A case of atypical teratoid/rhabdoid tumor in an adult, with long survival

Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant tumor that mostly occurs in early childhood and has poor prognosis despite aggressive therapy. Adult cases are rare and, as far as we are aware, only 30 cases have been reported to date. Here we present the case of a 27-year-old female with left parietal AT/RT with the chief complaint of numbness of the right superior limb. First, the tumor was surgically removed and the diagnosis was grade II glioma. With additional radiotherapy, the clinical course after surgery was favorable. After 6 years, she had an operation for recurrence and the diagnosis was grade III glioma. Temozolomide was prescribed, and a disease-free period of 2 years followed. Surgery was performed for a third time for second recurrence with histology of diffuse growth of rhabdoid cells. Immunohistochemistry was partially positive for vimentin and epithelial membrane antigen. Ki-67 labeling index was extremely high and tumor cells showed no staining of INI1 suggestive of diagnosis of AT/RT. We re-evaluated past specimens and none had immunoreactivity of INI1. Ki-67 labeling index and O-6 methylguanine DNA methyltransferase (MGMT) staining were also re-examined and both increased gradually. She is still alive without recurrence for more than 1 year. As far as we are aware, this is the second longest survival of an adult with AT/RT.     

Relationships Between Leaching of Methylmercury from the Soil and the Basic Characteristics of Alkali Soil Polluted by Mercury in Guizhou China

To determine the relationship between soluble methylmercury and soil characteristics which was contaminated by mercury, several experiments were conducted. As a result, a good correlation was founding between the leached methylmercury level from soil and the EC (electronic conductivity) level of soil. Moreover, to grasp the relationship between soluble methylmercury and soluble anions from soil, several anions (Cl⁻, NO³⁻, SO₄ ²⁻) were measured using the ion chromatography method. Although the correlation coefficient was small (r = 0.40), only a correlation between the level of SO₄ ²⁻ and leached methylmercury was recognized.     

Association between sleep duration and hemoglobin A1c level

ObjectiveThe association between sleep habits and hemoglobin A_1c (HbA_1c) level has not been sufficiently examined. In the present study of residents in a local community, the associations between sleep duration and HbA_1c level were examined.MethodsSelf-administered questionnaires were mailed to 1062 residents in a rural community in Japan, and completed questionnaires were collected. At the time of collection, the fasting plasma glucose and HbA_1c levels were measured using peripheral blood samples. For the analyses, values that were considered to represent high levels were a fasting plasma glucose level of ⩾126 mg/dl and a HbA_1c level of ⩾6.5%. Logistic regression analyses were performed to examine the associations between sleep duration and high fasting plasma glucose or high HbA_1c levels.ResultsThe prevalence of high fasting plasma glucose and high HbA_1c levels was significantly high (p < 0.01) in subjects with a short or a long sleep duration. Logistic regression analyses demonstrated a significant association between high HbA_1c level and sleep duration. The adjusted odds ratios for a high HbA_1c level showed high values with regard to both short and long sleep durations.ConclusionsHbA_1c level showed a U-shaped association with sleep duration. These results suggest that there may be an appropriate range of sleep duration in individuals with glucose tolerance disorders. It is expected that the present findings will contribute to the treatment and prevention of diabetes mellitus.     

Testosterone decreased urinary-frequency in nNOS-deficient mice

To observe the effect of testosterone on the frequency of urination in mice lacking neuronal nitric oxide synthase (nNOS(-/-)), we compared the urination patterns between unanaesthetized male wild-type (n = 27) and nNOS(-/-) mice (n = 50) with or without testosterone treatment. Compared with wild-type mice, nNOS(-/-) mice showed a greater frequency of urination during a 24-h observation period (3.0 vs. 5.4 times/day, p < 0.0001) without any significant difference in the total voided volume or the functional voiding capacity. While testosterone treatment did not affect the urination patterns in wild-type, it decreased the daytime frequency of urination (5.4 vs. 3.7 times, p = 0.0198) and the nighttime urination (4.4 vs. 2.9 times, p = 0.039) in nNOS(-/-) mice. The nNOS(-/-) mice can be a useful animal model for urinary frequency. Testosterone improved the functional abnormalities in the voiding of nNOS(-/-) mice.     

Development of a reflected optical fiber system for measuring oxygen saturation in an integrated artificial heart-lung system

Abstract:  The purpose of this study was to develop a blood oxygen saturation (OS) monitoring system for use with an integrated artificial heart–lung system (IAHLS). The OS monitoring system consists of two paired optical fiber probes (OFPs) and a measurement system. To investigate the effect of the OFP configuration and incident light wavelength on the relationship between OS and the reflectance ratio for wavelengths of 810 and 645 nm, we performed theoretical analyses of the relationship between OS and R810/R645 using a diffusion equation. The prototype OFP located on the blood outlet port of our IAHLS housing was evaluated using an in vitro test. An OS range of 65–100% was adjusted to supply oxygen and nitrogen gas to the IAHLS. The blood flow rate was maintained at 3 L/min by the rotational speed of an impeller in the IAHLS. The OS-corrected blood from the IAHLS was measured using a commercial gas analyzer. The correlation coefficients ( r ²) between the theoretical ratio of R810/R645 and OS, and between measured OS and the reflectance ratio of R810/R645 were 0.97 and 0.78, respectively. In conclusion, we confirmed that the development of this oximetry system is applicable for IAHLS.       

Effects and risks of radiofrequency ablation on the pulmonary tissue and vascular system: A preliminary histological study

Purpose Radiofrequency ablation (RFA) is one of the minimally invasive therapeutic modalities for malignant tumors. However, the effects and risks associated with RFA on pulmonary tumors have not yet been well investigated. We pathologically examined the effects of RFA on the healthy pulmonary parenchyma in the inflated and deflated states of swine lungs. Methods We used two 2-year-old female pigs. Under general anesthesia, RFA was performed twice. Results The mean duration of cauterization for the inflated lungs (93.0 ± 65.4 s) was significantly shorter than that for the deflated lungs (390.3 ± 75.6 seconds) (P = 0.0062). Histologically, the dilatation and congestion of the microvessels were more marked in the lungs. However, no histopathological differences were noticed between the inflated and deflated lungs. Adventitial degeneration was seen in the small vessels, but not in the wall of the large vessels. Conclusions This study confirmed, pathologically, that RFA is effective with an acceptable degree of minimal damage to the normal lung tissue, irrespective of its conditions, i.e., inflated or deflated, and can be safely done near the pulmonary vessels. Therefore, RFA appears to be a promising therapeutic strategy to control local lesions in the field of thoracic surgery. The authors have nothing to declare regarding any conflicts of interest.     

Double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct

We report a case of double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct. A 73-year-old woman was admitted to the hospital complaining of upper abdominal pain. Endoscopic retrograde cholangiography showed a stenotic lesion in the lower common bile duct and no visualization of the cystic duct or gallbladder. Enhanced computed tomography revealed a heterogeneously enhanced tumorous lesion around the lower bile duct in the pancreatic head. A diagnosis of cancer arising from the cystic duct that entered the lower part of the common hepatic duct was made by intraductal ultrasonography, which showed an intraluminal protruding lesion in the cystic duct. Isolated gallbladder cancer was also diagnosed, by abdominal computed tomography. She underwent pancreaticoduodenectomy with dissection of regional lymph nodes. Histological examination revealed moderately differentiated adenocarcinoma of the cystic duct and well-differentiated adenocarcinoma of the gallbladder. Double cancer of the cystic duct and gallbladder is extremely rare, and this case also suggests a relationship between a low junction of the cystic duct and neoplasm in the biliary tract.