The retention indices of 201Tl-SPECT in brain tumors

OBJECTIVE: The aim of this study was to assess the utility of 201Tl SPECT in the differential diagnosis of intracranial tumors and to determine the relationship between 201Tl uptake and histological types. METHODS: Thirty-eight patients (19 males and 19 females) with thirty-eight brain tumors were evaluated with 201Tl-SPECT. The early and delayed 201Tl uptake ratio was calculated, and the retention index (RI) was applied as follows; RI = delayed uptake ratio/early uptake ratio. RESULTS: The RI of malignant tumors was higher (0.72 +/- 0.18) than that of benign tumors (0.50 +/- 0.16) and the difference was statistically significant (p = 0.00045). The difference between high-grade glioma (0.80 +/- 0.15) and metastatic tumors (0.64 +/- 0.19) was statistically significant (p = 0.039). CONCLUSION: 201Tl-SPECT may add useful biochemical information and could differentiate malignant brain tumors from benign lesions, but the RI of metastatic tumors varied depending on the organs with the primary lesion and histological types.     

Surgical statistics of the Department of Urology, Isesaki Municipal Hospital during a five-year period (June 1998-May 2003)

We reviewed the surgical statistics of the Department of Urology, Isesaki Municipal Hospital between June 1998 and May 2003. A total of 1940 surgeries were performed. These consisted of 399 surgeries on the kidney, adrenal, and pelvis, 212 on the ureter, 433 on the bladder, 256 on the prostate, 149 on the urethra and the penis, 192 on the scrotum, 255 on the arteriovenous fistula and CAPD. In September 2003, a screening program for prostate cancer was started, and the number of prostate biopsies and total prostatectomies increased. As the adaptation of many procedures to laparoscopy expanded, the number of laparoscopic surgeries increased.     

A novel method of 'preparative' myocardial protection using green tea polyphenol in oral uptake

Reperfusion injury has been one of the serious problems in cardiac surgery and medicine. We report a novel method of myocardial protection. Eight Sprague-Dawley rats, group A, were administrated green tea polyphenol orally. Eight other rats, group B, received no medication. Isolated hearts were perfused with a Langendorff's apparatus, and reperfused after 90min arrest. The left ventricular (LV) function, size, weight and the oxidative stress spaciotemporal analysis were performed. The LV size in group B became enlarged by 1.8+/-0.12 (mean+/-SD), but in group A, the LV enlarged only 1.1+/-0.08 times. The heart weight ratio was lighter (1.35+/-0.05) in group A than in group B (1.49+/-0.03, P<0.05). The LV end-systolic pressure volume relationship remained higher in group A. Oxidative stress as shown by 8-hydroxy-2'-deoxyguanosine was lower in group A (81.5+/-11.6) than in group B (226.9+/-35.6, P<0.0001). Polyphenol labeled FITC was located in the cell membrane of cardiomyocite. Polyphenol can protect a heart from oxidative stress, and maintain good LV function after ischemic arrest and reperfusion. This pre-treatment by polyphenol may add further benefit to current treatments of myocardial protection.     

Periurethral injection of autologous adipose‐derived regenerative cells for the treatment of male stress urinary incontinence: Report of three initial cases

Objectives: To report a novel cell therapy using autologous adipose tissue‐derived regenerative cells for male stress urinary incontinence caused by urethral sphincteric deficiency, and the outcomes in the initial cases undergoing periurethral injection of adipose tissue‐derived regenerative cells. Methods: Three patients with moderate stress incontinence after radical prostatectomy and holmium laser enucleation of the prostate were enrolled. Adipose tissue‐derived regenerative cells were isolated from the abdominal adipose tissue by using the Celution system. Subsequently, the isolated adipose tissue‐derived regenerative cells, and a mixture of adipose tissue‐derived regenerative cells and adipose tissue were transurethrally injected into the rhabdosphincter and submucosal space of the urethra, respectively. Short‐term outcomes during a 6‐month follow up were assessed by a 24‐h pad test, a validated patient questionnaire, urethral pressure profile, transrectal ultrasonography and magnetic resonance imaging. Results: Urinary incontinence progressively improved after 2 weeks of injection up to 6 months in terms of decreased leakage volume, decreased frequency and amount of incontinence, and improved quality of life. Both maximum urethral closing pressure and functional profile length increased. Magnetic resonance imaging suggested a sustained presence of the injected adipose tissue. Enhanced ultrasonography showed a progressive increase in the blood flow to the injected area. No significant adverse events were observed peri‐ and postoperatively. Conclusion: These preliminary findings suggest that periurethral injection of the autologous adipose tissue‐derived regenerative cells is a safe and feasible treatment modality for male stress urinary incontinence.     

