Thymidine phosphorylase expression is preserved after radiotherapy in patients with cervical squamous cell carcinoma

Purpose The aim of this study was to investigate the changes in two of the enzymes involved in fluorouracil metabolism, thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD), in uterine cervical squamous cell cancer tissue after radiotherapy.Subjects and methods Cervical tissue from 27 patients diagnosed with stage IIIB or IV uterine cervical squamous cell cancer was compared with normal cervical tissue from 33 patients with benign gynecologic diseases. Expression of TP and DPD in the cervical tissues was measured using enzyme-linked immunosorbent assays. TP and DPD expression before and after irradiation with 10 and 20 Gy was measured in 9 of the 27 patients with cervical cancer.Results Before irradiation, DPD expression in cancer tissue did not differ from that in normal tissue. TP expression and the TP/DPD ratio were significantly higher in cancer tissue than in normal tissue (P<0.00001). TP and DPD expression and the TP/DPD ratio were not significantly changed by irradiation with 10 and 20 Gy. TP expression and the TP/DPD ratio after irradiation with 10 and 20 Gy were significantly higher than in normal tissue.Conclusion The increased TP expression and the elevated TP/DPD ratio following irradiation with up to 20 Gy may offer an increased clinical advantage to chemoradiotherapy with capecitabine or doxyfluridine over radiotherapy alone.     

Recognition of facial expressions and emotional situations in patients with dementia of the Alzheimer and vascular types

The aim of this study was to investigate the ability of patients with dementia to recognize facial expressions and emotional situations. We evaluated 16 patients with dementia of the Alzheimer type (DAT) and 15 with vascular dementia (VD) for general cognition, discrimination of facial expressions and individual faces, and recognition of facial expressions and emotional situations. VD patients performed significantly worse than DAT patients at recognizing facial emotions, even though there was no difference between them in their general cognition and visuoperceptual abilities. There was no significant difference between them in their ability to recognize emotional situations. The results of this and past studies suggest that caregivers in nursing homes and hospitals need to be aware that VD patients lose the ability to comprehend facial expressions.     

Preoperative evaluation of pelvic masses with combined F-fluorodeoxyglucose positron emission tomography and computed tomography

OBJECTIVE: To prospectively evaluate the diagnostic value of combined 18F-fluorodeoxyglucose position emission tomography and computed tomography (FDG-PET/CT) to discriminate malignant or borderline malignant tumors from benign pelvic masses. METHODS: A prospective study of 30 women with suspected ovarian cancer who presented from July 2006 through August 2007. Selection was based on evidence from ultrasound, magnetic resonance imaging, and rising tumor marker levels. All patients underwent FDG-PET/CT prior to standard debulking surgery for a pelvic mass. Results: The sensitivity and specificity of FDG-PET/CT to detect malignant or borderline malignant pelvic tumors were 71.4% and 81.3%, respectively. The sensitivity and specificity of FDG-PET/CT to detect ovarian cancer were 100% and 85.0%, respectively. The maximum standardized uptake value in borderline tumors was significantly lower compared with malignant tumors, but not significantly different compared with benign tumors. CONCLUSION: FDG-PET/CT had a high diagnostic value in differentiating between malignant and benign tumors, and a low diagnostic value in differentiating between borderline malignant and benign tumors.     

Age‐related changes in histogram pattern of anterior horn cells in human cervical spinal cord

The purpose of the present study was to clarify age‐related changes in histograms of spinal anterior horn cells. The study examined Rexed lamina IX of the C7 spinal cord segment in 22 men who had died of non‐spinal disease (age range, 0–85 years). First, we confirmed that the size of nucleoli exhibited a linear relationship to the diameter of spinal anterior horn cells by preparing histograms of nucleoli. Second, this formula was used to create histograms of cervical anterior horn cells. Results were as follows: (i) diameter of nucleoli ranged from 2.0 µm to 6.0 µm; (ii) in each subject, no changes were seen in histogram patterns among ventral, intermediate, dorsal and overall sections; (iii) at ≤ 20 years of age, histograms displayed a single peak for the diameter of nucleoli at about 4.0–4.5 µm; (iv) at 21–60 years of age, histograms displayed two peaks, at about 3.5–4.0 µm and 5.0–5.5 µm; and (v) at 61–85 years of age, histograms displayed a single peak at about 5.0–5.5 µm.     

