Effect of guanidine hydrochloride on the conformation of egg yolk low density lipoprotein

The denaturation of egg yolk low-density lipoprotein (LDL) induced by guanidine hydrochloride (GdnHCl) has been investigated by using circular dichroism (CD) and fluorescence measurements. The transition curves were obtained from changes of the residue ellipticity at 222 nm and the fluorescence intensity of the aromatic residues, tyrosine and fluorescence. Different transition curves were obtained at the molarities of GdnHCl between 2 and 6 M, and between 1 and 4 M from the CD and the fluorescence measurements, respectively. The noncoincidence of the transition curves as well as the asymmetry of the transition curve obtained from the fluorescence measurements suggests that the denaturation process of LDL consists of several transition states. A very low apparent free energy of denaturation (delta G(app) H2O = 3.0 kcal mol-1) obtained by CD data suggests that LDL has an unstable folded structure in its native state.

Proton radiation therapy for clivus chordoma--case report

A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepentaacetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma.

The role of thallium-201 single photon emission tomography in the investigation and characterisation of brain tumours in man and their response to treatment

The aim of this study was to characterise brain tumour type and treatment response in relation to the uptake of thallium-201. 201T1 single photon emission tomography (SPET) was performed in 58 patients with brain tumours. Fifty-six patients were utilised for the statistical comparison of the early and delayed 201T1 indices expressed as the ratio of tumour to contralateral cerebral hemisphere uptake. The retention index of 201T1 in the tumour tissue calculated from the early and delayed scans was also analysed. Furthermore, in 56 patients with 58 brain tumours, a comparison was made of the diagnostic value of high 201T1 uptake and gadolinium diethylene triamine penta-acetic acid (Gd-DTPA) enhancement on MRI scans. Although high 201T1 uptake was observed in viable malignant gliomas, brain metastases, meningiomas and malignant teratoma, the viable malignant gliomas could not be differentiated from brain metastases and extracerebral tumours by means of 201T1 indices. 201T1 SPET failed to diagnose a viable ring-enhanced tumour with a thin rim and small tumours of less than 1.5 cm in diameter visualised by Gd-DTPA-enhanced MRI. In spite of this, 201T1 SPET appears to be effective for determination of the malignant viability of tumours.

A prospective study of atrophic gastritis and stomach cancer risk

The relation of atrophic gastritis, other gastric lesions and lifestyle factors to stomach cancer risk was prospectively studied among 3,914 subjects who underwent gastroscopic examination and responded to a questionnaire survey at the Aichi Cancer Center Hospital. During 4.4 years of follow-up on average, 45 incident cases of stomach cancer were identified at least three months after the initial examination. If the baseline endoscopic findings indicated the presence of atrophic gastritis, the risk of developing stomach cancer was increased 5.73-fold, compared with no indication at the baseline. The risk further increased with advancing degree of atrophy and increasing extension of atrophy on the lesser curvature. These trends in the relative risks were statistically significant (P = 0.027 and P = 0.041, respectively). The risk of developing stomach cancer was statistically significantly increased among subjects with gastric polyps, but not among those with gastric ulcer. Stomach cancer cases tended to consume more cigarettes, alcohol, rice, pickles and salted fish gut/cod roe and less fruits and vegetables and to have more family histories of stomach cancer than noncases, although these differences were not statistically significant. The results of the present study provide additional evidence on the relation between atrophic gastritis and stomach cancer and suggest a need for intensive follow-up of patients with atrophic gastritis and gastric polyps.

