Outcomes analysis of ruptured distal anterior cerebral artery aneurysms treated by endosaccular embolization and surgical clipping

Although endovascular surgery is now widely used to treat intracranial aneurysms, no comparative studies of clipping versus endovascular surgery to address distal ACA aneurysms at the same institution are available. We compared the results of these treatment modalities to address distal ACA aneurysms at our institution. We treated 68 patients with ruptured distal ACA aneurysms (endovascular surgery, n=13; clipping surgery, n=55). We performed a retrospective comparison of the treatment outcomes. To study the efficacy of endovascular surgery we classified all our cases into three types: type A were small-necked aneurysms, type B were wide-necked aneurysms on the parent artery, and type C were aneurysms in which the A3 portion of the ACA arose from the aneurysmal dome near the neck. Intraoperative hemorrhage occurred in 7.7% of aneurysms treated by endovascular surgery and in 34.5% treated by clipping surgery. In 7.7% of the endovascularly-treated aneurysms we noted coil migration during embolization surgery; venous infarction due to cortical vein injury occurred in 7.3% of clipped aneurysms. Of the endovascularly-treated aneurysms, 7.7% manifested post-embolization hemorrhage; 23.1% manifested coil compaction. In clipping surgery, postoperative rerupture occurred in 1.8% of the aneurysms; one patient presented with postoperative acute epidural hematoma. Clip dislocation was noted in 1.8% of aneurysms. Angiography was indicative of post-treatment vasospasm in 7.7% of aneurysms treated endovascularly and in 50.9% of the clipped aneurysms. The clinical outcome showed no significant difference between endovascular surgery and clipping surgery.

Dose measurement for medical staff with glass dosemeters and thermoluminescence dosemeters during 125I brachytherapy for prostate cancer

Photoluminescence glass dosemeters (PLDs) and thermoluminescence dosemeters (TLDs) are commonly used as a personal monitoring dosemeter. PLDs and TLDs were used for surface dose monitoring of medical staff involved in (125)I brachytherapy for prostate cancer because these dosemeters have a wide dose-response linearity and high sensitivity for low photon energy. Surface doses measured with PLDs agreed with those with TLDs within ∼20 % except for a few cases. Surface doses at a surgeon's left hand and arm were higher than those at the other measuring points. A surgeon received a maximum dose of 650 μGy at the back of left hand. Surface doses to an assistant were <100 μGy. Surface doses to a nurse, a radiologist, an anaesthesiologist and a radiological technologist were <10 μGy. The occupational exposure to a surgeon could be reduced by the adjustment of fluoroscopic parameters and the use of lead gloves.

Formation of Au Colloid Particles in Silica Glass by Ion Implantation

Formation of Au colloid particles and their optical property have been investigated in silica glasses implanted with Au+ ions at an acceleration energy of 1.5MeV and fluence levels of 1016-1017 ions/cm2. The Au colloid particles are formed in the as-implanted glasses. It is inferred that the average radius of Au colloid particles depends on the fluence level, although the fluence level does not affect the distribution of Au atomic concentration. The heat-treatment little affects the Au atomic distribution. The Au colloid particles grow to 4.3nm in average radius during heat treatment. It is revealed that the large nonlinear optical property of the Au+ -ion-implanted silica glass is attributed to the high concentration of the Au colloid particles in the narrow region.

Properties of Diamondlike Carbon Films

Hard carbon films have been deposited onto room-temperature silicon substrates in a de plasma of methane and hydrogen. The substrates are placed on the cathode. A stainless mesh is held at the same potential as the cathode and is set above the substrates. Although the deposited films are amorphous and contain 24.4 atomic percent hydrogen, they have the following diamondlike properties: hardness is almost equivalent to that of natural diamond; electrical resistivity is on the order of 1013Ωcm; chemical inertness is excellent to acids; thermal diffusivity is 5.2 cm2 /sec. However, the films have a large compressive stress of 1.3×1010 dyn/cm2.

Annealed films exhibit dehydrogenation, graphitization, an increase in chemical reactivity, volume expansion and stress relaxation above 400°C. The activation energy for the transformation from the diamondlikephase to the graphitic phase is 18 kcal/mole.

