Chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion: a case report

We report on an extremely rare chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion. Prenatal ultrasound examination demonstrated a heterogeneous mass in the right thorax associated with a massive pleural effusion and right lung compression at 29 weeks of gestation. The patient underwent pleuroamniotic shunting at 30 weeks and was delivered at 33 weeks by cesarean delivery secondary to fetal distress. After management of the respiratory distress and evaluation of the mass, surgery was performed at day of life 8. Histological examination confirmed the diagnosis of a chest wall mesenchymal hamartoma.     

A neonatal case of anterior spinal artery syndrome presenting with bilateral arm paresis

Anterior spinal artery syndrome is rare in children, especially in neonates. We present a girl with hydrops fetalis and hypothyroidism who developed flaccid paresis of both arms in the neonatal period (around day 25). MRI of the spine performed on day 52 revealed atrophic changes at C5-Th1 without Gd-DTPA-induced enhancement. Nerve conduction studies were also helpful in the diagnosis;in the upper limbs, motor potential was not elicited, while sensory nerve conduction velocity was normal. These clinical and laboratory findings suggested an atypical case of anterior spinal artery syndrome.     

Pattern of<Superscript>111</Superscript>in-chloride bone marrow scintigraphy in myelodysplastic syndrome; comparison with clinical characteristics

111In-chloride bone marrow scintigraphy (bone marrow scintigraphy) was performed in patients with myelodysplastic syndrome (MDS), tracer accumulation was classified into patterns, and the relationship between the accumulation patterns and prognostic factors was investigated to assess the usefulness of bone marrow scintigraphy. The subjects were 14 patients diagnosed with MDS. Accumulation of the bone marrow scintigraphy tracer was classified according to the degree of accumulation in the axial bone marrow and peripheral expansion. International Prognostic Scoring System (IPSS), which are frequently used for prognostic evaluation of MDS, and conversion to leukemia were investigated in prognostic factors. We also investigated the relationship between enlargement of the liver and spleen and the prognostic factors. The accumulation patterns were as follows: pattern I, The normal accumulation pattern (2 cases); pattern II, the expanded accumulation pattern (6 cases); pattern III, low accumulation pattern (5 cases); and pattern IV, heterogeneous accumulation pattern (1 case). The relationships between the two prognostic factors and accumulation patterns were investigated, and the prognosis was found to be significantly poorer in the patients with the low accumulation pattern than the expanded accumulation pattern. Enlargement of the liver and spleen was not significantly correlated with the prognostic factors.     

Cytoarchitecture and intercalated disks of the working myocardium and the conduction system in the mammalian heart

Working and specialized cardiac myocytes and their intercalated disks (ID) in the mammalian heart were examined by transmission and scanning electron microscopy. The NaOH/ultrasonication treatment of cardiac tissues resulted in the digestion of collagen fibers and separation of intercellular junctions. Auricular and ventricular myocytes were cylindrical in shape, bifurcated, and connected end-to-end at the ID. The ID in the working myocardium showed a stair-like profile, consisting of steps (plicate segments) and corresponding risers (interplicate segments). The ventricular myocytes had many steps and risers. The steps were filled with numerous finger-like microprojections, including desmosomes, fasciae adherentes, and small gap junctions. The risers showed the smooth surface, including desmosomes and large gap junctions. The cell strands of the sinoatrial node were oriented linearly, while those of the atrioventricular node formed a reticular network. The ID in both nodal cells was underdeveloped, having few microprojections. Myocytes in the His bundle and its branches were arranged in parallel, and Purkinje cell strands formed reticular networks. The ID in the His-Purkinje system was irregular in appearance, and the microprojections were larger in size and smaller in number than those of working myocytes. There were few microprojections in the sheep Purkinje cells. The gap junctions in the conduction system were few or small in size in the nodal tissue, but large in the His-Purkinje system.     

Metabolic fate of orally administered phyllodulcin in rats

Naturally occurring phyllodulcin (1) was orally administered to rats to investigate its metabolic fate. Urinary metabolites were analyzed by three-dimensional HPLC. Phyllodulcin-3'-O-sulfate (2), phyllodulcin-3'-O-beta-glucuronide (3), 2-[2-(3,4-dihydroxyphenyl)ethyl]-6-hydroxybenzoic acid (4), and one novel bibenzyl derivative, 2-[2-(3-hydroxy-4-methoxyphenyl)ethyl]-6-hydroxybenzoic acid (5), together with thunberginol G (6) and hydrangenol (7) were isolated from the phyllodulcin-treated urine. 1 was extensively metabolized to 4-6 by a rat fecal suspension after incubation for 24 h. Urinary excretion of 4-6 in rats administered phyllodulcin orally was substantially reduced when the rats were treated with antibiotics to suppress their intestinal flora. On the other hand, the incubation of 1 with rat liver S-9 mix showed the presence of 7 together with 4 and 5.     

