Computed tomography of hepatic cavernous hemangioma

Fifty hepatic hemangiomas in 38 patients were evaluated by CT using sequential scanning following bolus injection. Lesions were assessed for the following CT features: (a) low density lesion on unenhanced scan; (b) early peripheral contrast enhancement; (c) progressive opacification from the periphery to the center; (d) a delay of at least 3 min before total opacification; and (e) eventual isodense appearance with or without unopacified cleft. The criteria for diagnosis of hepatic hemangioma were (d) and (e) plus at least two of the remaining three features. Forty-eight lesions were identified by CT; 38 displayed all five features, five lesions were missing one feature, and five lesions did not meet the criteria for diagnosis. Larger lesions required a significantly longer period to opacify (p less than 0.05). The positive predictive value of CT in the diagnosis of hemangioma was 100%.     

Effects of calcium in continuous cardioplegia on myocardial protection

The effects of calcium (Ca) on a hyperkalemic cardioplegic solution for continuous cardioplegia were examined in an isolated perfused working rat heart model. The coronary arteries were perfused with a modified Krebs-Henseleit bicarbonate buffer (K-H) solution, containing various concentrations of Ca(0.1, 0.6, 1.2, and 2.5 mmol/l) and a high concentration of potassium (20 mmol/l), for 180 min, after which cardiac arrest was induced at 37°C for 180 min. Cardiac function and creatine kinase (CK) were measured. In the control group, K-H solution was infused in place of the cardioplegic solution, and cardiac arrest was not induced. No significant differences were observed between the groups infused with the K-H solution containing Ca concentrations of 0.6, 1.2, and 2.5 mmol/l in the percent recovery of aortic flow (82.1±2.9%, 80.6±2.0%, and 71.5±3.7% (mean±SEM) respectively) or in the recovery of other indices of cardiac function, or in CK leakage. There were also no significant differences in the recovery of cardiac function and CK leakage between these groups and the control group. In the Ca 0.1 mmol/l group, however, the characteristic Ca paradox was observed. These findings suggest that if the Ca concentration in a cardioplegic solution is higher than 0.6 mmol/l during continuous cardioplegia, excellent cardioprotective effects will be achieved.     

E-cadherin gene mutations in human intrahepatic cholangiocarcinoma

Deletions or mutations of the E-cadherin gene may result in reduced cell adhesiveness. In particular, conservative point mutations within the N-terminal calcium-binding pocket (including exons 7, 8, and 9) are frequently detected in several cancers and are enough to abolish cell-cell adhesion. There have been no studies on E-cadherin gene mutations in human intrahepatic cholangiocarcinoma (ICC). Human ICCs were therefore investigated for E-cadherin gene mutations within exons 7, 8, and 9. In addition, the relationships were analysed between their mutations and the immunohistochemical expression of E-cadherin, histological grade, and clinicopathological parameters. The E-cadherin gene was analysed in 34 tumours by nested polymerase chain reaction/single-strand conformation polymorphism (PCR/SSCP) followed by DNA sequencing. In four of the 34 cases (11.8%), tumour-restricted mobility shifts were observed; two cases harboured a single shift, one case presented two different mobility shifts, and one case presented three different mobility shifts within exons 7 and 8, encoding extracellular domains of E-cadherin. Polymorphism as previously reported was not identified and all seven new DNA alterations were not present in genomic DNA of non-tumour origin. The E-cadherin gene mutations correlated significantly with down-regulated E-cadherin protein expression and high ICC histological grade. These data suggest that E-cadherin gene mutations in ICC are associated with reduced cell adhesiveness and high histological grade.     

The antiallergic agent amoxanox suppresses SRS-A generation by inhibiting lipoxygenase

Amoxanox has potent antiallergic activity because it inhibits the release of chemical mediators such as histamine and leukotrienes. We studied the in vitro effect of amoxanox on arachidonic acid metabolism, including the lipoxygenase and cyclooxygenase pathways. Amoxanox inhibited calcium ionophore A23187-induced formation of 5-HETE, LTB4, SRS-A (LTC4, LTD4 and LTE4), and 12-HETE in rat peritoneal resident monocytes. These results indicate that amoxanox inhibits 5- and 12-lipoxygenases. The compound, however, did not affect the formation of TXB2 or 6-keto-PGF1 alpha in guinea pig lung fragments and PGE2 or PGF2 alpha in bovine seminal vesicles, suggesting that it did not inhibit cyclooxygenase. These results show that the antiallergic action of amoxanox is associated, at least in part, with the reduction of leukotrienes due to the inhibition of lipoxygenases.     