The dependence of the thermal diffusivity and hydrogen content on both the CH4/H2 gas mix ratio and the total pressure have been measured for the films deposited in a dc plasma without the mesh.

Phase Transformation of Titanium Disilicide Induced by High-Temperature Sputtering

The reaction between sputtered Ti thin films and heavily arsenic doped Si(100) is studied. The use of an arsenic implantation to pre-amorphize the Si substrate and the choice of the substrate temperature during Ti sputtering are both found to have a significant effect on subsequent TiSi2 reactions. Cross-sectional transmission electron microscopy reveals that an amorphous TiSix layer is formed at the interface between Si and as-sputtered Ti. The thickness of this interfacial layer increases with the sputtering temperature. After rapid thermal anneals in nitrogen, the sheet resistances of TiSi2 thin films grown with the pre-amorphization step and a high sputtering temperature (450°C) are generally lower than films processed under other conditions. This apparent reduction in the temperature for the polymorphic C49 to 54 phase transformation in TiSi2 is shown to originate from a higher nucleation density of the C54-TiSi2 phase. These dependencies of the silicide reaction are ascribed to the interfacial amorphous TiSix layer. In increasing the nucleation density of the C54-TiSi2 phase, the amorphous TiSix layer is speculated to either act as a direct nucleation source for the C54-TiSi2 phase, or lead to more defective C49-TiSi2 structures which facilitate the C54-TiSi2 nucleation.

Radiation dose evaluation in multidetector-row CT imaging for acute stroke with an anthropomorphic phantom

This study evaluated radiation dose and dose reduction in CT imaging for acute stroke. Radiation doses in three types of CT imaging (i.e. non-contrast-enhanced CT, CT perfusion (CTP) and CT angiography (CTA)) were measured with an in-phantom dosimetry system for 4-, 16- and 64-detector CT scanners in 5 hospitals. To examine the relationship between image quality and radiation dose in CTA, image contrast-to-noise ratio was evaluated. Doses to the brain, lens, salivary glands and local skin obtained with scan protocols in routine use were: 42-71 mGy, 30-88 mGy, 3.9-7.3 mGy and 40-97 mGy in non-contrast-enhanced CT; 41-75 mGy, 9.9-10 mGy, 1.5-2.1 mGy and 107-143 mGy in CTP; and 8.2-55 mGy, 26-69 mGy, 2.0-73 mGy and 32-72 mGy in CTA. For the combination of these CT examinations, on average a patient would receive 236 mGy for the maximum local skin dose and 4.2 mSv for the effective dose evaluated by the International Commission on Radiological Protection (ICRP) 103. Effective doses in CTP in this study were less than those obtained with representative protocols of Western countries. Average effective doses in each CT examination were not more than 1.5 mSv. The use of reduced kV and a narrow scan range would be effective in dose reduction of CTA and CTP, and intermittent scanning would be essential in CTP. Although lens and maximum local skin doses were far less than the thresholds for deterministic effects, since radiation risks would be increased in repeated CT examinations, efforts should be devoted to dose reduction in stroke CT examinations.

A model for analysis of the yield and the level of clustering of radiation-induced DNA-strand breaks in hydrated plasmids

Although it is widely accepted that the spatial distribution of strand breaks is highly relevant to the biological consequences of radiation, the extent to which strand breaks are clustered is not usually demonstrated directly from the experimental data. To evaluate the spatial distribution of radiation-induced strand breaks, the authors have developed a model for the generation of strand breaks after irradiation. The model assumes that (1) a radiation track has a certain probability of 'hitting' a plasmid, (2) the radiation generates strand break(s) by chance within a relatively small region that could produce double-strand breaks and (3) the number of strand breaks generated within the region follows a Poisson distribution. To find out whether the model is valid, the authors compared the calculated values with the experimental data obtained by a plasmid DNA assay. Taking into account the inherent bias of the plasmid assay, the model described well the experimental results of hydrated plasmids exposed to radiation.

Determination of the Avogadro constant by counting the atoms in a 28Si crystal

The Avogadro constant links the atomic and the macroscopic properties of matter. Since the molar Planck constant is well known via the measurement of the Rydberg constant, it is also closely related to the Planck constant. In addition, its accurate determination is of paramount importance for a definition of the kilogram in terms of a fundamental constant. We describe a new approach for its determination by counting the atoms in 1 kg single-crystal spheres, which are highly enriched with the 28Si isotope. It enabled isotope dilution mass spectroscopy to determine the molar mass of the silicon crystal with unprecedented accuracy. The value obtained, NA = 6.022,140,78(18) × 10(23) mol(-1), is the most accurate input datum for a new definition of the kilogram.

