situ irradiation experiments revealed the formation of metallic bcc tungsten from monoclinic W(18)O(49) nanowires under 200 keV electron irradiation.

Theoretical quest for photoconversion molecules having opposite directions of the electric dipole moment in S0 and S1 states

Ab initio calculations at the level of CASPT2 with Dunning's correlation consistent cc-pVXZ (X=D, T, Q) basis sets have been carried out for pyrimidine, quinoxaline, phthalazine, and their substituted compounds to find candidates that show a change in the direction of the electric dipole moment for the S(0)-->S(1) transition. The present calculations reveal that 6,7-difluorophthalazine and 6,7-dichlorophthalazine are strong candidates having a large and clear change in the direction of the electric dipole moment on the S(0)-->S(1) transition.

Local VEGF administration enhances healing of colonic anastomoses in a rabbit model

BACKGROUND/AIMS

Many studies report the role of vascular endothelial growth factor (VEGF) in wound healing, but few describe local VEGF administration to the digestive tract. Leakage from colonic anastomoses, including those due to ischemia, represents a major complication causing increased mortality and morbidity. Angiogenesis is crucial to anastomotic healing and restoration of blood supply, and VEGF is a potent angiogenic factor showing improved healing in various models of reconstruction and anastomosis. Here, we examine the effects of local VEGF-A(165) administration on postoperative rabbit colon anastomosis.

METHODS

Two colotomies per animal were made in the sinistral colon on opposite sides of the mesentery. Randomly assigned VEGF (10 microg/0.1 ml) or saline (0.1 ml) was injected into the muscularis propria on both sides of each colonic anastomosis before closing the access laparotomy using single-layer sutures. On postoperative days 3, 4 and 7, the bursting pressure of partially healed anastomoses was measured. On postoperative day 4, anastomotic tissues were examined for the following: hydroxyproline; histopathologically for inflammatory infiltrate and tissue organization and immunohistochemically for capillary proliferation and density; vessel density of midzone collaterals around anastomoses by microangiography.

RESULTS

Compared to saline, VEGF administration significantly improved bursting pressure (p = 0.014, paired t test) and increased hydroxyproline (p = 0.027, paired t test) on postoperative day 4. Inflammatory cell infiltration and fibroblast proliferation were prominent, and submucosal capillary vascular counts were significantly higher for VEGF.

CONCLUSIONS

Administration of VEGF to colonic anastomosis accelerates wound healing and strengthens the anastomosis by increased angiogenesis.

Sagittalis nucleus: a novel hypothalamic nucleus

The sagittalis nucleus (SGN) of the hypothalamus is a newly-identified nucleus that is located in the interstitial area between the arcuate and ventromedial nuclei of the rat hypothalamus and for which the long axis of the nucleus is oriented sagittally. Interestingly, the SGN exhibits structural and physiological sex differences, as defined by Nissl staining and oestrogen receptor (ER)alpha immunoreactivity (-ir), being larger in males than females. The structural sex difference is established by sex steroid action in neonates because the treatment of female pups with testosterone propionate masculinised the SGN. The phenotypical sex difference in ERalpha-ir is mediated hormonally in adulthood. Ovariectomy of female rats caused a significant increase in ERalpha-ir in the SGN, and eliminated the physiological sex difference, but with recovery to the level of gonad-intact females when given oestradiol replacement. Adult females have oestrous cycle-related variations in ERalpha-ir in the SGN, with levels at a nadir during the evening of pro-oestrous. The discovery of the SGN, a target of sex steroid action, provides a new opportunity for explaining hormonal regulation of sexually-differentiated behavioural and endocrine functions.

Influence of early postweaning traits on genetic improvement of meat productivity in purebred Berkshire pigs

