Design, synthesis, and biological activities of madindoline analogues

A research program is under way to develop a series of madindoline-based inhibitors targeting interleukin 6. Such inhibitors will have potential use in fighting a variety of diseases for which no effective therapeutic drugs currently exist. Madindoline is no longer available from natural sources. Consequently, we have developed a purely synthetic route to ensure a supply of the compound. The synthesis of a range of analogues is described, all of which were evaluated for their inhibitory activity against the growth of IL-6-dependent 7TDI cells. From these assays, several synthetic madindoline analogues were identified as highly promising candidates for further development.

Efficient propagation of polarization from laser photons to positrons through compton scattering and electron-positron pair creation

We have demonstrated for the first time the production of highly polarized short-pulse positrons with a finite energy spread in accordance with a new scheme that consists of two-quantum processes, such as inverse Compton scattering and electron-positron pair creation. Using a circularly polarized laser beam of 532 nm scattered off a high-quality, 1.28 GeV electron beam, we have obtained polarized positrons with an intensity of 2 x 10(4) e+ /bunch. The magnitude of positron polarization has been determined to be 73 +/- 15(stat) +/- 19(syst)% by means of a newly designed positron polarimeter.

A concise stereoselective route to the indoline spiroaminal framework of neoxaline and oxaline

The stereoselective synthesis of tetracyclic intermediate, the indoline spiroaminal 3 for neoxaline (1) and oxaline (2), has been accomplished. The key step of the stereoselective synthesis of 3 was the Lewis acid mediated transcyclization of 4 to the diaminal 18, and the tungstate-catalyzed oxidation of 18 to obtain the nitrone 19, which easily cyclizes to the indoline spiroaminal framework 3. [structure: see text]

Temporary hyperglycaemia provokes monocyte adhesion to endothelial cells in rat thoracic aorta

AIMS/HYPOTHESIS

Several epidemiological data suggest that patients with postprandial hyperglycaemia are at high risk of cardiovascular disease. The aim of this study was to elucidate the effect of a glucose 'spike' on monocyte adhesion to rat aortic endothelial cells.

MATERIALS AND METHODS

Monocyte adhesion to endothelial cells in vivo was quantitated using an en face method for observation of endothelial surface after immunohistochemical staining for CD68 in the thoracic aortas of Sprague-Dawley rats after several kinds of blood glucose rises.

RESULTS

The number of monocytes adhering to endothelial cells increased at 30 min after injection of glucose in 8-week-old Sprague-Dawley rats. The increased adhesion returned to the basal level at 120 min after glucose injection, concomitantly with the return of blood glucose levels to normal. The infusion of octreotide to inhibit endogenous insulin secretion did not prevent the glucose-induced increase in monocyte adhesion to endothelial cells. On the other hand, the number of monocytes adhering to endothelial cells did not increase in rats with streptozotocin-induced diabetes and sustained hyperglycaemia.

CONCLUSIONS/INTERPRETATION

Our data demonstrate that a temporary rise in blood glucose levels can in itself promote a reversible increase in monocyte adhesion to arterial endothelial cells.

Malignant mixed mullerian tumor of primary mesenteric origin

Malignant mixed müllerian tumor (MMMT) is a rare tumor. A literature search revealed very few reports on MMMT, especially those arising in the peritoneum. We recently encountered an MMMT of primary mesenteric origin associated with left fallopian tube cancer. There have been no previous reports about its occurrence in the mesentery. When cases of peritoneal MMMT were reviewed, the disease was found to be associated with synchronous or metachronous gynecologic tumors of müllerian duct origin (ie, ovarian tumors, primary serous carcinoma of the peritoneum, fallopian tube cancer, endometrial cancer, and adenocarcinoma of the cervix) in 12 out of 32 patients (37.5%). Peritoneal MMMT are frequently associated with gynecologic tumors.

