Hepatocellular carcinoma: a case of extrahepatic seeding after percutaneous radiofrequency ablation using an expandable needle electrode

A 2.5-cm diameter, exophytic seeding of hepatocellular carcinoma was detected by contrast-enhanced computed tomography in a 76-year-old man. He had previously undergone a radiofrequency ablation therapy with an expandable, ten-hook needle electrode for the treatment of a 1.5-cm hepatocellular carcinoma in liver segment VI. Ultrasound-guided fine needle biopsy revealed that this hepatocellular carcinoma was moderately differentiated, as initial tumor was. An additional radiofrequency ablation achieved complete ablation of this neoplastic mass on contrast-enhanced computed tomography scanning. Recurrences were not found for eight months after. To prevent tumor seeding, using thermocoagulation when retracting the needle electrode may be useful.     

Primary malignant peripheral nerve-sheath tumor of the common bile duct

Primary malignant peripheral nerve-sheath tumors of the common bile duct are extremely rare. To our knowledge, the published literature contains no previous case report of this disease. Here we report on a 58-year-old Japanese woman with a primary malignant peripheral nerve-sheath tumor of the common bile duct, which was completely resected. A hypoechoic mass was identified in the hepatic hilus, using ultrasonography and computed tomography. Endoscopic retrograde cholangiography revealed a smooth stricture and deviation of the common bile duct. Laparotomy exposed a firm mass around the common bile duct that had not invaded the surrounding tissues. Partial resection of the common bile duct and cholecystectomy were performed as the treatment of choice. The final histopathological diagnosis was malignant peripheral nerve-sheath tumor arising from the wall of the common bile duct.     

Clinical significance and developmental changes of auditory-language-related gamma activity

ObjectiveWe determined the clinical impact and developmental changes of auditory-language-related augmentation of gamma activity at 50–120 Hz recorded on electrocorticography (ECoG).MethodsWe analyzed data from 77 epileptic patients ranging 4–56 years in age. We determined the effects of seizure-onset zone, electrode location, and patient-age upon gamma-augmentation elicited by an auditory-naming task.ResultsGamma-augmentation was less frequently elicited within seizure-onset sites compared to other sites. Regardless of age, gamma-augmentation most often involved the 80–100 Hz frequency band. Gamma-augmentation initially involved bilateral superior-temporal regions, followed by left-side dominant involvement in the middle-temporal, medial-temporal, inferior-frontal, dorsolateral-premotor, and medial-frontal regions and concluded with bilateral inferior-Rolandic involvement. Compared to younger patients, those older than 10 years had a larger proportion of left dorsolateral-premotor and right inferior-frontal sites showing gamma-augmentation. The incidence of a post-operative language deficit requiring speech therapy was predicted by the number of resected sites with gamma-augmentation in the superior-temporal, inferior-frontal, dorsolateral-premotor, and inferior-Rolandic regions of the left hemisphere assumed to contain essential language function (r² = 0.59; p = 0.001; odds ratio = 6.04 [95% confidence-interval: 2.26–16.15]).ConclusionsAuditory-language-related gamma-augmentation can provide additional information useful to localize the primary language areas.SignificanceThese results derived from a large sample of patients support the utility of auditory-language-related gamma-augmentation in presurgical evaluation.     

Determining early gastric cancer lesions appropriate for endoscopic submucosal dissection trainees: a proposal related to curability

Endoscopic submucosal dissection (ESD) was introduced worldwide as a new treatment option for early gastric cancer. Our objective was to discuss the limited ESD reports available and to determine the lesions suitable for use in training endoscopists on which lesions are appropriate for ESD. We reviewed a series of ESD reports that have been written on various risk factors related to the resectability or curability of a variety of lesions. These published studies show that certain risk factors such as tumor size and location and the presence of ulceration are closely related to both resectability and curability. Because the combination of these risk factors resulted in a much higher risk than did any single factor, we recently established a 'risk assessment chart' to determine an individual's total risk of treatment failure for early gastric cancer that has been treated using ESD. This risk chart provides a clear indication that small, non-ulcerated lesions located in the lower third of the stomach have a high rate of curative resection and are technically less challenging if ESD is used. We suggest that trainees should gain ESD experience with such lesions before they start to perform ESD on more difficult lesion types that have a lower probability of curative resection. In addition, we suggest that this risk assessment chart is suitable for the pretreatment assessment of curability and the likelihood of successful en bloc resection.     

