Facial lichen striatus: successful treatment with tacrolimus ointment

We report a 22-year-old Japanese woman with facial lichen striatus (LS). The distribution of the lesions corresponded to that of Blaschko's lines. Histology of the lesional skin showed an inflammatory cell infiltrate around hair follicles and eccrine glands. Treatment of the linear lesions with tacrolimus ointment once or twice daily resulted in a dramatical improvement in a short time. LS is a T-cell-mediated inflammatory disease and tacrolimus ointment may be an effective alternative treatment for this disease especially when the lesions are located on the face.

Criteria for early detection of temporal hemianopia in asymptomatic pituitary tumor

PURPOSE

To determine new criteria for early detection of temporal hemianopia in patients with asymptomatic pituitary tumor.

METHODS

Fifteen patients without visual symptoms had pituitary tumor and subtle defects or normal visual fields by Goldmann perimetry. Twelve patients with visual symptoms had pituitary adenoma and visual field defects detected by Goldmann perimetry. All were examined by automated perimetry. The relationship between the tumor and the optic chiasm was graded by magnetic resonance imaging (MRI) on a scale of 0-4. Grade number increased with extent of compression. Temporal hemianopia observed by automated perimetry was estimated from normal data (52 normal fields). Vertical step was determined from the number of adjacent pairs along the midline; sensitivity was lower in the temporal field than in the nasal field. Temporal depression was calculated by the quadrant sum of sensitivity.

RESULTS

All patients with symptomatic pituitary adenoma had vertical step and temporal depression in the upper field. Nine of 15 patients without visual symptoms had vertical step or temporal depression. Of nine patients with temporal hemianopia, two of four patients had grade 1 compression, three of five had grade 2, and four of four had grade 3.

CONCLUSIONS

New criteria by automated perimetry could detect temporal hemianopia in patients with asymptomatic pituitary tumor.

Iron lactate induction of pancreatic and endometrial proliferative lesions and a lack of increased tumors in a 104-week carcinogenicity study in F344 rats

Iron lactate has been used as a food additive for iron supplementation. The present study was conducted to determine whether it might have carcinogenic potential. A total of 150 male and 150 female Fischer 344 rats were divided into three groups and fed basal diet containing 0, 1 or 2% of iron lactate for 104 weeks. No iron lactate-induced tumors were observed in any groups, although the incidences of pancreatic acinar cell and endometrial gland hyperplasias were increased in males and females, respectively, in the 2% group. Thus our in vivo animal data indicate that iron lactate lacks carcinogenicity in male and female F344 rats. However, estrogenic effects might be concluded based on the data for endometrial lesions. In a second experiment, an estrogen responsive rat pituitary tumor cell line, MtT/Se, and a human breast cancer cell line, MCF-7, were therefore employed to examine the estrogenic potential of iron lactate with regard to receptor binding affinity and ERE-reporter gene activation. Results in both cases were negative. Further investigations are needed to elucidate the mechanisms of induction of pancreatic and endometrial proliferative lesions by iron lactate.

Coexistence of beta2 microglobulin and lambda light chain in amyloid fibrils of dialysis-unrelated plasma cell dyscrasia-associated systemic amyloidosis

BACKGROUND

Systemic amyloidosis occurs as a result of amyloid deposition in various tissues. The amyloid fibrils in systemic amyloidosis have been reported to originate from immunoglobulin light chains.

OBJECTIVE

We studied the composition of amyloid fibrils from two patients with plasma cell-associated systemic amyloidosis (PASA).

METHODS

A double immunofluorescence study of the lesional skin of PASA was undertaken. Amyloid proteins were extracted with distilled water from one case of PASA.

RESULTS

The double immunofluorescence study showed that anti-lambda light chain and anti-beta2 microglobulin antibodies mostly reacted with the same area of amyloid deposit. Amyloid deposits from two patients with PASA who had never undergone haemodialysis showed a positive reaction with the antibodies for beta2 microglobulin as well as immunoglobulin lambda light chain. By the use of immunoblot assay of amyloid fibril proteins, polypeptides immunoreactive with antigamma light chain antibody (29 kDa) and with anti-beta2 microglobulin antibody (12 kDa) were detected.