Abstract P2-02-12: Utility of Targeted Sonography Using Real-Time Virtual Sonography (RVS) for Breast Lesions That Were Suspicious on MRI

PURPOSE : MRI-detected suspicious breast lesions that are not expected from previous MMG or sonography, are detectable initially on MRI in 48% maximum. Therefore, biopsy is required for definitive diagnosis of MRI-detected lesions. Although MRI-guided biopsy is often necessary, sonographically guided biopsy after targeted sonography is more broadly available and less time-consuming and costly. The aim of this study was to verify the utility of targeted sonography using Real-time Virtual Sonography (RVS) for the identification of MRI-detected suspicious lesions.

METHOD AND MATERIALS : From 196 breast MRI examinations, all MRI-detected suspicious lesions and subsequent biopsy were identified between February 2006 and December 2009. All patients were examined using MMG, sonography, MRI and RVS that could synchronize a sonography image and the MRI cutaway images of the same site to be displayed in real time using magnetic navigation system. Following the conventional dynamic enhanced image, MRI was obtained on a 1.5-T imager in the supine position using a flexible body surface coil in order to achieve the same position as in sonography. We searched all cases for MRI-detected suspicious lesions and investigated targeted sonography with or without RVS in identifying the lesions.

RESULTS : Of the 196 patients, MRI-detected suspicious lesions were detected in 55 (28%) patients. A total of 67 suspicious lesions in 55 patients comprised this analysis. Of the study lesions, 24 (36%) were malignant and 43 (64%) were benign. Overall mean lesion size was 6.7mm. A total of 46 (69%) mass lesions were identified, compared with 16 (24%) foci and 5 (7%) nonmasslike lesions. 18 (27%) lesions were detected in targeted sonography without RVS and were revealed as cancers in eight, benign lesions in 10. In contrast, 60 (90%) lesions were detected in targeted sonography with RVS and were revealed as cancers in 21, benign lesions in 39. Although seven (10%) lesions were not detected with RVS, all lesions were able to project enhanced MRI information onto a body surface correctly as we checked ultrasound form images without the use of large-scale equipment.

CONCLUSION: The present results suggest that targeted sonography with RVS appears to be not time consuming technique which can identify a large part of MRI-detected suspicious lesions.

Synthesis of cold antihydrogen in a cusp trap

We report here the first successful synthesis of cold antihydrogen atoms employing a cusp trap, which consists of a superconducting anti-Helmholtz coil and a stack of multiple ring electrodes. This success opens a new path to make a stringent test of the CPT symmetry via high precision microwave spectroscopy of ground-state hyperfine transitions of antihydrogen atoms.

A case of non-traumatic subgaleal hematoma effectively treated with endovascular surgery

Non-traumatic subgaleal hematoma is very rare. We present a case of refractory non-traumatic subgaleal hematoma occurring in a 15-year-old male patient. The patient was successfully treated by embolization of the superficial temporal artery. This therapeutic approach to refractory non-traumatic subgaleal hematoma is discussed.

Human papillomavirus genome integration in multifocal vulvar Bowen's disease and squamous cell carcinoma

Human papillomavirus (HPV) is an important aetiological agent in cervical carcinomas and in malignant skin tumours. Integration of the HPV DNA into host genome is one of the most important risk factors for malignant transformation. We report a patient with multiple black plaques and an erythematous nodule on her vulva. On histological examination, multifocal vulvar Bowen's disease (BD) and invasive squamous cell carcinoma (SCC) were found. An amplification of papillomavirus oncogene transcripts (APOT) assay showed that two locations of BD had only episome-derived HPV16 transcripts, but the other two sites of BD and the nodule of invasive SCC had HPV16 transcripts derived from integration. Sequencing analysis revealed that the invasive SCC had its integration site at 8q24, the Myc locus. Our results suggest that the APOT assay in multiple sites of the same patient may be a valuable tool for evaluation of the clinical degree of malignancy for vulvar BD.

