AI Beam Angle Prediction in Proton Therapy for Brain Patients

PURPOSE/OBJECTIVE(S)

Patients receiving brain Intensity-modulated Proton Therapy (IMPT) are treated with 1-3 fields. Typically, beam angles must be selected manually, requiring substantial planner time and experience. The choice of beam angles has a major impact on the treatment plan quality. An AI model was developed to automate this process aiming to improve efficiency and potentially plan quality. AI performance was tested by comparing predicted beam angles to the human ground truth angles and evaluating plans resulting from each set of beam angles.

MATERIALS/METHODS

Previously treated IMPT brain patients were divided into a training (n = 40) and validation set (n = 10) for the AI. Beam-angle selection in the AI was cast as a multi-label classification problem, training the convolution neural network with a Circular Earth Mover's Distance based regularization and multi-label circular-smooth label technique. An analytical post-processing algorithm is employed to minimize distance to the target and avoid organs-at-risk. Finalized gantry angle predictions are discretized in steps of 5°. For an independent test set of n = 10 patients beam angles were predicted by the AI and compared to those chosen by human planners. Both sets of angles were used to create treatment plans with an automated knowledge-based planning (KBP) tool for brain IMPT utilizing single-field optimization and robust optimization. Plan differences are therefore solely due to the choice of beam angles as automated KBP removes human optimization variability. Resulting plan quality was compared by standard clinical dosimetric parameters to the CTV, brain, brainstem, cochlea, cord, eye, lens, optic chiasm, optic nerves, pituitary, and temporal lobes.

RESULTS

All Human and AI selected beam angles are shown in the table. For cases 1-6, AI and Human selected beam angles were within ±15° and resulting plans showed minimal dosimetric differences. In cases 7-9 AI beam angles reduced max dose while keeping organ-at-risk dose within ±2 Gy. In case 10 the AI chosen beam angles reduced cord Dmax by 9.1 Gy but increased left eye Dmax by 4.9 Gy, other organs-at-risk showed minimal differences.

CONCLUSION

Gantry beam angle selection was automated by a newly developed AI model and tested on 10 brain IMPT patients. The comparison showed that the AI often chooses similar beam angles to the human planners. When there are differences, dosimetric analysis demonstrated that plans created from AI beam angles have at least the same quality as the human ones. Results motivate further research into this approach showing the AI being a promising tool to fill a current gap in the strive for automating proton treatment planning, increasing planning efficiency and potentially quality.

Pedagogically fast model to evaluate and optimize passively Q-switched Nd-doped solid-state lasers

The coupled rate equations with the spatial overlap effect for four-level passively Q-switched lasers are fully considered. A transcendental equation is derived for the residual fraction of the inversion density after the finish of the Q-switched pulse. Comprehensive calculations for the transcendental equation were executed to attain an analytical function for precisely fitting the residual fraction of the inversion density. With the fitting function, a pedagogical model with the correction for high output coupling is developed to straightforwardly analyze the output pulse energy and peak power. Detailed experiments are carried out to validate the model.

Propagation-dependent evolution of interfering multiple beams and kaleidoscopic vortex lattices

In this Letter, we experimentally explore the propagation-dependent evolution of generating the pseudo-nondiffracting quasi-crystalline (crystalline) beams based on the multibeam interference. We originally derived an analytical formula to exactly manifest the propagation evolution of interfering multiple beams. With the analytical formula, the formation of quasi-crystalline structures in the focal plane can be explicitly verified. Furthermore, the distance of the effective propagation-invariant region can be verified in terms of experimental parameters. More importantly, we employed the developed formula to confirm the formation of kaleidoscopic vortex lattices by means of numerically computing the propagation-dependent phase singularities.

Novel and traditional anthropometric indices for identifying arterial stiffness in overweight and obese adults

BACKGROUND

Obesity and arterial stiffness are both independently associated with cardiovascular risk. New anthropometric indices can better reflect abdominal obesity than traditional anthropometric indices. Thus, we hypothesized that compared with conventional parameters, these newly developed anthropometric parameters were more accurate to identify arterial stiffness among overweight and obesity population.