Novel method to evaluate femoral head penetration in the polyethylene liner after total hip arthroplasty: three-dimensional evaluation on standing radiographs

BACKGROUND: After total hip arthroplasty, the femoral head penetrates the liner because of polyethylene wear and the so-called bedding-in phenomenon. The head moves three-dimensionally, but few reports have evaluated such movement radiographically. Moreover, even fewer reports have evaluated it in a standing position, although the load stress influences the movement. The purpose of the present study was to evaluate the head movement in the liner three-dimensionally using standing images. METHOD: The distance between the centers of the metal shells and femoral heads were measured in 29 unilateral hips implanted with porous-coated acetabular components. Standing anteroposterior and lateral radiographs obtained approximately 2 years after operation were photographed by a digital camera, and the data were used. The measured distances divided by the time after operation and enlargement ratio of the radiographs gave linear penetration rates in the frontal and sagittal planes, and three-dimensional linear penetration rates were calculated from the penetration vectors. Frontally evaluated and three-dimensionally calculated penetration rates were compared, and the correlation of age and other factors with the penetration rate was evaluated. RESULTS: Linear penetration rates were 0.14 +/- 0.11 mm/year frontally, 0.18 +/- 0.08 mm/year sagittally, and 0.21 +/- 0.10 mm/year three-dimensionally. The mean three-dimensional penetration rate was 42% greater than the frontal rate. An inverse correlation was observed between age and the sagittal penetration rate (r = -0.621), and between age and the three-dimensional penetration rate (r = -0.388). The sagittal and three-dimensional penetration rates were significantly higher (P = 0.0008 and 0.0010, respectively) in patients aged <75 years compared to those aged > or = 75 years. CONCLUSIONS: The average three-dimensional penetration rate during the first 2 years after operation was markedly greater than the frontal two-dimensional penetration rate that was conventionally applied for postoperative evaluation. Three-dimensional evaluation using both frontal and sagittal radiographs is necessary to avoid undervaluation of the head movement after total hip arthroplasty.     

Increased killer inhibitory receptor KIR2DL1 expression among natural killer cells in women with pelvic endometriosis

OBJECTIVE: To investigate the host immunologic response to endometriosis in terms of killer inhibitory receptor (KIR) expression by natural killer (NK) cells. DESIGN: Case-control study of immunologic markers. SETTING: University hospital. PATIENT(S): We compared cells from Japanese women with laparoscopically diagnosed endometriosis to cells from 40 women with other laparoscopic diagnoses. INTERVENTION(S): Peripheral venous blood sampling and laparoscopic peritoneal fluid collection. MAIN OUTCOME MEASURE(S): Flow cytometry was used to assess expression of KIR by NK cells in the cell samples. RESULT(S): The percentage of cells that expressed KIR2DL1 among NK (KIR2DL1(+)NK) cells in peritoneal fluid and peripheral blood was significantly higher in women with endometriosis than in controls. The proportion of KIR2DL1(+)NK cells in peripheral blood NK cells before and 1 month after laparoscopic surgery did not differ significantly. CONCLUSION(S): The proportion of KIR2DL1(+)NK cells was increased in peritoneal fluid and peripheral blood in women with endometriosis; this difference is probably related to NK cell suppression in endometriosis. This increase in KIR2DL1 expression by NK cells may represent a risk factor in the pathogenesis of endometriosis.     

Glucose Fluctuation and Severe Internal Carotid Artery Siphon Stenosis in Type 2 Diabetes Patients

The impact of glucose fluctuation on intracranial artery stenosis remains to be elucidated. This study aimed to investigate the association between glucose fluctuation and intracranial artery stenosis. This was a cross-sectional study of type 2 diabetes mellitus (T2DM) patients equipped with the FreeStyle Libre Pro continuous glucose monitoring system (Abbott Laboratories) between February 2019 and June 2020. Glucose fluctuation was evaluated according to the standard deviation (SD) of blood glucose, coefficient of variation (%CV), and mean amplitude of glycemic excursions (MAGE). Magnetic resonance angiography was used to evaluate the degree of intracranial artery stenosis. Of the 103 patients, 8 patients developed severe internal carotid artery (ICA) siphon stenosis (≥70%). SD, %CV, and MAGE were significantly higher in the severe stenosis group than in the non-severe stenosis group (<70%), whereas there was no significant intergroup difference in the mean blood glucose and HbA1c. Multivariable logistic regression analysis adjusted for sex showed that SD, %CV, and MAGE were independent factors associated with severe ICA siphon stenosis. In conclusion, glucose fluctuation is significantly associated with severe ICA siphon stenosis in T2DM patients. Thus, glucose fluctuation can be a target of preventive therapies for intracranial artery stenosis and ischemic stroke.