Prevention of progression of interstitial lung lesions by early combination therapy with corticosteroids and cyclosporine/cyclophosphamide in two patients with amyopathic dermatomyositis

Two patients with amyopathic dermatomyositis complicated by interstitial lung lesions were effectively treated with a combination of corticosteroids and cyclosporine and/or cyclophosphamide. A 48-year-old female patient was treated with pulse methylprednisolone and cyclosporine 2 months after onset of dermal symptoms. A 45-year-old male patient was treated with oral prednisolone and pulse cyclophosphamide 2 1/2 months after onset of dermal symptoms. Early evaluation of interstitial lung lesions and early extensive therapy may improve prognosis of interstitial lung lesions in patients with amyopathic dermatomyositis.     

Importance of the CT/MRI fusion method as a learning tool for CT-based postimplant dosimetry in prostate brachytherapy.

BACKGROUND AND PURPOSE: To compare the CT-based and CT/MRI fusion-based postimplant dosimetry after permanent prostate brachytherapy and to evaluate the improvement in CT-based dosimetry by physicians with or without experience in using the CT/MRI fusion method. PATIENTS AND METHODS: Thirty-eight consecutive patients agreed to participate in a prospective study. The prostate contours from CT/MRI fusion are the gold standard for determining the prostate volume and dose volume histogram (DVH). CT-based postimplant dosimetries were performed by two physicians. Observer 1 was a radiologist who had never used CT/MRI fusion method for postimplant dosimetric analysis. Observer 2 was a radiation oncologist experienced in postimplant analysis using the CT/MRI fusion method. The prostate dosimetry was evaluated by prostate D90 and V100. RESULTS: No significant difference was observed in the mean prostate volumes between the two observers and the CT/MRI fusion data. However, the correlation coefficient value for observer 2 (R(2)=0.932) was greater than that for observer 1 (R(2)=0.793). The D90 and V100 values as evaluated by the two observers were significantly underestimated in comparison to those evaluated using the CT/MRI fusion methods. The DVH related parameters were underestimated more frequently by observer 1 than by observer 2: (prostate D90: 99.56% for observer 1, 102.97% for observer 2, 109.37% for CT/MRI fusion. Prostate V100: 88.12% for observer 1, 90.14% for observer 2, 91.91% for CT/MRI fusion). CONCLUSIONS: The difference in the mean value in D90 and V100 by observer 1 was significantly greater than that for observer 2. These findings suggest that the CT/MRI fusion method provides accurate feedback which thereby improves CT-based postimplant dosimetry for prostate brachytherapy.     

Relationship between hepatic hemodynamics and biliary pressure in dogs: Its significance in clinical shock following biliary decompression

The changes in the hepatic hemodynamics were promptly reflected in the biliary pressure in dogs. Both wedged hepatic venous pressure and portal venous pressure increased in response to the elevated biliary pressure, and conversely decreased following rapid biliary decompression, suggesting that the changes in the biliary pressure might affect the hepatic hemodynamics post-sinusoidally. It was supposed that too rapid biliary decompression might trigger the following consequences; 1) decrease in sinusoidal pressure, 2) increase in sinusoidal inflow, and 3) extravasation of intravascular fluid in the perivascular space. When these were not sufficiently compensated, they could trigger shock in the jaundiced patients.     

Elevated levels of soluble interleukin-2 receptor in serum of patients with hematological or non-hematological malignancies

We measured the levels of soluble interleukin-2 receptor (sIL-2R) in the serum of 53 patients with hematological malignancies (14 with acute leukemia, 10 myeloproliferative disorders, 21 non-Hodgkin's lymphoma and 8 multiple myeloma), 40 with non-hematological solid malignancies (24 with lung cancer, 11 digestive system cancer and 5 other cancers) and 95 healthy subjects as a control using an enzyme-linked immunosorbent assay. Both hematological and non-hematological neoplasms showed significantly higher sIL-2R levels than normal subjects (p<0.01). However, compared to solid malignancies, hematological neoplasms displayed a wide range of sIL-2R levels and extremely elevated values of sIL-2R were seen in certain cases. These results seem to suggest that sIL-2R levels may serve as one of non-invasive markers of differential diagnosis for patients with bulky mass lesions between hematological and solid malignancy.     

