[Solitary capillary hemangioma in the lung: report of a case].

We report a case of pulmonary solitary capillary hemangioma of 59-year-old woman who visited our hospital for an abnormal chest shadow. She had no symptoms, but a computed tomography (CT) revealed a small irregular nodule at the periphery of right S9. Early lung cancer was suspected. Video-assisted thoracic surgery (VATS) was performed for the difinitive diagnosis and treatment in January, 2008. Macroscopically, the nodule showed ill defined margin and irregular in shape. Partial resection of the lung was performed and the histopathological diagnosis was solitary capillary hemangioma. Postoperative course was uneventful and there is no signs of recurrence.

Comparative study of survival of patients with hepatocellular carcinoma predicted by different staging systems using multivariate analysis.

AIMS: In a previous pilot study, we reported the usefulness of the modified the Cancer of the Liver Italian Program (CLIP) score for patients with hepatocellular carcinoma (HCC). To determine the best staging system for predicting the survival of HCC patients, we conducted a comparative analysis of prognosis using multivariate analysis in 210 Japanese HCC patients who underwent hepatic resection. METHODS: We compared the survival as predicted by various staging systems, including tumour node metastasis (TNM) stage of the American Joint Commission on Cancer (AJCC) and the Liver Cancer Study Group of Japan, the Japan Integrated Staging (JIS) score (Japanese TNM and Child-Pugh classification), CLIP score and our modified CLIP score using protein induced by vitamin K absence or antagonist II (PIVKA-II). RESULTS: Univariate analysis showed that discrimination of disease-free survival in the early and advanced stages by the JIS score and modified CLIP score was clearer than by the Japanese or AJCC TNM or the original CLIP score. Discrimination between stages of overall survival by all staging systems was significant. Multivariate analysis showed that the JIS, CLIP and modified CLIP scores were better staging systems for predicting survival than the Japanese and AJCC TNM. The modified CLIP score showed the lowest Akaike information criteria statistical value for disease-free and overall survival, which means the best discrimination ability for patient survival compared with the JIS score and CLIP score. CONCLUSIONS: A staging system that combines tumour factors, sensitive tumour marker(s) and hepatic function is the best predictor of prognosis of HCC patients.

Identification of a single phosphorylation site within octopus rhodopsin.

Light-dependent phosphorylation of rhodopsin (Rho) is a first step in the desensitization of the signaling state of the receptor during vertebrate and invertebrate visual transduction. We found that only 358Ser of the photoactivated octopus Rho (oRho*) was phosphorylated by octopus rhodopsin kinase (oRK). Tryptic truncation of the C-terminal PPQGY repeats of oRho that follow the phosphorylation region did not influence spectral or G-protein activation properties of oRho but abolished phosphorylation. Despite significant structural differences between oRK and mammalian RK, these results provide further evidence of the importance of singly phosphorylated species of Rho* in the generation of arrestin binding sites.

Platelet-derived endothelial cell growth factor expression is an independent prognostic factor in colorectal cancer patients after curative surgery.

AIMS: Platelet-derived endothelial cell growth factor (PD-ECGF) is an angiogenic factor that undergoes increased expression in colorectal carcinomas, but its prognostic value is a topic of debate. The aim of this study is to clarify the prognostic value of PD-ECGF expression in colorectal carcinomas. METHODS: PD-ECGF expression was measured by enzyme-linked immunosorbent assay in frozen materials from 134 colorectal cancer patients who had received curative resections. Patients were divided into high expression and low expression groups based upon selected cut-off value. Correlations among PD-ECGF expression, clinicopathologic features, and disease-free interval were studied by univariate and multivariate analysis. To evaluate the origin of PD-ECGF, serial sections of the 134 tumours were stained for PD-ECGF and CD68. RESULTS: PD-ECGF expression in the normal mucosa was 34.4+/-15.5 (Units/mg protein) and the cut-off value was 65.4 (mean+2SD). There were no significant correlations between clinicopathological features and PD-ECGF expression. The disease-free interval for the high PD-ECGF expression group was significantly longer than that of the low expression group (P=0.05). A multivariate Cox's regression analysis revealed that high PD-ECGF expression is an independent factor for better outcome. In immunohistochemical study, almost all tumour cells were negative for PD-ECGF, but stromal macrophages were predominantly positive for PD-ECGF. CONCLUSIONS: The PD-ECGF expression originated from stromal macrophages was a predictor for favorable outcome after curative resections for colorectal cancer.

