CagA protein secreted by the intact type IV secretion system leads to gastric epithelial inflammation in the Mongolian gerbil model

Helicobacter pylori causes various gastro-duodenal diseases, including gastric cancer. The CagA protein, an H. pylori virulence factor, induces morphological changes in host cells and may be associated with the development of peptic ulcer and gastric carcinoma. The present study has analysed the role of CagA protein in the pathogenesis of H. pylori infection in the Mongolian gerbil model. Mongolian gerbils were challenged with wild-type H. pylori strain TN2, which has a functional cag pathogenicity island or isogenic mutants with disrupted cagA (DeltacagA) or cagE (DeltacagE) genes. They were sacrificed at 7, 13, and 25 weeks after inoculation. Pathological changes of the gastric mucosa were determined and apoptosis was assessed by the TUNEL assay. Immunohistochemistry for PCNA, phospho-IkappaBalpha, and phospho-Erk was also performed. All of the bacterial strains colonized the gerbil stomach at similar densities; however, the DeltacagA mutant induced milder gastritis than did the wild type. The extent of apoptosis and lymphoid follicle formation in the epithelium appeared to depend on intact cagA. The DeltacagA mutant induced less phosphorylation of IkappaBalpha and Erk, and less expression of interferon-gamma and interleukin-1beta mRNA in the epithelium than did the wild type. It is concluded that CagA protein may be essential for the induction of severe gastritis in the Mongolian gerbil model.

Cutaneous infiltration with Waldenström macroglobulinemia

A 59-year-old Japanese man was diagnosed as Waldenström macroglobulinema. With impaired general performance and a 2-year history of pruritic eruptions that were initially confined to the forearms, but later involved the face, limbs, and trunk. A skin biopsy that was performed on the forehead showed infiltration with abnormal cells of the dermis around the central vessels. PCR analysis of the skin biopsy showed immunoglobulin heavy chain rearrangement. As the rearrangement band occurred at the same site as that of the bone marrow aspiration, skin infiltration with abnormal cells was proven.

Chorioretinal temperature monitoring during transpupillary thermotherapy for choroidal neovascularisation

AIMS

To investigate the difference in temperature rise between normal choroid and choroidal revascularisation (CNV) during transpupillary thermotherapy (TTT) and the relation between laser spot size and power in the rat fundus.

METHODS

A modified slit lamp, which was installed with two laser wavelengths (490 nm for illumination and fluorescein excitation and 810 nm for hyperthermia), was developed for TTT and temperature monitoring. Temperature rise during TTT was monitored by observing fluorescence released from thermosensitive liposomes encapsulating carboxyfluorescein. Two types of liposomes were prepared; their phase transition temperatures were 40 degrees C and 46 degrees C, respectively. Laser power settings required to observe fluorescence released from 46 degrees C liposome in normal choroid or CNV were compared. Next, the power settings with 0.5 mm and 0.25 mm spot sizes were compared following administration of 40 degrees C liposome or 46 degrees C liposome.

RESULTS

The minimum power values when release from 46 degrees C liposome was observed showed a significant difference in distribution of power values between normal choroid and CNV. CNV required significantly higher power than normal choroid. With 40 degrees C liposome, the power was 9.7 (1.9) mW (mean (SD)) at a spot size of 0.25 mm, and 12.1 (1.6) mW at 0.5 mm, respectively. When using 46 degrees C liposome, the power setting was 10.2 (1.2) mW at a spot size of 0.25 mm, and 14.6 (2.2) mW at 0.5 mm, respectively.

CONCLUSIONS

CNV demonstrated varying heat conduction, compared with normal choroid. Laser power required to raise the temperature should not necessarily be doubled, even when the spot size is doubled. Close attention should be given to the selection of power settings when performing TTT for CNV.

Memory retention of vestibuloocular reflex motor learning in squirrel monkeys

The vestibuloocular reflex (VOR) motor learning can be induced chronically by wearing lenses for several weeks to months, or acutely by visual-vestibular mismatch for several hours. Cerebellar long term depression (LTD) has been proposed as a causal mechanism for acute learning. We demonstrate differences in retention of acutely and chronically acquired VOR gains in squirrel monkeys and discuss neuronal correlates and possible roles of cerebellar LTD. Our data is compatible with the idea that cerebellar LTD might be a mechanism responsible for acute VOR adaptation.

Painful Schmorl's node treated by lumbar interbody fusion

STUDY DESIGN

A case report of painful lumbar Schmorl's node is presented.