(+)-Phorboxazole A Synthetic Studies. A Highly Convergent, Second Generation Total Synthesis of (+)-Phorboxazole A

[structure: see text] A second generation total synthesis of the potent antitumor agent (+)-phorboxazole A (1) has been achieved. The cornerstone of this approach comprises a more convergent strategy, involving late-stage Stille union of a fully elaborated C(1-28) macrocycle with a C(29-46) side chain. The second generation synthesis entails the longest linear sequence of 24 steps, with an overall yield of 4.2%.

Polymorphism of the solute carrier family 12 (sodium/chloride transporters) member 3, SLC12A3, gene at exon 23 (+78G/A: Arg913Gln) is associated with elevation of urinary albumin excretion in Japanese patients with type 2 diabetes: a 10-year longitudinal study

AIMS/HYPOTHESIS

We have shown previously that the SLC12A3 +78G/A polymorphism in exon 23 (Arg913Gln) was a new candidate for conferring susceptibility to diabetic nephropathy. The aim of this study was to confirm the effect of this polymorphism on the elevation of urinary albumin excretion in type 2 diabetic patients.

METHODS

We retrospectively studied 264 Japanese patients with type 2 diabetes over a ten-year period. The subjects were classified into two groups: (1) persistent normoalbuminuria or microalbuminuria, or improvement from microalbuminuria to normoalbuminuria (group N); and (2) progression from normoalbuminuria to microalbuminuria or overt proteinuria, or progression from microalbuminuria to overt proteinuria (group P). They were assessed for association with the +78G/A polymorphism.

RESULTS

The frequency of the +78A allele was significantly higher in group N than in group P (10% vs 1%, p=0.021). By logistic regression analysis and discriminant analysis, the substituted allele was shown to be an independent factor correlating negatively to the elevation of albumin excretion (p=0.043 and 0.022, respectively).

CONCLUSIONS/INTERPRETATION

The SLC12A3 +78A(+) genotype may have a protective effect against the development and/or progression of diabetic nephropathy in Japanese type 2 diabetic patients.

Hemodynamic infarction of the spinal cord: involvement of the gray matter plus the border-zone between the central and peripheral arteries

OBJECTIVE

Hemodynamic infarction of the spinal cord that affected an 81-year-old female having a dissecting aortic aneurysm is presented. During the graft replacement operation, systemic hypotension occurred and the patient was subsequently complicated with paraplegia of the lower limbs. The patient died 2 weeks after the surgery due to gastrointestinal bleeding. An autopsy, which did not include the brain, was performed and the spinal cord was sampled. The aim of this report is to describe the pathologic profile of the spinal cord of the patient, and to gain insight into the pathogenesis of the lesion.

METHODS

Histochemical and immunohistochemical methods were employed to study the spinal cord ranging from the lower thoracic to sacral segments.

RESULTS

The whole central areas of the spinal cord showed coagulation and/or liquefaction necroses, while the white matter on the circumference of the cord remained unaffected, thus exhibiting a 'ring-like' appearance.

CONCLUSION

This case is an example of hemodynamic infarction of the spinal cord involving the gray matter that is supplied by the central artery, plus the border-zone that is supplied by both the central and peripheral arteries. The former is probably associated with selective vulnerability of the gray matter to ischemia, while the latter is probably associated with intrinsic vulnerability of the border-zone to systemic hypotension or low blood-flow states.

Total Synthesis of (+)-Discodermolide: A Highly Convergent Fourth-Generation Approach

[structure: see text] A highly convergent, fourth-generation total synthesis of (+)-discodermolide (1), with a longest linear sequence of 17 steps and an overall yield of 9.0%, has been achieved. Highlighting the strategy is the efficient construction and sequential, bidirectional union of a linchpin comprising the C(9)-C(14) Wittig salt-vinyl iodide (-)-18. Importantly, Wittig salt generation proceeded in excellent yield under ambient pressure.