METHODS

Cross-sectional data on socio-demographic, lifestyle, clinical characteristics and biochemical measurements were collected for 1442 Chinese obese and overweight adults. Six anthropometric indices including a body shape index (ABSI), body mass index (BMI), ABSI combined with BMI, body roundness index (BRI), waist circumference and waist-to-hip ratio were calculated. Carotid-femoral pulse wave velocity (cf-PWV) was detected in all subjects. Meanwhile, visceral fat area (VFA) was quantificationally measured by CT. Partial Spearman correlation coefficients were used to clarify the association between anthropometric measures with cf-PWV. Logistic regression analyses were used to identify to the association between anthropometric measures and arterial stiffness.

RESULTS

After adjusting for covariates, BRI had the strongest correlation with cf-PWV and VFA in all anthropometric indices. Multivariate regression analysis showed VFA (β = 0.322, p < 0.001) and BRI (β = 0.307, p < 0.001) remained independently associated with cf-PWV. BRI had a highest odds ratios in all anthropometric indices (OR = 1.543, p < 0.001). ABSI only displayed a weak correlation with arterial stiffness. Meanwhile, BRI had the highest area under curve for abnormal cf-PWV, and the optimum cutoff value was a BRI ≥5.4.

CONCLUSION

BRI was found to have a close relationship with arterial stiffness in overweight and obesity people. However, ABSI was weakly correlated with arterial stiffness, but not better than traditional anthropometric indices.

The feasibility of two anthropometric indices to identify metabolic syndrome, insulin resistance and inflammatory factors in obese and overweight adults

OBJECTIVES

A body shape index (ABSI) and body roundness index (BRI) were reported to predict diabetes and hypertension in general population, but their validity was regularly questioned. The aim of this study was to evaluate whether ABSI and BRI are the best anthropometric indices to reflect metabolic syndrome (MetS), insulin resistance (IR), and inflammatory factors in obese and overweight Chinese adults.

METHODS

Cross-sectional data on sociodemographic, lifestyle, anthropometric indices, clinical characteristics, and biochemical measurements were collected for 1442 Chinese obese and overweight adults. Logistic regression analysis examined the associations between anthropometric indices with incidences of MetS and IR in both sexes. Furthermore, the correlation between anthropometric indices and inflammatory factors was assessed.

RESULTS

Multivariate regression analysis depicting BRI and waist circumference (WC) were associated significantly with MetS and IR. BRI had the highest odds ratios (ORs) for IR and WC had the highest ORs for MetS in all anthropometric indices. However, ABSI did not exhibit any association between the MetS and IR. The ABSI adjusted regression coefficients (β values) were 0.403 for high-sensitivity C reactive protein, 0.077 for tumor necrosis factor-α, and 0.022 for interleukin-6. BRI and WC were also significantly associated with three inflammatory factors. Comparing the lowest with the highest quintile, BRI had the largest ORs for MetS (OR, 5.778; 95% confidence interval [CI], 2.954-11.303; P < 0.01) and IR (OR, 6.212; 95% CI, 2.912-13.250; P < 0.01).

CONCLUSION

Only BRI and WC, not ABSI, can significantly determine the presence of MetS and IR. BRI showed the optimal capability to identify IR in obese and overweight population.

Small dense low density lipoprotein-cholesterol and cholesterol ratios to predict arterial stiffness progression in normotensive subjects over a 5-year period

BACKGROUND

Small dense low density lipoprotein-cholesterol (sdLDL-C), cholesterol ratios and carotid-femoral pulse wave velocity (cf-PWV) impart risk for all-cause morbidity and mortality independently of conventional cardiovascular disease (CVD) risk factors. This study was designed to identify feasible indicators for predicting arterial stiffness progression.

METHODS

We followed up 816 normotensive participants without diabetes or CVD for nearly 5.0 years. Cholesterol parameters, ratios and other clinical and laboratory data were collected at baseline. cf-PWV were measured at baseline and the end of follow-up.

RESULTS

PWV progression subjects had higher levels of PWV parameters, sdLDL-C and TG/HDL-C ratio. sdLDL-C and TG/HDL-C were significantly correlated with all PWV parameters. Multiple regression models showed that sdLDL-C was closely associated with follow-up PWV (β = 0.222, p < 0.001) and △PWV (β = 0.275, p < 0.001). TG/HDL-C was only one cholesterol ratios that associated with all PWV parameters. sdLDL-C (OR = 2.070, 95%CI: 1.162 to 3.688, p = 0.014) and TG/HDL-C (OR = 1.355, 95%CI: 1.136 to 1.617, p = 0.001) could significantly determine the progression of PWV after correction for covariates. High sd-LDL-C quantiles subjects were more likely to develop arterial stiffness progression than low quantiles (Tertiles 3 vs Tertiles1, RR = 2.867, 95%CI: 1.106 to 7.434, p = 0.03).