CONCLUSIONS

These results indicate that beta2 microglobulin is a component of amyloid fibrils in PASA.

Demonstration of the optic pathway in large pituitary adenoma on heavily T2 weighted MR images

The objective of the investigation was to understand preoperatively the detailed anatomical relationship of large pituitary adenomas to surrounding structures, using the heavily T2-weighted reversed (T2R) MR images. This study consisted of 28 patients with pituitary adenoma, presenting with visual disturbance. The MRI scanner used was a Gyroscan ACSNT 1.5T and the slice thickness of the image was 3 mm with 0.5 mm interslice gap. The relation of pituitary adenoma to optic pathway and to the degree of visual field defect was assessed. Relations of the optic chiasm to adenoma were classified into three types: anterior, superior and posterior. The optic chiasm was directly visualized and identifiable in all patients studied. It was located anterior in four cases, superior in 22 and posterior in two in relation to the adenoma. Its location was further confirmed by the anatomical delineation of surrounding structures such as anterior commissure and lamina terminalis. Optic nerve or tract was unidentifiable in one case, for each category. Detectability of each optic component was higher on T2R images than on conventional T1-weighted images. The adenoma extended into and in front of the third ventricle in anterior and posterior types, respectively. The anterior communicating artery complex and the optic pathway were relocated together in anterior and superior types, and were separated in the posterior type. In a case of the posterior type, the complex was sectioned to obtain a wider surgical field during anterior interhemispheric approach. While degrees of visual field defect were proportional to tumour size in the superior type, they were unrelated in the anterior and posterior types. On choosing a transcranial approach, the transcallosal route is unsuitable for an adenoma of posterior type, which extends in front of the third ventricle. This preoperative MRI information makes it possible to visualize directly the optic pathway even in huge adenomas, and is useful in predicting surgical anatomy and selecting a proper surgical approach.

Expression of the 67-kDa elastin receptor in perforating skin disorders

BACKGROUND

Perforating skin dermatoses include elastosis perforans serpiginosa (EPS), reactive perforating collagenosis, Kyrle's disease and perforating folliculitis. In addition to these four diseases, an acquired form of perforating dermatosis associated with diabetes mellitus and/or chronic renal failure has been reported for which the term acquired perforating dermatosis (APD) was proposed. The molecular mechanism of transepidermal elimination of dermal components in perforating skin dermatoses remains unclear. We recently demonstrated that the 67-kDa elastin receptor can be detected in the epidermis eliminating altered elastic fibres in EPS, suggesting that the elastin-keratinocyte interaction may play a role in transepidermal elimination in EPS.

OBJECTIVES

To determine whether the 67-kDa elastin receptor is involved in other perforating diseases.

METHODS

Paraffin-embedded skin specimens from new cases of EPS (n = 2), APD (n = 15) and perforating granuloma annulare (PGA; n = 2) were studied immunohistochemically using a specific antibody to the 67-kDa elastin receptor. In one case of EPS, two different sites from a single lesion, a central atrophic area and a peripheral keratotic area, were studied.

RESULTS

Expression of the elastin receptor was detected in the epidermis surrounding the elastic materials in both cases of EPS. The elastin receptor was not detected in the central inactive area, whereas it was expressed strongly in the peripheral keratotic active area. The elastin receptor was also detected in three of 15 cases of APD in which a few elastic fibres were found in the eliminated dermal materials. In one case of APD, the elastin receptor was not detected in spite of the presence of a few elastic fibres in the eliminated materials. The elastin receptor was not detected in either case of PGA.

CONCLUSIONS

Expression of the elastin receptor in EPS was seen in both cases studied and was dependent on the stage of the lesion. Expression of the elastin receptor in APD appeared to be related to the amount of elastic fibres in the eliminated materials. Thus, expression of the elastin receptor in perforating skin disorders may depend on the stage of the lesion and/or the content of elastic fibres in the dermal materials being eliminated.

Heavily T2 weighted MR images of anterior optic pathways in patients with sellar and parasellar tumours - prediction of surgical anatomy

OBJECTIVE

Location of anterior optic pathways in sellar and parasellar tumours was preoperatively evaluated, by use of heavily T2 weighted MR images.