OBJECTIVE

To describe diagnostic evidence and the result of surgical treatment of a rare case of painful Schmorl's node.

SETTING

Niigata, Japan.

CASE REPORT

A 55-year-old housewife was diagnosed with painful Schmorl's node of L3 by discography, which depicted leakage of the contrast medium into the L3 vertebra through a disruption of the central part of the cranial end plate with concomitant back pain. Segmental fusion surgery was performed. Mechanical low back pain of the patient improved just after surgery. Histologic examination demonstrated that fibrocartilaginous tissue herniated through a disruption of the superior end plate and forced into the vertebral spongiosa.

CONCLUSIONS

Painful Schmorl's node can be diagnosed by discography, which demonstrates an intravertebral disc herniation with concomitant back pain. Surgical treatment should be considered in a patient with persistent disabling back pain. When surgical treatment is indicated, eradication of the intervertebral disc including Schmorl's node and segmental fusion are preferable.

Congenital pulmonary-systemic collateral vein without obstructed left atrial egress is associated with conotruncal anomalies

We present a case of congenital pulmonary systemic collateral vein associated with truncus arteriosus. Pulmonary systemic collateral vein with nonobstructed left atrial egress is different from those with obstructed left atrial egress in that it is functionally redundant. Including this case, 8 patients among 33 reported cases with pulmonary systemic collateral veins have had nonobstructed left atrial egress. Association with conotruncal anomalies in 4 of these 8 patients, as well as the reported finding that neural crest cells are distributed not only in the conotruncus but also in the cardinal vein, indicates that neural crest cells play roles in remodeling of the systemic venous system.

Tomatoes have natural anti-thrombotic effects

The prevention of arterial thrombotic diseases has a high priority in developed countries. An inappropriate diet may be an important risk factor for thrombotic events. The daily intake of an anti-thrombotic diet may offer a convenient and effective way of prevention. The aim of the present study was to test tomato extracts for anti-thrombotic effects and to identify those varieties that have such an effect. A shear-induced platelet-function test (haemostatometry) was used to test anti-thrombotic potential in vitro. Extracts from those tomato varieties that showed a significant anti-thrombotic activity in vitro were further assessed in vivo, using a laser-induced thrombosis test in mice. One tomato variety (KG99-4) showed significant anti-thrombotic activity both in vitro and in vivo. KG99-4 inhibited not only platelet-rich thrombus formation but also had a thrombolytic effect. It is concluded that haemostatometry can detect and classify the anti-thrombotic potential of fruits and vegetables and offers a simple way of screening for such effects.

A primary retroperitoneal serous cystadenocarcinoma with clinically aggressive behavior

CASE REPORT

We describe a 44-year-old woman with a primary retroperitoneal serous cystadenocarcinoma as the fourth report in the world literature. A contrast-enhanced computed tomographic scan of the abdomen demonstrated a mass with enhanced solid mural nodules and septa in the left retroperitoneum. Serum CA19-9 was elevated at 181 U/ml. The patient underwent a complete resection of the retroperitoneal tumor with a partial resection of the psoas major muscle and its fascia. Pathological examination showed a well-differentiated papillary serous cystadenocarcinoma of ovarian type and locoregional lymph node metastases. Seven months after surgery, the patient developed a pelvic recurrence, and underwent a total hysterectomy, a left salpingo-oophorectomy and a resection of the metastatic mesenteric mass. Two months after the second surgery, serum CA19-9 and CA125 increased to 1,114 U/ml and 218 U/ml, respectively. A solitary liver metastasis was confirmed on a computed tomographic scan. The patient is now being treated with weekly docetaxel and carboplatin.

CONCLUSION

The present case illustrates the clinically aggressive nature of a primary retroperitoneal serous cystadenocarcinoma.

Fundamental physio-mitotic theory

In differentiation division, the mitosis occurring within all tissues consists of more than one type of mitosis. It occurs as two antagonistic types: the essential duplication mitosis activated by the effect of duplication factor and the antagonistic maturation mitosis which develops from the essential type and is further stimulated by maturation factor. These different types of mitosis play antagonistic roles in histological development, while maintaining a specified physio-mitotic balance through their respective mitotic factors and mitotic regulatory mechanisms in the tissues. Depending on the physio-mitotic balance between duplication and maturation mitosis, each layer of organized tissue, comprised of intrinsic functional cells, differentiates from one of the three germ layers, without errors that create abnormal characteristics. In this way, the tissues establish histological identity and continuity while maintaining a prescribed histological organization without excess or reduced multiplication within the tissues. This forms the fundamental basis of the physio-mitotic theory.