Ascomycetes with cellulolytic, amylolytic, pectinolytic, and mannanolytic activities inhabiting dead beech (Fagus crenata) trees

It is generally accepted that dead tree decomposition is performed mainly by delignifying basidiomycetes. While ascomycetes have been reported to inhabit dead tree bark, their contribution to dead tree decomposition is still unclear. Here, we isolated five bark-inhabiting ascomycetes possessing cellulolytic activity from dead beech tree and assessed their polysaccharolytic activities. When cultivated in a medium containing filter paper as a sole carbon source, three strains degraded >40 % of the filter paper in a 4-week cultivation and the others degraded 15-30 % of the paper. The degraders possessed amylolytic, pectinolytic, and mannanolytic activities as well as cellulolytic activity, implying that they play an important role in dead tree decomposition after delignification by basidiomycetes. Phylogenetic analysis based on large subunit ribosomal DNA (lsu-DNA) sequences implied that the isolates belonged to Penicillium or Amorphotheca.

Development of multiwavelength-range fine-resolution spectrometer for hydrogen emissions and its application to large helical device periphery plasmas

We developed a spectrometer specialized for simultaneous observation of the hydrogen Balmer-alpha, -beta, -gamma lines and the Fulcher-alpha v(')=v(")=2 rovibronic transition band. The spectrometer was optimized for the light input coupled by nine optical fibers having 400 microm core diameters. The spectral resolutions were 0.02-0.03 nm for these wavelength ranges at the entrance slit width of 20 microm. The polarization resolved spectra of these emissions from the peripheral region of large helical device (LHD) plasmas were measured simultaneously and showed the polarization dependence coming from the magnetic field in the LHD plasma.

CD10 enhances metastasis of colorectal cancer by abrogating the anti-tumoural effect of methionine-enkephalin in the liver

OBJECTIVE

To examine the role of CD10, a characteristic marker of liver metastasis of colorectal cancers (CRCs).

DESIGN

The effect of CD10 and Met-enkephalin (MENK) in CD10-positive and -negative human CRC cells was investigated under in vitro and in vivo conditions. Human CRC samples were examined.

MAIN OUTCOME MEASURE

CD10-positive and CD10-knockdown HT29 cells and CD10-negative and CD10-transfected Colo320 cells in nude mice were treated with MENK and/or the CD10 inhibitor (thiorphan). Intracellular signalling of MENK and delta-opioid receptor (DOR) was examined by immunoblotting.

RESULTS

MENK inhibited the growth, invasion and survival of CRC cells following thiorphan-induced CD10 inactivation. Thiorphan suppressed liver metastasis of CD10-positive CRC cells. Inoculation of mice with CRC cells induced MENK expression in the liver. Inhibition of hepatic MENK expression by cholesterol-conjugated antisense S-oligodeoxynucleotide increased liver metastasis of CRC cells even when the cells did not express CD10. DOR activation by MENK decreased the phosphorylation of epidermal growth factor receptor and extracellular signal-regulated kinase and increased p38-dependent apoptosis. Nitric oxide was found to induce DOR expression in CRC cells. Co-treatment with thiorphan and a nitric oxide donor had a marked anti-tumour effect on liver metastasis of HT29 cells. Of 68 CRC patients, 19 (28%) showed CD10 expression, which was dependent on the extent of liver metastasis. MENK concentration in metastasis-positive human liver was higher than that in the normal liver.

CONCLUSION

CD10 expression in CRC cells abrogates the anti-tumour effect of hepatic MENK by degrading it, which enhances liver metastasis of CD10-positive CRC cells.

Impact of Virtual MRI Sonography with Magnetic Navigation on Detecting Residual Tumors in Patients with Breast Cancer Who Undergo Neoadjuvant Chemotherapy; Initial Experience