CONCLUSION

We founded that sdLDL-C and TG/HDL-C ratio can independently predict arterial stiffness progression in normotensive subjects, and high level sdLDL-C and TG/HDL-C ratio were associated with a higher risk of arterial stiffness.

Emergence of a sylvatic enzootic formosan ferret badger-associated rabies in Taiwan and the geographical separation of two phylogenetic groups of rabies viruses

Taiwan had been declared rabies-free in humans and domestic animals for five decades until July 2013, when surprisingly, three Formosan ferret badgers (FB) were diagnosed with rabies. Since then, a variety of wild carnivores and other wildlife species have been found dead, neurologically ill, or exhibiting aggressive behaviors around the island. To determine the affected animal species, geographic areas, and environments, animal bodies were examined for rabies by direct fluorescent antibody test (FAT). The viral genomes from the brains of selected rabid animals were sequenced for the phylogeny of rabies viruses (RABV). Out of a total of 1016 wild carnivores, 276/831 (33.2%) Formosan FBs were FAT positive, with occasional biting incidents in 1 dog and suspected spillover in 1 house shrew. All other animals tested, including dogs, cats, bats, mice, house shrews, and squirrels, were rabies-negative. The rabies was badger-associated and confined to nine counties/cities in sylvatic environments. Phylogeny of nucleoprotein and glycoprotein genes from 59 Formosan FB-associated RABV revealed them to be clustered in two distinct groups, TWI and TWII, consistent with the geographic segregation into western and eastern Taiwan provided by the Central Mountain Range and into northern rabies-free and central-southern rabies-affected regions by a river bisecting western Taiwan. The unique features of geographic and genetic segregation, sylvatic enzooticity, and FB-association of RABV suggest a logical strategy for the control of rabies in this nation.

[Analysis of malignancy of human brain glioma with silver colloid-staining technique]

The nucleolar organizer regions are loops of DNA that exist in cellular nucleolus and possess ribosomal ribonucleic acid genes. Ribonucleic acid polymerase I acts on these areas. This experience collects 52 primary human gliomas at TSGH from 1984 to 1989. These included 23 astrocytomas, 8 anaplastic astrocytomas and 21 glioblastoma multiforms. After thin cutting on slides and deparaffinizing, we stained each by the silver colloid technique. We counted the total quantity of Ag-NOR dots of over 400 tumor cells of each case and average of Ag-NOR dots per cell (+/- standard error of the mean) with X1000 oil lens. The results are 1.68 +/- 0.05, 2.00 +/- 0.10; 2.55 +/- 0.13 respectively, showing significant differences among these. The average Ag-NOR paralleled the degree of histopathological malignancy. With the average Ag-NOR of tumor cells to predict the patients prognosis, we found that the group containing patients with less than 2.00 Ag-NOR per cell had better prognosis than the group with 2.00 Ag-NOR or more. The silver colloid-staining technique is a simple, rapid and reproducible method to evaluate the malignancy of human brain gliomas and to estimate the long-term prognosis of patients.

Lupus nephritis, emphasizing tubulointerstitial lesions: a clinico-pathological analysis

Tubulointerstitial lesions (TIL) such as interstitial inflammation, fibrosis and tubular atrophy are frequently found in classes of lupus nephritis. A retrospective study evaluate lupus nephritis, the relationship between TIL and glomerular lesions, and the significance of TIL in assessing the severity and prognosis for cases of lupus nephritis. Between June 1983 and Jan 1990, 492 renal biopsies were performed. Lupus nephritis was diagnosed in 37 patients who fulfilled the American Rheumatology Association (ARA) criteria for Systemic lupus erythematosus (SLE). The results showed a significant correlation between degree of TIL and impairment of renal function. Degree of TIL and severity of glomerular lesions must be considered simultaneously to predict renal function of patients with lupus nephritis.