METHODS

Heavily T2 and conventional T1 weighted images were studied in 20 patients with sellar and parasellar tumours who underwent craniotomy. Pathology revealed pituitary adenoma in 5 patients, craniopharyngioma in 8 and parasellar meningioma in 7. Maximum sizes ranged from 15 mm to 58 mm. Sequence parameters of TR/TE for heavily T2 weighted and T1 weighted images were 5800/220 msec and 600/20 msec, respectively, and slice thickness was 3 mm for both.

RESULTS

The anterior optic pathway was detected in 95% on heavily T2 weighted images and 50% on T1 weighted images. All preoperative heavily T2 weighted images were compatible with operative findings. The optic chiasms were most commonly supero-posterior in pituitary adenomas, anterior (prefixed) in craniopharyngiomas and posterior in meningiomas. The optic nerves were commonly located superior or lateral to the tumours. However, parasellar meningiomas, off the midline, revealed the optic nerves in various locations, depending on the tumour origin. In such tumours, heavily T2 weighted images provided surgical information on the width of the working space through prechiasmal and/or optico-carotid spaces in the pterional approach. Spatial relation of the tumours to the lamina terminalis, anterior commissure and anterior communicating artery complex was clearly shown in craniopharyngioma patients, who underwent the anterior interhemispheric approach.

CONCLUSION

Heavily T2 weighted MR images are useful in determining the location of optic pathways and surgical approach and in individual prediction of the anatomy for even large sellar and parasellar tumours.

Oedema along the optic tracts due to pituitary metastasis

The MRI finding of oedema along the optic tract has been reported in patients with craniopharyngioma, as a useful diagnostic sign among common pituitary tumours. We report two patients with pituitary metastasis with this MRI finding. A 59-year-old woman and a 54-year-old man had diabetes insipidus and extraocular impairment due to a pituitary metastasis tracts. To our knowledge, this is the first MRI report of oedema along the optic pathway due to pituitary metastasis. Our cases and review of literature indicate that this MRI sign is non-specific. Appearance of the oedema well corresponded to the initiation of visual complaint, which make a good contrast to reported clinical presentations of craniopharyngioma. Clinical significance and pathomechanism of this MRI sign are discussed.

Strain difference in regulation of pituitary tumor transforming gene (PTTG) in estrogen-induced pituitary tumorigenesis in rats

Recently a novel oncogene, PTTG (pituitary tumor transforming gene) was isolated from a rat pituitary tumor cell line whose expression is apparently correlated with pituitary tumorigenesis. In the rat, estradiol (E(2)) is known to induce anterior pituitary hyperplasia. The effects of E(2), however, vary greatly among rat strains. Therefore we examined the expression of PTTG and its regulation by E(2) in F344, Wistar, Brown-Norway and Donryu rats. Four-week-old females were ovariectomized and a pellet containing 10 mg of E(2) was given s.c. Total RNA was isolated from the pituitary gland and PTTG mRNA was measured with a competitive RT-PCR technique. The F344 strain was the most susceptible to E(2) induction of pituitary tumorigenesis, followed by Wistar and Brown-Norway, while no increase in pituitary weight was noted in Donryu rats. PTTG mRNA in the gland was induced by E(2) within 48 - 72 h in F344 and Wistar, but not in Brown-Norway or Donryu strains. These data suggest that PTTG expression may at least in part be responsible for strain differences in E(2)-induced pituitary tumorigenesis.

Metastasis to the penis in a patient with squamous cell carcinoma of the lung with a review of reported cases

Metastasis to the penis is very rare in lung cancer. We describe a patient with squamous cell carcinoma of the lung who developed a metastatic lesion in the penis. A 75-year-old Japanese male visited a local hospital complaining cough and bloody sputum. A chest plain radiograph and computed tomographic (CT) scans of the chest demonstrated a right hilar mass. He was diagnosed with squamous cell carcinoma of the lung at stage IIIB (T4N2M0). Then he was treated with concurrent chemoradiotherapy consisting of cisplatin, docetaxel, and thoracic irradiation, and after the chemoradiotherapy, he achieved a partial response. However, 6 months later, he visited an urologist complaining of firm mass in the penis with slight pain. A biopsy of the corpus cavernosum penis was performed, which provided a histological diagnosis of squamous cell carcinoma. The histology of the specimen was consistent with that of previous lung cancer, so he was considered to have penile metastasis from squamous cell carcinoma of the lung. Radiotherapy was given to the metastatic tumor in the penis. The penile tumor was diminished and the pain was completely relieved. In addition, we review reported cases to investigate the clinical characteristics and appropriate management of this rare involvement.