Objective: The accurate evaluation of the extent of residual disease after neoadjuvant chemotherapy (NAC) for breast cancer appears essential for successful clinical outcomes. However, there are limited date about the success of achieving negative margins in breast conservation therapy. Recently, we have developed virtual MRI sonography with magnetic navigation (real-time virtual sonography; RVS). RVS can overlay high-resolution structural image taken by sonography with functional image reflecting vascular permeability taken by MRI of the same site in real time. The objective of our study was to determine the relative accuracy of RVS in detecting residual tumors after NAC.Materials and Methods: Between April 2007 and May 2009, 96 breast conservation therapy were performed for invasive ductal carcinoma at our hospital. Fourteen patients with stage IIA-IIIB palpable invasive ductal carcinoma were enrolled in a study investigating the effects of NAC on tumor imaging. All patients underwent mammography, sonography, MRI, and RVS before and after NAC. MRI was performed with a 1.5-T scanner in the supine position using a flexible body surface coil to achieve the same position as that used in sonography. Based on MRI results, the absence or presence of residual tumors was used to classify treatment response into a clinically complete response (cCR) or non-cCR, respectively. Nine patients received lumpectomy, and 5 received mastectomy. The surgical resection area was determined by RVS. Detection rate was determined for residual tumors with or without RVS. The pathologically complete response (pCR) was defined as no invasive carcinoma.Results: All index tumors were detected by sonography and MRI before NAC. After NAC, a cCR was seen in 5 (5 of 14, 36%) patients. MRI correctly diagnosed pCR in 4 (4 of 5, 80%) patients. Detection rate for residual tumors was 9% (1 of 11) for mammography, 33% (3 of 9) for sonography alone, 78% (7 of 9) for MRI, and 89% (8 of 9) for RVS. It was noteworthy that 5 (5 of 5, 100%) cases with cCR were accurately localized onto the body surface with supplementation using RVS combined with pre- and post-NAC imaging while we were checking sonography. Although surgical excision was incomplete in 5 (5 of 9, 56%) patients, all positive surgical margins were ductal carcinoma in situ.Conclusions: By using RVS, two different forms of diagnostic imaging can be integrated in real time and thereby complement each other. The present results suggest that RVS is a useful imaging technique for detecting residual tumors that have been associated with local recurrence after NAC.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5024.

Radiation dose evaluation in 64-slice CT examinations with adult and paediatric anthropomorphic phantoms

The objective of this study was to evaluate the organ dose and effective dose to patients undergoing routine adult and paediatric CT examinations with 64-slice CT scanners and to compare the doses with those from 4-, 8- and 16-multislice CT scanners. Patient doses were measured with small (<7 mm wide) silicon photodiode dosemeters (34 in total), which were implanted at various tissue and organ positions within adult and 6-year-old child anthropomorphic phantoms. Output signals from photodiode dosemeters were read on a personal computer, from which organ and effective doses were computed. For the adult phantom, organ doses (for organs within the scan range) and effective doses were 8-35 mGy and 7-18 mSv, respectively, for chest CT, and 12-33 mGy and 10-21 mSv, respectively, for abdominopelvic CT. For the paediatric phantom, organ and effective doses were 4-17 mGy and 3-7 mSv, respectively, for chest CT, and 5-14 mGy and 3-9 mSv, respectively, for abdominopelvic CT. Doses to organs at the boundaries of the scan length were higher for 64-slice CT scanners using large beam widths and/or a large pitch because of the larger extent of over-ranging. The CT dose index (CTDI(vol)), dose-length product (DLP) and the effective dose values using 64-slice CT for the adult and paediatric phantoms were the same as those obtained using 4-, 8- and 16-slice CT. Conversion factors of DLP to the effective dose by International Commission on Radiological Protection 103 were 0.024 mSvmGy(-1)cm(-1) and 0.019 mSvmGy(-1)cm(-1) for adult chest and abdominopelvic CT scans, respectively.

Isolation of folate-producing microalgae, from oligotrophic ponds in Yamaguchi, Japan

AIMS

Folate (FA) is a B-vitamin that plays an important role in the prevention of several disorders. Although synthetic FA currently dominates the market, consumers tend to demand natural FA. Because microalgae can produce organic compounds photoautotrophically, we isolated and characterized FA-producing microalgal strains.

METHODS AND RESULTS

To isolate microalgae that produce vitamins de novo, fresh water samples were cultivated in a mineral salts medium without any vitamins. After repeated subculture, 11 isolates were obtained. A biological assay revealed that four isolates accumulated FA at significantly higher levels (15-36 mg kg(-1) in dry biomass) than any known commercial microalgae. Thiamine content of the isolates was also remarkably high (71-90 mg kg(-1) in dry biomass). Phylogenetic studies based on SSU-rDNA suggested that one isolate was Chlamydomonas reinhardtii, while others were likely novel species of Chlorococcum.