Carcinoid tumor localized in the liver--two cases report: immunohistochemical and ultrastructural studies

Two cases of carcinoid tumors, considered to be probably hepatic in origin, occurring in a 53-year-old man and a 69-year-old woman are reported. In both cases no endocrine syndrome appeared, and an alternative primary source of the tumor was not found in case two, despite an intensive search at operation. The neoplasms in both cases were soft, firm, brown-pink and well-encapsulated. They were composed of small uniform cells, that had distinct borders and grew in insular, nests, trabeculae and strands that were separated by a delicate fibrous stroma. Stains of argentaffin and argyrophil showed strong positivity in both cases. The immunohistochemical and ultrastructural studies all demonstrated characteristics of a carcinoid. The postoperative recovery was good. They have remained well 5 years later in case 1 and 3 years in case 2 after surgical treatment. Literature concerning this rare condition is also reviewed.

Scanning electron microscopic study of three glioblastoma multiforme (GBM) cell lines of the Chinese brain in vitro and in vivo

Three permanent glioblastoma multiforme (GBM) cell lines have been successfully established and characterized from the Chinese brain GBM tumors. The tumorigenicity in the athymic nude mice with multiple pulmonary metastases are observed. The scanning electron microscopic examinations reveal numerous surface microvilli and blebs of various size on the primary GBM tumors, the cultured tumor cells in vitro and the xenografted tumor cells in the nude mice in vivo. The distinct ultrastructural features of stellate cultured cells with astrocytic-differentiation after db-cAMP treatment of 96 hours show many intermittent dilations (pseudopods) along the long cytoplasmic processes. The intermittent dilatations and growth cones also express strongly positive immunostaining for GFAP. The growth inhibition of db-cAMP treated, cultured in vitro tumor cells is also observed. We are convinced that the continuous, established cell lines and tumorigenicity in the athymic nude mice may constitute the best reliable in vitro and in vivo systems for the investigation of human brain GBM.

Small cell lung carcinoma: clinicopathological, immunohistochemical, and ultrastructural study

Sixty-seven cases of small cell lung carcinoma (SCLA) in Tri-Service General Hospital (TSGH) during the past 16 years were studied. For patients with extensive stage of disease, the mean survival time and 2-year survival rate were 7.2 months and 3.1% versus 13.4 months and 16.7% for patients with limited stage. A better prognosis was obtained by treatment with a combination of intensive chemotherapy and radiotherapy. Immunohistochemical studies were performed by the peroxidase-antiperoxidase method. The positive rates in descending order were bombesin (80%), synaptophysin (74.3%), neurofilament (68.6%), neuron-specific enolase (60%), low molecular weight cytokeratin (54.3%), high molecular weight cytokeratin (25.7%), chromogranin-A (22.9%), adrenocorticotrophic hormone (0). Seven cases were examined and found to be ultrastructure; only 3 cases were found to contain neurosecretory granules. We emphasize that electron microscopy is not necessary as a routine diagnostic procedure, while light microscopy should be employed whenever possible; the immunohistochemical study should be considered within this context.

Focal glomerulosclerosis: a clinico-pathological analysis of 36 adult patients with idiopathic nephrotic syndrome

A retrospective study was conducted to determine the clinicopathological correlation of focal glomerulosclerosis in 36 adult patients with idiopathic nephrotic syndrome. All cases were divided into two groups, focal segmental glomerulosclerosis (FSGS, 23 cases) and focal global glomerulosclerosis (FGBG, 13 cases), on the basis of pathological findings. Most patients with FSGS were non-responsive/partial-responsive (22/22) to the corticosteroid treatment. By contrast, those with FGBG gave a relatively high responsive rate of 7/12 to the same therapy. The 5 non-responders with FGBG, however, were noted to have intensive interstitial fibrosis/mononuclear cell infiltrate of the renal lesions (4 cases), or diffusely glomerular Clq deposition without other coexisting immune deposits (1 case). Most cases of FSGS (20/23) became steroid dependent or remained heavy proteinuria resistant to corticosteroids/other immunosuppressive agents over a mean of 3.4 (ranged, 1 to 7) years after renal biopsy. Three of the 5 patients of FGBG initially non-responsive/partial-responsive to corticosteroids turned out to have protein-free urine (less than 4 mg/hr/m2) (2 patients) 1 month after leaving the hospital and became mildly proteinuric (1 patient) two months after discharge, respectively. The remainders of FGBG (10/13) were free of protein in their urine sample or had occasional episodes of proteinuria over a mean duration of 4.1 (ranged, 1 to 7) years. In addition, chronic renal insufficiency on discharge was noted in 2 cases of FSGS (2/23) and 1 case of FGBG (1/13). Only two cases of FSGS (2/23) progressed into a uremic status 3 and 5 years, respectively, after the time of the presumed clinical onset of their disease. These findings suggest that FGBG clinically behaves similar to a minimal change disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Congenital Letterer-Siwe disease with intrauterine fetal death: a case report and review of the literature

