Evaluation of cerebral aneurysms with high-resolution MR angiography using a section-interpolation technique: correlation with digital subtraction angiography

BACKGROUND AND PURPOSE: The objective was to evaluate the results of high-resolution, fast-speed, section-interpolation MR angiography and digital subtraction angiography (DSA), thereby examining the potential use of a primary noninvasive screening test for intracranial aneurysms. METHODS: The images were obtained in 39 cerebral aneurysmal lesions from 30 patients with a time-of-flight MR angiographic technique using a 1.5-T superconducting MR system. The total image volume was divided into four slabs, with 48 partitions each. To save time, only 24 phase-encoded steps were measured and interpolated to 48. The parameters used included 30/6.4 (TR/TE), a flip angle of 25 degrees , a 160x512 matrix, a field of view of 150x200, 7 minutes 42 seconds of scan time, an effective thickness of 0.7 mm, and an entire thickness of 102.2 mm. Maximum intensity projection was used for the image analysis, and a multiplanar reconstruction technique was used for patients with intracranial aneurysms. RESULTS: Among 39 intracranial aneurysmal lesions in 30 patients, 21 were ruptured and 18 were unruptured. Twelve lesions were less than 2 mm in size, 12 were 3 to 5 mm, 12 were 6 to 9 mm, and three were larger than 10 mm. At initial examinations, 38 of 39 aneurysmal lesions were detected by both MR angiography and DSA, with 97% sensitivity. In confirming aneurysms in neck and parent vessels, multiplanar reconstruction was successful in detecting all 39 aneurysms, whereas MR angiography was successful in detecting 27 (69%) and DSA was successful in detecting 32 (82%) of the lesions. CONCLUSION: High-resolution MR angiography with a section-interpolation technique showed equal results to those of DSA for the detection of intracranial aneurysms and may be used as a primary noninvasive screening test. In the evaluation of aneurysms in neck and parent vessels, the concurrent use of MR angiography and multiplanar reconstruction was far superior to the use of either MR angiography or DSA alone.     

Osteochondroma and secondary synovial osteochondromatosis

Secondary synovial osteochondromatosis (SOC) is a rare disorder caused by a variety of joint disorders. Two unusual cases of secondary SOC are presented. The first patient is a 43-year-old man with extensive SOC developing within a bursa surrounding an osteochondroma of the pubic bone. The second patient is a 23-year-old man who developed florid and progressive SOC of his hip joint following excision of a femoral neck osteochondroma. SOC recurred despite three excisions over a 15-month period. Imaging was useful in pre-operative diagnosis of bursal SOC in the first patient and in detecting multiple recurrences in the second patient. Both cases illustrate prominent SOC developing secondary to osteochondroma. The different hypotheses regarding bursal and secondary SOC are reviewed. Received: 8 October 1998 Revision requested: 28 October 1998 Revision received: 13 November 1998 Accepted: 16 November 1998     

Synthesis, corticotropin-releasing factor receptor binding affinity, and pharmacokinetic properties of triazolo-, imidazo-, and pyrrolopyrimidines and -pyridines

The synthesis and CRF receptor binding affinities of several new series of N-aryltriazolo- and -imidazopyrimidines and -pyridines are described. These cyclized systems were prepared from appropriately substituted diaminopyrimidines or -pyridines by nitrous acid, orthoester, or acyl halide treatment. Variations of amino (ether) pendants and aromatic substituents have defined the structure-activity relationships of these series and resulted in the identification of a variety of high-affinity agents (Ki's < 10 nM). On the basis of this property and lipophilicity differences, six of these compounds (4d,i,n,x, 8k, 9a) were initially chosen for rat pharmacokinetic (PK) studies. Good oral bioavailability, high plasma levels, and duration of four of these compounds (4d,i,n,x) prompted further PK studies in the dog following both iv and oral routes of administration. Results from this work indicated 4i,x had properties we believe necessary for a potential therapeutic agent, and 4i1 has been selected for further pharmacological studies that will be reported in due course.     