CONCLUSION

There are no reports of toxicity associated with Chlamydomonas and Chlorococcum; therefore, the isolates are expected to be safe and useful not only as a promising alternative source of FA and thiamine but also as nutraceuticals for humans and animals.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present results advance our understanding of FA-producing microalgae in aquatic environments and suggest their potentials for application to biotechnological vitamin production.

Co-treatment with deoxycholic acid and azoxymethane accelerates secretion of HMGB1 in IEC6 intestinal epithelial cells

OBJECTIVES

High-mobility group box 1 (HMGB1) is a nuclear protein that acts as a ligand of the receptor for advanced glycation end products (RAGE) and its expression enhances progression of cancer. However, the mechanism underlying HMGB1 secretion is still unclear. In this study, we examined the effect of deoxycholic acid (DCA), a promoter of colon carcinogenesis, on HMGB1 secretion.

MATERIALS AND METHODS

We used an in vitro transformation model comprised of IEC6 intestinal epithelial cells treated with azoxymethane (AOM) and/or DCA. HMGB1 expression and secretion were examined by Western and Northern blot analyses, and ELISA. Intracellular translocation of HMGB1 was examined by protein fractionation.

RESULTS

AOM + DCA-treated IEC6 cells showed upregulation of HMGB1 mRNA expression and increased level of HMGB1 protein in culture medium, but decreased level of HMGB1 protein in the nucleus. AOM + DCA treatment increased level of histone H4 acetylation, which induced translocation of HMGB1 from the nucleus to the cytoplasm and increased HMGB1 secretion. Leptomycin B inhibited extranuclear translocation and secretion of the HMGB1 protein.

CONCLUSION

These findings suggest that DCA affects intracellular localization and secretion of HMGB1.

Reg IV enhances peritoneal metastasis in gastric carcinomas

OBJECTIVES

The role of Regenerating (Reg) IV on peritoneal metastasis was examined in gastric cancer using.

MATERIAL AND METHODS

Reg IV-transfected human gastric cancer cells (MKN28-R1, MKN28-R2, TMK1-R1), control transfectants (MKN28-R0, TMK1-R0), and REG4-knocked down MKN45 cells were examined in in vitro and in nude mice peritoneal metastasis models.

RESULTS AND DISCUSSION

Increase of expression and secretion of Reg IV, and levels of BCL-2, BCL-XL,survivin, phosphorylated AKT, and phosphorylated EGFR, and decrease of nitric oxide-induced apoptosis were found in Reg IV-transfectants, whereas those were abrogated in the knockdown cells. In mice models, increased number and size of peritoneal tumors and decreased apoptosis were found in Reg IV-transfectants, whereas those were abrogated by the knockdown cells. Mice survivals were worsened in Reg IV-transfectants-inoculated mice, but were improved in Reg IV-knockdown cell-inoculated mice. Levels of Reg IV protein in peritoneal lavage fluids increased in Reg IV-transfectants inoculated mice, but decreased in Reg IV-knockdown cell inoculated mice. In metastasized human gastric cancers, Reg IV positivity in peritoneum-metastasis cases was higher than those in negative cases. Reg IV was detected in peritoneal lavage fluids from human gastric cancer patients, in whose lavages keratin mRNA was detected by reverse transcriptase-polymerase chain reaction. Collectively, Reg IV might accelerate peritoneal metastasis in gastric cancer. Reg IV in lavage fluids might be a good marker for peritoneal metastasis.

Reg IV expression is associated with cell growth and prognosis of adenoid cystic carcinoma in the salivary gland

AIMS

Regenerating islet-derived family, member 4 (Reg IV) is associated with the progression of various cancers. The aim was to examine Reg IV expression in adenoid cystic carcinomas (ACCs) in salivary glands.

