Effect of copper(II) chloride on suppression of racemization in peptide synthesis by the mixed anhydride and related methods

In segment couplings by the mixed anhydride method using isobutyloxycarbonyl chloride, the use of copper(II) chloride as an additive suppressed racemization completely in the same manner as in the carbodiimide method reported previously. This was confirmed by employing a number of couplings between Z-dipeptides and amino acid esters. The racemization-suppressing effect of other compounds were also evaluated by employing one of these model couplings to be at best only limitedly effective. Copper(II) chloride was effective also in the related method using EEDQ. Thus, in the couplings where a low level of racemization was observed without an additive, the addition of copper(II) chloride eliminated racemization even at ambient temperature where EEDQ is usually used. The effectiveness of copper(II) chloride was confirmed also in the BOP-C1 method. In the presence of HOBt racemization was reduced to a low but still detectable level, while it was suppressed completely by the addition of copper(II) chloride.     

Proliferative activity in intrahepatic metastasis of hepatocellular carcinoma

To assess the characteristics of intrahepatic metastatic lesions (IML) in hepatocellular carcinoma (HCC), we analysed both the histological features and proliferative activities of 15 resected cases of HCC accompanied by IML. The histological features of the IML were essentially the same as those observed in the main nodules in 12 (80%) of 15 cases. In 13 (87%) of 15 cases, the labelling index of proliferating cell nuclear antigen (PCNA) in the IML was either higher than or the same as in the main nodules. In 10 (77%) of 13 cases, the MIB-1 labelling index in the IML was either higher than or the same as in the main nodules. The results indicate that the histological features of the IML are essentially the same as those of the main nodules, while the proliferative activities in the IML were generally higher than those in the main nodules. Such characteristics may thus provide a clue to help distinguish intrahepatic metastasis from the multicentric occurrence of HCC.     

Three‐dimensional endoscopic ultrasonography for the assessment of early gastric carcinoma invasion: could it provide diagnostic innovations?

Background: This study aimed to evaluate a three‐dimensional endoscopic ultrasonographic (3‐D EUS) system in the assessment of the tumor invasion depth of early gastric carcinoma. Methods: Sixty‐nine macroscopically early cancer lesions in 67 patients were recruited in an in vivo study. The surgically resected gastric specimens of 30 of them were re‐examined in an ex vivo study. An Olympus 3‐D EUS imaging system was employed in both studies. Diagnostic accuracy for tumor invasion depth was evaluated and compared with histopathological sections stained by H&E and Masson’s trichrome stain. Reconstructed surface‐rendering images were evaluated and compared with the endoscopic and macroscopic findings. Results: Three‐dimensional EUS allowed rapid tomographic assessment of the lesions in both the in vivo and ex vivo studies. The accuracy of 3‐D EUS for the assessment of tumor invasion depth was 87% in the in vivo study. The accuracy rate was significantly lower (P = 0.03) for the cancer lesions associated with ulcer fibrosis (74%) than for those with no fibrosis (97%). In the 30 subjects who underwent both studies, the accuracy rates were higher in the ex vivo than the in vivo study (94%vs 77% for all the lesions, and 93%vs 74% for cancers associated with fibrosis), but were not statistically significant. The rates of good surface‐rendering images were 64% and 94% in the in vivo and ex vivo studies, respectively. The differences were attributed to the clearer dual‐plane reconstruction images obtained in the ex vivo study in absence of motion artifacts. Conclusions: Three‐dimensional EUS is a promising imaging technique for the assessment of tumor invasion depth of early gastric cancer.     

Serum cholesterol levels in patients with panic disorders: A comparison with major depression and schizophrenia

Abstract Results of several long-term follow-up studies suggest that mortality due to cardiovascular diseases is high in males with panic disorder (PD). Based on these data, various studies have been undertaken to determine the relationship between PD and total cholesterol (TC) levels; however the results obtained so far have not been consistent. We compared TC levels in 46 PD patients to those in 46 sex, age, smoking and alcohol consumption matched patients with major depression and 46 matched patients with schizophrenia. The relationship between TC and the severity of PD was investigated, and before- and after-treatment TC change was compared. TC levels were significantly higher in the PD group than in the other groups, regardless of sex. The severity of PD was not correlated with TC levels. TC levels did not decrease in remitted PD patients. These findings suggest that relatively high TC levels in PD patients are attributable to endogenous disease-specific factors. Clinicians should pay close attention to the correlation between high mortality due to cardiovascular diseases and relatively high TC levels in male PD patients.     

