Intranuclear inclusions of meningioma associated with abnormal cytoskeletal protein expression

We describe a case of meningothelial meningioma with a large number of intranuclear inclusions. Morphologically, these are divided into cytoplasmic inclusions and nuclear vacuoles. The cytoplasmic inclusion has a limiting membrane with cell organelles and filaments. Inclusions of this type are generally eosinophilic, like the cytoplasm. However, there are many inclusions that are more eosinophilic than the cytoplasm or that have a ground-glass appearance. Some of them may contain fine or coarse granules. On the other hand, the nuclear vacuole lacks a limiting membrane and appears empty. In most of the inclusions of this type, there is a faintly basophilic substance in the margin. Generally, the cytoplasmic inclusions are as immunopositive as cytoplasm with vimentin, but some of these cytoplasmic inclusions are more reactive. Under the electron microscope, abnormal aggregation of intermediate filaments is recognized in the cytoplasmic inclusions. It is considered that a strong reaction of cytoplasmic inclusions with vimentin immunostaining is due to abnormal aggregation of intermediate filaments. The present study distinctly demonstrates abnormal localization of intermediate filaments in the cytoplasmic inclusions, and it is suggested that the cytoskeleton participates in the evolution of the cytoplasmic inclusions.     

Regulation of the level of epidermal growth factor by oestrogen in the submandibular gland of female mice

The concentration of epidermal growth factor (EGF) in the submandibular gland of immature female mice (less than 6 weeks old) was low, ranging from 0.07 to 0.17 pmol (0.4 to 1.0 ng)/mg wet wt, but increasing to 7.61 pmol/mg wet wt by 8 weeks of age. It remained relatively constant up to 24 weeks of age, but thereafter the glandular EGF concentration increased again during the post-reproductive period to reach 62.9 pmol/mg wet wt. In contrast, the glandular EGF content in male mice increased greatly during the first 17 weeks of age to about 310 pmol/mg wet wt, and thereafter remained relatively constant up to 48 weeks of age. Ovariectomy of mature virgin mice markedly increased the glandular concentration of EGF to about 74.4 pmol/mg wet wt 4 weeks after the operation. This increase was suppressed by oestradiol-17 beta administered to ovariectomized mice at a dose of 1 microgram/mouse per day but not by 1 mg progesterone. Histological studies indicated that granular convoluted tubular cells that produced EGF in the submandibular gland were much less abundant in 12-week-old female and in oestrogen-treated ovariectomized mature mice than in 40-week-old female and ovariectomized mature mice. We conclude that oestrogen suppresses the concentration of EGF in the submandibular gland of female mice.     

Observation of occlusal force in prosthetic crown cementings

The method of pressure force in crown cementing was examined. Continuous occlusal force was always supported by the patients' personal occlusal force in cementing crowns. We found that continuous occlusal force continuously decreased as the occlusal force increased, and the decreasing morphologies were classified into four types, 'Rapid decrease', 'Step-wise decrease', 'Intermediate decrease' and 'Gradual decrease'.     

Assessment of medication adherence and treatment satisfaction in Japanese patients with psoriasis of various severities

Psoriasis is a chronic, relapsing, inflammatory keratotic skin disease. To elucidate the medication adherence and treatment satisfaction, we performed a questionnaire survey using the eight‐item Morisky Medication Adherence Scale (MMAS‐8) and nine‐item Treatment Satisfaction Questionnaire for Medication (TSQM‐9) of 163 psoriatic patients who regularly visited hospitals or clinics. To assess the relationship between the MMAS‐8/TSQM‐9 outcomes and severity of psoriasis, two different clinical severity indices were used: the Psoriasis Area and the Severity Index (PASI) for disease severity and the Psoriasis Disability Index (PDI) for quality of life (QOL) impairment. The MMAS‐8 score for oral medication was significantly higher than that for topical medication. The oral and topical MMAS‐8 scores were significantly correlated with the PDI score, but not with the PASI score, indicating that QOL impairment lowered treatment motivation. All of the TSQM‐9 domain scores (effectiveness, convenience and global satisfaction) were significantly correlated with both the PASI and PDI scores, suggesting that patients whose skin and QOL conditions were under good control had high satisfaction with treatment. Patients treated with biologics had higher satisfaction than those treated with non‐biologics.     

Surgical resection of primary liposarcoma of the anterior mediastinum.

We report on the rare and surgical treatment of a case of primary mediastinal liposarcoma. A 64-year-old male complained of hoarseness for one month and was admitted to our hospital because of an abnormal shadow, which was postulated to be an anterior mediastinal tumor on a chest computed tomography (CT) scan. Horizontal T1-weighted magnetic resonance imaging (MRI) showed an anterior mediastinal round mass with a signal intensity similar to that of subcutaneous fat, which was 6.5 cm in diameter. An operation similar to extended thymectomy was perfomed through a median sternotomy. Histological examination of the resected specimen revealed that the tumor was composed of well-differentiated liposarcoma and pleomorphic malignant fibrous histiocytoma and the tumor was diagnosed as a de-differentiated liposarcoma. We discuss it with reference to a collective review of the Japanese literature for surgical cases of primary liposarcoma of the mediastinum.     

Significance of immunosuppressive acidic protein in the diagnosis and follow-up of patients with ovarian cancer, in particular as a marker for chemotherapeutic effects

Serum immunosuppressive acidic protein (IAP) was determined in patients with ovarian cancer and was examined as a marker for ovarian cancer when, chemotherapy in particular, was applied. Samples were sera obtained from 68 ovarian cancers, 74 benign ovarian tumors, 54 cervical cancers, 57 uterine myomas and 88 healthy controls. Elevated levels of IAP were found in 89.5% of patients with ovarian cancer and this high positive ratio was not affected by tumor histologic features. The measurement of the serum IAP level is useful for the initial diagnosis of ovarian cancer because of low false positive rates (8.1%) in benign ovarian tumors and high positive rates even in the early stage of ovarian cancer. Serial determinations of serum IAP levels were well correlated with the response to the treatment (chemotherapy in particular) and the prognosis of cancer patients, even in the case of patients with leucocytopenia induced by the intensive chemotherapy. In case of recurrent patients (whose lesions were observed in the intraperitoneal space), IAP values tended to increase earlier than other conventional tumor-derived markers. Therefore, IAP may also be a useful follow-up marker for patients with ovarian cancer (particularly, for the early detection of recurrence).