Stroke patients' evolving symptoms assessed by tractography

PURPOSE: To test the hypothesis that an interval evolution in the location of the depicted sensorimotor tract relative to the infarct (the "tract-infarct relationship") may be related to stroke victims' symptom progression. MATERIALS AND METHODS: Patients (N = 7) who underwent multiple diffusion-tensor imaging (DTI) studies during symptomatic progression were included in this study. DTI was performed using a single-shot echo-planar imaging (EPI) technique with a motion-probing gradient in six orientations, a b-value of 800 seconds/mm2, and six image averages. The total scan time was four minutes and 24 seconds. Fiber-tracking of the sensorimotor pathways was performed, and the locations of these tracts were retrospectively assessed in relation to the evolution of the symptoms. RESULTS: Five of the seven patients showed an interval enlargement of the infarct on diffusion-weighted (DW) images. In two of these cases the lesion enlarged to involve the sensorimotor tracts, while in three cases the lesion enlarged only so far to come into close proximity to the sensorimotor tract. In the remaining two cases there was no interval enlargement of the infarct, and therefore the tract-infarct relationship could not account for the evolution of the symptoms in these cases. CONCLUSION: A tract-infarct relationship can be observed with the use of a fiber-tracking technique, and the results may improve our understanding of the symptom progression seen in stroke victims.     

Role of substance P in an NC/Nga mouse model of atopic dermatitis-like disease

BACKGROUND: Atopic dermatitis (AD) can be exacerbated or induced in genetically predisposed individuals by psychological stress, which causes the release of substance P (SP). Therefore, SP may play an etiological role in the mechanisms underlying AD. METHODS: Changes in the number of mast cells and SP-containing mast cells in lesional skin, and the serum concentrations of SP and IgE during the development of AD-like disease up to 8 weeks after the start of picryl chloride (PiCl) induction in NC/Nga mice were examined. RESULTS: Clinical signs and symptoms seen in PiCl-treated NC/Nga mice as a model of AD-like disease began with erythema and haemorrhage, followed by oedema, superficial erosion, deep excoriation, scaling and dryness of the skin, as well as retarded growth, and the changes were exacerbated with an increase in the number of PiCl applications. An increase in the number of mast cells and eosinophil infiltration was observed in the lesional skin. The increase in SP-positive mast cells in the dermis in this model was significant from 1 week after the start of induction treatment, compared with intact mice, and SP-positive nerve fibres were observed in the dermis. CONCLUSION: SP is a crucial mediator of both dermatitis and scratching behaviour in this model.     

Lung adenocarcinoma presenting with enlarged and multiloculated cystic lesions over 2 years

We report a case of lung adenocarcinoma in which cystic lesions enlarged and multiloculated over 2 years. Histological examination of the resected specimen found proliferation of nonmucinous adenocarcinoma cells along the alveolar walls, revealing bronchioloalveolar cell carcinoma type extension. In cystic lesions, particularly those not associated with inflammation, lung adenocarcinoma, particularly bronchioloalveolar cell carcinoma type, should be a diagnostic consideration. .     

Inhibitory effects of bucillamine on the expression of vascular cell adhesion molecule-1 in human umbilical vein endothelial cells

Bucillamine (BUC) has been found to have beneficial effects in the treatment of rheumatoid arthritis (RA), in which the activation of endothelial cells plays an important role in the pathogenesis. The current studies examined the effect of BUC and its intramolecular disulfide form (BUC-ID) on the expression of adhesion molecules in human umbilical vein endothelial cells (HUVEC) stimulated with tumor necrosis factor-alpha (TNF-alpha). HUVEC (4 x 10(4)/well) were incubated with medium M199 containing heparin and 20% FCS with endothelial cell growth supplement (ECGS) for 24 h in the presence or absence of BUC or BUC-ID, after which the culture medium was replaced with ECGS free medium. Then the cultures were further carried out for additional 24 h with TNF-alpha (10 ng/ml) in the presence or absence of BUC or BUC-ID. BUC-ID, but not BUC, appeared to suppress the expression of VCAM-1 on HUVEC stimulated with TNF-alpha in a dose-response manner at its pharmacologically relevant concentrations (0.3-3.0 microg/ml), whereas only the 3 microg/ml concentration level of BUC-ID had a statistically significant effect, although the effect was relatively small. By contrast, lower concentrations of BUC-ID (1-3 microg/ml) suppressed the secretion of soluble VCAM-1 by HUVEC much more effectively. Of note, at the concentration of 3 microg/ml neither BUC nor BUC-ID significantly influenced the expression of ICAM-1 and E-selectin on TNF-alpha stimulated HUVEC. These results indicate that BUC-ID, but not BUC, specifically downregulates the surface expression of VCAM-1 as well as the release of soluble VCAM-1 by HUVEC stimulated with TNF-alpha. BUC-ID suppressed the production of solubleVCAM-1 by RA bone marrow CD34+ cells stimulated with SCF, GM-CSF and TNF-alpha more effectively than BUC. The data thus suggest that one of the mechanisms of action of BUC involves the inhibition of the activation of endothelial cells.     