The objective of this study was to estimate genetic parameters for growth and body composition traits at 60 d of age and at finish in a population of Berkshire pigs and to evaluate the effectiveness of selection at 60 d of age for meat productivity. A total of 4,548 purebred Berkshire (2,344 males and 2,204 females) pigs born between December 1994 and January 2005 were used in this study. The traits analyzed were BW at 60 d of age; daily BW gain from birth to finish, from weaning to 60 d, from weaning to finish, and from 60 d to finish; age at finish; backfat thickness at 60 d of age and at finish; loin eye area at 60 d of age (LEA60) and at finish; and the number of teats. The heritability estimates for BW at 60 d of age, daily BW gain from weaning to 60 d, backfat thickness at 60 d of age, and LEA60 were 0.22, 0.25, 0.49, and 0.22, respectively. The estimated common environmental effect for BW at 60 d of age, daily BW gain from weaning to 60 d, backfat thickness at 60 d of age, and LEA60 were 0.12, 0.13, 0.18, and 0.21, respectively. Therefore, the common environmental effect should be included in the model to analyze traits at 60 d of age. The positive genetic correlation between LEA60 and loin eye area at finish and the negative genetic correlation between LEA60 and backfat thickness at finish indicated that improvement of the ultrasonic loin eye area at 60 d of age may result in favorable correlated responses to the traits at finish, an increase in loin eye area, and a decrease in backfat thickness. In addition, genetic correlations of backfat thickness at 60 d of age with backfat thickness at finish and loin eye area at finish were found to be favorable, indicating that improvement of ultrasonic backfat thickness at 60 d of age may result in greater correlated responses to the traits at finish: an increase in loin eye area and a decrease in backfat thickness. Therefore, constructing a selection scheme that includes body composition traits at 60 d and traits at finish is practical for gaining a greater selection response.

Primary malignant lymphoma of the gallbladder: a case report and literature review

Primary malignant lymphoma of the gallbladder is extremely rare and the associated radiological findings are not well described in the literature. We report a case of malignant lymphoma in the gallbladder wall of a 78-year-old woman. Pre-operative CT and MRI showed homogeneous submucosal thickening of the gallbladder wall with a preserved mucosal surface. These unique radiological findings may be useful for diagnosing malignant lymphoma of the gallbladder.

Human Sgo1 downregulation leads to chromosomal instability in colorectal cancer

BACKGROUND AND AIMS

Chromosomal instability (CIN) is recognised as a hallmark of cancer and is caused by a spindle assembly checkpoint disorder or chromosome mis-segregation during mitosis. Although the recent identification of human shugoshin (hSgo1), an important player in proper chromosome segregation, has suggested the involvement of hSgo1 in colorectal tumourigenesis, little is known about how it is involved. The aim of this study was to obtain information about the status of hSgo1 in human colorectal cancer.

METHOD AND RESULTS

Among the 46 colorectal cancer cases, hSgo1 mRNA expression was decreased in the tumour tissue in comparison with the corresponding normal tissue (p = 0.032). Human Sgo1-downregulated tumours (tumour to normal mucosa ratio<0.5) had preferential location on the left side large bowel rather than on the right side (p = 0.012), and a higher variation of centromere numbers revealed by fluorescence in situ hybridisation (FISH). To assess the effects of hSgo1 downregulation, hSgo1 knockdown was performed by transfecting the diploid HCT116 cell line with a short hairpin RNA expression vector. hSgo1 knockdown cells proliferated slowly because of both G(2)/M arrest and apoptosis (p<0.001), and markers of CIN in the form of aneuploidy (p<0.001) and micronuclei (p<0.005) were later observed in hSgo1 knockdown cells. Increased centrosome amplification (p<0.05), the presence of binucleated cells and mitotic catastrophes were also noted in hSgo1 knockdown cells.

CONCLUSIONS

These findings suggest that hSgo1-downregulated colorectal cancers have a clinicopathological character of CIN, and hSgo1 downregulation leads to CIN in colorectal cancer cells.

Comparison of pulmonary CT findings and serum KL-6 levels in patients with cryptogenic organizing pneumonia

The aim of this study was to retrospectively compare high-resolution CT findings among cryptogenic organizing pneumonia (COP) patients with normal and elevated serum KL-6 levels. Chest CT scans performed between April 1999 and April 2007 in 20 COP patients with a normal KL-6 level and 17 COP patients with an elevated KL-6 level were evaluated retrospectively by two chest radiologists. The CT findings in the COP patients with either a normal or an elevated KL-6 level mainly consisted of consolidation (n = 17 and n = 13, respectively) followed by ground-glass opacity (n = 11 and n = 13, respectively). Traction bronchiectasis and architectural distortion were significantly more frequent in patients with an elevated KL-6 level than in those with normal levels (n = 7 and n = 1, and n = 13 and n = 3, respectively) (p = 0.0077 and p = 0.00017, respectively). In follow-up CT scans, a relapse within 1 year after initial treatment with steroids, performed in 16 patients with a normal KL-6 level and 16 with an elevated KL-6 level, occurred in 2 (12.5%) patients with a normal KL-6 level and in 6 (37.5%) with an elevated KL-6 level. The frequency of relapse in patients with an elevated KL-6 level was higher than in those with a normal KL-6 level; however, no significant difference between the two groups was observed (p = 0.103). In conclusion, CT findings of traction bronchiectasis and architectural distortion in COP patients are associated with increased serum KL-6 levels, which might be related to a relapse after treatment.