Comparison of 3.0-and 1.5-tesla diffusion-weighted imaging in the visibility of breast cancer

Purpose The aim of this study was to compare diffusion-weighted imaging (DWI) at 3.0 T and 1.5 T by evaluating the apparent diffusion coefficient (ADC) value and visibility of breast cancer in the same patients. Materials and methods A total of 13 patients (16 lesions) with breast cancer underwent DWI at 3.0 T and 1.5 T. Tumors were classified into two groups based on the lesion size. The ADC values were measured, and visibility of the tumors was scored blindly. Results No significant difference was found for ADC values between 3.0 T and 1.5 T in either group (P > 0.05). All of the large lesions were visible clearly at both magnetic field strengths, and image scores were not different (P > 0.05). In contrast, small lesions were more clearly visible and had better image scores at 3.0 T than at 1.5 T (P < 0.001). Conclusion Small cancers were more clearly visible on DWI at 3.0 T than 1.5 T.     

Effect of pancreastatin on cerulein-stimulated pancreatic blood flow and exocrine secretion in anaesthetized rats

BACKGROUND: Pancreastatin (PST) is an inhibitor of pancreatic exocrine secretion in vivo but not in vitro, which suggests that the inhibitory effect of PST is indirect, that is, not mediated by a specific receptor on pancreatic acinar cells. In this study, we investigated the effects of PST on pancreatic exocrine secretion and local pancreatic blood flow in anaesthetized rats to elucidate the participation of PST in indirect regulation of pancreatic exocrine function through blood supply. METHODS: Pancreastatin (100, 200 or 500 pmol/kg per h) was administered intravenously under background infusion of cerulein (0.5 microg/kg per h), a cholecystokinin analogue. Pancreatic exocrine secretion was monitored by volume and protein output of the pancreatic juice and local pancreatic blood flow was measured by the hydrogen gas clearance method. RESULTS: Pancreastatin significantly reduced cerulein-induced local pancreatic blood flow in a dose-dependent manner. Pancreatic exocrine secretion was also reduced significantly by PST dose-dependently. Pancreastatin did not change systemic blood pressure.These results suggested that the reduction of pancreatic blood flow is associated with the reduction of pancreatic exocrine secretion. CONCLUSIONS: We conclude that the mechanism of PST-induced inhibition of pancreatic exocrine secretion is, at least, partly mediated by the reduction of local pancreatic blood flow through blockade, caused by the action of cerulein on pancreatic blood flow.     

Development of Terumo implantable left ventricular assist system (T-ILVAS) with a magnetically suspended centrifugal pump

The research group of Terumo, NTN, and the Setsunan University have been developing an implantable left ventricular assist system (T-ILVAS) featuring a centrifugal blood pump with a magnetically suspended impeller (MSCP). The present study describes recent progress in the development of the T-ILVAS, focusing on ex vivo and in vivo evaluations of the prototype MSCP. The MSCP is composed of four parts: a magnetic bearing, an impeller, a housing, and a DC burshless motor. The impeller is suspended by a magnetic bearing, thus providing contact-free rotation of the impeller inside the pump. The prototype MSCP was placed paracorporeally in three sheep and implanted intrathoracically in two sheep to evaluate its long-term durability and nonthrombogenicity. One sheep implanted ex vivo with the paracorporeal MSCP (Model I) survived for 864 days without any mechanical failure or thromboembolic complications, and with negligible hemolysis. The implantable Model II pump was evaluated ex vivo in two sheep and intrathoracically implanted in one sheep. These experiments were terminated 70, 79, and 17 days after implantation due to mechanical failure caused by blood leakage through the intrahousing connector of the Model II pump. However, there was no intradevice thrombus formation in any of the retrieved pumps. The dual connector system was then introduced to the Model II pump (the modified Model II), and the pump was intrathoracically implanted in a sheep. The sheep survived for more than 14 months without major complications, and the study is being continued. The preliminary chronic animal experiments demonstrated improved durability and nonthrombogenicity of the MSCP, with a low hemolysis rate for up to 864 days. Thus, the MSCP has significant potential for longterm application as an implantable circulatory assist system. Further developments toward a totally implantable system, including an implantable controller and a transcutaneous energy/information transfer system, are under way.     