Fusion vaccine therapy by IL-2-gene-transduced dendritic cells and tumor cells

We evaluated the usefulness of fusion vaccine prepared from IL-2-gene-transduced splenic dendritic cells (DCs) and fibrosarcoma tumor cells (QRsP) in treating of lung metastasis. The IL-2 or LacZ gene was transferred into spleen-derived DCs using an adenoviral vector. Irradiated QRsP tumor cells were fused with IL-2 gene transduced DCs (fusion/IL-2) or LacZ gene transduced DCs (fusion/LacZ) by polyethyleneglycol. These fusion cells expressed major histocompatibility complex (MHC) class I and MHC class II, CD86, CD11c and CD8alpha. IFN-gamma and cytotoxic T lymphocyte (CTL) activity of splenic lymphocytes in mice vaccinated with fusion cells increased significantly as compared with those of DC or tumor cells vaccinated mice. CTL levels in fusion/IL-2-vaccinated mice were higher than that in fusion/LacZ-vaccinated mice. The number of lung metastasis in the fusion/IL-2 or fusion/LacZ-vaccineatd mice was significantly lower than that in mice vaccinated with DCs, tumor or PBS. The introduction of the IL-2 gene into fusion cells produced more potent therapeutic effects. Our results suggest that the fusion cells prepared from IL-2 gene transduced spleen derived DCs and tumor cells have the ability to induce therapeutic effect against lung metastasis.     

Anti-diabetic action of Punica granatum flower extract: activation of PPAR-gamma and identification of an active component

Peroxisome proliferator-activated receptor (PPAR)-gamma activators are widely used in the treatment of type 2 diabetes because they improve the sensitivity of insulin receptors. Punica granatum flower (PGF) has been used as an anti-diabetic medicine in Unani medicinal literature. The mechanism of actions is, however, unknown. In the current study, we demonstrated that 6-week oral administration of methanol extract from PGF (500 mg/kg, daily) inhibited glucose loading-induced increase of plasma glucose levels in Zucker diabetic fatty rats (ZDF), a genetic animal model for type 2 diabetes, whereas it did not inhibit the increase in Zucker lean rats (ZL). The treatment did not lower the plasma glucose levels in fasted ZDF and ZL rats. Furthermore, RT-PCR results demonstrated that the PGF extract treatment in ZDF rats enhanced cardiac PPAR-gamma mRNA expression and restored the down-regulated cardiac glucose transporter (GLUT)-4 (the insulin-dependent isoform of GLUTs) mRNA. These results suggest that the anti-diabetic activity of PGF extract may result from improved sensitivity of the insulin receptor. From the in vitro studies, we demonstrated that the PGF extract enhanced PPAR-gamma mRNA and protein expression and increased PPAR-gamma-dependent mRNA expression and activity of lipoprotein lipase in human THP-1-differentiated macrophage cells. Phytochemical investigation demonstrated that gallic acid in PGF extract is mostly responsible for this activity. Thus, our findings indicate that PPAR-gamma is a molecular target for PGF extract and its prominent component gallic acid, and provide a better understanding of the potential mechanism of the anti-diabetic action of PGF.     

Multiple spontaneous dissecting aneurysms of the anterior cerebral and vertebral arteries

A 50-year-old woman presented with rare multiple dissecting aneurysms that appeared first in the anterior cerebral artery (ACA) and shortly afterwards in the vertebral artery (VA). She initially suffered sudden motor weakness in the left lower limb due to acute brain infarction. Angiography revealed diffuse string sign in the right ACA. Conservative treatment resulted in resolution of the deficits. Follow-up angiography performed 1 year later revealed recovery of the ACA stenosis. Fourteen days later, she complained of sudden headache and became comatose. Computed tomography showed diffuse subarachnoid hemorrhage. Angiography revealed a new right VA dissecting aneurysm involving the posterior inferior cerebellar artery (PICA). The orifice of the dissection was not apparent in the operative field and the dissection extended to the median. The patient underwent extracranial right VA ligation, clipping of the proximal PICA, and revascularization between the right occipital artery and distal PICA. Her postoperative course was uneventful and she was discharged without neurological deficits. VA dissecting aneurysms involving the PICA without evident orifice or extending over the median can be treated by extracranial ligation with clipping of the PICA, followed by revascularization.     

Is the national nutrition survey in Japan representative of the entire Japanese population?

OBJECTIVE: We examined the representativeness of the sample used in the National Nutrition Survey in Japan (J-NNS). METHODS: The distribution of the J-NNS sample from 1995 to 2000 was compared with that of the national census with respect to gender, age group, place of residence, and number of household members. RESULTS: In the survey sample, as compared with the national census distributions, the proportion of females was 1% to 2% larger, the proportion of individuals who were 20 to 39 y of age was a few percentages smaller, and a slight bias toward rural areas was seen. Among individuals who were 20 to 59 y of age, the proportion of individuals who lived in single-person households was 50% to 66% of that found in the national census. Observed disparities between the sample and the population were minimal except in the case of the proportion of individuals who lived alone. CONCLUSIONS: The sample used in the J-NNS is generally representative of the entire Japanese population with the exception of individuals in single-person households.