Papillary Eccrine Adenoma with a Pomegranate-like Appearance

Papillary eccrine adenoma (PEA) is a rare cutaneous tumor which histopathologically presents numerous intradermal tubular structures with inward papillary projections. Only a few cases of PEA have been reported recently. We report a case of PEA of a 58-year-old Japanese man. The marked hyperkeratosis and pits gave the tumor the clinical appearance of a burst-open pomegranate. Compact hyperkeratosis within proliferated epidermis contained spiral ducts mimicking intraepidermal eccrine sweat ducts histopathologically. These keratinous structures were thought to correspond to the pores. Several tubular structures running up to the overlying thickened epidermis were observed in the upper dermis. With these findings and with immunohistochemical studies, we proposed that this tumor originated from eccrine sweat ducts.     

Mild hypothermia reduces apoptosis of mouse neurons in vitro early in the cascade.

Recent experimental work has shown that hypothermia with even small decreases in temperature is broadly neuroprotective, but the mechanism of this protection remains unclear. Although reduction of metabolism could explain protection by deep hypothermia, it does not explain the robust protection found with mild hypothermia. Several reports have suggested that ischemic apoptosis is reduced by hypothermia. The authors examined the effects of hypothermia on neuronal apoptosis using serum deprivation, a well-accepted model that induces neuronal apoptosis. Mild hypothermia (33 degrees C) significantly reduced the number of morphologically apoptotic neurons to less than half the number seen in normothermic culture temperatures (37 degrees C) after 48 hours. They examined the effect of hypothermia on several steps in the cascade. Caspase-3, -8, and -9 activity was significantly increased after 24 hours at 37 degrees C, and was significantly lower in cultures deprived of serum at 33 degrees C. Cytochrome c translocation was reduced by hypothermia. Western blot analysis failed to detect significant changes in Bax, bcl -2, or hsp -70 at early time points, whereas hypothermia significantly reduced cJun N-terminal kinase activation. The authors conclude that small decreases in temperature inhibit apoptosis very early, possibly at the level of the initiation of apoptosis, as suggested by reduced cJun N-terminal kinase activation and before the translocation of cytochrome c, with subsequent prevention of caspase activation.     

The binding sites for the very low density lipoprotein receptor and low-density lipoprotein receptor-related protein are shared within coagulation factor VIII

Coagulation factor VIII (FVIII) is a ligand for two members of the low-density lipoprotein receptor family, low-density lipoprotein receptor-related protein (LRP) and low-density lipoprotein receptor, which cooperate in regulating clearance of FVIII from the circulation. This study was aimed to explore the mechanism of interaction of FVIII with very low density lipoprotein receptor (VLDLR), another member of the family, and map receptor-binding sites. Binding of plasma-derived FVIII and its fragments to recombinant soluble ectodomain of VLDLR (sVLDLR) was studied in solid-phase and surface plasmon resonance assays. Full-length FVIII and its light chain bound to sVLDLR with similar affinities (KD = 114 +/- 14 and 95 +/- 11 nmol/l, respectively); in contrast, exposure of high-affinity VLDLR-binding site within the heavy chain (KD = 30 +/- 2 nmol/l) required proteolytic cleavage by thrombin. The VLDLR-binding sites within heavy and light chains were mapped to the A2 domain residues 484-509 and the A3-C1 fragment, based on the inhibitory effects of anti-A2 monoclonal antibody 413 and anti-A3-C1 antibody fragment scFv KM33, respectively, previously shown to inhibit FVIII/LRP interaction. Soluble ligand-binding fragment of VLDLR inhibited activation of factor X by the intrinsic Xase in purified system. In cell culture, a higher Xase activity was associated with wild-type human embryonic kidney cells compared with transfected cells that express VLDLR on the cell surface. We conclude that the binding sites for VLDLR and LRP within FVIII overlap and the A2 site becomes exposed upon physiological activation of FVIII. A functional role of FVIII/VLDLR interaction may be related to regulation of intrinsic Xase activity.     