Molecular genetics of Mycobacterium tuberculosis in relation to the discovery of novel drugs and vaccines

Genetic systems that allow mycobacterial genomes to be mutagenized in a targeted or random fashion have provided the means for developing new tools for the diagnosis, prevention and treatment of tuberculosis by allowing potential targets to be identified and validated. In this review, we highlight key historical developments in the field of mycobacterial genetics, which have yielded the powerful repertoire of genetic tools that are now in hand and provide examples that illustrate their use in exploring specific aspects of mycobacterial metabolism.     

Associations between baseline plasma MHPG (3-methoxy-4-hydroxyphenylglycol) levels and clinical responses with respect to milnacipran versus paroxetine treatment

The purpose of this study was to investigate the effects of milnacipran and paroxetine on plasma levels of catecholamine metabolites, and we attempted to elucidate the differences between the mechanisms of these drugs in catecholaminergic neurons. In depressed patients, we investigated the relationships among pretreatment levels of catecholamine metabolites, the changes in plasma catecholamine metabolite levels before and after administration of milnacipran or paroxetine, and clinical response to these drugs. Responders to milnacipran showed lower pretreatment levels of plasma 3-methoxy-4-hydroxyphenylglycol (pMHPG) than did nonresponders to milnacipran; there was also a positive correlation between changes in pMHPG levels and percent improvement of the score on the 17-item Hamilton Rating Scale for Depression (HRSD). On the other hand, responders to paroxetine showed higher pretreatment levels of pMHPG than did nonresponders to paroxetine, and a negative correlation was observed between changes in pMHPG levels and percent improvement of the HRSD score. However, a significant difference was not observed in the pretreatment plasma level of homovanillic acid between responders and nonresponders to treatment with milnacipran or paroxetine. These results suggest that there is an association between baseline pMHPG levels and clinical responses with respect to milnacipran versus paroxetine treatment.     

Evaluation of liver metastasis of colorectal cancer following hepatic arterial infusion with degradable starch microspheres and adriamycin, mitomycin C as seen in changes in CEA at early stage of therapy

OBJECTIVE: Recently, for the treatment of unresectable colorectal cancer with liver metastasis, hepatic artery injection of anticancer drugs suspended in degradable starch microspheres (DSM) is being performed. To predict its effectiveness, we did a retrospective study to see whether or not changes in CEA at early stages of therapy are significant. SUBJECTS AND METHOD: The subjects were 16 patients with unresectable colorectal cancer with liver metastasis (H3) who had undergone DSM therapy at least three times (mean age 65, male to female ratio of 10:6, 6 cases of synchronous metastasis and 10 cases of metachronous metastasis). Adriamycin (ADM) 30 mg and mitomycin C (MMC) 10 mg were suspended in 600 mg of DSM and injected into the common hepatic artery until embolization of the vessel was recognized (once/3-4 weeks). We examined the changes in CEA level (doubling time or half time) and the time to progression (TTP) of CEA after the third DSM treatment. RESULTS: Of the 16 patients, 4 (25%) showed rise in CEA, of which 3 died within a year. In the 12 cases with decreased CEA, the half time was 20-526 days (mean of 80 days). When the TTP of CEA was compared for the group with CEA half time less than 80 days (n = 6) to those with more then 80 days (n = 6), the TTP was significantly longer in the group with half time less than 80 days (p = 0.02 logrank test). CONCLUSION: To evaluate the effectiveness of DSM therapy, it is important to examine the changes in CEA at the early stages of treatment.     

Effect of pravastatin on coronary plaque volume

A volumetric analysis by 3-dimensional intravascular ultrasound revealed that lipid-lowering therapy with pravastatin significantly reduced coronary plaque volume. The changes in plaque volume were inversely correlated with the changes in plasma levels of high-density lipoprotein cholesterol but not with changes in levels of total cholesterol or low-density lipoprotein cholesterol.