Long-term results of lipiodol-transcatheter arterial embolization with cisplatin or doxorubicin for unresectable hepatocellular carcinoma.

The long-term effects of Lipiodol-transcatheter arterial embolization (Lp-TAE) combined with cisplatin (CDDP) or doxorubicin (ADM) on unresectable hepatocellular carcinoma (HCC) were analyzed. Eighty-four consecutive patients with unresectable HCC were treated with TAE. Of the 84, 38 patients were treated with CDDP-Lp-TAE (CDDP group), whereas the remaining 46 patients were treated with ADM-Lp-TAE (ADM group). No significant difference in characteristics of patients and tumors was noted between the groups. CDDP (50 mg) or ADM (20-50 mg) was administered with Lp followed by embolization of the feeding arteries using gelatin sponge particles. The mean number of TAE treatments was 3.3 in the CDDP group and 1.9 in the ADM group (p < 0.01). The 5-year overall survival rates of the CDDP group and the ADM group were 19% and 6%, respectively. The overall survival rate of the CDDP group was significantly higher than that of the ADM group (p < 0.05). No serious side effects were observed in either group. CDDP-Lp-TAE improved the prognosis of unresectable HCC compared with ADM-Lp-TAE, which may be attributable to the fact that CDDP-Lp-TAE treatment could be repeated more times than ADM-Lp-TAE.

[MR diffusion-weighted imaging of cerebral infarction].

MR diffusion-weighted imaging was performed to investigate changes in water diffusion in patients with cerebral infarction, and diffusion-weighted images (DWI) were compared with T2-weighted images (T2WI). Acute and subacute infarcts were seen as areas of high intensity on DWI and showed lower apparent diffusion coefficients (ADCs), while chronic infarcts showed a relative increase in ADCs. The relative ADC increased progressively over time, becoming renormalized at 3 to 4 weeks, and was elevated in the chronic state. On DWI, infarcts as small as 5 to 6 mm in diameter and lesions adjacent to the ventricular or subarachnoid space could be readily identified. DWI was useful for distinguishing acute lesions from chronic lesions in patients with multiple cerebral infarction, and provided valuable pathophysiologic information on the course of ischemic stroke evolution.

[HTLV-I negative adult T cell leukemia; a case report of acute type].

We described a case of adult T cell leukemia (ATL) not associated with human T-cell leukemia virus type I (HTLV-I), a clinical entity that was first reported by Shimoyama et al. A 79-year-old male was admitted with anorexia and fever in October, 1989. Physical examination revealed marked hepatosplenomegaly and superficial lymphadenopathies. Hematological examination revealed marked leukocytosis (136,300/microliters) with abnormal lymphoid cells showing highly lobulated nuclei. Hypercalcemia (11.2 mg/dl) and elevation of lactic dehydrogenase were also recognized. Surface marker analysis showed that the abnormal lymphoid cells in the peripheral blood were positive for CD2 and CD4 but negative for CD8. Southern blot analysis of the DNA from peripheral blood leukemic cells revealed monoclonal rearrangement of T-cell receptor beta-chain gene. The clinical and hematological findings of the patient were compatible with those of acute type ATL, however, serum anti-HTLV-I antibody was negative and HTLV-I proviral DNA was not detected in the leukemic cells by Southern blot analysis. Furthermore, the polymerase chain reaction showed no integration of the HTLV-I proviral DNA in the leukemic cells.

[A case of renal hemangiopericytoma].

The patient is a 33-year-old female. On precontrast CT, the tumor shows a high density area with a low density area. On postcontrast CT, the tumor demonstrates a well-marginated low density area. Angiographically, the tumor shows a hypervascular mass with tumor vessels like a weeping willow and unhomogeneous stain. This is only the fourth such case ever reported before in Japan.

[MRI of lymphedema using short-TI-IR (STIR)].

Thirty four cases with lymphedema of the extremities were examined with MRI at 0.5 tesla. On T1-weighted image, the enlarged subcutaneous tissue and the subcutaneous trabecular structures were seen in all cases. Moreover, the trabecular structures in the enlarged subcutaneous tissue showed low signal intensity on T1-weighted image and high signal intensity on T2-weighted image in all cases. Additionally, in 12 of 15 cases examined by Short-TI-IR (STIR) image, the trabecular structures and fluid collections in the subcutaneous tissue were shown more definitely in high signal intensity than by T2-weighted image. We consider MRI using STIR is to be useful in the evaluation of edematous disease.

