Failure to detect urethral Trichomonas vaginalis in Japanese men with or without urethritis

AIM: Trichomonas vaginalis may cause symptomatic or asymptomatic urethritis in men. There are few recent studies on the prevalence of T. vaginalis infection in Japanese men, and quantification of the number of cases of urethritis attributable to this pathogen has not been performed in Japan. The aim of this study was to determine the prevalence and morbidity of T. vaginalis infection in Japanese men. METHODS: One hundred subjects with or without urethritis were examined for the presence of urethral T. vaginalis using culture swabs. RESULTS: Urethral swabs from all subjects were negative for T. vaginalis. CONCLUSION: These results indicate Japanese men, including those with urethritis, have a low incidence of urethral T. vaginalis infection or colonization. T. vaginalis appears to be an uncommon pathogen for male urethritis in Japan.     

A case of Kabuki make-up syndrome with EBV+ Burkitt's lymphoma

Kabuki make-up syndrome was first reported in 1981 and is characterized by peculiar facies with post natal growth deficiency and mental retardation. Since the first report, approximately 100 cases have been reported, but there have been no reports of tumor development. A case is reported of a patient with Kabuki make-up syndrome who developed malignant lymphoma in his abdomen at the age of 3 years. The tumor was histologically diagnosed as Burkitt's lymphoma and Epstein-Barr virus was detected by in situ hybridization.     

Clinicopathological factors predicting recurrence of N0M0 renal cell carcinoma: A case series analysis of one facility

BACKGROUND: Although many factors have been reported as predictors of the recurrence of renal cell carcinoma (RCC), none of the factors are consistent among different studies. In the study presented here, the potential clinicopathological predictors of the recurrence of N0M0 RCC were examined. METHODS: A total of 201 patients who underwent nephrectomy for N0M0 RCC were examined to determine the pathological tumor stage (pT stage), pathological tumor grade of malignancy (tumor grade), symptoms, and tumor size. RESULTS: RCC recurred in 29 patients (14.4%), 50% of whom developed new tumors within 24 months after nephrectomy. The disease-free 3- and 10-year survival rates declined as the pT stage and tumor grade increased: these rates were, respectively, 98.6% and 86.5% for pT1a; 93.7% and 87.9% for pT1b; 100% and 100% for pT2; 78.6% and 58.0% for pT3a; and 88.9% and 16.7% for pT3b. Significant differences in the recurrence rate were noted between pT3 and pT1 or pT2, as well as between grade 3 disease and grade 1 or grade 2 tumors. Multivariate analysis showed that a combination of the pT stage, grade, and presence of symptoms was useful for predicting the recurrence of RCC. CONCLUSION: The present study showed that patients undergoing nephrectomy for N0M0 RCC should be followed-up carefully for 2 years postoperatively with special attention to high pT stage, high grade, and the development of symptoms.     

Cardiac Pacing in Fetal Lambs: Intrauterine Transvenous Cardiac Pacing for Fetal Complete Heart Block

To evaluate the feasibility of intrauterine transvenous cardiac pacing, the right ventricular output was measured during pacing in six fetal lambs. Under maternal anesthesia, the uterus was opened, and, under local anesthesia, the pacing lead (Medtronic Capsure SP4023) was inserted via the fetal left internal jugular vein. Right ventricular output was estimated using an Aloka SSD-730 ultrasound device, and tricuspid valve regurgitation was evaluated with an Aloka SSD-880 using the transuterine approach. The ultrasonic right ventricular cardiac output was measured under three different conditions: (1) with the tip of the pacing lead in the superior vena cava (control); (2) with the tip of the pacing lead in the right ventricle; and (3) with pacing at 200 beats/min. The right ventricular output decreased when the pacing lead was inserted into the right ventricle, as well as during pacing at 200 beats/min ([1] = 107 ± 13.2 ml/kg per min; [2] = 73.8 ± 17. 5 ml/kg per min; and [3] = 78.3 ± 23.6 ml/kg per min), Tricuspid regurgitation did not change under any of the conditions tested. Intrauterine transvenous cardiac pacing was successfully achieved. Insertion of the pacing lead into the right ventricle decreased the ventricular output without increasing tricuspid valve regurgitation.     

Granular Cell Tumor of the Cecum: Two Case Reports

Abstract: We experienced two cases of cecal granular cell tumor. The site of occurrence and diagnosis are discussed in relation to the literature on granular cell tumor of the large intestine. Most granular cell tumors of the large intestine tend to remain constant in size, showing the morphology of a submucosal tumor. Endoscopic excision was considered a useful diagnostic procedure. S-100 protein was positive in most cases, supporting the hypothesis that the tumor is derived from Schwann cells.     

Involvement of growth factor receptor-bound protein-2 in rat hepatocyte growth

Growth factor receptor-bound protein-2 (GRB-2) is a protein linking receptor tyrosine kinase and Sos ( Son of Sevenless gene; Ras GDP/GTP exchange protein), leading to activation of the Ras-mitogen-activated protein kinase (MAPK) cascade. So far, it remains unclear how GRB-2 plays a role in signal transduction pathways evoked by hepatotrophic factors. This study was attempted to evaluate the involvement of GRB-2 in signalling in rat hepatocyte growth. Using rat cultured hepatocytes stimulated by hepatotrophic factors and regenerating livers after partial hepatectomy (PH) we examined GRB-2-mediated linkage of hepatotrophic factor receptors to signal transducing molecules such as Sos or dynamin-II by immunoprecipitation and western blot analysis. In primary cultured hepatocytes stimulated with hepatocyte growth factor (HGF) or epidermal growth factor (EGF), GRB-2 linked HGF receptor or EGF receptor, respectively, to Sos which activated the mitogen-activated protein kinase (MAPK) cascade. In contrast, in primary cultured hepatocytes stimulated with insulin, GRB-2 linked insulin receptor substrate-1 (IRS-1) to dynamin-II as well as Sos. In the early phase after PH, GRB-2 activated the Ras-MAPK cascade by linking HGF receptor, IRS-1, or EGF receptor to Sos. In the late phase after PH, a complex of IRS-1-GRB-2 associated with dynamin-II, indicating that GRB-2 may transduce signals from IRS-1 to dynamin-II. We conclude that GRB-2 may play a role in transmitting signals from hepatotrophic factors to not only MAPK but also to other signalling pathways in hepatocyte growth.     

