ENCEPHALOMYELONEURITIS WITH MEDIASTINAL GERM CELL TUMOR A Paraneoplastic Condition ?

An unusual case of encephalomyeloneuritis associated with germ cell tumor with mature and immature teratoma arising in the mediastinum is presented. There was an unusually long interval from the onset of neurologic symptoms to the development of malignancy. The histopathology, characterized by limbic encephalitis, brain stem encephalitis, cortical cerebellar degeneration and myeloneuritis, was similar to that of paraneoplastic encephalomyeloneuritis previously described in the literature. Virological and immunological studies failed to demonstrate any causative agents or autoantibodies reacting with brain tissue. The causal relationship between the malignant neoplasm and encephalomyeloneuritis thus seems to be very complex.     

Large aspiny cells in the matrix of the rat neostriatum in vitro: physiological identification, relation to the compartments and excitatory postsynaptic currents.

1. Large aspiny neurons (20-60 microns diam) in the neostriatum were studied in an in vitro rat slice preparation by whole-cell recording to reveal physiological identification from medium-sized spiny projection cells (10-20 microns diam), relation to the patch and matrix compartments, and excitatory synaptic inputs. Recorded cells were identified by intracellular biocytin staining. Compartmental identification was made by calbindinD28K immunohistochemistry in fixed slices. 2. Large stained neurons were morphologically heterogeneous and had aspiny or sparsely spiny dendrites and dense local axonal branches. They were located in the matrix or on the patch-matrix border. Axonal branches of the large aspiny cells were preferentially distributed in the matrix and gave off terminal boutons there. Some of the secondary dendrites arising from stem dendrites running along the border, however, crossed compartment boundaries and made fine branches in a patch. 3. Large aspiny cells had less negative resting membrane potentials and lower thresholds for spike generation than medium spiny cells. They showed longer-duration and larger-amplitude afterhyperpolarizations (AHPs) than medium spiny cells. During hyperpolarizing current pulses, apparent resistance slowly reduced, and a prominent sag was observed in the voltage record, which was absent in medium spiny cells. The large aspiny cells showed no spontaneous firing but had a tendency to fire repetitive spikes in response to depolarizing current pulses, although spike interval tended to increase in later spikes. Spike frequency of large aspiny cells increased less with current intensity than that of medium spiny cells. 4. Most large aspiny cells were considered to belong to a single physiological class, although one large aspiny cells showed shorter-duration AHPs than both most other large aspiny cells and medium spiny cells, and little spike-frequency adaptation. 5. Excitatory postsynaptic currents (EPSCs) of large aspiny cells induced by intrastriatal stimulation had two components. An early, linear component was blocked by 10 microM 6-cyano-7-nitro-quinoxaline-2,3-dione (CNQX), a selective antagonist of non-N-methyl-D-aspartate (NMDA) receptors. A later component with a nonlinear current-voltage (I-V) relationship was blocked by 50 microM DL-2-amino-5-phosphonovaleric acid (DL-APV), a selective antagonist of NMDA receptors. 6. From these results, four conclusions can be drawn. 1) Most large aspiny neostriatal cells in the matrix, although they take heterogeneous shapes, belong to one physiological class with long-duration AHPs and a strong time-dependent component of anomalous rectification.(ABSTRACT TRUNCATED AT 400 WORDS)     

Cell lines that support replication of a novel herpes simplex virus 1 UL31 deletion mutant can properly target UL34 protein to the nuclear rim in the absence of UL31

Previous results indicated that the herpes simplex virus 1 (HSV-1) U(L)31 gene is necessary and sufficient for localization of the U(L)34 protein exclusively to the nuclear membrane of infected Hep2 cells. In the current studies, a bacterial artificial chromosome containing the entire HSV-1 strain F genome was used to construct a recombinant viral genome in which a gene encoding kanamycin resistance was inserted in place of 262 codons of the 306 codon U(L)31 open reading frame. The deletion virus produced virus titers approximately 10- to 50-fold lower in rabbit skin cells, more than 2000-fold lower in Vero cells, and more than 1500-fold lower in CV1 cells, compared to a virus bearing a restored U(L)31 gene. The replication of the U(L)31 deletion virus was restored on U(L)31-complementing cell lines derived either from rabbit skin cells or CV1 cells. Confocal microscopy indicated that the majority of U(L)34 protein localized aberrantly in the cytoplasm and nucleoplasm of Vero cells and CV1 cells, whereas U(L)34 protein localized at the nuclear membrane in rabbit skin cells, and U(L)31 complementing CV1 cells infected with the U(L)31 deletion virus. We conclude that rabbit skin cells encode a function that allows proper localization of U(L)34 protein to the nuclear membrane. We speculate that this function partially complements that of U(L)31 and may explain why U(L)31 is less critical for replication in rabbit skin cells as opposed to Vero and CV1 cells.     

Neuron-specific enolase and Leu-7 immunoreactive small round-cell neoplasm. The relationship to Ewing's sarcoma in bone and soft tissue

The authors present an immunohistochemical analysis of tissue from five cases of morphologically distinctive Ewing's sarcoma in bone and soft tissue. The mean age of the five patients was 16.6 years, with a range of 6-28 years. The tumors existed in chest wall, pelvis, and lower extremities. Two siblings with tumor in bone were clinically diagnosed as having Ewing's sarcoma. All cases had immunoreactivity for neuron-specific enolase (NSE), and four cases revealed positive staining for Leu-7. Neuron-specific enolase is highly specific for neurons and neuroendocrine cells. In addition, immunoreactivity for Leu-7, expressing a natural killer activity, has been demonstrated in peripheral nerve fibers and neuroendocrine cells. The authors suggest that NSE and Leu-7 immunoreactive small round-cell neoplasm is probably a primitive neuroectodermal tumor and should be categorized as Ewing's sarcoma in bone and soft tissue.     