Tissue potassium,selenium, and iron levels associated with gastric cancer progression

The contents of 10 minor and trace elements in histologically confirmed gastric adenocarcinomas and their corresponding normal gastric mucosal tissues obtained from 39 patients at the time of gastric resection were simultaneously determined by instrumental neutron activation analysis. Specimens were irradiated by reactor neutrons and subsequently subject to direct analysis using a high-resolution HPGe -spectrometer. Univariate analysis revealed that gastric cancer tissues had significantly higher concentrations of Fe, K, Mg, Na, Rb, Se, and Zn than normal gastric mucosal tissues. However, multivariate analysis found that Fe, K, and Se were independent elements that associated with gastric cancer. Upon further evaluation of their clinical significance, we found a high tissue K level was related to lymphatic duct metastasis. High Se tissue levels were linked to intestinal type adenocarcinoma. A positive correlation was found between high Fe levels and vascular involvement. These findings suggest that Fe and K are associated with gastric cancer progression. Se is involved in carcinogenesis of stomach in high-risk areas. The mechanisms that underlie the corresponding pathohistological features deserve further study.     

High-speed black blood imaging of vessel stenosis in the presence of pulsatile flow.

Stenosis phantoms were created to study the ability of "black blood" methods to image a vessel stenosis in the presence of pulsatile flow. Black blood images were acquired with a modified TurboFLASH (fast low-angle shot) method that eliminates flow signal by applying a set of prepulses before segmented data acquisition. With this high-speed approach, imaging can be completed within 16 seconds. This technique was compared with conventional spin-echo black blood, gradient-echo black blood, and gradient-echo bright blood methods. Loss of flow signal, which extended beyond the site of the stenosis, was seen on the gradient-echo bright blood images. The pattern of signal loss varied with the type of stenosis. Flow voids were achieved with spin-echo black blood imaging; however, substantial ghosting artifacts were seen. With gradient-echo black blood imaging, it was difficult to eliminate all flow signal, particularly for in-plane flow. The modified TurboFLASH method produced high-quality black blood images in a fraction of the time needed for spin-echo imaging. It showed no ghosting artifacts even in the presence of pulsatile flow.     

Down-Regulation of Osteoblastic Cell Differentiation by Epidermal Growth Factor Receptor

The role of epidermal growth factor receptors (EGF-R) in osteogenic cell differentiation was investigated using preosteoblastic MC3T3-E1 (MC3T3) cells and osteoblast-like ROS 17/2.8 (ROS) cells. When cultured in the presence of β-glycerophosphate (GP) and ascorbic acid (AA), MC3T3 cells underwent spontaneous differentiation into osteoblasts which was confirmed as they expressed osteoblast markers such as alkaline phosphatase (ALP), bone sialoprotein (BSP) and osteocalcin (OC). Interestingly, the number of EGF-binding sites decreased during their differentiation into osteoblasts, and the osteogenic protein-1 (OP-1) treatment, which accelerated their differentiation, lowered the number of EGF-binding sites even further. On the other hand, ROS cells with high expression levels of osteoblast markers and no EGF-R, after being transfected with human EGF-R cDNA (EROS cells), expressed numerous EGF-binding sites as well as EGF-R mRNA and protein; in the process, they ceased to express osteoblast markers, indicating their dedifferentiation into osteoprogenitor cells. Both MC3T3 and EROS cells showed increased cell growth in response to EGF, whereas ROS cells did not. These results imply that the EGF/EGF-R system in osteogenic cells has a crucial function in osteoblast phenotype suppression and osteogenic cell proliferation.     