Long-term Karnofsky performance status and neurological outcome in patients with neurohypophyseal germinomas

Long-term posttreatment Karnofsky Performance Status (KPS) and neurological status of 16 patients with neurohypophyseal (NH) germinomas were retrospectively analysed, in order to deduce the best treatment modality to achieve a good outcome. The average age at treatment was 15.5 years (rouge 6-26) and they were followed up for 107.3 months (26-209). The KPS averaged 81.5 (0-100). Three patients were below 60 in the KPS. The first one had hemiparesis due to a delayed cerebrovascular accident (CVA), and the second became indifferent and inactive with recent memory loss. The third died from marginal recurrence of tumour and subsequent systemic metastasis. The low scores were all more or less attributable to complications related to irradiation: delayed CVA, diffuse cortical atrophy and inappropriate selection of irradiation field, respectively. The second case had the tumour origin at the hypothalamus, which indicates intraparenchymal tumour location as another factor to worsen the quality of life (QOL). Visual field and acuity, and EOM impairment were observed in eight and five patients, respectively. It improved in all patients but one. The visual and EOM dysfunction recovered satisfactorily and was not a disabling factor. The intraparenchymal lesion resulting in hemiparesis and higher cortical dysfunction due to either irradiation-related complications or tumour invasion is a major determining factor of lower KPS. Irradiation related complications are considered to be avoidable by reducing radiation dosage with appropriate chemotherapy and/or proper selection of irradiation field. Patients with smaller tumour size of less than 20 mm had higher KPS. Accordingly, repeated studies of tumour markers and neuroimages are required in patients with idiopathic diabetes insipidis, in order to detect the tumour, if present, at the small-sized and early stage.

Potential anti-androgenic activity of roxithromycin in skin

Since acne formation is a multistep process accelerated by androgens, we examined whether a new anti-acne antibiotic roxithromycin (RXM) may act as anti-androgen using transient transfection assays in human skin fibroblasts. The result showed no significant effect of 0.5, 1 and 5 microg/ml RXM on 10(-9) M R1881-induced androgen receptor (AR) transcriptional activity. While the cotransfection of exogenous ARA55, a novel AR coactivator, increased AR transactivation up to 2.59-fold, this increase was attenuated by 5 microg/ml RXM to 64.7%. Semiquantitative RT-PCR results showed that 0.1 mM H(2)O(2) treatment increased ARA55 mRNA expression level, indicating that reactive oxygen species increase the expression of ARA55 in skin. These results suggest that RXM may serve as anti-androgen only in the hypersensitive state to androgen, but not in the physiological state, through modulating end-organ hypersensitive condition to androgen possibly involving the pathway from reactive oxygen species to ARA55.

In vitro activities of moxifloxacin and other fluoroquinolones against Mycoplasma pneumoniae

A total of 105 isolates of Mycoplasma pneumoniae were evaluated for susceptibility to moxifloxacin, sparfloxacin, levofloxacin, and ciprofloxacin. Moxifloxacin, a newly synthesized compound, showed the greatest activity. The MICs and MBCs at which 50 and 90% of isolates were affected were 0.15 (MIC(50) and MBC(50)) and 0.3 microg/ml (MIC(90) and MBC(90)) respectively. The results indicate that moxifloxacin might be promising an antimycoplasmal agent.

[A case of renal cell carcinoma arising in bilateral original kidneys after failure of transplant graft function]

We report a case of renal cell carcinoma arising in bilateral original kidneys after failure of transplant graft function. A 47-year-old man had received a living related renal transplantation on December 10, 1985. He had resumed hemodialysis (HD) therapy because of graft failure on January 8, 1996. Periodic computed tomography (CT), after resumption of HD, revealed multiple cystic change in bilateral original kidneys and a mass in the right kidney. He was referred to our hospital on August 4, 1998 for management of the increased right renal lesion. Abdominal angiography demonstrated a hypervascular and solid mass not only in the right kidney but also in the left kidney. He underwent transperitoneal bilateral nephrectomy. Histopathological examination revealed renal cell carcinoma, bilaterally, with alveolar type and granular cell subtype. He was free of evidence of recurrence and metastasis for 30 months after nephrectomy.