METHODS AND RESULTS

Reg IV expression was detected by immunohistochemistry and compared with clinicopathological parameters. Expression of phosphorylated epidermal growth factor receptor (pEGFR), phosphorylated AKT (pAKT) and MUC2 was examined by immunohistochemistry. Reg IV function was assessed with Reg IV antisense S-oligodeoxynucleotides (AS) in ACC3 human ACC cells. Reg IV was expressed by salivary duct epithelia and acinus myoepithelia, but not in squamous epithelia. Reg IV expression was found in 41% (17/41) of ACCs, but in none of 40 oral squamous cell carcinomas (OSCCs) and was associated with nodal metastasis (P = 0.047) and poor prognosis (P = 0.012) in ACCs. Reg IV expression was associated with pEGFR (14/17, 82%) in Reg IV+ ACCs, but had no relationship with pAKT or MUC2 expression in ACCs. Cell growth was inhibited by AS treatment in Reg IV+ ACC3 cells, but not in HSC-4 OSCC cells, whereas in vitro invasion of neither cell types was affected by AS treatment.

CONCLUSIONS

These results suggest that Reg IV might accelerate cell growth and disease progression of ACCs.

The role of real-time virtual sonography in the management of enhancing breast lesions on contrast-enhanced MRI

Abstract #4001

[Purpose]&#x2028; The aim of this study was to evaluate the role of real-time virtual sonography (RVS) in the management of enhancing breast lesions visualized with contrast-enhanced MRI.&#x2028; [Materials]&#x2028; Between April 2006 and May 2008, 92 women underwent breast MRI at our hospital. Of these 92 patients, 55 underwent MRI for staging of known breast cancer, and the remaining 37 underwent MRI for problem solving, including abnormal findings at physical examination or on conventional images. All patients were examined using mammography, sonography, MRI and RVS. The RVS system is capable of superimposing a sonography image with the MRI image of the same section in real time using a position tracking system with a magnetic sensor. Breast MR images were obtained on a 1.5-T imager using a flexible body surface coil, with the patient in the supine position.&#x2028; [Results]&#x2028; Overall sensitivity for detecting primary breast cancer was 74% (43/58) for mammography, 93% (54/58) for sonography, 97% (56/58) for MRI, and 97% (56/58) for RVS. Incidental enhancing / suspicious lesions (IELs) which were not predicted by the previous conventional imaging techniques were found in 55% of the patients (51/92),. Of these, 59% (24/41) of IELs could be identified only on repeated sonography, but 85% (35/41) of them were identified easily using the RVS system (p&lt;0.05). The RVS system was able to project enhanced MRI information onto a body surface correctly while checking sonography form images without the use of large-scale equipment. Histologically, 10% (4/41) of the IELs were invasive ductal carcinoma.&#x2028; [Conclusions]&#x2028; The present results suggest that the RVS system offers excellent accuracy for identification of enhancing breast lesions. RVS can accurately select the cases in which MR guided biopsies are required.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4001.

Bony tunnel formation in the middle meningeal groove: an anatomic study for safer pterional craniotomy

OBJECTIVE

When the bone flap is removed in a pterional craniotomy, the middle meningeal artery (MMA) should be gently dissected to minimize blood loss. However, when the MMA pierces a bony tunnel in the middle meningeal groove it is easily damaged upon bone flap elevation. We have performed an anatomic study of this tunnel to render pterional craniotomy safer.

METHODS

We examined 78 sides from 39 adult skulls for the presence and length of the tunnel, the distance between the lateral border of the superior orbital fissure and the proximal part of the tunnel, and examined the relationship between the MMA piercing the tunnel to a surface landmark, i.e., the junction of the sphenoparietal, sphenosquamosal, and squamosal sutures.

RESULTS

We found 59 tunnels on 78 sides (75.6%); 2 were at the branching of the MMA on one side. The tunnels were located on the temporal side of the lesser wing of the sphenoid bone. The length of the tunnel and the distance from the superior orbital fissure were 3-23 mm (mean: 12.2 mm) and 11-33 mm (mean: 18.9 mm), respectively. Most tunnels (86.4%) were bilateral; in 67.8% of the specimens the MMA piercing the tunnel was just beneath the surface landmark.

CONCLUSION

As we found a high incidence of bony tunnel formation in the middle meningeal groove, actual findings can be different from the accepted nomenclature. If a tunnel exists, the MMA is easily damaged upon cracking of the lesser wing during bone flap elevation. Recognition of this anatomy may render pterional craniotomy safer.

