Ectopic chromosome around centrosome in metaphase cells as a marker of high-risk human papillomavirus-associated cervical intraepithelial neoplasias

This report describes the appearance of ectopic chromosome around centrosome (ECAC) in metaphase cell nuclei of high-risk HPV-associated cervical neoplasms. ECAC are clearly visible on HE-stained sections as a tiny (approx. 0.7 micro), round, dark structure or an aggregate of filamentous chromosome, often symmetrical at bilateral centrosomes. They appear in CINs from an early stage (CIN I), with the highest incidence in HPV16-associated CIN II-III (75%), and are less common in HPV-related invasive carcinomas (21%) and in lesions associated with high-risk HPV types other than 16. Rates for ECAC-positive nuclei in metaphase preparations (ECAC rate) for each lesion ranged 3.6-30%, the average being 14.5%. ECAC appeared very rarely in CINs associated with intermediate-risk HPVs and was never encountered in HPV6/11-induced condylomas or HPV-unrelated neoplasms in other organs. ECAC may be morphologic evidence of HPV-induced chromosomal instability working as a background mechanism in cervical carcinogenesis and also a useful marker for the histopathologic differentiation of high-risk CINs.     

BRPK, a novel protein kinase showing increased expression in mouse cancer cell lines with higher metastatic potential

A novel protein kinase named BRPK was isolated and partially characterized. BRPK was expressed at a higher level in three carcinoma cell lines with higher metastatic potential. Mouse and human BRPK cDNAs are well conserved and encode 580 and 581 amino acids, respectively. BRPK has a serine/threonine-type protein kinase domain, and the recombinant proteins of BRPK were capable of autophosphorylation. The results of a comparative sequence analysis indicated a possible link of BRPK to BRAP2. BRAP2 is known to bind the nuclear localization signal of BRCA1. We cloned mouse BRAP2 cDNA and showed the presence of isoforms.     

Hepatic encephalopathy secondary to intrahepatic portosystemic venous shunt: balloon-occluded retrograde transvenous embolization with n-butyl cyanoacrylate and microcoils

We report a 70-year-old woman with hepatic encephalopathy due to an intrahepatic portosystemic venous shunt that was successfully occluded by percutaneous transcatheter embolization with n-butyl cyanoacrylate and microcoils.     

Does contrast enhancement on CT suggest tumor response for chemotherapy in small cell carcinoma of the lung?

PURPOSE: The purpose of this article is to assess the correlation between contrast enhancement on CT and the tumor reduction ratio in small cell carcinoma of the lung after first-line chemotherapy. MATERIALS AND METHODS: Twenty-eight patients with small cell carcinoma of lung underwent preenhancement and postenhancement CT scans before and after first-line chemotherapy, followed by second-line chemotherapy in 7 patients who had relapsed. The authors retrospectively analyzed the correlation between the tumor reduction ratio and the CT numbers of contrast enhancement in each case by multiple regression analysis using SPSS. RESULTS: The mean tumor-reduction ratio was 58.2 +/- 43.2% after first-line chemotherapy, and the mean CT enhancement was 33.2 +/- 11.0 Hounsfield units (HU). The correlation coefficient between the tumor reduction ratio and the CT numbers of contrast enhancement was 0.57 (r = 0.32), and p value was < 0.002. After chemotherapy, more than 90% tumor reduction was seen in 11 patients. They revealed an average 41.9 +/- 7.6 HU tumor enhancement. Less than 50% tumor reduction was seen in 10 patients. They revealed an average 26.2 +/- 7.9 HU tumor enhancement. If these criteria of 30 HU contrast enhancement and 80% tumor reduction ratio were applied as a guide for chemotherapy response, the sensitivity, specificity, positive predictive value, and negative predictive value would be calculated as 85.7%, 84.6%, 85.7%, and 84.6%, respectively. CONCLUSION: In small cell carcinoma of the lung, it is statistically proven that the more enhanced tumor on CT, the better response to chemotherapy. Tumor enhancement of 30 HU is a suggestive guide for chemotherapy response in patients with small cell carcinoma.     

Effects of intracoronary calcium chloride on regional oxygen balance and mechanical function in normal and stunned myocardium in dogs

Background. Brief myocardial ischaemia has been demonstratedto result in mechanical and coronary endothelial dysfunction,in which calcium may play a role. We examined whether the mechanicaland vascular responses to calcium are altered in postischaemic,reperfused myocardium. Methods. Regional myocardial oxygen consumption (MV^·_O2),mechanical function and coronary blood flow (CBF) in responseto calcium chloride (0.10, 0.25, 0.50 and 0.75 mg ml^–1of CBF) directly infused into the left anterior descending (LAD)artery were determined before (normal) and 30 min aftera 15-min-period of LAD occlusion (stunned) in an open-chestcanine model. Percentage segment shortening (%SS) and percentagepostsystolic shortening (%PSS) in the LAD territory were determinedusing ultrasonic crystals and CBF using a Doppler transducer.Myocardial extraction of oxygen (E_O2) and lactate (E_lac) wascalculated. Results. The infusion of calcium chloride resulted in dose-dependentincreases in %SS and MV^·_O2 but did not affect %PSS innormal myocardium. These changes were accompanied by parallelincreases in CBF, resulting in no change in E_O2. In stunnedmyocardium, the responses to calcium chloride were not significantlyaltered, with the exception of a reduction in %PSS. However,ischaemia and reperfusion itself significantly reduced %SS andE_lac and increased %PSS. Conclusions. These data suggest that calcium chloride improvesregional systolic and diastolic function both in normal andstunned myocardium. Calcium chloride is unlikely to cause directcoronary vasoconstriction or to deteriorate regional mechanicalfunction in postischaemic myocardium. Br J Anaesth 2002; 88: 78–86     