Cancer prevention with green tea and monitoring by a new biomarker, hnRNP B1

The study of green tea polyphenols as a cancer preventative is approaching a new era, with significant results accumulating rapidly. This paper briefly reviews four topics related to mechanisms of action of tea polyphenols: (I) identification of the genes commonly affected by EGCG, as demonstrated by Clontech's Atlas cDNA Expression Array; (II) the significance of heterogeneous nuclear ribonucleoprotein B1 (hnRNP B1) as a new biomarker for early detection of lung cancer, and inhibition of its expression by EGCG; (III) the synergistic or additive effects of EGCG with the cancer preventive agents, sulindac and tamoxifen, on induction of apoptosis in PC-9 cells and on inhibition of intestinal tumor development in multiple intestinal neoplasia (Min) mice; (IV) the results of a 10 year prospective cohort study demonstrating the effectiveness of daily consumption of green tea in preventing cancer, and a prototype study for developing green tea beverage as cancer preventive.

[Efficiency improvement of dispensing of drugs for injection by a total automatic injection dispenser system including infusion fluids and its evaluation]

For the appropriate use of drugs for injection, injection dispensing by pharmacists has been initiated at various institutions. With this movement, automatic injection dispensers have actively been developed. In our hospital, an injection order system was connected with an automatic injection dispenser in November, 1997, and this integrated system has been operating in all wards. However, the efficiency of dispensing work was not satisfactory because there were limitations in the types and volume of drugs placed in the automatic injection dispenser. Therefore, we constructed an automatic injection dispenser system that allows us to use more than 100 ml infusion fluids and also to use drugs stored in a cool place, which could not be used in the conventional system. In the new system, two trays coming from an ampoulevial line and an infusion fluid line are automatically coordinated using a discharge lifter for each patient and transported into an injection cart. After the introduction of this system, the automatic dispenser utilization rate in terms of the number of used injections increased from 52.6% to 73.3%. In addition, since the dispensing time for infusion fluids and drugs stored in a cool place, which had been collected by man power, was reduced, it became possible to pay more attention to checking for prescription.

Suppression by estrogen receptor beta of AP-1 mediated transactivation through estrogen receptor alpha

The estrogen receptor (ER) is known to mediate gene transcription from AP-1 enhancer elements as well as the well-documented estrogen responsive elements (EREs). Investigations of AP-1 mediated transactivation through ER have been performed with rather complex promoters such as insulin like growth factor 1 (IGF-1) and collagenase promoters. In the present study, we investigated AP-1 mediated transactivation through ERalpha and ERbeta with a less complicated reporter consisting of only consensus AP-1 motifs. NIH 3T3 cells were transiently transfected with human ERalpha and ERbeta expression plasmids and AP-1-luc and ERE-luc reporters. 17beta-Estradiol failed to activate ERbeta-AP-1 responses while activating ERalpha-AP-1, ERalpha-ERE, ERbeta-ERE mediated transcription. On the other hand, antiestrogens such as tamoxifen enhanced AP-1 mediated transactivation through both ERalpha and ERbeta. An ERalpha positive human breast cancel cell line, MCF-7, also showed the same manner of AP-1 mediated transactivation through ERalpha. When NIH 3T3 with ERalpha and MCF-7 were co-transfected with ERbeta, E2 dependent AP-1 responses decreased in both cell lines depending on the amount of the ERbeta expression plasmid. These results suggest that ERalpha and ERbeta may function in opposition with ERbeta actually suppressing the function of ERalpha in AP-1 mediated transactivation.