Coil embolization of a large,wide-necked aneurysm using a double coil-delivered microcatheter technique in combination with a balloon-assisted technique

Abstract

The present paper describes a double coil-delivered microcatheter technique used in combination with a balloon-assisted technique to treat a patient with a large, wide-necked basilar tip aneurysm with detachable coil treatment. The aneurysm was completely occluded using this technique. There was no recanalization or any neurological deterioration within 12 months of embolization. [Neurol Res 1999; 21: 324-326]     

Nanoridge patterns on polymeric film by a photodegradation copying method for metallic nanowire networks

Topographical patterns are widely applied in many manufacturing areas due to the unique role in modifying performance related to physical, chemical and biological fundamentals. The patterns are usually realized by buckling or wrinkling, self-assembly or epitaxy, and lithography techniques. However, the combination of satisfactory controllability, ridge robustness, cost and dimensional precision is still difficult to achieve by any of the strategies above. A novel, simple and low-cost nanopatterning technique named “photodegradation copying method” with high technological flexibility has been initially proposed in this study. As a perfect example, a nanoridge-patterned surface has been successfully realized on a polymeric film thanks to the selective photodegradation of polymer and the shielding effect of silver nanowire (AgNW) networks. Roughness, wettability and transmittance of the polymeric film became simply and effectively controllable by adjusting the photodegradation time or the size and distribution of AgNWs. In addition, the ridge-patterned film could also be employed as a substrate in transfer printing for more flexible devices. Various topographical nanopatterns are expected to be simply realized by the photocopying method, just replacing nanowires with other masks like nanodisks, nanocubes, nanotriangles, and so on. This promising photocopying technique is believed to play an important role in the development of topographical nanopatterns, and enable more intriguing applications simply, flexibly and inexpensively.

A simple photocopying method based on selective polymer photodegradation is proposed for fabricating topographical nanopatterns. Nanoridges are structured on a polyethylene terephthalate film due to ultraviolet shielding of silver nanowire networks.     

Zinc finger protein 804A (ZNF804A) and verbal deficits in individuals with autism

Background

In a genome-wide association study of autism, zinc finger protein 804A (ZNF804A) single nucleotide polymorphisms (SNPs) were found to be nominally associated in verbally deficient individuals with autism. Zinc finger protein 804A copy number variations (CNVs) have also been observed in individuals with autism. In addition, ZNF804A is known to be involved in theory of mind (ToM) tasks, and ToM deficits are deemed responsible for the communication and social challenges faced by individuals with autism. We hypothesized that ZNF804A could be a risk gene for autism.

Methods

We examined the genetic association and CNVs of ZNF804A in 841 families in which 1 or more members had autism. We compared the expression of ZNF804A in the postmortem brains of individuals with autism (n = 8) and controls (n = 13). We also assessed in vitro the effect of ZNF804A silencing on the expression of several genes known to be involved in verbal efficiency and social cognition.

Results

We found that rs7603001 was nominally associated with autism (p = 0.018). The association was stronger (p = 0.008) in the families of individuals with autism who were verbally deficient (n = 761 families). We observed ZNF804A CNVs in 7 verbally deficient boys with autism. In ZNF804A knockdown cells, the expression of synaptosomal-associated protein, 25kDa (SNAP25) was reduced compared with controls (p = 0.009). The expression of ZNF804A (p = 0.009) and SNAP25 (p = 0.009) were reduced in the anterior cingulate gyrus (ACG) of individuals with autism. There was a strong positive correlation between the expression of ZNF804A and SNAP25 in the ACG (p < 0.001).

Limitations

Study limitations include our small sample size of postmortem brains.

Conclusion

Our results suggest that ZNF804A could be a potential candidate gene mediating the intermediate phenotypes associated with verbal traits in individuals with autism.     

Expression of matrix metalloproteinases in cardiac allograft vasculopathy and its attenuation by anti MMP-2 ribozyme gene transfection

OBJECTIVE: Proliferation and migration of vascular smooth muscle cells (SMCs) causes intimal thickening during cardiac allograft vasculopathy (CAV). This process requires the degradation or remodeling of extracellular matrix (ECM) surrounding the cells. Imbalance between degradation and accumulation of ECM also contributes to the development of CAV. In this study, we investigated the contribution of matrix metalloprotenases (MMPs), enzymes regulating ECM turnover, to the development of CAV. METHODS: Donor hearts from male DBA mice were heterotopically transplanted to male B10.D2 recipient mice, and harvested at days 15 and 30 post transplantation. We examined expression MMP-2, -3, -9 and -13 of graft vessels using immunohistochemistry. To clarify the role of MMP-2 in CAV, anti MMP-2 ribozyme was delivered into donor hearts just before transplantation, mediated by a hemagglutinating virus of Japan-liposome complex to specifically suppress MMP-2 activity. RESULTS: All MMPs were immunopositive in SMCs from the slightly thickened neointima at day 15. In the advanced stage of intimal thickening at day 30, in addition to increased number of SMCs, accumulation of collagenous fibers was observed; expression of MMP-3, -9 and -13 was decreased. In contrast, MMP-2 expression remained distinctly positive throughout the progression of the vascular remodeling. After the gene transfer of MMP-2 ribozyme, luminal occlusion was significantly decreased compared to non-treated allografts [25.0+/-6.5 vs. 55.1+/-7.0% (P<0.05)] at day 30 post transplantation. CONCLUSION: MMP-2 is a principle MMP throughout the progression of the vascular remodeling in CAV. Anti MMP-2 therapy could therefore be one of the candidates for a supplemental therapy for CAV.