Prospective study on the risk of hepatocellular carcinoma among hepatitis C virus-positive blood donors focusing on demographic factors, alanine aminotransferase level at donation and interaction with hepatitis B virus

The risk for hepatocellular carcinoma (HCC) among asymptomatic hepatitis C virus (HCV) carriers is not well understood. A community-based prospective study was conducted for over 8 years by record linkage to the Osaka Cancer Registry. The subjects were 1,927 individuals who were positive for anti-HCV through screening for second-generation HCV antibody (passive hemagglutination assay: >or= 2(12)) in voluntary blood donation. The risk factors for HCC and interaction between HCV and hepatitis B virus (HBV) infection were evaluated by including additional blood donors: 2,519 individuals positive for hepatitis B virus surface antigen (HBsAg) alone, 25 positive for both anti-HCV and HBsAg, 150,379 negative for both anti-HCV and HBsAg. The incidence of HCC (/10(5) person-years) among the HCV-positive individuals increased with age in both genders, ranging from 68 to 1,306 among those aged 45-74 years. In the HCV-positive individuals, the cumulative risk of developing HCC between the ages of 40 and 74 year was 21.6% among males and 8.7% among females. A stepwise increase in risk was noted as the serum alanine aminotransferase level increased or serum cholesterol level at baseline decreased in multivariate Cox proportional hazard analysis. The 9-year cumulative incidence of HCC among individuals positive for HCV alone, those positive for HBsAg alone and those positive for both was 3.0%, 2.0% and 12.0%, respectively. The age-and-sex-adjusted rate ratio was 126, 102 and 572, respectively, when those negative for both were used as a reference. The results demonstrate an increased risk for HCC among asymptomatic HCV-positive individuals in Japan. Coinfection with HBV and HCV carried a superadditive risk for HCC.     

Phase I trial of carboplatin and weekly paclitaxel in patients with advanced non-small-cell lung cancer

OBJECTIVE: This study was designed to determine the maximum tolerated dose of paclitaxel administered weekly in combination with carboplatin and to assess its dose limiting toxicity and preliminary activity in patients with previously untreated, advanced non-small-cell lung cancer. METHODS: Carboplatin was administered at a fixed dose that maintained an area under the curve of 6. Paclitaxel was given over 1 h once a week for 3 weeks starting at 60 mg/m(2) and escalated in 10 mg/m(2) increments. RESULTS: Twenty-one patients were treated with six dose levels (60, 70, 80, 90, 100, 110 mg/m(2)) of paclitaxel. The dose limiting toxicity was infection and the maximum tolerated dose was 110 mg/m(2). Nine of 21 (42.9%) patients demonstrated a therapeutic response. CONCLUSION: Weekly paclitaxel and carboplatin were well tolerated. Based on our results, 100 mg/m(2) of paclitaxel for 3 weeks of a 4-week cycle, in combination with carboplatin, was recommended for a phase II study.     

Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens

BACKGROUND: A proper understanding of prostatic and periprostatic anatomy is essential for surgical procedures and pathological diagnosis; however, the detailed features have not been commonly investigated and completely understood. METHODS: Seventy-nine non-nerve-sparing radical prostatectomy specimens were microscopically investigated for Denonvilliers' fascia, lateral pelvic fascia, prostatic capsule, anterior fibromuscular stroma and the neurovascular bundle. RESULTS: At the lateral aspect, the lateral pelvic fascia and the prostatic capsule were separated by adipose tissue in 41 cases (52%), whereas they adhered in 38 cases (48%). In only 41 cases (52%), the neurovascular bundle existed locally at the postero-lateral region with definite 'bundle' formations. Denonvilliers' fascia and the prostatic capsule adhered tightly at the center of the posterior aspect in 77 cases (97%). A smooth transition from the prostatic capsule to the anterior fibromuscular stroma was observed in all cases. In 70 cases (89%), no prostatic capsule was independently recognized at the anterior aspect. In the remaining 9 cases (11%), the capsule was recognizable as distinct from the anterior fibromuscular stroma. In 67 cases (85%), the lateral pelvic fascia connected and fused with the anterior fibromuscular stroma, and covered the outermost regions of the lateral and anterior surfaces. CONCLUSIONS: All the periprostatic structures are closely related and influence each other. The results support the rationale of anatomical radical prostatectomy, and should be taken into consideration for surgical procedures and pathological diagnosis.     

A case of metastatic liver tumor from colorectal carcinoma--continued arterial infusion chemotherapy through a microcatheter located in replaced right hepatic artery

The patient was a 78-year-old male with a history of colon cancer. After surgical resection of colon cancer, he suffered a multiple liver metastasis. We treated him by arterial infusion chemotherapy with the catheter edge embedded at the common hepatic artery. For a long period, the lesions were defined as partial response on WHO-criteria, but a wide area of the common hepatic artery was shrunk. After changing the treatment to systemic intravenous chemotherapy, the metastatic lesions began to enlarge. Then, we somehow were able to put a microcatheter into the replaced right hepatic artery (rRHA), and could restart arterial infusion chemotherapy. We continued this procedure for over a year without any complication.