Atrophic gastritis and stomach cancer risk: cross-sectional analyses

The relationship between atrophic gastritis and stomach cancer risk was investigated in case-control analyses involving 387 cases with stomach cancer and 5,422 control subjects who received gastroscopic examination at Aichi Cancer Center Hospital from April, 1985 to March, 1989. The presence of atrophic gastritis, the degree and extension of the atrophy and the presence of granularity and erosion were diagnosed endoscopically by six gastroenterologists. The prevalence of atrophic gastritis increased with age and was higher in males than in females. The relative risk (RR) of stomach cancer was 5.13 (95% confidence interval (CI): 2.79-9.42) if a subject had any type of atrophic gastritis. The risk further increased with advancing degree of atrophy and increasing extension on the greater and lesser curvatures. The RR associated with severe atrophy was 7.73 (95% CI: 3.95-15.12). These associations remained significant when analyzed by sex and age. The presence of granularity and erosion did not much affect the estimated risks. A clear difference in risk appeared in the analyses by histological type of cancer. The RR associated with atrophic gastritis was 24.71 (95% CI: 3.46-176.68) for the intestinal type and 3.49 (95% CI: 1.77-6.87) for the diffuse type. These findings may suggest a need for intensive follow-up of patients with severe atrophic gastritis.

Malignancy and viability of intraparenchymal brain tumours: correlation between Gd-DTPA contrast MR images and proliferative potentials

The feasibility of diagnosing the malignancy and viability of intraparenchymal brain tumours using Gd-DTPA, enhanced and unenhanced T1-weighted MRIs was investigated. The relationship between the Gd-DTPA enhancement pattern, the growth fraction (GF) determined by using the anti-bromide-oxyuridine (BrdU) monoclonal antibody, the clinical condition, the proliferative potential and the change of Gd-DTPA enhancement over time was studied. Forty-five patients with intracranial tumours were studied with the static method of Gd-DTPA MRI. The enhanced effect in Gd-DTPA MRIs was dependent on tumour-cell density, vascularization, necrosis, and dilatation of vascular lumen. Tumour-cells were observed in eighty-seven of eighty-nine specimens taken from areas with Gd-DTPA enhanced MRIs. Seventy-four percent of these specimens (64 of 87) showed a malignancy of more than 5% growth fraction. On the other hand, tumour cells were observed in twenty-seven of fifty-six specimens taken from areas with Gd-DTPA unenhanced MRIs. Eighty-five percent of these specimens (23 of 27) showed a malignancy value of less than 5% GF. However, fifteen percent of these specimen showed values between 5 and 15% GF. In the kinetic study of Gd-MRIs five patients who were in a clinically stable condition and one patient who had radionecrosis showed a constant pattern of enhancement or slightly increased enhancement 30 min after injection compared to 4 min after injection. Therefore, GD-DTPA MRI can be used effectively in the diagnosis of tumour viability and malignancy after treatment.

Symptomatic cerebral vasospasm after intraventricular hemorrhage from ruptured arteriovenous malformation

We present a rare case showing symptomatic vasospasm after intraventricular hemorrhage from a ruptured arteriovenous malformation. No significant subarachnoid hemorrhage in the basal cisterns was observed on computed tomography in the entire course of illness. Although most cases showing vasospasm are associated with the deposition of blood in the basal cisterns, this case suggests the possibility of some other important factor in causing the subsequent development of vasospasm.

Foramen magnum meningioma and arachnoid cyst coinciding in the lateral cerebellomedullary cistern--case report

An extremely rare foramen magnum meningioma associated with an arachnoid cyst in the lateral cerebellomedullary cistern occurred in a 65-year-old female presenting with dizziness. Neuroimaging revealed a meningioma at the left lateral edge of the foramen magnum and an arachnoid cyst mainly located in the right lateral cerebellomedullary cistern, compressing the medulla oblongata bilaterally. After fenestration of the cyst wall and tumor removal, the clinical symptoms ameliorated. We recommend that where a foramen magnum tumor coexists with an arachnoid cyst of the posterior fossa, the tumor should be removed after shrinking the cyst to obviate the need for brainstem retraction.

Morphometrical analysis of GFAP-positive cells in human astrocytomas

The morphometrical characteristics of human astrocytoma were examined using the shape, size, and intercellular distances of glial fibrillary acidic protein-positive cells in samples from 21 patients with various astrocytomas and normal samples resected during operations on seven patients with other brain tumors. The results showed that astrocytoma cells were rounder than normal astrocytes with fewer processes. Low-grade astrocytomas were smaller than astrocytes or rapid regrowth astrocytomas. Morphological analysis of astrocytoma may be valuable for evaluating the potential migration to adjacent tissue.