High Energy Radiofrequency Catheter Ablation for Common Atrial Flutter Targeting the Isthmus between the Inferior Vena Cava and Tricuspid Valve Annulus Using a Super Long Tip Electrode

There have been controversies concerning the optimal target sites and approaches in radiofre-quency catheter ablation of common atrial flutter. We attempted high energy radiofrequencv catheter ab-lation targeting the isthmus between the inferior vena cava and tricuspid valve annulus (IVC-TV isthmus) with a super long (8 mm) tip electrode, and compared the efficacy of this anatomical approach with the electrophysiological approach targeting the posteroseptal right atrium posterior to the coronary sinus us-ing a standard 4-mm tip electrode. Atrial flutter was successfully ablated in 12 of 12 patients (100%) with-out recurrence with the anatomical approach, while, in 7 of 9 patients (64%) with 2 recurrences with the electrophysiological approach. In comparison of ablation data between the anatomical and electrophysi-ological approaches, there were significant differences in the mean number of application pulses (anatomical vs electrophysiological: 2.3 ± 0.8 vs 9.9 ± 6.4, P < 0.01), applied wattage (39 ± 12Wvs24 ± 6W.P < 0.01), applied energy per application (1.986 ± 426 / vs 659 ± 323 J. P < O.O1), fluoroscopic time (26 ± 11 min vs 74 ± 30 minutes, P < 0.01), and procedure time (59 ± 8 min vs 181 ± 53 min. P < 0.01). In conclusion, the anatomical approach is superior to the electrophysiological one with respect to proce-dure and radiation time, and linear ablation at the IVC-TV isthmus with an 8-wm tip electrode and high energy application is highly effective and safe.     

Significance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of renal cell carcinoma and immunohistochemical glucose transporter 1 (GLUT-1) expression in the cancer

OBJECTIVE: Positron emission tomography (PET) is now primarily used in oncological indication owing to the successful application of fluorine-18 fluorodeoxyglucose (FDG) in an increasing number of clinical indications. Glucose transporter 1 (GLUT-1) is recognized as a major early marker of cellular malignant transformation. The aims of this study were to assess whether FDG-PET is a useful diagnostic tool for renal cell carcinoma and to compare the pathologic characteristics. METHODS: Nineteen consecutive patients who had renal cell carcinoma were examined using FDG-PET preoperatively. The results of PET were then compared to the histology obtained after radical surgery and the immunoreactivity of GLUT-1 was also studied. RESULTS: Pathologic examination confirmed that all 19 patients suffered from renal cell carcinoma. Increased FDG uptake was found in six of the 19 patients (31.5%). The immunohistochemical examination of GLUT-1 in renal cell carcinoma produced different results in each patient. There was no correlation with GLUT-1 immunoreactivity and FDG-PET positivity. CONCLUSION: These results suggest that FDG-PET may not be a useful diagnostic tool for renal cell carcinoma.     

RHINOPHYMA IN JAPAN

Background. Rhinophyma is an end stage of acne rosacea. It results in a large nose due to a proliferation of sebaceous glands and fibrous tissue. Many cases of rhinophyma have been reported in the Western world; however, in Japan, rhinophyma has been an uncommon disease. Methods. We present two patients associated with rhinophyma who were treated by cross-shaped full-thickness excision followed by direct closure and compare the rhinophyma in Japan with that in the West. Results. To date, only 20 rhinophyma cases including our 2 cases have been reported in Japan. Epidemiologic factors of rhinophyma between the West and Japan do not differ except for location, malignancy and surgical treatment. Conclusions. In Japan, almost all cases are located on the lower half of the nose, treated by full-thickness excision followed by application of either skin grafts or direct closure. None have been malignant.     

A Case of Choledochocele Associated with Carcinoma of the Pancreas

A-59-year old woman was admitted with lumbago and back pain. An abdominal ultrasonography and abdominal computed tomography demonstrated a tumor of the body of the pancreas and multiple space occupying lesions in the liver. Endoscopic retrograde chorangiopancreatography revealed a 11 mm cystic dilatation of the terminal portion of the common bile duct protruding into the duodenal lumen and an obstruction of the pancreatic duct in the body portion. Celiac artery angiography showed an irregularity in the wall of the splenic artery. In line with these findings, the patient was diagnosed as suffering from choledochocele associated with carcinoma of the pancreas. As she already had multiple metastatic liver tumors, her treatment was limited to amelioration of her symptoms. Increasing stenosis of the common bile duct, however, required endoscopic sphinctomy and endoscopic retrograde biliary drainage. Type 3 Choledochocele of Alonso-Lej's classification is very rare, and only a few cases have been reported in association with malignant bile duct tumors. We believe this case to be the first one in our country linked with carcinoma of the pancreas.