Extracapillary proliferation and arteriolar hyalinosis are associated with long-term kidney survival in IgA nephropathy

Background

The Oxford classification of IgA nephropathy consists of four markers as prognosticators. We retrospectively examined the relevance of extracapillary proliferation involving cellular and fibrocellular crescents (Ex) and arteriolar hyalinosis (A) on the long-term outcome of renal function.

Methods

A total of 314 Japanese patients who were diagnosed with IgA nephropathy, with 12 months or more of follow-up period were included in this study. A total of 186 patients were with UP ≥ 0.5 g/day. Patients with diabetes mellitus or severe kidney injury (eGFR < 30 ml/min/1.73 m²) were excluded. The presence of Ex and A were scored 0 in the absence, and 1 in the presence, of each lesion. The end point was determined as a 50 % reduction in initial eGFR or end-stage renal disease defined as eGFR < 15 ml/min/1.73 m².

Results

In univariate analyses, the kidney survival rate was significantly lower in patients with Ex1 and A1 if UP ≥ 0.5 g/day. In the patients with UP < 0.5/day, none of the clinical and pathological parameters was determined as a risk factor. In the multivariate model including pathological parameters, Ex1 and A1 were independent risk factors for renal outcome if UP ≥ 0.5 g/day. In those patients treated with RAS-blocker or treated before introduction of methylprednisolone pulse therapy, Ex was the only independent risk factor. In multivariate analysis including clinical parameters, eGFR alone was a risk factor, due to strong correlation with other parameters.

Conclusion

Ex and A would be associated with the renal outcome of the patients with UP ≥ 0.5 g/day.

     

Surgical strategy for aortic prosthetic graft infection with 18F-fluorodeoxyglucose positron emission tomography/computed tomography

A 30-year-old man with Marfan syndrome who underwent Crawford type II extension aneurysm repair about 9 years ago was referred to our hospital with persistent fever. Computed tomography (CT) showed air around the mid-descending aortic prosthetic graft. Because the air did not disappear in spite of intravenous antibiotics, ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) was performed. FDG-PET/CT revealed four high-uptake lesions. After dissecting the aortic graft particularly focusing on the high-uptake lesions, this patient underwent in situ graft re-replacement of descending aortic graft with a rifampicin-bonded gelatin-impregnated Dacron graft and omentopexy. The patient remains well without recurrent infection at 3 months after surgery.     

Distraction osteogenesis of the sternum for thoracic expansion in a severe case of jeune syndrome: a preliminary report

Severe asphyxiating thoracic dystrophy (Jeune syndrome) is usually fatal. The authors used distraction osteogenesis in a severe case and achieved 45?mm distraction of the sternum and improvement in tidal volume, lung compliance, and mean airway pressure.     

Activin A induces terminal differentiation of cultured human keratinocytes

Activin A, a member of the TGFbeta-superfamily, is well known to play important roles in the growth and differentiation of various target cells. We have previously demonstrated that activin A is produced at an early stage of cultivation at both the protein and the mRNA levels in cultured human keratinocytes. In this study, the effects of activin A on differentiation and proliferation of human keratinocytes were examined. Activin A (> or =1 nM) induced cornified envelope formation and the synthesis of loricrin, keratin 1, involucrin, and transglutaminase 1. In addition, transglutaminase activity and mRNA level of transglutaminase 1 were increased by activin A. [3H]Thymidine incorporation and cell number were reduced by activin A (> or =1 nM) compared with control, suggesting an inhibitory effect of activin A on cell proliferation. On the basis of these findings, it is likely that activin A contributes to differentiation and suppression of proliferation in human keratinocytes.