[Treatment of metastatic brain tumors: effect of surgery of multiple metastatic brain tumors and systemic metastasis with special reference to quality of life]

To assess the efficacy of surgical resection of brain metastases from patients with multiple brain metastases or/and with other systemic metastases, the authors analysed treatment results of 90 cases of metastatic brain tumors. The patients were divided into three groups. Group A (nine cases): Patients with single brain tumor and their primary cancers were well controlled. Their brain tumors were removed surgically and followed by radiation. Their mean survival time was 17.0 months, and 14.6 months were independent (Karnofsky score greater than or equal to 70) in cases of lung cancer. Five patients (55.6%) improved by treatment. Group B (21 cases): Patients with multiple brain metastases or/and with systemic metastases. Their brain tumor(s) which gave rise to neurological symptoms were surgically removed in order to improve their quality of life. In cases of lung cancer, mean survival time was 9.5 months and 7.1 months were independent. 11 patients (52.3%) improved by treatment. Group C (60 cases): Patients treated conservatively. Their mean survival time was 4.9 months and 2.7 months were independent in cases of lung cancer. Only 13 patients (21.7%) improved by treatment. However 23 (38.3%) deteriorated in their quality of life during treatment. Two patients of this group had single brain tumor and their primary cancers were controlled well. They refused surgery. Their mean survival time was 13.0 months, and 7.0 months were independent. These times were statistically shorter than group A. Seven patients had similar systemic and neurological states as those in group B. Their mean survival time was 5.0 months and 3.0 months were independent. These times were also statistically shorter than those in group B.(ABSTRACT TRUNCATED AT 250 WORDS)

MR imaging of diffuse glioma

Neuroradiologic diagnosis of "gliomatosis cerebri" is hampered by the diffuse, isodense character of the lesion, and the fact that it may not enhance when intravenous contrast medium is administered. Clinical signs and symptoms are usually nonspecific, nonfocal, and disproportionately mild. We report a case of diffuse glioma in a 30-year-old man, discuss the difficulty in arriving at a precise diagnosis of gliomatosis cerebri, and examine the possible role of MR in its detection and delineation.

Central nervous system metastasis from gallbladder carcinoma--case report

Systemic metastases from gallbladder carcinoma occur frequently, but involvement of the central nervous system is rare. We describe such a case in a 68-year-old female. Solitary brain metastasis from gallbladder carcinoma was completely removed 4 months after operation for the primary tumor. Planned chemotherapy was then given to prevent recurrence. She was leading a normal life 4 years later. Patients with solitary brain metastasis from gallbladder carcinoma can achieve a better outcome and longer survival after removal of the brain metastasis if there is no other metastasis.

Large arteriovenous malformation associated with persistent primitive hypoglossal artery--case report

A rare case of large arteriovenous malformation (AVM) with persistent primitive hypoglossal artery in a 43-year-old male was treated by staged embolization, followed by total removal. AVM associated with carotid-basilar anastomosis is quite rare, but the incidence of AVM in patients with carotid-basilar anastomosis is high. AVM associated with persistent carotid-basilar anastomosis has no distinguishing features compared with ordinary AVM, but participation of the posterior circulation as a feeder is characteristic.

Radiolucent osteoma of the skull: case report

A rare case of a radiolucent osteoma of the skull is reported. The radiological and pathological findings of this lesion, including magnetic resonance imaging findings, are presented, and the efficacy of magnetic resonance imaging for the diagnosis of this skull tumor is evaluated. The differential diagnosis of radiolucent bone tumors is discussed.

Normal brain damage after radiotherapy of brain tumours

A total of 106 patients were examined for adverse effects to the brain from 60Co or proton radiotherapy. Radiation induced change (RIC) developed within the irradiated field 40-60 months after doses of 800-1000 neuNSD or 70 TDF and in 10-20 months after doses of more than 1700 neuNSD or 100 TDF. The incidence of RIC increased significantly with increasing age. Furthermore pathological changes like oedema and infarction in the brain tissue may be an important factor for the development of RIC in the central nervous system (CNS).