Letterer-Siwe disease is a rare proliferative disorder of the Langerhans cells, usually encountered inpatients under the age of 3 years. We present an unusual case of intrauterine fetal death at the 28th gestational week associated with generalized papular skin eruptions and systemic histiocytic infiltrates characteristic of Letterer-Siwe disease. Histopathologic features of Langerhans cells were further confirmed by immunocytochemistry and electron microscopy. The events occurring in pregnancy which may be worth mentioning are: (1) routine chest P-A view X-ray exposure of the mother 2 days before LMP, (2) the mother was exposed to certain Chinese herbs, in particular, the 101 hair growth solution (A Chinese herb mixture used for alopecia; contents unknown) from assisting her husband in topical applications, and (3) the mother has worked in front of computer monitors 8 hours a day for 10 years.

Inflammatory pseudotumor of the liver with occlusive endophlebitis: report of a case

Inflammatory pseudotumor (IPT) of the liver is an extremely rare benign tumor. Only 12 cases have so far been reported in the English literature. The etiology and pathogenesis of IPT remain obscure. We herein present an additional case of IPT of the liver with occlusive endophlebitis in a 36-year-old female. Immunohistochemical studies demonstrated the polyclonal nature of the plasma cells in the tumor, including IgA, IgM, IgG, kappa and lambda. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying malignant lesions.

Tumor localization of human brain malignant glioma xenograft in nude mice with a radiolabeled monoclonal antibody

A murine monoclonal antibody designated as MAb 3H9 (IgG1 subclass immunoglobulin, kappa light chain) expressed specific antibody binding activity to a human brain malignant glioma cell line (GBM8401/TSGH,NDMC) and many formalin-fixed and paraffin-embedded malignant gliomas that have been produced in our laboratory by hybridoma technology. The immunohistochemical indirect immunofluorescence, peroxidase-antiperoxidase assays, and specific electron microscopic immunogold staining revealed that 3H9 probably recognized a distinct glioma-associated surface antigen on the GBM8401 cultured cells. In vivo radioimmunolocalization of GBM8401 xenografts in nude mice by external scintigraphy with radiolabeled 3H9 has been performed to evaluate potential clinical application as diagnostic or therapeutic reagents. On the 3rd day after an intravenous injection of 15 microCi, the 125I- or 131I-radiolabeled 3H9 was successful in immunolocalization of a human brain GBM8401 xenograft in the nude mouse. In large xenografts, the radioactivity ratios of tumor to brain and tumor to blood were 11.0 and 2.4, respectively. In small xenografts, the tumor to brain and tumor to blood ratios were 14.0 and 2.9, respectively. The clearance of radiolabeled 3H9 in the bloodstream of the nude mouse was not affected by the presence of a GBM8401 xenograft. This preliminary experiment reveals that human brain GBM8401 xenografts in nude mice can be detected in vivo by radiolabeled 3H9.

Simultaneous renal cell carcinoma and angiomyolipoma in a kidney--a case report and literature review

Renal cell carcinoma (RCC) is the most common tumor of the kidney. Angiomyolipoma is frequently present in the patient who has the stigma of tuberous sclerosis. We reported a case of a 39-year-old female, without the stigma of tuberous sclerosis, who was admitted on account of a firm, huge, fixed and palpable mass over the left flank region for one week. After radical nephrectomy, the pathological report was renal cell carcinoma, granular cell type, associated with angiomyolipoma. The literature concerning this unusual case is reviewed.

Inflammatory pseudotumor of the spleen--case report and literature review

Inflammatory pseudotumor (IPT) of the spleen is an extremely rare benign lesion. We herein report an additional case of a 64-year-old man with IPT of spleen to compare with seven cases previously reported in the literature. However, the immunohistochemical studies has demonstrated to polyclonality of plasma cells which was comparable to these seven previously reported cases. The clinical and pathological findings, as well as the possibilities of etiology and pathogenesis are also described.