Structure and function of plant canopies

This section comprises a set of papers taken from those presented at a symposium held to commemorate the 50th anniversary of the Monsi-Saeki theory (1953), together with invited papers. The papers describe recent advances in the study of structure and function of plant canopies and are written by former students (and their collaborators) of Professors Monsi and Saeki. The topics cover construction and maintenance of efficient photosynthetic systems at leaf, individual plant and stand level. Canopy structure and function are analysed with respect to optimization and an evolutionarily stable strategy. A new translation of the original paper by Monsi and Saeki (1953) into English has been commissioned and is included in this section.

[Lung resections for lung cancer with idiopathic pulmonary fibrosis]

PURPOSE

The aim of this study was to investigate the postoperative complications after lung resections for lung cancer with idiopathic pulmonary fibrosis (IPF).

MATERIAL AND METHODS

There were 23 patients who underwent lung resections for lung cancer with IPF. There were 8 major complications. Acute exacerbation of IPF occurred in 4 cases, pulmonary edema in 1 case, bronchofistula in 1 case, bacterial pneumonia in 1 case, prolonged hypoxia in 1 case. Three cases died due to acute exacerbation of IPF (2 cases) and bronchofistula (1 case).

RESULTS

There were 4 complications among 7 patients who underwent wedge resections and 4 complications among 16 patients who underwent lobectomy. All the 4 complicated cases who underwent wedge resections had low preoperative percent forced vital capacity (%VC) for 79+/-6%. For the patients who had lobectomy, the preoperative %VC and predicted postoperative %VC was significantly different between the 2 groups of complicated patients and uncomplicated ones (p < 0.05). For the prevention of acute exacerbation of IPF, we used clarithromycin in 11 cases, steroid in 2 cases, ulinastatin in 2 cases. However, the acute exacerbation was occurred in 4 cases.

CONCLUSIONS

For the patients of lung cancer with IPF who had low preoperative %VC, even wedge resections should be carefully indicated.

Design, Synthesis, and Evaluation of Analogues of (+)-14-Normethyldiscodermolide

[Structure: see text] The design, syntheses, and biological evaluation of nine totally synthetic analogues of the microtubule-stabilizing agent (+)-14-normethyldiscodermolide (2) are reported. Simplification at the C(21)-C(24) terminal diene and at the C(1)-C(5) lactone moieties reveals significant structure-activity relationships.

Design, Synthesis, and Evaluation of Carbamate-Substituted Analogues of (+)-Discodermolide

[Structure: see text] The design, syntheses, and biological evaluation of 22 totally synthetic analogues of the potent microtubule-stabilizing agent (+)-discodermolide (1) have been achieved. Structure-activity relationships of the C(19) carbamate were defined, exploiting two synthetically simplified scaffolds, as well as the parent (+)-discodermolide framework.

A practical improvement, enhancing the large-scale synthesis of (+)-discodermolide: a third-generation approach

[reaction: see text] A significant improvement to the Penn one-gram synthesis of (+)-discodermolide (1) has been achieved. Specifically, reduction of the steric bulk of the C(11) hydroxyl protecting group permits formation of the requisite AB Wittig salt at the expense of the undesired intramolecular cyclization upon treatment with PPh(3) at ambient pressure.

[Lung cancer with ground glass opacity diagnosed by transbronchial lung biopsy using an ultrathin bronchoscope and virtual bronchoscopy]

Although thoracic computed tomography (CT) screening indicated that there are many patients who have pulmonary shadow with ground glass opacity, it is sometimes difficult to obtain the appropriate specimens for histological diagnosis of such patients. We herein report a lung cancer patient with ground glass opacity who was diagnosed preoperatively by an ultrathin bronchoscope and virtual bronchoscopy. A 78-year-old female was admitted to our hospital due to bacterial pneumonia. At the admission, CT showed another abnormal small shadow in her right middle lobe. Since the shadow was not visible by fluoroscopy, we reconstructed the images of virtual bronchoscopy using the data obtained by multidetector CT. The location of the shadow was determined in the peripheral area of a dorsal branch of right B4aialpha. Then the transbronchial lung biopsy using an ultrathin bronchoscope with simultaneous CT guidance was performed. The histological findings of the biopsy specimens revealed that the shadow was highly suspicious for malignancy. Therefore, the right middle lobectomy was conducted, and the tumor was diagnosed as an adenocarcinoma. An ultrathin bronchoscope with virtual bronchoscopy is useful to diagnose a pulmonary shadow with ground glass opacity.

