Multifocal hyperfunctioning thyroid carcinoma without metastases

Hyperthyroidism due to thyroid carcinoma is rare, and most cases are caused by hyperfunctioning metastatic thyroid carcinoma rather than primary carcinoma. Among primary hyperfunctioning thyroid carcinoma, multifocal thyroid carcinoma is exceedingly rare, with the only one case being reported in the literature. Here, we describe the case of a 62-year-old woman with multifocal functioning thyroid carcinoma. Technetium-99m (99m Tc) scintigraphic imaging showed four hot areas in the thyroid gland. Histopathological examination of all four nodules revealed papillary carcinoma, corresponding to hot areas in the 99m Tc scintigram. DNA sequencing of the thyrotropin receptor (TSH-R) gene from all nodules revealed no mutation, indicating that activation of TSH-R was unlikely in the pathophysiogenesis of hyperfunctioning thyroid carcinoma in the present case.     

Relationship between Intensity of Reflected Light and Temperature Increase: Assessment of Fundus Pigmentation for Transpupillary Thermotherapy

Purpose

To develop a new device for measuring reflected light during diode-laser irradiation in transpupillary thermotherapy (TTT) and to assess the correlation between fundus pigmentation, the measured intensity of reflected light, and the increase in fundus temperature.

Methods

We developed a device to measure reflected light by modifying a slit-lamp-mounted 810-nm diode-laser delivery system used clinically for TTT. The diode laser was used to irradiate test charts with various degrees of reflectance in in vitro experiments, and the fundus of nonpigmented or pigmented rabbits in in vivo experiments; then, the intensity of the reflected light and the temperature increase at the target were measured. The retinal sections were also examined histologically.

Results

There was a significant negative correlation between the intensity of the reflected light and the temperature increase in the target that depended on the degree of reflectance of the charts or the pigmentation of the rabbit eyes. On histopathologic examination, the extent of the changes in the irradiated retina after TTT was clearly different between pigmented and nonpigmented rabbits.

Conclusions

Correlations between fundus pigmentation, the intensity of reflected light during diode-laser irradiation, and the temperature increase in TTT were demonstrated in vitro and in vivo. Our results suggest that measurement of the intensity of reflected light should be helpful for modulating the laser power in TTT according to the degree of fundus pigmentation.?Jpn J Ophthalmol 2007;51:462–469 © Japanese Ophthalmological Society 2007     

Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy

PURPOSE: To identify the tomographic features of the branching vascular networks in patients with polypoidal choroidal vasculopathy (PCV). METHODS: We prospectively performed third-generation optical coherence tomography (OCT) and fluorescein angiography for 44 eyes of 42 patients (mean age +/- SD, 67.1 +/- 9.1 years) with PCV. All eyes had branching vascular networks and polypoidal lesions that were confirmed by indocyanine green angiography. RESULTS: OCT showed double reflective layers that consisted of retinal pigment epithelium (RPE) and another highly reflective layer beneath the RPE ("double-layer sign") in the area of the branching network vessels in 26 (59%) of 44 eyes. The remaining 18 eyes had no double-layer sign, but 17 (94%) of 18 eyes had a slightly elevated RPE. A serous retinal detachment was present in 23 (88%) of 26 eyes with a double-layer sign, while only 1 (6%) of 18 eyes without the sign had a serous retinal detachment. CONCLUSIONS: In PCV, the double-layer sign is seen frequently in the area of the network vessels, particularly in eyes with a serous retinal detachment. The sign may reflect fluid accumulation between RPE and Bruch membrane resulting from leakage from the network of abnormal vessels.     

Cell lineage-specific interactions between Men1 and Rb in neuroendocrine neoplasia

Inactivation of multiple endocrine neoplasia (MEN) type 1 gene (Men1) results in development of multiple endocrine tumors in Men1(+/-) mice and in humans. Intriguingly, loss of the wild-type retinoblastoma 1 (Rb) gene also leads to MEN-like phenotype in Rb(+/-) mice. To evaluate potential genetic interactions between these genes, we prepared and characterized Men1(+/-)Rb(+/-) compound mice in parallel with their parental genotypes. Men1 and Rb did not cooperate in tumor suppression, as demonstrated by comparable survival rates of Rb(+/-) and Men1(+/-)Rb(+/-) mice, absence of tumor growth acceleration and lack of novel neoplasms. Notably, the loss of the remaining copy of the wild-type Men1 and Rb was mutually exclusive in all tumors of Men1(+/-)Rb(+/-) mice, including pituitary anterior lobe and adrenal medulla neoplasms shared by Rb- and Men1-deficient phenotypes. Down-regulation of Men1 targets p18 and p27 and increased presence of phosphorylated-Rb were observed in Men1-deficient pheochromocytomas of Men1(+/-)Rb(+/-) and Men1(+/-) mice. At the same time, the RNA interference (RNAi) knock-down of Men1 mRNA resulted in increased apoptosis of Rb-deficient medullary thyroid carcinoma cells. These results demonstrate that, depending on cell lineage context, combined Men1 and Rb deficiency may be either redundant or detrimental to neoplastic growth. Identification of cell lineage-specific interactions between Men1 and Rb may have important implications for development of rationally designed therapeutic approaches.     

Correction to: Differences in gut microbiota associated with age,sex, and stool consistency in healthy Japanese subjects

Journal of Gastroenterology - The authors would like to correct the errors in the publication of the original article. The correction details are given below for your reading.     

Perforation in pediatric non-complicated appendicitis treated by antibiotics: the real incidence

Pediatric Surgery International - The incidence of perforation during antibiotic therapy (AT) of children triaged as non-complicated acute appendicitis (NC-Ap) was investigated. Abdominal...