Membrane type 1-matrix metalloproteinase expression is regulated by E-cadherin through the suppression of mitogen-activated protein kinase cascade

To elucidate the role of E-cadherin in matrix metalloproteinases (MMPs) expression, we transfected to squamous carcinoma cells with E-cadherin cDNA. HN5 cells and mock-transfected HN5-neo cells expressed proMMP-2 and active MMP-2. E-cadherin-transfected HN5-EC cells produced comparable proMMP-2 but low active MMP-2; and membrane type 1-MMP (MT1-MMP) mRNA declined. Phosphorylated ERK, a marker of mitogen-activated protein (MAP) kinase cascade, also declined in HN5-EC cells. The addition of anti-E-cadherin antibody resulted in the disappearance of these alterations in HN5-EC cells. These results suggest that E-cadherin suppresses MAP kinase cascade and down-regulates MT1-MMP.     

Clinical features of poorly differentiated thyroid papillary carcinoma

Objective

To investigate the clinical feature of the poorly differentiated thyroid papillary carcinoma.

An elder case of neurosarcoidosis associated with brain infarction]

A 75-year-old woman with sarcoidosis developed sudden weakness of the left upper and lower limbs. Neurological examination revealed left-sided hemiplegia, hyperreflexia with pathological reflexes and hypesthesia. She was disoriented and euphoric. Diffusion-weighted brain MRI showed high intensity lesions in the right parietooccipital lobes. Electroencephalogram showed diffuse slowing of the background activity. Serum lysozyme increased to 18.4 mg/ml, CSF protein to 51 mg/dl. After admission, she presented psychotic manifestation followed by a progressive disturbance of consciousness. Epithelioid granulomas without caseous necrosis were present in the biopsied lymph node and specimens from the occipital cortex, indicating neurosarcoidosis. Necrosis was also present in the sampled brain tissue. The psychotic symptoms and consciousness disturbance rapidly ameliorated after the treatment with oral prednisolone, 40 mg/day. Neurosarcoidosis should be considered even in an elder case of sarcoidosis complicated with a stroke.     

Oxygen-enhanced MR imaging: correlation with postsurgical lung function in patients with lung cancer

PURPOSE: To prospectively determine if lung function as assessed with oxygen-enhanced magnetic resonance (MR) imaging correlates with postsurgical lung function in patients with lung cancer, as compared with quantitative and qualitative findings of computed tomography (CT) and scintigraphy. MATERIALS AND METHODS: Study received institutional review board approval, and informed patient consent was obtained. Thirty consecutive patients (16 men and 14 women, aged 44-81 years; mean age, 65 years) considered candidates for lung resection underwent oxygen-enhanced MR imaging, CT, perfusion scintigraphy, and measurement of forced expiratory volume in 1 second (FEV1). A respiratory-synchronized inversion-recovery half-Fourier single-shot turbo spin-echo MR sequence was used for data acquisition. Correlation of postsurgical lung function (postsurgical FEV1) as determined with oxygen-enhanced MR imaging (FEV1MR), quantitative assessment with CT (FEV1Quant), qualitative assessment with CT (FEV1Qual), and perfusion scintigraphy (FEV1PS) was conducted with actual postsurgical FEV1, and the limits of agreement of each were determined with Bland-Altman analysis. RESULTS: Correlation between postsurgical FEV1MR and actual postsurgical FEV1 values was excellent (r2= 0.81, P < .001); it was better than that of FEV1Qual (r2= 0.76) and FEV1PS (r2= 0.77) and similar to that of FEV1Quant (r2= 0.81) values. The limits of agreement of FEV1MR were between -9.9% and 10.9%. CONCLUSION: Oxygen-enhanced MR imaging can be used to predict posturgical lung function in patients with lung cancer, similar to quantitative CT.     

Compensatory changes in static and dynamic subjective visual vertical in patients following vestibular schwanoma surgery

OBJECTIVE: Among patients with vestibular schwanoma (VS), vestibular function is nonhomogeneous, both before and after surgical removal of the VS. This paper reports investigations of neural changes, especially changes in the contribution of visual input to vestibular system integration, after VS surgery. METHODS: We examined 33 patients who underwent VS surgery via a middle fossa approach. Static and dynamic subjective visual vertical (SVV) was measured once after surgery and compared to those measured in control subjects. SVVs were assessed using a paradigm requiring the subject to manually adjust an image of a bar to the perceived vertical alignment. SVVs were measured when the background was stationary or rotating. RESULTS: In almost all patients, static SVV deviated toward the operated side. In VS subjects, the mean static SVV was 1.8+/-2.2 degrees; the amount of deviation in the dynamic SVV toward the operated side (11.7+/-8.3 degrees ) was significantly larger than that to the intact side (8.8+/-5.5 degrees ). In VS subjects, static SVV was correlated with dynamic SVV only in cases of bar adjustments toward the operated side (R=0.67, P<0.001), but not in cases of adjustments toward the intact, unoperated side. The axis of rotation was defined as the mean value of dynamic SVV for adjustments toward either side. There was only a weak correlation between the static SVV and the axis of rotation (R=0.31; P<0.05) in the control subjects. On the other hand, a more robust correlation between static SVV and axis of rotation was found (R=0.67, P<0.001) in VS subjects. There was no correlation between the static SVV and the deviation of dynamic SVV from static SVV for CCW and CW in control subjects. In contrast, there were significant correlations between static SVV and deviation of dynamic SVV from static SVV for adjustments made toward both operated (r=0.48, P<0.001) and intact sides (r=038, P<0.05). CONCLUSION: It is assumed that the amount of deviation in static SVV reflects the individual level of compensation. In addition, increased visual dependency evoked a symmetrical bias of the dynamic SVV from the measures at initial SVV assessment (i.e. static SVV or the center of tilt). As a result, we conclude that the contribution of visual inputs had changed after surgery, while at the same time, each patient used their static SVV as their reference point for orientation.     

Bilirubin as a tracer for detecting gastroesophageal reflux

PURPOSE: The usefulness of intraesophageal monitoring of bilirubin, in diagnosing gastroesophageal reflux, was studied. PATIENTS AND METHODS: Bilirubin concentration and pH at 5 cm oral and anal to the esophagogastric junction were monitored for 24 hours in 19 patients with reflux esophagitis. The duration of bilirubin presented and pH less than 4.0 were obtained as the holding time (HT) of bilirubin and acid, respectively. RESULTS: There was no difference between HT of bilirubin and acid in the stomach and esophagus. In the stomach, HT of bilirubin did not correlate with acid. Whereas, in both of bilirubin and acid, HT in the esophagus correlated significantly with that in the stomach. The correlation was more definite for bilirubin than acid. CONCLUSIONS: Bilirubin and acid presented in the upper stomach for sufficient period independently. Bilirubin monitoring was useful to evaluate the etiology of damaging the esophageal mucosa and causes of symptoms by estimating duodenogastro-esophageal reflux, which has synergistic effect with acid.