Left innominate vein-pulmonary artery shunt with Glenn anastomosis in a Fontan candidate with central pulmonary artery stenosis

Heart failure developed 9 years after Fontan takedown with systemic-pulmonary artery shunt in a 12-year-old girl with pulmonary atresia, intact ventricular septum, and obstruction in the proximal pulmonary artery. Surgical scar after multiple operations complicated direct repair of the pulmonary artery, and thus she was not eligible for definitive palliation. Left innominate vein-to-left pulmonary artery shunt using an expanded polytetrafluoroethylene conduit in association with Glenn anastomosis functionally established an unobstructive superior cavopulmonary connection without direct repair of the central pulmonary artery, later facilitating one and a half ventricle repair. Use of an extraanatomical shunt may functionally relieve central pulmonary artery obstruction in candidates for Fontan-like circulation.

[Report on the ECR2003 (European Congress of Radiology): non-contrast intracranial MR venography with 3D-phase contrast imaging: optimization of presaturation pulse and velocity encoding]

BACKGROUND

Intracranial MR venography is useful for the diagnosis of dural sinus thrombosis and the preoperative assessment of sinus patency encased by tumors. Recently, contrast-enhanced MR venography has been applied for suspected dural sinus occlusion in a shorter time. However, it has some disadvantage for the evaluation of hypervascularized enhancing thrombus mimicking flow in chronic sinus thrombosis. So far, we have evaluated optimal imaging technique and slice orientation and have shown that sagittal three-dimensional (3D) -phase contrast (PC) imaging is the most suitable for the non-contrast intracranial MR venography.

PURPOSE

To assess the optimal presaturation pulse (SAT) and velocity encoding (VENC) for the non-contrast intracranial 3D-PC MR venography.

METHODS AND MATERIALS

Firstly, we performed phantom experiment to assess the best SAT thickness using arterial presaturation. Second, MR imaging was performed in 7 healthy volunteers to measure the dural sinus flow velocity using a 1.5 T MR. Third, 3D-PC MR venography was performed with a VENC settings at 10, 15, 20 and 30 cm/sec for healthy volunteers. All data were displayed as maximum intensity projection images and three neuroradiologists assessed the visibility of the dural sinuses and the cortical vein.

RESULTS

The mean flow velocity of the dural sinuses was 6.3 cm/sec. The thickness of the best SAT was 100 mm. In the assessment of the visibility of the 3D-PC images, dural sinuses were adequately visualized at a VENC of 15 cm/sec.

CONCLUSIONS

Non-contrast intracranial 3D-PC MR venography was optimized at 100mm thickness of SAT and a VENC of 15 cm/sec.

Intravenous gene therapy for familial hypercholesterolemia using ligand-facilitated transfer of a liposome:LDL receptor gene complex

Familial hypercholesterolemia (FH) is an autosomal dominant disorder because of a mutation in the low-density lipoprotein receptor (LDLR) gene. Although lowering plasma cholesterol decreases the risk of coronary artery disease, FH patients respond poorly to pharmacologic treatment. Transferrin-facilitated intravenous transfer of a cationic liposome rabbit LDLR cDNA complex alleviated hypercholesterolemia in Watanabe Heritable Hyperlipidemic Rabbits (WHHL), an animal model of FH. Intravenous treatment dose dependently decreased plasma total and LDL cholesterol levels, correlating with an increased level of LDLR mRNA transcripts in leukocytes. Transferrin-facilitated intravenous delivery of cationic liposome LDLR gene complexes could serve as an important adjunct therapy for the treatment of FH.

Successful treatment by spinal cord stimulation for gait disturbance in a patient with diffuse axonal injury

The authors present a case of diffuse axonal injury (DAI) treated by cervical spinal cord stimulation (C-SCS) for gait disturbance. The patient had right hemiparesis of moderate degree, mild ataxia, ideational apraxia and gait disturbance, when admitted to our hospital for rehabilitation. He could not walk by himself, nevertheless neurorehabilitation was done for four months. Xenon-CT was examined by C-SCS loading and the changes of regional cerebral blood flow were significantly increased in both hemispheres, especially in the thalamus. C-SCS was performed continuously on condition of 25 Hz, 200 microsec and 0.5 V, daily for a month. Neurological deficits, especially gait disturbance due to ideational apraxia, were gradually improved after initiation of C-SCS, and the patient could walk by himself. We speculate that C-SCS played a role in triggering improvement of gait disturbance at the chronic stage in our case, and SCS may be helpful for neurorehabilitation of focal symptoms after DAI.