Occurrence of an active form of gelatinase in human gastric and colorectal carcinoma tissues

Profiles of gelatinase released during 4 h incubation of explants from human carcinoma tissues (15 gastric and 15 colorectal carcinomas) in serum-free RPMI 1640 medium were compared with those of corresponding normal tissue specimens obtained 2 and 10 cm apart from tumor periphery. All the culture supernatants of both tumor and normal tissues contained gelatinase species of 200, 130, 92 and 72 kDa as detected by zymography with gelatin as a substrate. Besides these gelatinase species, all carcinoma tissue culture supernatants had an additional 66-kDa gelatinase, an active form of the 72-kDa gelatinase. This gelatinase was not detectable in the normal tissues 10 cm apart from the tumor mass, with an exceptional case of gastric carcinoma of Borrmann type 4. These results suggest that the presence of active form of gelatinase might be one of the characteristic properties of these malignant human tumors.

Isolated cerebral varix with magnetic resonance imaging findings--case report

A rare case of isolated cerebral varix of the left deep sylvian vein was discovered incidentally in an 11-year-old boy by computed tomographic scanning, magnetic resonance (MR) imaging, and cerebral angiography. MR imaging was most useful in diagnosis of cerebral varix. Review of 21 similar reported cases shows no significant in age, sex, location, or size character.

[Ultrastructure of glioma vessel--morphometric study for proliferative potential of endothelial cell]

In this study we quantified the morphological abnormalities of human glioma vasculature in operated sample of low grade astrocytomas and malignant gliomas. Only those vessels with a diameter of less than 10 micron and containing one nucleus at least on axial section present in the marginal area of the tumors devoid of necrosis were subjected to the present study. A total of 58 vessels were analyzed with computer assisted morphometry for ultrastructural evidence of proliferative potentials of endothelial cells. 5 specific features of the endothelial cells and/or the capillaries which were not related to the vascular permeability were assessed: (1) Degree of vascular luminal narrowing (LN: Ratio of luminal area to abluminal area), (2) Thickness of basement membrane (BM), (3) Mean % ratio of the endothelial cells including Weibel-Palade bodies to whole endothelial cells (WPB-1) and the number of Weibel-Palade bodies in an endothelial cell section (WPB-2), (4) Irregularity of nuclear shape (NA: semiquantified grade 0 to 3). (5) Mitochondrial density (MIT). We found that: (1) LN was significantly stronger in malignant glioma capillaries (MGC, 28%) than low grade astrocytoma capillaries (LAC, 39%). (2) BM was significantly thicker in MGC (2.9 microns) than in LAC (1.2 microns), (3) WPB-1 and WPB-2 were significantly higher in MGC (34% and 0.92) than LAC (14% and 0.39). (4) NA was significantly higher in MGC (grade 2.1) than LAC (grade 1.3), (5) MIT was significantly higher in MGC (5.6%) than LAC (4.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

A comparative case-control study of colorectal cancer and adenoma

We conducted a comparative case-control study of colorectal cancer and adenoma involving 221 cases with colorectal cancer, 525 cases with colorectal adenoma and 578 neighborhood controls. Daily vegetables intake was associated with lower risks of distal colon adenoma (relative risks (RR) = 0.59, 95% confidence interval (CI): 0.39-0.89) and rectal cancer (RR = 0.46, 95% CI: 0.25-0.84). Daily beans intake was associated with lower risk of colon adenoma (RR = 0.58, 95% CI: 0.37-0.91 for the proximal colon and RR = 0.63, 95% CI: 0.45-0.88 for the distal colon) and daily intake of seaweeds was associated with lower risk of rectal cancer (RR = 0.42, 95% CI: 0.22-0.82). Daily intake of fish and shellfish also showed an inverse association with the risk of colon adenoma (RR = 0.67, 95% CI: 0.45-0.99 for the proximal colon and RR = 0.70, 0.52-0.94 for the distal colon). Generally, intakes of animal or vegetable fat-rich foods, especially meats, were associated with decreases in risks of both adenoma and cancer, though the association of cancer was not statistically significant. Other than dietary factors, daily alcohol drinking was associated with an increased risk of adenoma in the proximal colon (RR = 1.95, 95% CI: 1.15-3.29) and ex-drinkers showed higher risks for colon adenoma and colorectal cancer. Sports or occupational activities and coffee drinking were inversely associated and family history of colorectal cancer was positively associated with the risk of both colorectal adenoma and cancer.