A case of spontaneous cervical carotid artery dissection managed by using primary stent placement

The authors report the case of a 35-year-old male who underwent stenting for spontaneous cervical carotid dissection. He presented with sudden onset of hemicrania and left facial palsy followed by left hemiparesis and dysarthria. On admission, carotid angiography revealed postsinus tapering occlusion of the right internal carotid artery. Initially, he was managed with conservative treatment, but his neurological status deteriorated. Findings of brain CT, MRI and IMP-SPECT suggested hypoperfusion of the right cerebrum. A Palmaz stent, 39 mm in length, was successfully placed over the site of the dissection to restore normal patency through the dissected carotid artery. Following stent implantation, his neurological signs improved gradually but completely. Since the procedure, with oral administration of antiplatelet medication, he has suffered no cerebral ischemic events. Follow-up carotid angiography one year after stent implantation showed good patency of the stented segment. The present case emphasizes the usefulness of stenting for spontaneous cervical carotid dissection.     

Serial changes in N-isopropyl-p[125I]-iodoamphetamine in mouse lung observed with a confocal laser scanning microscope

Serial changes in N-isopropyl-p[125I]-iodoamphetamine (125I-IMP) in mouse lungs were observed with a confocal laser scanning microscope. Male mice were intravenously injected with 125I-IMP and subjected to autoradiographic procedures 20 minutes, and 3 and 24 hours after injection. Differential interference contrast (DIC) images and confocal images were obtained with a confocal laser scanning microscope, and superimposed images were evaluated. Large numbers of silver grains were observed in the interstitium, bronchioles, and alveolar sacs 20 minutes after the injection, and lamellar distribution of the grains was observed on the ciliary surface. The numbers of silver grains in the interstitium and bronchioles had decreased 3 hours after the injection of 125I-IMP, but the numbers of silver grains in the alveolar spaces had not. Although small numbers of silver grains remained in both the bronchioles and alveolar sacs 24 hours after the injection, most of them had washed out. Confocal laser scanning microscopy is considered to be a useful procedure for studying the distribution of radioisotopes by microautoradiography, because it allows clear autoradiographs to be obtained in which tissues and silver grains are perfectly matched and all silver grains are in focus.     

CT appearance of implanted esophageal stents

Three different types of esophageal stents, the Z-stent, Ultraflex, and Wall-stent, exhibit different shapes on CT, which may suggest a difference in the radial forces applied by each of the stents. CT is useful for displaying the relationship between an esophageal stent and adjacent structures and complications.     

The influence of the use of mupirocin nasal ointment on the incidence of endogenous MRSA infections in an intensive care unit

Nasal carriage of MRSA is a significant risk-factor for the endogenous MRSA infection in immunocompromised patients. MRSA infection in ICU patients is thus mostly endogenous infection. To evaluate the impact of mupirocin use on the incidence of endogenous infection caused by MRSA in an intensive care unit, we prospectively treated all patients in the unit with mupirocin, 3 times daily for 3 days. This routine use of mupirocin led to eradication of nasal MRSA carriage in 81.8% of surveillance cultures and to a significant reduction in the total incidence of MRSA infection among MRSA carrier patients (0 episode in 11 patients) when compared to historical controls prior to the use of mupirocin (3 episodes in 7 patients). Mupirocin nasal ointment was significantly effective to prevent endogenous MRSA infection.     

Effect of total higher-order aberrations on accommodation in pseudophakic eyes

PURPOSE: To analyze the effect of total higher-order aberrations (HOAs) on the range of accommodation in pseudophakic eyes and the size of near-vision optotypes. SETTING: Department of Ophthalmology, Nara Medical University, Nara, Japan. METHODS: The study comprised 30 patients (44 eyes) who were diagnosed with cataract at Nara University of Medical Science Hospital and Municipal Oyodo Hospital. Inclusion criteria included no other eye disorder and a best corrected distance acuity of 20/20 or better 1 month after cataract surgery. All patients had small-incision phacoemulsification followed by in-the-bag implantation of a monofocal intraocular lens (SA60AT, Alcon). All incisions were self-sealing. Accommodation in pseudophakic eyes was measured by the lens-loading method in an examination room under constant illumination. Ocular HOAs were measured using the KR-9000PW Hartmann-Shack wavefront analyzer (Topcon). RESULTS: The mean patient age was 75.8 years +/- 5.4 (SD) (range 64 to 83 years). The Pearson correlation coefficient (r) showed a significant positive correlation between the range of accommodation and Z7 (vertical coma) for a 4.0 mm pupil using the 1.0 near-vision optotype. There was a significant negative correlation between the range of accommodation and Z12 (spherical aberration) for a 4.0 mm pupil using the 1.0 near-vision optotype (r = .311, P = .040 for Z7;r = -.365, P = .015 for Z12). No other parameter was significantly correlated with the range of accommodation. CONCLUSIONS: Measurement of accommodation in pseudophakic eyes by the lens-loading method using the 1.0 near-vision optotype showed that eyes with larger vertical coma aberrations achieved a larger range of accommodation. In contrast, eyes with larger spherical aberrations had smaller amounts of accommodation. The size of the near-vision optotype may affect accommodation analysis in pseudophakic eyes.