Modulation of gene expression by (-)-epigallocatechin gallate in PC-9 cells using a cDNA expression array

Green tea is the most effective cancer preventive beverage. In the light of this, the mechanisms of action of tea polyphenols were investigated on the molecular levels. We present here the effects of (-)-epigallocatechin gallate (EGCG) on expression of 588 genes in human lung cancer cell line PC-9 cells, using a human cancer cDNA expression array. The levels of gene expression in non-treated control cells, and cells treated with EGCG alone, with the tumor promoter okadaic acid alone, and with EGCG plus okadaic acid, were studied, and their expression levels were classified into down-regulation (under 0.5 fold) and up-regulation (over 2.0 fold) by comparing with the levels of control. Non-treated PC-9 cells expressed 163 genes out of 588, and EGCG-treated cells induced down-regulated expression of 12 genes and up-regulated expression of 4 other genes. From a comparison of gene expression in the cells treated with EGCG and in cells treated with EGCG plus okadaic acid, we found the following genes commonly affected by EGCG: down-regulation of four genes, NF-kappaB inducing kinase (NIK), death-associated protein kinase 1 (DAPK 1), rhoB and tyrosine-protein kinase (SKY); up-regulation of one gene, retinoic acid receptor alpha1. Among them, we think down-regulation of NIK gene expression is significant for cancer prevention, based on evidence that inhibition of NF-kappaB activation is a result of inhibition of NIK/IKK signalling complex.

Different expression of androgen receptor coactivators in human prostate

OBJECTIVES

To investigate the expression of androgen receptor (AR) coactivators in the human prostate for a better understanding of androgen action in prostate cancer.

METHODS

Using reverse transcriptase-polymerase chain reaction, we examined the expression levels of AR coactivators (ARA55, SRC1, ARA54, TIF2, RAC3) in four prostate cancer cell lines (DU145, PC3, LNCaP, and LN-TR2), nine benign prostatic tissue samples, and 21 prostate cancer tissue specimens.

RESULTS

In the cell lines, SRC1 was expressed ubiquitously at almost equal amounts. Contrary to this, ARA55, ARA54, TIF2, and RAC3 displayed cell line-specific expression. In the LN-TR2 cells, established from LNCaP cells by long-term treatment with tumor necrosis factor-alpha, the expression levels of ARA55 and TIF2 were much higher than those in the LNCaP cells. In every prostatic tissue specimen, the expression levels of TIF2 and RAC3 were very low. The expression levels of ARA55 and SRC1 were higher in the cancer specimens with a higher grade or poor response to endocrine therapy than in those with a lower grade or good response to endocrine therapy.

CONCLUSIONS

Prostate cancer cells express AR coactivators. Long-term stimulation by tumor necrosis factor-alpha could increase ARA55 and TIF2 expression in LNCaP cells. The different expression of coactivators may contribute to the different response of prostate cancer to androgenic stimulation or endocrine therapy.

Visual evoked potentials in relation to visual acuity in macular disease

PURPOSE

To investigate how central retinal function contributes to pattern visual evoked cortical potentials (PVECPs), we recorded transient and steady-state PVECPs in patients with macular disease and compared the results with those of patients with optic neuritis. The results were also evaluated for correlation with visual acuity and kinetic perimetric measurements.

METHODS

PVECPs to 3 rev/s stimulation (transient) and 12 rev/s stimulation (steady-state) for check sizes 15' and 30' were obtained from all patients and age-matched healthy controls. The peak latency and amplitude of the P100 component of the transient VECP and the amplitudes of the steady-state VECP were measured and evaluated.

RESULTS

Patients with macular disease produced significant delay of P100 latency and amplitude attenuation of the steady-state VECP, as compared with healthy subjects. P100 latency delay was less in patients with macular disease than in those with optic neuritis, while the attenuation rate of the steady-state VECP amplitude was similar between groups. Visual acuity was correlated with P100 latency and steady-state VECP amplitude reduction.

CONCLUSIONS

Although the delay of latency was less in patients with macular disease than in those with optic neuritis, the electrophysiologic alterations that occur in macular disease demonstrate a potential for diagnostic value at the level of the retina.