Roles of cytosolic phospholipase A(2) and platelet-activating factor receptor in the Ca-induced biosynthesis of PAF.

Casein-elicited peritoneal exudate cells (PEC), mainly consisted of neutrophils, were collected from platelet-activating factor receptor-knock-out (PAFR-KO), cytosolic phospholipase A(2) knock-out (cPLA(2)-KO), and wild-type (WT) mice. After stimulation of PEC with calcium ionophore A 23187, PAF levels were measured by radio-ligand binding assay using receptor-rich membrane fraction prepared from the PAF receptor transgenic mice. We found that the level of PAF production by PEC was not different between WT and PAFR-KO mice. On the other hand, cPLA(2)-KO mice were deficient in the PAF production. These results provide the direct evidence while cPLA(2) is essential in the production of PAF, PAF receptor deficiency has little effect on the PAF production.

Crohn's disease in the esophagus--report of a case.

A case of esophageal Crohn's disease is described. Crohn's lesion was observed in the lower esophagus, and sarcoid-like granulomas were found in the biopsied specimen. A clinical consideration of this phenomenon is presented.

[MR imaging of optic neuritis using short T1 IR (inversion recovery)].

We evaluated the ability of MRI using short T1 inversion recovery (STIR) to diagnose optic neuritis. Eleven patients with previous or recent attack of optic neuritis were studied with MRI at 0.5 tesla. STIR images revealed high signal regions in 7 of 12 symptomatic and 5 of 10 asymptomatic nerves. Three of five asymptomatic nerves with high intensity were pertinent to the cases with past attack and seemed to reflect the demyelinating change. The other two nerves were pertinent to the cases without past attack and seemed to show occult lesions. We consider that STIR is useful in detection of optic nerve lesions associated with optic neuritis.

[MR imaging of hepatocellular carcinoma following transcatheter hepatic chemo-embolization].

Transcatheter chemo-embolization (TCE) for hepatocellular carcinoma (HCC) was performed on 31 patients, and on 4 of the 31 patients, it was performed twice. The patients were examined by MR both before TCE and after TCE (1 week and 4-5 weeks respectively). On MR images, the change of the tumor signal intensity was classified into 3 groups. In group 1, (G1, 8 cases), obvious change of intensity was seen in the whole tumor. In group 2, (G2, 10 cases), it was seen in some parts of the tumor and in group 3, (G3, 17 cases), only a very slight change of intensity was seen in the whole tumor. In G1 and G2, the rate of AFP decrease was remarkable, but in G3, it was very slight. In G1 and G2, the change of the tumor signal intensity was divided into 2 types on a T2 weighted image. One, is the increase of the intensity, (6 cases). The other, is decrease of intensity, (12 cases). The former seemed to reflect the intra-tumoral hemorrhage accompanying tumor necrosis, the latter, seemed to reflect the coagulation necrosis. The ring of low and high intensity around the tumor appeared anew in 11 cases, and in 2 cases, it increased in size. These changes which have never been recognized on CT images, were thought to be a granulation tissue around the tumor. The influence of the accumulated lipiodol is slight for the change of intensity on the tumor.

MR imaging of the liver before and after transcatheter hepatic chemo-embolization for hepatocellular carcinoma.

Transcatheter chemo-embolization (TCE) in hepatocellular carcinoma (HCC) was performed in 38 patients. The patients were examined by MR imaging before TCE as well as one week and 4 to 5 weeks after TCE. The tumor signal intensity in T2 weighted images increased in 13 cases and decreased in 19 cases after TCE. Increased intensity seemed to reflect intra-tumoral hemorrhage or liquefaction accompanying tumor necrosis. Decreased intensity seemed to reflect coagulation necrosis. In 9 of 18 cases followed over a 2-month period the signal intensity had decreased in both T1 and T2 weighted images. In these patients the tumor showed no recurrence at angiography and the decreased signal seemed to reflect the completion of coagulation necrosis. A hyper- and/or hypointense rim around the tumor appeared in 22 cases. These changes were thought to be perifocal edema or granulation tissue around the tumor. MR imaging was useful in evaluating the necrotic process of the tumor after TCE.