[Comparative case-control analysis of gastric and duodenal ulcers]

A case-control analysis was conducted comparing gastric and duodenal ulcers involving 369 cases with gastric ulcer, 127 cases with duodenal ulcer an 3,104 control subjects based on a questionnaire survey of subjects who received gastroscopic examination at the Aichi Cancer Center Hospital from April, 1985 to March, 1989. Risk of gastric ulcer was positively associated with smoking (relative risk (RR) = 3.67, 95% confidence interval (CI): 2.63-5.13), irregular time of meals (RR = 1.39, 95% CI: 1.06-1.81) and milk intake (RR = 1.60, 95% CI: 1.25-2.04) and inversely associated with fruit intake (RR = 0.73, 95% CI: 0.57-0.95), while the risk of duodenal ulcer was positively associated with smoking (RR = 1.94, 95% CI: 1.16-3.26), a preference for foods that are not rich (RR = 1.55, 95% CI: 1.03-2.32), intake of pickled vegetables (RR = 1.76, 95% CI: 1.21-2.55) and presence of methods of diversion (RR = 1.77, 95% CI: 1.16-2.71). These results suggest that life style is involved in the etiology of both diseases and that there are some differences in the associations between both diseases.

A comparative case-control analysis of stomach cancer and atrophic gastritis

We conducted a comparative case-control analysis of stomach cancer and atrophic gastritis involving 427 cases with stomach cancer, 1414 cases with atrophic gastritis, and 3014 control subjects based on a questionnaire survey conducted for the subjects who received gastroscopic examination at Aichi Cancer Center Hospital from April 1985 to March 1989. The risk of atrophic gastritis in both males and females was not associated with any environmental factors. The risk of stomach cancer compared with the control subjects was positively associated with an intake of salted fish guts or cod roe [relative risk (RR) = 1.52, 95% confidence interval (CI) = 1.08-2.15] and smoking (RR for 20 or more cigarettes per day = 2.84; 95% CI = 1.79-4.51) and inversely associated with Western-style breakfast (RR = 0.68; 95% CI = 0.48-0.96) in males. Additionally, the risk of stomach cancer was inversely associated with a daily intake of raw vegetables (RR = 0.56; 95% CI = 0.34-0.94) in males when compared with the patients with atrophic gastritis as controls. Several environmental factors, such as intake of green-yellow vegetables, fruit, and meat, and a family history of stomach cancer, were only associated with intestinal types of cancer in females, whereas a clear difference between diffuse and intestinal types was not observed in males. The results of the present study suggest that risk factors for stomach cancer may be different from those for premalignant lesions.

[Radiation injury of the normal brain tissue after external radiotherapy of brain tumor]

The calculated dose expressed by neuNSD (or neuret) shows a significant relationship between a therapeutic dose and a post-radiation time in the normal brain injury. An aged patient and a patient with the vulnerable brain in the irradiated field had the high risk of radiation injury. Radiotherapy needs to consider the cost-benefit balance for those risk patients. The hyalinization of the vessels and demyelination were observed even in low-dose radiation areas in non-aged patients, and in aged patients fibrinoid necrosis was observed in low-dose radiation areas. The combination of intraarterial chemotherapy and radiotherapy increased the injury of the brain. If the low-density area existed within the irradiated field on CT, it could be a cause of radiation injury. Steroid and anticoagulant drugs should be given to recover from the condition before radionecrosis.

A small temporal lobe glioma detected only by magnetic resonance imaging

The authors were able to demonstrate a very small glioma (1.0 x 0.8 cm in size) of the temporal lobe using MRI. They discuss the relative merits of CT and MRI in the diagnosis of gliomas in terms of their size. CT fails to detect tumours less than 2.0 x 1.5 cm in size which are not calcified. So far, MRI has revealed a tumour as small as 1.0 x 0.8 cm. Therefore, MRI is superior to CT for detecting small gliomas.