Marked asymmetry of putaminal pathology in an MSA-P patient with Pisa syndrome

We report on an autopsy case of a 62-year-old Japanese woman with a 2.5-year history of axial dystonia. She presented with a form of axial dystonia reminiscent of Pisa syndrome. The pathophysiological mechanism underlying forms of axial dystonia remains to be elucidated. We report here the histopathological findings of a multiple system atrophy of parkinsonian predominance (MSA-P) patient with Pisa syndrome.

Design, synthesis and cytotoxicity of 7-deoxy aryl discodermolide analogues

A series of 7-deoxy discodermolide analogues in which the lactone fragment 'C' was replaced by aryl substituents were designed, synthesized, and evaluated for cytotoxicity.

Achievement of ultralow emittance beam in the accelerator test facility damping ring

For high luminosity in electron-positron linear colliders, it is essential to generate low vertical emittance beams. We report on the smallest vertical emittance achieved in single-bunch-mode operation of the Accelerator Test Facility, which satisfies the requirement of the x-band linear collider. The emittances were measured with a laser-wire beam-profile monitor installed in the damping ring. The bunch length and the momentum spread of the beam were also recorded under the same conditions. The smallest vertical rms emittance measured at low intensity is 4 pm at a beam energy of 1.3 GeV, which corresponds to the normalized emittance of 1.0x1.0(-8) m. It increases by a factor of 1.5 for a bunch intensity of 10(10) electrons. The measured data agreed to the calculation of intrabeam scattering within much better than a factor of 2.

Elevated CO2 and nitrogen availability have interactive effects on canopy carbon gain in rice

•  Here we analysed the effects of CO₂ (C_a ) elevation and nitrogen availability on canopy structure, leaf area index (LAI) and canopy photosynthesis of rice (Oryza sativa). •  Rice was grown at ambient and elevated C_a (c. 200 µmol mol^-1 above ambient, using the free-air CO₂ enrichment, FACE) and at two N availabilities. We measured leaf area, area-based leaf N contents and leaf photosynthesis, and calculated net daily canopy photosynthesis. •  FACE plants had higher light-saturated rates of photosynthesis (P_max ) and apparent quantum yields than ambient plants, when measured at their own growth CO₂ . C_a elevation reduced the total leaf N in the canopy (N_leaf ) but had no effect on LAI, and the average leaf N content (N_leaf /LAI) was therefore reduced by 8%. This reduction corresponded well with our model predictions. Leaf area index increased strongly with N availability, which was also consistent with our model. •  Calculated canopy photosynthesis increased more strongly with N_leaf under elevated than under ambient C_a . This indicates that there is an N × C_a interactive effect on canopy carbon gain. This interaction was caused by the increase in LAI with N availability, which enhanced the positive effect of the higher quantum yield under C_a elevation.

Low grade malignant peripheral nerve sheath tumour: varied cytological and histological patterns

BACKGROUND

A small number of malignant peripheral nerve sheath tumours (MPNSTs) are low grade, and the nature of these low grade tumours has never been systematically assessed.

AIMS

To describe the clinicopathological, immunohistochemical, and ultrastructural features of low grade MPNST and to discuss the main differential diagnoses.

METHODS

Four cases of low grade MPNST were studied, including one coexistent with neurofibromatosis type 1. The tumours were analysed with respect to nuclear atypia, cellularity, nuclear enlargement, hyperchromasia, mitotic rate, and necrosis. Immunohistochemistry was performed by standard techniques, and an ultrastructural study was performed on one tumour.