Human bronchial intraepithelial T cells produce interferon-gamma and stimulate epithelial cells

Intraepithelial lymphocytes (IELs) can be identified among epithelial cells in systemic mucosal tissues. Although intestinal IELs play a crucial role in mucosal immunity, their bronchial counterparts have not been well studied. The purpose of this study was to determine the immunological functions of human bronchial IELs, which interact directly with epithelial cells, unlike lamina propria lymphocytes (LPLs). We isolated successfully bronchial IELs and LPLs using a magnetic cell separation system from the T cell suspensions extracted from bronchial specimens far from the tumours of resected lungs. Human bronchial IELs showed an apparent type 1 cytokine profile and proliferated more actively in response to CD2 signalling than did bronchial LPLs. CD8(+) IELs were identified as the most significant sources of interferon (IFN)-gamma. Human bronchial epithelial cells constitutively produced the T cell growth factors interleukin (IL)-7 and IL-15, and levels of those factors increased when cells were stimulated by IFN-gamma. Bronchial epithelial cells expressed cell surface proteins CD58 and E-cadherin, possibly enabling adhesion to IELs. In summary, human bronchial IELs have immunological functions distinct from bronchial LPLs and may interact with epithelial cells to maintain mucosal homeostasis.

Regulatory mechanisms of C4b-binding protein (C4BP)alpha and beta expression in rat hepatocytes by lipopolysaccharide and interleukin-6

BACKGROUND

C4b-binding protein (C4BP), a multimeric protein structurally composed of alpha chains (C4BPalpha) and a beta chain (C4BPbeta), regulates the anticoagulant activity of protein S (PS). Patients with sepsis have increased levels of plasma C4BP, which appears to be induced by interleukin (IL)-6. However, it is not fully understood how lipopolysaccharide (LPS) and IL-6 affect the plasma C4BP antigen level and C4BPalpha and C4BPbeta expression in hepatocytes.

OBJECTIVES

To assess the effect of LPS and IL-6 on plasma C4BP, PS-C4BP complex levels, PS activity, and C4BP expression by rat liver in vivo and on C4BP expression by isolated rat hepatocytes in vitro.

RESULTS

Plasma C4BP antigen level transiently decreased from 2 to 12 h after LPS (2 mg kg(-1)) injection, and then it abruptly increased up to 24 h after LPS injection. Plasma C4BP antigen level increased until 8 h after IL-6 (10 microg kg(-1)) injection, and then gradually decreased up to 24 h after IL-6 injection. LPS significantly decreased the protein and mRNA expression of both C4BPalpha and C4BPbeta in rat hepatocytes, and this effect was inhibited by NFkappaB and MEK/ERK inhibitors. IL-6 mediated increase in C4BPbeta expression in rat hepatocytes, which leads to increased plasma PS-C4BP complex level and to decreased plasma PS activity, was inhibited by inhibition of STAT-3.

CONCLUSION

LPS decreases both C4BPalpha and C4BPbeta expression via the NFkappaB and MEK/ERK pathways, whereas IL-6 specifically increases C4BPbeta expression via the STAT-3 pathway, causing an increase in plasma PS-C4BP complex, and thus decreasing the anticoagulant activity of PS.

Relationship between Focal Inflammation and Symptom Exacerbation after Endovascular Coil Embolization for Symptomatic Intracranial Aneurysms

SUMMARY

As endovascular surgery (EVS) of symptomatic unruptured aneurysms can result in symptom exacerbation due to intra-aneurysmal thrombosis or lump formation by coils, this treatment remains controversial. We present five women ranging in age from 58 to 76 years (mean 65.6 years) who suffered post-EVS symptom exacerbation attributable to local inflammation. The aneurysms measured from 8 to 25 mm (mean 19 mm) and were located at the cavernous portion in four patients and at the origin of the ophthalmic artery in one. All underwent endosaccular embolization under local anesthesia. Immediately after embolization, 24 h anticoagulation therapy was started via the continuous injection of heparin; they also received antiplatelet therapy. At one to three days post-EVS, all five patients manifested worsening of their cranial nerve symptoms. In three other patients the symptoms were improved after EVS. We posit that inflammation induced by coil embolization may worsen cranial nerve symptoms transiently. Our findings suggest that post-EVS followup is necessary and that patients exhibiting aninflammatory reaction be treated with anti-inflammatory drugs.