Diaphragmatic defect as a cause of massive hydrothorax in cirrhosis of liver

A 56-year-old woman with a 2-year history of cirrhosis of the liver and frequent right pleural effusion was admitted with intractable shortness of breath. Chest x-ray examination showed marked pleural effusion of the right lung field with a shift of the mediastinum to the left. Ascites was not conspicuous. Except for the liver cirrhosis, there was no clinical evidence of other underlying diseases. The patient died with a relatively short course after hospitalization. At autopsy, an apparent bleb with 1-mm hole in the tendinous portion of the right diaphragm was noted. We suggest that the ascitic fluid directly crossed the diaphragmatic defect to the pleural cavity, which contributed to the hydrothorax. In this article we review the pertinent literature.

Primary intraosseous malignant meningioma of the skull: case report

Primary intraosseous meningioma of the skull is rare. This report describes a 61-year-old man who was treated by craniectomy 3 times for a repeatedly recurrent primary intraosseous malignant meningioma. Transmission electron microscopy revealed interdigitation of cytoplasmic processes, microfilaments, and distinct desmosomal structures. Immunocytochemical studies of cultured cells showed strong expression of vimentin and weakly positive staining for S-100 protein. Primary intraosseous malignant meningioma should be considered in the differential diagnosis of massive solitary osteolytic lesions of the skull.

[Expression of epithelial and nervous-system-related antigens on pleomorphic adenoma of the salivary glands--an analysis of 20 cases]

The expression of cytokeratin (40-52 kD), carcinoembryonic antigen (CEA), vimentin, neuron-specific enolase (NSE), S-100 protein, glial fibrillary acidic protein (GFAP) were investigated in 20 cases of pleomorphic adenoma of the salivary glands and 10 cases of normal salivary glands, in order to analyze and correlate the antigens' expressions with the probably histogenetic mechanisms of the various histopathological differentiations in pleomorphic adenoma of the salivary glands and their probably original cells in normal salivary glands. Immunohistochemistry has provided some evidence for the relationship of the tumor cells to normal salivary glands: In the normal glands, the acinic cells exhibited cytokeratin, CEA and focal, predominantly nuclear S-100 protein staining. In both normal glands and pleomorphic adenomas, the duct-lining cells were immunoreactive for cytokeratin, CEA and had both cytoplasmic and nuclear S-100 positivity; The myoepithelial cells of the normal glands as well as the periduct cells, epithelial nests/cords, squamous metaplasia and the stellate/spindle/cartilaginous cells in the myxomatous-chondroid areas of the pleomorphic adenoma contain immunoreactive vimentin, NSE, S-100 proteins and GFAP, and lesser amounts cytokeratin (40-52 kD)/CEA. The varicosities of the terminal axon may lie directly on the basal membrane, or penetrate the basal membrane and lie in direct contact with the effector cells (duct-acinar-myoepithelial cells) of the salivary glands. The peripheral neurons and axons of the autonomic nervous system were identified by vimentin, NSE, S-100 proteins and GFAP. The combination of epithelial cytokeratin and nervous system-related vimentin, NSE, S-100 and GFAP immunostaining in myoepithelium of the normal glands and in all component elements (particularly the periduct cells) of pleomorphic adenoma reflects pleomorphic adenoma of the salivary glands is an epithelial tumor, the probably original cells or the probably histogenetic mechanisms of the various histopathological differentiations is correlated not only with "duct-acinar-myoepithelial cells" but also with the neuroectoderm in the normal salivary glands."

Establishment and characterization of a malignant glioma cell line, GBM8401/TSGH,NDMC

A permanent human brain malignant glioma cell line, GBM8401/TSGH,NDMC, has been successfully established from a 31-year-old Chinese female with brain glioblastoma multiforme (GBM) in monolayer culture and has been subcultured for more than 100 passages during 24 months in vitro. The tumor cell doubling time in vitro was approximately 38 hr. The tumorigenicity in athymic nude mice was observed; the tumor volume doubling time was approximately 4 days. Glial fibrillary acidic protein (GFAP) and 10-nm-diameter intermediate filaments were identified by immunohistochemical peroxidase-antiperoxidase (PAP), immunofluorescence assay, and transmission electron microscopic methods. The scanning electron microscope revealed numerous surface microvilli and various-sized blebs. Karyotypic analysis showed this malignant glioma cell line to be of human origin, near-diploid with a modal chromosome number of 48,XX.