Papillary cystadenocarcinoma of the prostate

A giant cystic formation was found behind the prostate of a 69-year-old man who presented with urinary retention. Ultrasonography, computed tomography scans and magnetic resonance imaging revealed a large cystic intrapelvic mass and biopsy of the cyst wall diagnosed papillary cyst adenocarcinoma. Immunohistochemically, the tumor originated from the prostate.     

A long-term survivor of ruptured hepatocellular carcinoma after hepatic resection

Abstract We treated a patient who had previously undergone a hepatic resection for ruptured hepatocellular carcinoma (HCC) but developed a solitary peritoneal recurrence at the site of the incision 8 years and 9 months later. Since no other recurrence was evident, we resected the tumour. The primary tumour was 2.5 cm in size and histological examination revealed HCC without any histological risk factors for intrahepatic recurrence. The peritoneal tumour consisted of less differentiated cancer cells than those found in the primary tumour. The positive rates of Ki-67 were 10% in the primary tumour and 23.3% in the peritoneal recurrence. The DNA indexes in both tumours were considered to be identical.
The comparison between the primary and peritoneal tumours suggested that the histological differentiation and proliferation activity can change after recurrence, in spite of consistent DNA ploidy contents. Clinically, a patient who undergoes a hepatic resection for ruptured HCC can survive for a long time, such as 10 years, if they have good liver function and small HCC without any histological risk factors for intrahepatic recurrence. However, since late recurrence is possible, a follow up for as long as 10 years is recommended.     

Acute myositis with transient decrease of albumin, immunoglobulin, and complement following rotavirus gastroenteritis

A 2-year-old boy developed acute myositis associated with rotavirus gastroenteritis. He had remarkable swelling and subcutaneous edema, mostly in the legs, 4 days after the onset of gastroenteritis. Marked elevation of creatine kinase was observed while serum albumin, immunoglobulin, and complement were decreased.     

Detection of oral streptococci with collagen‐binding properties in saliva specimens from mothers and their children

International Journal of Paediatric Dentistry 2010; 20: 254–260 Background. Approximately 10–20% of Streptococcus mutans strains have been reported to possess collagen‐binding properties, whereas other species in the oral cavity with those properties remain to be elucidated. Aim. To identify strains with collagen‐binding properties and analyse their characteristics in comparison with S. mutans. Design. A total of 110 expectorated saliva specimens were collected from 55 pairs of mothers and their children. Bacterial strains with collagen‐binding properties were isolated and the species specified. In addition, strains with collagen‐binding properties isolated from mother–child pairs were analysed using molecular biological approaches. Results. The detection frequency of strains with collagen‐binding properties was shown to be 40.9%, among which S. salivarius was the most frequently detected, followed by S. mutans. The collagen‐binding activity of the S. mutans group was the highest, followed by S. salivarius. In addition, S. mutans and S. salivarius strains from 3 and 1 mother–child pairs, respectively, were shown to be the same clones. Conclusions. Our results indicate that S. mutans and S. salivarius are major species with collagen‐binding properties in the oral cavity, and that strains with such properties may be related to mother–child transmission.     

How frequent are invasive therapies required in patients receiving tamsulosin for benign prostatic hyperplasia? A retrospective long‐term study

Three hundred Japanese patients with benign prostatic hyperplasia (BPH) who started an alpha1-adrenoceptor blocker, tamsulosin, between 1993 and 1996 were followed for 3.0+/-3.3 years (mean+/-SD) to determine whether an association existed between the disease severities measured prior to the tamsulosin treatment and the timing at which the invasive therapy was implemented. Patients with a lower quality of life (QOL) index or maximum urinary flow rate (Qmax) were transferred for invasive therapy earlier than those with less severe BPH. The International Prostate Symptom Score (I-PSS) was also associated, but apparently to a lesser extent, with the timing of the invasive therapy. Finally, the overall severity evaluated using all of the above three indices, I-PSS, QOL index, and Qmax, in accordance with the 'Severity Criteria for BPH' issued by the Japanese Urological Association, was found to be a good measure for predicting the prognosis of patients with BPH treated with tamsulosin.