MR imaging analysis of heterogeneous leiomyomas of the uterus.

Thirty-six leiomyomas from the same number of patients that were heterogeneous on MR imaging were evaluated for analyzing their MR patterns and for differentiating each type of secondary changes by means of MR imaging-pathologic correlation. The tumors with a mean diameter of 9 cm could be classified into 4 patterns depending on the morphological appearance of signal intensity: speckled (n = 14); nodular (n = 11); cystic (n = 9); or indeterminate (n = 2). Speckled pattern was associated with a mild degree of hyaline or myxoid degeneration or focal necrosis. Nodular pattern was caused by necrosis or cellular leiomyoma, and cystic pattern was related to severe hyaline or myxoid degeneration or necrosis. Each type of secondary changes within leiomyomas showed distinctive MR findings, if they were severely involved. However, use of an additional contrast-enhanced study was necessary in some instances for further clarification. MR imaging has a potential in distinguishing each type of secondary changes that occur in leiomyomas. Various degenerative changes occur in approximately 65% of uterine leiomyomas, and are caused mainly by alteration in the blood supply originating from rapid growth, pregnancy, mechanical accident, and postmenopausal atrophy. These changes include hyaline, mucoid, or myxoid degeneration, calcification, cystic changes, necrosis (red degeneration), and fatty metamorphosis. It is well known that the presence of degenerative changes within leiomyomas can be predicted on MR imaging by a heterogeneous signal intensity on T2-weighted images, although clear distinction of each type of degeneration can not be made by this modality. Recently, cellular leiomyoma, one of the variants of leiomyomas, was also reported to cause heterogeneous signal intensity. However, because various other uterine tumors can also have similar signal intensity on MR imaging, further evaluation for the heterogeneous leiomyomas appears to be necessary. The purpose of our study was to analyze the patterns of heterogeneous leiomyomas and to differentiate each type of secondary changes by means of MR imaging-pathologic correlation.

Compensation of cATSCs-derived TGFß1 and IL10 expressions was effectively modulated atopic dermatitis.

In this study, we found an effective and novel therapeutic approach to atopic dermatitis (AD) therapy via treatment with a canine adipose tissue stem cell (cATSC) extract. We determined that the therapeutic application of cATSC-derived interleukin 10 (IL10) and transforming growth factor ß1 (TGFß1) effectively modulated the overloaded immune response after the induction of AD. In addition, we investigated the molecular role of the cATSC extract during AD treatment. Dogs with naturally occurring AD that was treated at Seoul National University Veterinary Teaching Hospital was enrolled in this study. Owner consent was obtained for privately owned dogs before enrollment. We prepared a primary fat-derived cATSC extract that contained various functional factors, including IL10 and TGFß1, as a treatment for AD. We found that the cATSC extract significantly ameliorated the pathological symptoms of canine AD. The cATSC extract secreted the immunomodulatory cytokines IL10 and TGFß1, which modulated the overloaded immune response after the induction of AD. Moreover, these immunomodulatory cytokines modulated AD-induced inflammation and inactivated the pathological signals IL6, INFγ, iNOS, eNOS and Nox4. Additionally, these cytokines protected against apoptotic keratinocyte degeneration. This study demonstrated the novel therapeutic efficacy of the cATSC extract during successive AD treatments, which suggests a potential therapeutic use for human AD patients.

Molecular targeting of NOX4 for neuropathic pain after traumatic injury of the spinal cord.

Neuropathic pain is a well-known type of chronic pain caused by damage to the nervous system. Until recently, many researchers have primarily focused on identifying cellular or chemical sources of neuropathic pain or have approached neuropathic pain via the basis of biological study. We investigated whether both mmu-mir-23b (miR23b) and NADPH oxidase 4 (NOX4) antibody infusion can alleviate neuropathic pain by compensating for abnormally downregulated miR23b via reducing the expression of its target gene, NOX4, a reactive oxygen species (ROS) family member overexpressed in neuropathic pain. Ectopic miR23b expression effectively downregulated NOX4 and finally normalized glutamic acid decarboxylase 65/67 expression. Moreover, animals with neuropathic pain showed significantly improved paw withdrawal thresholds (PWTs) following miR23b infusion. Normalizing miR23b expression in tissue lesions, caused by neuropathic pain induction, reduced inflammatory mediators and increased several ROS scavengers. Moreover, γ-aminobutyric acid (GABA)ergic neurons coexpressed suboptimal levels of miR23b and elevated NOX4/ROS after pain induction at the cellular level. MiR23b finally protects GABAergic neurons against ROS/p38/c-Jun N-terminal kinase (JNK)-mediated apoptotic death. By evaluating the functional behavior of mice receiving pain/miR23b, normal/anti-miR23b, anti-miR23b/si-NOX4, pain/NOX4 antibody, pain/ascorbic acid, and pain/ascorbic acid/NOX4 antibody, the positive role of miR23b and the negative role of NOX4 in neuropathic pain were confirmed. Based on this study, we conclude that miR23b has a crucial role in the amelioration of neuropathic pain in injured spinal cord by inactivating its target gene, NOX4, and protection of GABAergic neurons from cell death. We finally suggest that infusion of miR23b and NOX4 antibody may provide attractive diagnostic and therapeutic resources for effective pain modulation in neuropathic pain.