Age-dependent exposure to radioactive iodine (131I) in the thyroid and total body of newborn, pubertal and adult fischer 344 rats

Female rats of the Fischer 344 strain at ages of 1, 4 and 9 weeks were exposed to 131I intraperitoneally with activities of 0.38, 1.03 and 3.42 kBq per gram of body weight under the condition of iodine deficiency. The absorbed doses in the thyroid increased linearly depending on the injected activities. Irradiation at 1 week old caused heavier exposure than those at 4 and 9 weeks old by 7.5 and 7.7 times, respectively; however, damage of the thyroid tissue was more obvious in the 4-week-old groups than in the 1-week-old groups. The absorbed doses in the total body were proportional to the square root of the injected activities. The one-week-old groups were exposed more heavily than the 4- and 9-week-old groups by 3.6 and 4.7 times, respectively, shown by the slow excretion of 131I with the values of effective half-life of 131I activity (Teff). An IDD-treatment was not so effective to enhance the 131I absorption in the total body, as in the thyroid. No matter how the iodine concentration in the blood changed, the 1-week-old groups could not react to normalize the level. We drew standard curves, which enabled us to estimate the absorbed doses in the thyroid and the total body in the case of the injected activities of 131I for the newborn, pubertal and adult rats.

Contrast medium precipitation in the stomach between contiguous plain and contrast CT scans

Precipitation of diluted Gastrografin (meglumine sodium amidotrizoate) occurred in the stomach during computed tomography (CT) examination in a 43-year-old man with fasting. Precipitation was not observed on the initial plain CT scan, but was demonstrated on the contrast-enhanced CT scan following the plain CT. Hyperacidity in the stomach might be promoted during CT examination and cause precipitation between scans.

A new bisphosphonate treatment option for giant cell tumors

Treatment of giant cell tumors (GCT) especially in the vertebrae remains controversial. With multidisciplinary treatments, their results are still insufficient. Moreover, GCT shows the potential for malignant transformation and metastasis, additional options such as adjuvant medication must be considered. We report favorable results in three consecutive cases diagnosed with GCT of the spine which were treated with radiotherapy and bisphosphonate (BP) as a new treatment option, and present a review of the literature and a comparison with these case reports.

Dose-threshold for thyroid tumor-promoting effects of orally administered kojic acid in rats after initiation with N-bis(2-hydroxypropyl) nitrosamine

In order to evaluate the threshold dose of thyroid tumor-promoting effects of KA, male F344 rats were initiated with N-bis(2-hydroxypropyl) nitrosamine (DHPN; 2000 mg/kg body wt., single s.c. injection) and, starting 1 week later, received pulverized basal diet containing 0%, 0.002%, 0.008%, 0.03%, 0.125%, 0.5% or 2%KA for 20 weeks. Five rats each in the 0%, 0.125%, 0.5% and 2%KA groups were sacrificed at week 12, and 10 rats each in all groups at week 20. As an additional experiment, three groups without DHPN initiation received basal diet, a diet containing 0.5% or 2%KA for 20 weeks. The serum T4 levels were significantly decreased in the DHPN-initiated groups given 0.125%KA or more at week 12. No significant decreases in serum T3 levels were observed in the groups treated with DHPN + KA and a significant increase was evident in the 2%KA-alone group at week 20. Some rats in the DHPN + 2%KA group at weeks 12 and 20 and the 2%KA-alone group at week 20 showed pronounced elevation of serum TSH. Thyroid weights were significantly increased in the DHPN-initiated groups receiving 0.5% and 2%KA at weeks 12 and 20 and in the 2%KA-alone group at week 20. Histopathologically, the incidences of focal thyroid follicular cell hyperplasias in the DHPN-initiated groups treated with 0.125%, 0.5% and 2%KA at week 20 were 5/10, 10/10 and 8/8 rats, respectively. At week 20, adenomas were observed in 7/10 rats in the DHPN + 0.5%KA group and 8/8 rats in the DHPN + 2%KA group, and carcinomas were observed in 6/8 rats in the DHPN + 2%KA group. In the groups without DHPN initiation, only focal follicular cell hyperplasia was observed in 1/9 rats in the 2%KA-alone group. These results suggest that the no-observed-adverse effect for the thyroid tumor-promoting effect of KA is 0.03% (15.5 mg/kg/day) under the present experimental conditions, and that KA possesses weak tumorigenic activity in rats due to continuous serum TSH stimulation by a non-genotoxic mechanism.