Plasma cell cheilitis treated with intralesional injection of corticosteroids

Plasma cell cheilitis is an idiopathic, benign, inflammatory condition characterized by a dense band-like infiltrate of plasma cells in the oral mucosa. In addition to the lips, the disease can affect the penis, vulva, buccal mucosa, palate, gingiva, tongue, epiglottis, and larynx. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic responses to topical steroids. We describe three patients with plasma cell cheilitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.     

Cloning and expression analysis of retinoic acid receptors in the zebra finch brain

The vitamin A derivative retinoic acid is produced postembryonically in discrete portions of the songbird brain, including some of the nuclei involved in song production and song learning, and its synthesis is required for the normal maturation of song behavior. To identify the brain targets for retinoic acid action, we cloned the zebra finch homologs of the alpha, beta, and gamma classes of retinoic acid receptors (RARs). In situ hybridization analysis revealed that the mRNAs for all three RARs are expressed at different levels in several brain areas, with a broader distribution than the mRNA for retinaldehyde-specific aldehyde dehydrogenase (zRalDH), a retinoic acid-synthesizing enzyme. Detectable RAR expression was found in all nuclei of the song control system, with the most marked expression occurring within the striatal song nucleus area X. These observations are consistent with a persistent action of retinoic acid in the postembryonic and adult songbird brain and provide further evidence for an involvement of retinoic acid signaling in the control of learned vocal behavior in a songbird species. They also suggest that the striatum is a major target of retinoic acid in songbirds.     

Effects of vitamin E on phospholipase A2 activity and oxidative damage to the liver in streptozotocin-induced diabetic rats

BACKGROUND: The purpose of the present study was to investigate the effects of vitamin E on oxidative stress and cell membrane fluidity in the liver of streptozotocin (STZ)-induced diabetic rats. METHODS: Sprague-Dawley male rats weighing 100 +/- 10 g were fed a vitamin E-free diet (the DM-0E group), a 40 mg vitamin E/kg diet (the DM-40E group), or a 400 mg vitamin E/kg diet (the DM-400E group). RESULT: Dietary vitamin E reduced the increased concentration of lipid peroxides in the liver tissues of diabetic rats through decreasing their increased phospholipase A(2) (PLA(2)) activity and phosphatidylethanolamine hydrolysis. However, vitamin E reduced the accumulation of superoxide radical and decreased the generation of oxidative damage substances, such as the carbonyl value, increased membrane fluidity and lowered oxidative damage. CONCLUSIONS: Vitamin E was found to be excellent for regulating the activity of PLA(2), reducing the generation of reactive oxygen species and damaging oxidative substances, and maintaining cell membrane fluidity in the liver of diabetic rats.     

The usefulness of fractional anisotropy maps in localization of lacunar infarctions in striatum, internal capsule and thalamus

We aimed in this study to assess the clinical usefulness of fractional anisotropy (FA) maps in the evaluation of lacunar infarctions in striatum, internal capsule and thalamus. We retrospectively reviewed 28 patients (18 men, 10 women; mean age 63 years) who had acute lacunar infarction in striatum, internal capsule and thalamus on diffusion weighted MR imaging (DWI). Fractional anisotropy (FA) maps were generated in addition to conventional T2 weighted images (T2WI) and trace maps of DWI. Two radiologists reviewed the location of infarcts in combination with and without FA maps. Exact location of infarction was determined by FA maps, i.e. on the white band of internal capsule or outside the internal capsule. Accuracy and inter-observer agreement on determination of the location of infarction was evaluated. Accuracy of infarct localization by T2WI-DWI only was varied from 72 to 91% according to the observers. Inter-observer agreement value was moderate (Kappa=0.446), when images were interpreted by T2WI-DWI only. Clinical manifestation of each lesions were varied, but sensory motor stroke was mainly observed in thalamic lesion (50%), while pure motor hemiparesis was predominant in the case of infarct involving internal capsule, corona radiata (91%) and basal ganglia (83%). The FA map is useful in the evaluation of lacunar lesions in striatum, internal capsule and thalamus. Clinical presentation varies according to the exact location of lacunar infarctions, and more accurate diagnosis can be made by FA maps as well as conventional T2-weighted image and DWI.     