Mucosa-associated lymphoid tissue lymphoma of the pituitary gland: MR imaging features

We report the MR features in a previously healthy patient with mucosa-associated lymphoid tissue lymphoma of the pituitary gland. The MR images showed a homogeneously enhancing solid mass in the sellar region and both parasellar regions; this mass extended through the bilateral foramina ovale along the third branches of the trigeminal nerves. The mass completely encircled the cavernous segments of both internal carotid arteries without narrowing the lumen. Gadopentetate dimeglumine-enhanced T1-weighted MR images showed homogeneous, strong enhancement of the mass.     

Modulation of renal sympathetic nerve activity during pneumoperitoneum in rats

To examine neural control of renal function during pneumoperitoneum, renal sympathetic nerve activity (RSNA) was measured in pentobarbital-anesthetized rats that had their entire nervous system intact or that had undergone lower thoracic dorsal rhizotomy or abdominal vagotomy. During pneumoperitoneum with intraabdominal pressure (IAP) of 10 mmHg, the mean arterial pressure did not change, but central venous pressure increased by 10 mmHg in all groups. In intact rats, the RSNA increased to 285 +/- 22% during pneumoperitoneum and gradually recovered after release of the insufflation. The RSNA responses decreased during pneumoperitoneum in rats with dorsal rhizotomy or vagotomy compared to responses in intact rats. In intact rats the urine volume and Na+ excretion decreased during pneumoperitoneum and increased just after insufflation release. Dorsal rhizotomy, vagotomy, or renal denervation did not alter the antidiuretic and antinatriuretic responses during pneumoperitoneum; however, diuretic and natriuretic responses were completely abolished by either of these denervations following insufflation release. These results suggest that oliguria during pneumoperitoneum was not due to neural control of renal function but probably to a mechanical influence induced by the elevated IAP. On the other hand, diuretic and natriuretic responses after insufflation release were thought to be a neurally mediated response.     

Practical usefulness of bipolar scissors in hepatectomy

BACKGROUND/AIMS: Because less surgical stress might preserve quality of life of patients, it is more desirable to decrease both intraoperative blood loss and liver injury especially in hepatectomy. For the patients with hepatocellular carcinoma based on chronic liver dysfunction, it is more essential to control bleeding and reduce liver injury in hepatectomy than in other diseases. In the present study, a retrospective comparison about usefulness was made in hepatectomy between using bipolar scissors and using conventional procedure. Before 1997, in our hospital, we had dissected the liver by using the crushing clamp method in combination with cauterization by microwave coagulator for the purpose of reducing intraoperative blood loss. Since 1998, bipolar scissors have been introduced toward hepatectomy as a new, simple and easy device to use. METHODOLOGY: Fifty-three consecutive patients with primary hepatocellular carcinoma at TNM stage I/II who underwent partial hepatectomy between 1996 and 1999 were enrolled in the study. Thirty-two patients (1996-1997) were treated by using a conventional method (group CM) and 21 patients (1998-1999) were treated by using bipolar scissors (group BS). The factors related to surgical stress were compared between the two groups. RESULTS: The amounts of blood loss/transfusion were lower in group BS (641/100 mL) than in group CM (1112/450 mL). The percentages of patients who lost more than 1000 mL of blood were lower in group BS (19%) than in group CM (47%) (P = 0.04). An intraabdominal drainage was needed for 9.0 +/- 6.6 days in group BS, and the drainage period was shorter than that in group CM (15.0 +/- 8.7 days) (P = 0.01). CONCLUSIONS: These results indicated the superiority of bipolar scissors in decreasing blood loss and liver injury to the conventional method, suggesting the worth of performing the prospective randomized study.     

Actions of farnesol and xylitol against Staphylococcus aureus

BACKGROUND: Heavy colonization of atopic dermatitis (AD) with Staphylococcus aureus is well documented. The isolation rate of methicillin-resistant S. aureus is high in strains from AD in Japan. Our objective in the present study was to investigate the actions of farnesol and xylitol against S. aureus for the control of AD skin lesion-colonizing S. aureus. METHODS: We examined the actions of farnesol on plasma coagulation and superantigenic exotoxin production by S. aureus, the antimicrobial activity of beta-lactam antibiotics combined with farnesol at concentrations below the minimal inhibitory concentration (MIC) and the effect of xylitol on glycocalyx production. RESULTS: Coagulation by S. aureus cells was inhibited in plasma containing farnesol at a concentration of 1/12 of the MIC (100 microg/ml) after incubation for 24 h. The production of superantigenic exotoxins by S. aureus cells with farnesol (100 microg/ml) was about 10 times lower than that by S. aureus cells alone. The MICs of ampicillin and cefdinir against S. aureus were reduced to < or =0.06 microg/ml in Mueller-Hinton agar plates with farnesol (100 microg/ml). We suggest that farnesol at concentrations above the MIC had a suppressive effect against S. aureus cells in the exponential and stationary phase and acted on the cell wall of S. aureus cells in both phases. CONCLUSIONS: Farnesol is a promising adjuvant agent against S. aureus skin infections treated with beta-lactam antibiotics. Further, 5% xylitol inhibited glycocalyx production by S. aureus cells and consequently had a suppressive effect on the colonization of S. aureus on the horny cells of AD lesions.