RESULTS

The ages of the patients ranged from 32 to 72 years (mean, 58). Two were male and two were female. Three tumours occurred in the deep tissue, including one in the retroperitoneum, and one was located in the dermal and subcutaneous tissue. The maximum diameters of the tumours ranged from 3.5 to 8.0 cm. Microscopically, all tumours showed moderate hypercellularity, an increased nuclear to cytoplasmic ratio, and hyperchromasia, but exhibited varied growth patterns, including those that were atypical neurofibroma-like, low grade fibromyxoid sarcoma-like, low grade epithelioid, and haemangiopericytoma-like. All tumours showed immunoreactivity for S-100 protein and vimentin.

CONCLUSIONS

These findings suggest that careful clinical and histological evaluation, along with S-100 protein immunostaining, are essential for the accurate diagnosis of low grade MPNST.

Polarimetry of short-pulse gamma rays produced through inverse Compton scattering of circularly polarized laser beams

We have developed a polarimetry of ultrashort pulse gamma rays based on the fact that gamma rays penetrating in the forward direction through a magnetized iron carry information on the helicity of the original gamma rays. Polarized, short-pulse gamma rays of (1.1+/-0.2)x10(6)/bunch with a time duration of 31 ps and a maximum energy of 55.9 MeV were produced via Compton scattering of a circularly polarized laser beam of 532 nm off an electron beam of 1.28 GeV. The first demonstration of asymmetry measurements of short-pulse gamma rays was conducted using longitudinally magnetized iron of 15 cm length. It is found that the gamma-ray intensity is in good agreement with the simulated value of 1.0x10(6). Varying the degree of laser polarization, the asymmetry for 100% laser polarization was derived to be (1.29+/-0.12)%, which is also consistent with the expected value of 1.3%.

Expression of smooth muscle markers in so called malignant fibrous histiocytomas

AIMS

To obtain further information regarding the frequency and degree of positivity for smooth muscle markers in a large number of malignant fibrous histiocytomas (MFHs), as an aid to accurate diagnosis.

METHOD

The immunohistochemical features of 100 MFHs were studied and the results were compared with those for 30 leiomyosarcomas. Eighteen cases of MFH with smooth muscle actin (SMA) positivity were examined ultrastructurally.

RESULTS

Immunoreactivity for smooth muscle markers, such as desmin, SMA, muscle specific actin (MSA) and h-caldesmon (HCD), which is a specific marker for smooth muscle cells and their tumours, was found in 28, 30, 29, and 29 of 30 leiomyosarcomas. Immunoreactivity for desmin, SMA, MSA, and HCD was found in 17, 30, 14, and two of the MFHs. On electron microscopic examination, approximately half of the cases contained a varying proportion of myofibroblastic cells. The others had only fibroblastic or undifferentiated tumour cells. At least 30% of the cases were found to display features consistent with limited smooth muscle or myofibroblastic differentiation.

CONCLUSION

A large subset of so called MFH in fact shows poorly differentiated smooth muscle or myofibroblastic features, and perhaps such tumours should be regarded as pleomorphic leiomyosarcomas and/or pleomorphic myofibroblastic sarcomas.

Cohesive acceleration and focusing of relativistic electrons in overdense plasma

We describe our studies of the generation of plasma wake fields by a relativistic electron bunch and of phasing between the longitudinal and transverse fields in the wake. The leading edge of the electron bunch excites a high-amplitude plasma wake inside the overdense plasma column, and the acceleration and focusing wake fields are probed by the bunch tail. By monitoring the dependence of the acceleration upon the plasma's density, we approached the beam-matching condition and achieved an energy gain of 0.6 MeV over the 17 mm plasma length, corresponding to an average acceleration gradient of 35 MeV/m. Wake-induced modulation in energy and angular divergence of the electron bunch are mapped within a wide range of plasma density. We confirm a theoretical prediction about the phase offset between the accelerating and focusing components of plasma wake.