The retinal projections to the ventral and dorsal divisions of the medial terminal nucleus and mesencephalic reticular formation in the Japanese monkey (Macaca fuscata): a reinvestigation with cholera toxin B subunit as an anterograde tracer

After a monocular injection of the cholera toxin B subunit (CTB) into the vitreous chamber of the eye, retinal projections to the medial terminal nucleus (MTN) of the accessory optic system (AOS) were studied in the Japanese monkey. The anterogradely transported tracer was visualized with the peroxidase antibody technique by using an anti-cholera toxin antibody. One small accumulation of the CTB-immunopositive retinofugal terminals was located in a small area just medial to the medial edge of the cerebral peduncle and anterior to the attachment of the oculomotor nerve, suggesting the existence of a ventral division of the MTN of the AOS. Caudally, one very small bundle of the retinofugal fibers extending dorsally from this accumulation was seen running along the medial edge of the cerebral peduncle and substantia nigra to the small region corresponding to the dorsal division of the MTN. A few small bundles of CTB-immunopositive retinal fibers were observed to leave the superior fasciculus of the AOS at various points. These fibers coursed medially through the cerebral peduncle and substantia nigra to reach some restricted areas of the mesencephalic reticular formation between the medial lemniscus and the substantia nigra.     

A case of renal transplantation with granulomatous nephritis and arteritis associated with Pseudomonous aeruginosa infection

Abstract:  A case with graft function failure due to granulomatous interstitial nephritis and arteritis probably associated with a urinary tract infection by Pseudomonas aeruginosa within two months of kidney transplantation is reported. The recipient was a 42-yr-old male who had end-stage renal disease associated with chronic glomerulonephritis. He received a kidney transplant that was donated from a 54-yr-old male who died because of a subarachnoid hemorrhage. On the 60th day after operation, graft function failure occurred. A biopsy specimen showed granulomatous interstitial nephritis and vasculitis. At the same time, P. aeruginosa was detected by urine culture. The graft function is improved by treatment with the antibiotic faropenem for the urinary tract infection. On the basis of these clinical features, it was suggested that the present case developed granulomatous interstitial nephritis and arteritis associated with urinary tract infection by P . aeruginosa .     

Whole-body MRI for detecting metastatic bone tumor: diagnostic value of diffusion-weighted images.

PURPOSE: We assessed the diagnostic value of whole body magnetic resonance (MR) imaging (WB-MRI) using diffusion-weighted images (DWI) for detecting bone metastasis and compared it with that of skeletal scintigraphy (SS). MATERIALS AND METHODS: Thirty patients with malignancies (breast cancer, 17 patients; prostate cancer, 9; and one patient each, thyroid cancer, liposarcoma, leiomyosarcoma, and extraskeletal Ewing sarcoma) underwent both WB-MRI and SS to detect bone metastasis. All patients were followed more than 6 months by MR imaging, SS, or computed tomographic (CT) examination. For WB-MRI, patients were placed in feet-first supine position with table-top extender and quadrature body coil. We acquired DWI (axial plane from lower neck to proximal femur) (single shot short TI inversion-recovery [STIR]: repetition time [TR] 6243/echo time [TE] 59/inversion time [TI] 180 ms; b value: 600 s/mm(2); 5-mm slice thickness; 112 x 112 matrix), T(1)-weighted fast spin echo (T(1)WI), and STIR (sagittal plane of total spine images and coronal plane of whole body images) images. Four blinded readers independently and separately interpreted images of combined MR sequences of T(1)WI+STIR (session 1) and T(1)WI+STIR+DWI (session 2). RESULTS: In 10 of 30 patients, we detected a total of 52 metastatic bone lesions; in the other 20, follow-up examinations confirmed no metastatic bone lesions. For these 52 lesions, for session 2, the mean sensitivity was 96% and the positive predictive value (PPV) was 98%. Those values were superior to those of session 1 (sensitivity: 88%; PPV: 95%) and those of SS (sensitivity: 96%; PPV: 94%). CONCLUSION: WB-MRI that included DWI was useful for detecting bone metastasis.