Greater thickness of the aortic wall on postmortem computed tomography compared with antemortem computed tomography: the first longitudinal study

Objectives

To evaluate postmortem changes of the aorta on postmortem computed tomography (CT) in comparison with those on antemortem CT obtained in the same patients.

Materials and Methods

We studied 57 consecutive patients who had undergone antemortem CT, postmortem CT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. Postmortem CT was performed within 20 h after death, followed by pathological autopsy. Pathological autopsy confirmed the absence of cardiovascular disease such as aortic aneurysm, aortic dissection, or Marfan syndrome in all patients. Aortic wall thickness and aortic cross-sectional areas were measured on both antemortem CT and postmortem CT. Difference in aortic wall thickness between antemortem CT with and without contrast medium, and between antemortem CT and postmortem CT, and in cross-sectional area of the aortic wall between antemortem CT and postmortem CT was evaluated statistically.

Results

No significant difference in aortic wall thickness was observed on antemortem CT in comparison of contrasted and non-contrasted images. The aortic wall was significantly thicker on postmortem CT than on antemortem CT (p?Conclusion This is the first longitudinal study to confirm greater thickness of the aortic wall on postmortem images compared with antemortem images in the same patients and to show no change in cross-sectional area of the aortic wall between before and after death.     

Expression of mouse HtrA1 serine protease in normal bone and cartilage and its upregulation in joint cartilage damaged by experimental arthritis

Levels of HtrA1 protein in cartilage have been reported to elevate in joints of human osteoarthritis patients. To understand roles of HtrA1 in normal osteogenesis as well as in pathogenesis of arthritis, we examine HtrA1 expression pattern during bone and cartilage development and in articular cartilage affected by experimental arthritis. HtrA1 is not expressed in mesenchymal or cartilage condensations before initiation of ossification. When ossification begins in the condensations, the expression of HtrA1 starts in chondrocytes undergoing hypertrophic differentiation near the ossification center. Hypertrophic chondrocytes found in adult articular cartilage and epiphyseal growth plates also express HtrA1. When arthritis is induced by injection of anti-collagen antibodies and lipopolysaccharide, resting chondrocytes proceed to terminal hypertrophic differentiation and start expressing HtrA1. These data suggest that hypertrophic change induces HtrA1 expression in chondrocytes both in normal and pathological conditions. HtrA1 has been reported to inhibit TGF-beta signaling. We show that HtrA1 digests major components of cartilage, such as aggrecan, decorin, fibromodulin, and soluble type II collagen. HtrA1 may, therefore, promote degeneration of cartilage by inducing terminal hypertrophic chondrocyte differentiation and by digesting cartilage matrix though its TGF-beta inhibitory activity and protease activity, respectively. In bone, active cuboidal osteoblasts barely express HtrA1, but osteoblasts which flatten and adhere to the bone matrix and osteocytes embedded in bone are strongly positive for HtrA1 production. The bone matrix shows a high level of HtrA1 protein deposition akin to that of TGF-beta, suggesting a close functional interaction between TGF-beta and HtrA1.     

CD133 Expression at the Metastatic Site Predicts Patients’ Outcome in Colorectal Cancer with Synchronous Liver Metastasis

Background

CD133 is a transmembrane protein that is proposed to be a stem cell marker of colorectal cancer (CRC); however, the correlation between CD133 expression and survival of CRC patients with liver metastasis has not been fully examined.

Methods

CD133 expression was evaluated immunohistochemically, both in primary tumors and synchronous liver metastases of 88 consecutive CRC patients, as well as recurrent lesions in the remnant liver of 27 of these 88 patients. The relationship between CD133 expression and clinicopathological characteristics, recurrence-free survival, and overall survival (OS) was analyzed.

Results

CD133 expression in liver metastases (mCD133) was detected in 50 of 88 patients (56.8 %), and had significant correlation with CD133 expression in primary lesions (pCD133) (p < 0.001). CD133 expression in liver recurrent lesions (recCD133) also had a significant correlation with mCD133 (p < 0.001). mCD133+ patients had significantly longer disease-free survival (p = 0.043) and OS (p = 0.014) than mCD133? patients. In addition, mCD133+ patients had a significantly lower rate of extrahepatic recurrence (p < 0.001).

Conclusions

Patients without CD133 expression in liver metastasis had significantly shorter survival, perhaps because mCD133? patients had a significantly higher rate of extrahepatic recurrence.

     

Surgical treatment of lumbar ossification of the posterior longitudinal ligament. Report of two cases and description of surgical technique

The authors report two cases of patients with lumbar ossification of the posterior longitudinal ligament (OPLL). One patient underwent surgery via the single posterior approach, and the other patient underwent combined anterior-posterior surgery. The authors consider the anterior approach for excision of the ossified lesion to be the most reasonable for treatment of lumbar OPLL. It is extremely important, however, to select the surgical procedure according to the individual patient's condition.