Observation of incoherent diffraction radiation from a single-edge target in the visible-light region

An experiment to investigate the diffraction radiation from a single edge target has been performed at the accelerator test facility of KEK with the aim of developing noninvasive beam diagnostics. The yield and the angular distribution of diffraction radiation as a function of the impact parameter was measured in the visible light region. The distributions were qualitatively consistent with the theoretical expectation. This work exhibits the first observation of the incoherent diffraction radiation in the visible light region.

Muscle fibre composition and electromyographic features of cervical muscles following prolonged head extension in growing rats

Soft tissue stretching has been proposed as one of the control factors in craniofacial morphogenesis. However, its mechanism remains unclear. The present study investigated electromyographic (EMG) activity and muscle fibre composition of cervical muscles following prolonged head extension in growing rats. Thirty-six male Wistar rats were divided into two experimental (E1, E2) and one control (C) group at 25 days of age. To induce head extension, the experimental rats were raised in cylindrical cages, which were positioned horizontally for group E1 and tilted upward at 45 degrees for group E2. At 55 days of age, EMG activity was recorded from the anterior digastricus (AD), sternohyoideus (SH), sternomastoideus (SM), longus capitis (LC), and biventer cervicis (BC) muscles in the rest position and passive head extension. EMG activity was analysed on its integrated values (IEMG), and composition of muscle fibres was evaluated by myosin ATPase reaction and fibre cross-sectional areas were calculated. Group E1 showed a higher percentage of type I fibres and lower IEMG during passive head extension in AD. In group E2 there was a higher percentage of type I fibres, a higher IEMG at rest, and a lower IEMG during passive head extension in BC. The experimental groups demonstrated altered proportions of type IIA and IIB fibres in SM and LC. They also showed higher percentages of subtype fibres and reduced cross-section areas of type II fibres in most of the muscles investigated. These findings suggest that head extension affects fibre transition, distribution, cross-section area, and recruitment pattern in cervical muscles.

Suppression of bone resorption by madindoline A, a novel nonpeptide antagonist to gp130

IL-6 is a multifunctional cytokine involved in regulation of differentiation, antibody production, and growth of certain types of tumor cells. Its excessive production plays a major role in pathogenesis of multiple myeloma and postmenopausal osteoporosis. In the course of a screening program aimed at IL-6 inhibitor from microbial products, we found madindoline A (MDL-A) and madindoline B, which have a fuloindoline structure with diketocyclopentene bound to the methyl group. MDL-A has no cytotoxic activities. It inhibited only activities of both IL-6 and IL-11 without affecting the IL-6-specific signal transduction cascade, JAK2/STAT3. In a dose-dependent manner [(3)H]MDL-A binds to gp130, which is a signal transducing 130-kDa glycoprotein, but formation of the trimeric complex IL-6/IL-6 receptor/gp130 was not inhibited, suggesting that MDL-A suppresses dimerization of trimeric complexes. Not only did MDL-A markedly inhibit IL-6- and IL-11-induced osteoclastogenesis in vitro, but it also inhibited IL-6-stimulated serum amyloid A production and bone resorption in an experimental model of postmenopausal osteoporosis in vivo by a different mechanism from that of 17beta-estradiol. Here we show that MDL-A has a highly selective inhibitory effect on IL-6 and IL-11 activities by inhibiting a gp130 activity while suppressing bone loss in ovariectomized mice. MDL-A is anticipated as a lead compound for treatment of hormone-dependent postmenopausal osteoporosis, which has no serious side effects, and as a new mechanism of action, gp130 blocking.