Pinhole skeletal scintigraphic manifestations of Tietze's disease.

Tietze's disease (TD) is a self-limited, non-specific, inflammatory condition of the upper costochondral junction (CCJ). Unlike in many other skeletal diseases, radiography plays a relatively minor role in TD because radiographic changes are frequently obscured by physiological costochondral calcifications. Bone scanning is a sensitive test for TD, but its specificity is low. The present study has been conducted to assess prospectively whether pinhole scintigraphy (PS) can enhance diagnostic specificity in TD. Both planar and PS bone images were obtained in seven ribs of five patients with TD. Scans alterations were analyzed and compared with the radiographic findings. Planar scans showed "hot" areas in the region of the CCJ in all seven ribs, these hot areas lacking textural patterns. However, the magnified PS images of the CCJ showed two characteristic uptake patterns: drumstick-like uptake in acute cases and C- or inverted C-shaped uptake in chronic cases. Radiographically, chondritic sclerosis could be seen when physiological chondral calcifications were minimal or absent, but was observed when the calcification was prominent. The correlation of PS and radiographic findings revealed that C- or inverted C-shaped uptake indeed faithfully reflected the inflammatory process in the CCJ, the medial border of which is concave. The further correlation of magnetic resonance and PS images of two lesions in one patient in whom histological examination was performed showed that C- or inverted C-shaped uptake is closely associated with hypervascularity of TD. Differential diagnosis between TD, fracture and metastasis is discussed.

Gestational trophoblastic tumors of the uterus: MR imaging--pathologic correlation.

The purpose of this study is to evaluate the MR findings of gestational trophoblastic tumors (GTTs). Ten patients who confirmed the diagnosis (4 choriocarcinomas and 6 invasive moles) constituted the basis of our study. The MR findings from these patients were prospectively correlated with the histopathology of resected tumor specimens. MR findings of 4 patients with choriocarcinomas were well-defined, hemorrhagic masses with central necrosis. In contrast, 6 patients with invasive moles showed ill-defined, permeative masses with densely enhanced solid components and tiny cystic lesions. The trophoblastic proliferation, coagulation necrosis, and molar villi had varying signal intensities on T1- and T2-weighted images. Our results suggest that MR imaging is a promising tool for noninvasive morphologic analysis of GTTs.

Epstein-Barr virus associated posttransplant malignant lymphoma in renal allograft recipients.

We report two cases of posttransplant malignant lymphoma(PTML) of B cell origin associated with Epstein-Barr virus(EBV) infection. They were a 52-year-old male and a 37 year-old-female, in whom intermediate-grade diffuse malignant lymphomas of large cell type developed in the submandibular area and jejunum, respectively. DNA and RNA in situ hybridization revealed the presence of EBV-specific DNA and RNA sequences in the tumor cells.

A case of subcutaneous seeding of hepatocellular carcinoma after fine needle aspiration biopsy.

Cancer spread along the needle track following fine needle aspiration biopsy is said to be a rare complication. The authors report a case of subcutaneous implantation of hepatocellular carcinoma following ultrasono-guided fine needle aspiration biopsy. The patient, a 67-year-old Korean male was found to have a large hepatocellular carcinoma diagnosed by fine needle aspiration biopsy. Four months later, the patient felt two subcutaneous growing lumps at the previous aspiration site. The authors confirmed them histologically 11 months after aspiration.

MR imaging of tubo-ovarian abscess.

UNLABELLED: PURPOSE AND MATERIAL AND METHODS: MR findings of 9 surgically proven tubo-ovarian abscesses were analyzed in 8 patients. The images were evaluated for signal intensity characteristics and morphologic appearance of the mass, and presence of secondary changes in adjacent pelvic organs and structures. RESULTS: The signal intensity of the lesions on T1-weighted images was hypointense to the surrounding muscle and myometrium in 5 patients, isointense in 3 and hyperintense in 1. On T2-weighted images the signal intensity was hyperintense (n = 6) or heterogeneous (n = 3). A thin rim (1-3 mm) with hyperintensity on T1-weighted images was noted in the innermost aspect of the masses. Other findings were ill-defined margin, thickened wall, multiple internal septa, shading and gas collection. "Mesh-like" linear strands were noted in the pelvis in all patients, with involvement of adjacent pelvic organs in 7 and lymphadenopathy in 3. CONCLUSIONS: In this limited number of cases MR imaging showed great potential for demonstrating the extent of the disease, characterizing the lesions and making a specific diagnosis.