Hepatitis B virus-associated membranous glomerulonephropathy

A variety of extrahepatic abnormalities have been described in patients with hepatitis B viral infection, including the prodromal arthritis (serum sickness-like) syndrome, polyarteritis nodosa, and glomerulonephropathy. Five patients with hepatitis B virus (HBV)-associated membranous glomerulonephropathy (MGN) were persistent carriers of HBsAg. The deposition of HBsAg in the renal lesions of these patients was proved by using monospecific antibody and immunofluorescence technique. These findings support the hypothesis of an etiological correlation of hepatitis B viral infection with some cases of MGN. HBV-associated MGN may be much more frequent in the world than previously reported, and more cases must be collected for the understanding of this unique entity.

Immunoglobulin A nephropathy and ankylosing spondylitis. Report of two patients in Taiwan and review of the literature

We describe 2 patients with immunoglobulin A (IgA) nephropathy in association with ankylosing spondylitis. Renal biopsy demonstrated mesangial proliferative glomerulonephritis with prominent IgA, C3c, and less intense properdin deposition in the glomeruli. Intraglomerular clumps of virus-like particles were also observed in the kidney sample from one patient (case 2), who had an abnormal liver function. Our findings support the hypothesis that here is a possible common pathogenesis responsible for the concurrence of both IgA nephropathy and ankylosing spondylitis.

A monoclonal antibody (HO-No-1) with specificity for a human nucleolar protein

A murine monoclonal antibody (named HO-No-1) which specifically reacts with a target antigen of 72,000 mol. wt (p72) in the nucleoli of human cells, has been isolated. Using an avidin-biotin peroxidase immunoperoxidase method, it was found that this antibody stains exclusively the nucleolus and not other portions of the nucleus and cytoplasm. This reaction pattern was observed consistently, although to different degrees in 14 human normal tissues and human malignant cell lines. However, after pretreatment with actinomycin D (250 ng/ml) for 2 h, the antibody stains the nucleoplasm uniformly. Thus this study demonstrates evidence for an antibody which reacts specifically with human nucleoli to a protein which could play an important role in rRNA synthesis.

Discordant Tc-99m sulfur colloid and In-113m chloride blood pool images in patients with acute amebic liver abscess

Using combined Tc-99m sulfur colloid and In-113m chloride eluate imaging, studies from 32 patients with proven amebic liver abscess were analyzed. The results revealed good perfusion of the amebic lesion in three, poor perfusion in 11, and absent perfusion in 18. These results appear to depend on abscess size and age. Images with In-113m seem to be better than those with Tc-99m sulfur colloid in depicting amebic liver abscess during antiamebic therapy. Overall, the In-113m images provide more precise information concerning abscess size and shape.

Primary osteogenic sarcoma of the skull: case report

A case of primary osteogenic sarcoma of the skull with metastases to the lungs, left diaphragm, 2nd lumbar and 1st sacral vertebral bodies, and both femoral heads was presented. A young man with a lump over his right parieto-occipital region since the age of 14 had noticed rapid growth of the mass after having experienced definite head trauma. The tumor was surgically removed and the bony defect was repaired with a stainless stell plate. The recurrence of the tumor mass was suppressed by 60Co irradiation, but a necrotic lesion developed over the right temporal scalp. Twenty-two months after the surgical removal of the tumor, the patient died of respiratory failure and septicemia.

Antibodies to Epstein-Barr virus capsid antigen and early antigen in nasopharyngeal carcinoma and comparison groups

Antibodies to Epstein-Barr virus capsid antigen (anti-VCA) and early antigen (anti-EA) were measured in 263 patients with nasopharyngeal carcinoma (NPC), 624 age- and sex-matched neighborhood controls, 570 family members of NPC patients and 830 family members of neighborhood controls in Taiwan. The distribution of antibody titers was significantly different between NPC patients and the other three groups. More than 55% and 45% of NPC patients had titers of greater than or equal to 1:640 and greater than or equal to 1:80 for anti-VCA and anti-EA, respectively, while less than 6.7% and 2.5% of the other three groups had such high titers. The geometric means of anti-VCA and anti-EA titers were 1:352 and 1:45, respectively, in NPC patients compared to less than 1:77 and 1:12, respectively, in the comparison groups. Anti-VCA and anti-EA titers were significantly correlated. The association of EBV with NPC is discussed.