The first large-scale nucleic acid amplification testing (NAT) of donated blood using multiplex reagent for simultaneous detection of HBV, HCV, and HIV-1 and significance of NAT for HBV

The first nationwide nucleic acid amplification testing (NAT) for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus type 1 (HIV-1) of voluntarily donated blood after serological pre-screening and before release of cellular components and plasma for fractionation was implemented by the Japanese Red Cross Blood Transfusion Services. From February 1, 2000 to April 30, 2001, specimens from 6,805,010 units of serologically negative donation were screened in minipools of 50 samples within 24 hr after blood donation by NAT using multiplex HBV/HCV/HIV-1 reagent for blood transfusion including short shelf-life platelets. Among them, 112 HBV DNA-positives, 25 HCV RNA positives and 4 HIV-1 RNA positives were screened out and we could prevent transfusion of these NAT positive units. Subtypes/genotypes of HBV DNA, adr/C, adw/A, adw/B, adw/C, ayr/C and ayw/D were found and adr/C was predominant. A total of 61.6 % of them (69/112) were negative by overnight EIA. Sixth three of HBV NAT-positive samples carried virus loads less than 10(4) copies/mL and 92.1 % of them (58/63) were negative by overnight EIA. The virus growth curves of HBV in 6 cases obtained by retrospective and prospective follow-up study showed exponential straight lines in the early stage of serological window periods and the log times of HBV growth (10 fold increase) in serological window period were between 4.6 and 7.6 days. NAT screening with highly sensitive reagents in pool of specimens is useful to exclude blood units with low level of HBV and HBV mutants from blood transfusion.

Short total synthesis of (+)-madindolines A and B

[reaction: see text] A short and efficient total synthesis of (+)-madindolines A (1) and B (2), potent and selective inhibitors of interleukin 6, has been achieved. The synthesis features a key chelation-controlled 1,4-diastereoselective acylation to generate the quaternary carbon and an intramolecular acylation of allylsilane to build up the cyclopentene unit.

Lipomatous primitive neuroectodermal tumor with a glioblastoma component: a case report

A case of extracerebellar lipomatous primitive neuroectodermal tumor (PNET) with glioblastoma multiforme (GBM) areas is reported. A 44-year-old woman who had been on antipsychotic agents for schizophrenia complained of hemiparesis and drowsiness. She deteriorated progressively and died 3 months later. The autopsy revealed a huge, ill-defined tumor located from right basal ganglia to brain stem. Microscopically, the tumor consisted of three distinct components: clusters of small primitive cells consistent with PNET, mature lipoma-like islands, and a GBM-like component. Neuronal differentiation in PNET areas was confirmed by the presence of Homer Wright rosette, synaptophysin-positive fibrillary background, and ultrastructural demonstration of neuritic processes. Lipoma-like areas composed of lipidized cells containing large lipid droplets were intimately intermingled and closely related with PNET areas. Furthermore, GBM areas were, although predominantly located in the brain stem, often blended with the previous two components. This component was characterized by glial fibrillary acid protein immunoreactivity of atypical tumor cells and the presence of necrosis and endothelial proliferation. PNET areas with lipomatous differentiation in the present tumor may suggest the morphological and histogenetic similarity to liponeurocytoma, although the neuronal element in the former was anaplastic. The association with a GBM component makes the present tumor a unique, and, to our knowledge, previously unrecognized lesion.

Angiosarcoma of the breast: report of a case and its findings of MRI

A 67-year-old woman with angiosarcoma of the left breast is presented. Physical findings showed a hard mass in the left breast with skin discoloration and erythema. Mammography showed a high density shadow in the mass without microcalcification and spicula. On ultrasonography, a hypoechoic mass with an ill-defined boundary was detected. On MRI, the tumor had low signal intensity on T1-weighted images, and higher signal intensity on T2-weighted images. MRI with Gd-DTPA images showed higher signal intensity on T1-weighted images with relatively lower intensity in the central area of the tumor. The artery supplying the tumor derived from the left inner thoracic artery and was visualized on three-dimensional dynamic MRI angiography. Initially misdiagnosed as inflammatory breast cancer, an arterial injection of CPA (100 mg) and 5-FU (500 mg) had been performed preoperatively. The definitive diagnosis of angiosarcoma was established by intraoperative frozen section examination. She underwent modified radical mastectomy and is now free of recurrence. This case emphasizes the difficulties in the clinical diagnosis of angiosarcoma of the breast.