Significance of carbohydrate antigen sialyl-Lewis X, sialyl-Lewis A, and possible unknown ligands to adhesion of human urothelial cancer cells to activated endothelium

OBJECTIVE: To assess the contribution of the carbohydrate antigens, sialyl-Lewis X (sLe(x)) and sialyl-Lewis A (sLe(a)), which are known to be ligands for E-selectin, to the adhesion between human urothelial cancer cells and cytokine-activated human endothelial cells. MATERIALS AND METHODS: We studied the expression of sLe(x) and sLe(a) antigens of three bladder cancer cell lines (JTC 30, JTC 32, and T24) by flow cytometry and the adherence to interleukin 1beta-activated human umbilical vein endothelial cells (HUVEC). RESULTS: JTC 30 and JTC 32 cells expressed both sLe(x) and sLe(a) antigens, and showed adhesion to activated HUVEC, which was completely abolished by anti-E-selectin antibody. T24 cells expressed neither sLe(x) nor sLe(a) antigen, and did not adhere to activated HUVEC. Each of anti-sLe(a) or anti-sLe(x) antibody partially blocked the attachment of JTC 30 cells to activated HUVEC, and combination of these antibodies almost completely blocked the adhesion. The combination of antibodies did not significantly influence the adhesion of JTC 32 cells. CONCLUSION: These results indicate that both sLe(a) and sLe(x) carbohydrate antigens are involved in E-selectin-mediated adhesion of some urothelial cancers, and that there might be unknown ligands for E-selectin on urothelial cancer cells.     

Detection of Serum Transforming Growth Factor-α in Patients of Primary Epithelial Ovarian Cancers by Enzyme Immunoassay

Transforming growth factor-α (TGF-α) is a potent mitogenic polypeptide. It is secreted by a variety of transformed cells and tumors, modifying tumor growth through autocrine or paracrine mechanism. In the present study, serum levels of TGF-α were determined by enzyme-linked immunosorbent assay (ELISA) in 27 normal females, 116 patients with benign ovarian tumors, and 42 patients with epithelial ovarian cancers (10 with stage I, 7 with stage II, 19 with stage III, and 6 with stage IV). The ELISA assay could detect a minimum level of serum TGF-α concentration at 10 pg/ml. Serum samples were obtained from normal females and from patients with benign or malignant ovarian tumors before initial surgery. The detectable rates were 11% (3/27) in normal females, 28% (32/116) in benign ovarian tumors, and 62% (26/42) in ovarian cancers. The detectable rates in serous and endometrioid ovarian cancers were 71 and 70%, respectively, which were higher than the rate of 33% in mucinous type. However, there was no obvious relationship between the detectability of serum TGF-α and the stages of ovarian cancers. The mean concentration of TGF-α in ovarian cancer was 159.8 pg/ml, which was significantly higher than 27.7 pg/ml in benign ovarian tumors (P< 0.001) as well as 15 pg/ml in normal females (P< 0.001). The mean concentrations of serum TGF-α in stages I to IV ovarian cancers were 133.5, 96.2, 194.8, and 178.3 pg/ml, respectively. The mean concentration of serum TGF-α in any two stages of ovarian cancers was not statistically different. In conclusion, measurement of serum TGF-α can be used as a supplementary tumor marker to differentiate a malignant ovarian tumor from a benign one. However, the concentration of serum TGF-α has no special relation with the stage of ovarian cancer itself. Because of the small number of stage I ovarian cancers with detectable TGF-α in the present investigation, it would probably not be feasible to differentiate a stage I ovarian cancer from a benign ovarian tumor based only on the level of TGF-α in serum.     

Biliary hamartomas associated with biliary stones presenting as multiple microabscesses: case report

A 63-year-old men suffered from fever, jaundice, and right upper quadrant pain for 1 week. Biliary stones with biliary tract infection were diagnosed. He was treated with parenteral antibiotics. However, abdominal ultrasonography showed multiple hyperechoic lesions in both lobes, and infiltrating hepatocellular carcinoma was suspected initially. Numerous hypervascular nodular-enhancing lesions were revealed by computed tomography. Magnetic resonance imaging further disclosed numerous tiny cystic lesions with peripheral enhancement. Exploratory laparotomy was performed for biliary calculi and probable underlying malignancy. Cholecystectomy, choledocholithotomy, and liver wedge biopsy were done. The pathology revealed bile duct hamartomas with microabscess formation. The past literature about biliary hamartomas is reviewed.