Delayed-type hypersensitivity to allogeneic mouse epidermal cell antigens. III. Analysis of suppressor cells

The specificity of suppressor T cells (Ts cells) induced by intravenous administration of allogeneic spleen cells was studied in mice using a delayed-type hypersensitivity (DTH) assay. The DTH responses were induced by subcutaneous injection of allogeneic epidermal cells (ECs) and were assayed by footpad swelling. Afferent-phase Ts cells (Ts-aff cells) were transferred into the recipient mice before ECs immunization. Treatment with monoclonal anti-Thy-1.2 antibody and complement abolished the suppression by Ts-aff cells in the DTH response. The suppression induced by Ts-aff cells, however, was resistant to the treatment with monoclonal anti-I-A or anti-Lyt-2.2 antibody and complement. These results showed that Ts-aff cells were Lyt-2-, Ia- T cells. Efferent-phase Ts cells (Ts-eff cells) were transferred before challenge of the DTH assay. Phenotypic analysis of these Ts-eff cells showed them to be Lyt-2+, Ia- T cells. Studies using several strains of congenic mice revealed the antigen specificity of both Ts cell subsets. Adoptive transfer of Ts-eff cells required H-2 restriction, but Ts-aff cells did not. We also induced cognate suppression of the DTH responses to the alloantigens mediated by Ts-eff cells.     

Clinical results of arthroscopic rotator cuff repair in diabetic and non-diabetic patients

BackgroundAlthough the clinical outcomes of arthroscopic rotator cuff repair (ARCR) have been reported, few studies have focused on diabetic patients. We investigated and compared the clinical results of ARCR in patients with and without diabetes.MethodsThis retrospective study involved 195 consecutive patients who underwent ARCR from 2015 to 2018 in our hospital. Twenty-seven and 168 shoulders were assigned to diabetes and non-diabetes groups, respectively. Diabetic patients with poor control were preoperatively hospitalized for perioperative diabetic control. We evaluated range of motion (ROM), Japanese Orthopaedic Association shoulder (JOA) score, Constant Shoulder Score, and University of California, Los Angeles (UCLA) score preoperatively and at 6 months and 1 year post-ARCR. Rates of rotator cuff retear 1 year post-ARCR and preoperative and postoperative stiff shoulder were also evaluated. We compared the results between groups and analyzed them statistically. A p-value of <0.05 was considered statistically significant.ResultsPreoperative ROM, JOA score, Constant Shoulder Score and UCLA scores showed significant improvement at post-ARCR in both groups (p < 0.05). On comparing the groups, although preoperative JOA score and Constant Shoulder Score were significantly lower in diabetes group than in non-diabetes group (diabetic/non-diabetic group; 60.0/65.3 for JOA score; p = 0.003, 59.7/64.2 for Constant Shoulder Score; p = 0.003), there was no significant difference postoperatively (6 months post-ARCR; 88.0/89.7 for JOA score; p = 0.783, 88.1/88.6 for Constant Shoulder Score; p = 0.597, 1 year post-ARCR; 96.7/95.4 for JOA score; p = 0.238, 96.6/95.4 for Constant Shoulder Score; p = 0.248). Furthermore, preoperative and postoperative stiff shoulder and retear rates were not significantly different between groups (p = 0.152, p = 0.344, p = 0.347, and p = 0.563, respectively).ConclusionDiabetic patients showed comparable clinical results with non-diabetic patients post-ARCR. Perioperative diabetic control may be recommended for preoperatively uncontrolled diabetic patients.     

Prognostic significance of the Ki67 index and programmed death-ligand 1 expression after radical cystectomy in patients with muscle-invasive bladder cancer

ObjectivesTo investigate the association between Ki67 index and programmed death-ligand 1 (PD-L1) expression in muscle-invasive bladder cancer (MIBC) patients after RC.Materials and MethodsWe retrospectively evaluated 262 MIBC patients treated with RC between April 2004 and April 2020. The impact of Ki67 index and PD-L1 expression on prognosis was evaluated by univariate Cox regression analysis. In addition, a pathomolecular risk score, including Ki67 and PD-L1, was developed to predict prognosis and pathological factors. We also evaluated the link between the Ki67 index and PD-L1 under the IL-6 stimulation in the bladder cancer cell lines of T24 and 5637 cells.ResultsThe median age and follow-up period was 69 years and 52 months, respectively. Ki67 index and PD-L1 expression were significantly associated with tumor recurrence. Univariate Cox regression analysis showed that pT3–4, mixed histology, lymphovascular invasion positive (LVI+), pN+, Ki67-high (>17%), and PD-L1+ were significantly associated with recurrence-free survival (RFS). The pathomolecular risk score was developed using resection margin+ (1 point), mixed histology (1 point), LVI+ (1 point), pN+ (1 point), and Ki67-high (1 point). RFS and overall survival were significantly shorter in patients with higher pathomolecular risk scores (>1) than in those with lower risk scores (≤1). Cell proliferation was significantly increased in the T24 and 5637 cells under the IL-6 stimulation, while PD-L1 expression was not.ConclusionsA significant effect of Ki67-high and PD-L1 expression on poor prognosis was observed in patients with MIBC. Further studies are necessary to elucidate the precise mechanisms of cell proliferation and PD-L1 expression in patients with MIBC.     

The association between renal elasticity evaluated by Real-time tissue elastography and renal fibrosis

Clinical and Experimental Nephrology - The progression of chronic kidney disease (CKD) depends on the extent of fibrosis in the kidneys; however, a renal biopsy is necessary to evaluate the...