Differentiating malignant from benign common bile duct stricture with multiphasic helical CT

PURPOSE: To evaluate retrospectively the use of multiphasic helical computed tomography (CT) to differentiate malignant and benign common bile duct (CBD) strictures in patients with only a focal CBD stricture and to determine predictors for this differentiation. MATERIALS AND METHODS: Institutional review board approval and informed patient consent were not required. Fifty patients (35 men, 15 women; age range, 35-87 years; mean age, 61.6 years) with only a focal CBD stricture comprised the sample for this study (32 malignant and 18 benign strictures). The diagnosis of all malignant and five benign CBD strictures was confirmed by reviewing patients' surgical and pathology records; in 13 benign CBD strictures, the diagnosis was confirmed by means of clinical features. Multiphasic CT findings were analyzed with regard to the wall thickness, location, length, and enhancement pattern of the involved CBD, the upstream CBD diameter, and other findings. CT features to identify benign and malignant CBD strictures were compared by means of univariate analysis and multivariable stepwise logistic regression analysis. RESULTS: Malignant strictures were longer (17.9 mm +/- 6.6 [+/- standard deviation]) than benign strictures (8.9 mm +/- 6.8) (P < .0001), and upstream CBD diameters were larger in malignant cases (22.0 mm +/- 5.4) than in benign cases (17.8 mm +/- 4.6) (P = .033). The involved wall thickness was more than 1.5 mm in 26 malignant cases and three benign cases (P < .0001). During both hepatic arterial and portal venous phases, greater enhancement than that in the normal CBD were more frequently observed in malignant cases (in 27 and 30 patients for hepatic arterial and portal venous phase scans, respectively) than in benign cases (in two and three patients, respectively) (P < .0001). Results of multivariable stepwise logistic regression analysis showed that hyperenhancement of the involved CBD during the portal venous phase was the only variable that could be used to independently differentiate malignant from benign strictures. CONCLUSION: Hyperenhancement of the involved CBD during the portal venous phase is the main factor distinguishing malignant from benign CBD strictures.     

Renal cell carcinoma: analysis of postoperative recurrence patterns

PURPOSE: To retrospectively analyze the recurrence patterns of renal cell carcinoma (RCC) and the factors affecting tumor recurrence. MATERIALS AND METHODS: The institutional review board approved this study; patient informed consent was not required. There were 162 men (mean age, 54 years +/- 13 [standard deviation]) and 32 women (mean age, 56 years +/- 11) who had undergone complete surgical resection of RCC. Mean follow-up period was 45 months (range, 7-92 months). In consensus, two radiologists determined the presence or absence of tumor recurrence and recorded the time and sites of tumor recurrence. The relationships between tumor recurrence and tumor factors, including greatest diameter (> or =5 cm or <5 cm), T stage, N stage, stage group, histologic subtype, and nuclear grade, were evaluated by using Kaplan-Meier statistics. RESULTS: Tumor recurred in 41 (21%) patients. The mean time of tumor recurrence was 17 months (range, 3-50 months). Tumor recurred within 2 years after surgery in 34 (83%) patients. Tumor recurrence sites included lung (n = 29), bone (n = 13), the nephrectomy site (n = 7), brain (n = 6), liver (n = 5), mediastinal lymph nodes (n = 5), the contralateral kidney (n = 4), and the neck muscles (n = 2). The recurrence rate was greater for tumors 5 cm or larger than for those smaller than 5 cm, greater for T3a or T3b tumors than for T1 tumors, greater for stage III tumors than for stage I tumors, and greater for tumors with a nuclear grade of 3 or 4 than for those with a nuclear grade of 1 or 2 (P < .05 for all). CONCLUSION: RCC usually recurs within 2 years after surgery, with the lung being the most vulnerable site; greatest tumor diameter, T stage, stage group, and nuclear grade are important factors for recurrence.