Early detection of metachronous brain metastases by biannual brain MRI follow-up may provide patients with non-small cell lung cancer with more opportunities to have radiosurgery.

PURPOSE: Those who have brain metastases smaller than 30 mm in diameter and less than 5 in number can be treated less invasively with radiosurgery. This retrospective study evaluated the optimal brain magnetic resonance image (MRI) follow-up interval for non-small cell lung cancer (NSCLC) patients to detect radiosurgically manageable metachronous brain metastases (MBM). PATIENTS AND METHODS: The records of 551 patients with primary NSCLC, treated in our institute between 2002 and 2007, were reviewed. The initial brain MRI was performed within one month after diagnosis of NSCLC, and the follow-up brain MRI interval was at the discretion of physicians. The interval between the last MRI in which brain metastases were not found and the first MRI in which brain metastases were found was defined as the critical MRIs interval (CMI). The relationship between CMI and the maximum size or number of MBM was evaluated. RESULTS: Among reviewed patients, the initial MRI of 38 patients showed brain metastases and 29 patients were diagnosed as MBM. In these MBM patients, the median interval from diagnosis of NSCLC to diagnosis of brain metastases was 8.9 months. The median CMI was 4.7 (range: 1.6-18.9) months. All brain metastases smaller than 30 mm in maximum diameter were found when CMI was shorter than 6.0 months, although 5 or more brain metastases in number were detected even by shorter CMI than 3 months. CONCLUSION: Early detection of MBM by biannual MRI follow-up may provide NSCLC patients with more opportunities to have less invasive treatment.

Correlation and association of plasma interleukin-6 and plasma platelet-derived microparticles, markers of activated platelets, in healthy individuals.

INTRODUCTION: The aim of this study was to clarify the correlation and association of plasma IL-6 and PDMPs, both of which are associated with metabolic syndrome, in healthy individuals. MATERIALS AND METHODS: We conducted a cross-sectional study of 464 healthy Japanese volunteers (210 men and 254 women, median age 39 and 35years, respectively) who had no signs, symptoms or history of cardiovascular- or cerebrovascular disease and took no medications. We assayed their IL-6 levels with a conventional ELISA kit and their PDMP levels by ELISA and monoclonal antibodies against CD42b and CD42a (glycoprotein Ib and IX). RESULTS: By multivariate analysis, the plasma level of PDMP was correlated with diastolic blood pressure (p=0.015), platelet count (p<0.001), high sensitivity C-reactive protein, and the plasma level of IL-6 (p<0.001) in men (R(2)=0.454, p<0.001) and was correlated with platelet count (p<0.001) and the plasma level of IL-6 (p<0.001) in women (R(2)=0.159, p<0.001). Quartile range of plasma level of IL-6 was associated with plasma level of PDMP after adjustment for diastolic blood pressure, platelet count, and high sensitivity C-reactive protein in men (p<0.001) and associated with plasma level of PDMP after adjustment for platelet count in women (p<0.001). CONCLUSIONS: These results suggest the plasma IL-6 is correlated and associated with the plasma PDMPs, markers of activated platelets in healthy individuals.

Normal pressure hydrocephalus after radiosurgery for sphenoid ridge meningioma.

Normal pressure hydrocephalus after radiosurgery for meningioma has rarely been reported. We report such a case and discuss the role of radiosurgery in the development of hydrocephalus. A 75-year-old man with a growing tumor underwent linac-based radiosurgery. The tumor received 16 Gy to the 80% isodose line. He exhibited the triad of symptoms of normal pressure hydrocephalus and became bedridden three months after radiosurgery. Dilated ventricles were demonstrated with MRI. Examination of the cerebrospinal fluid revealed a high level of protein. The patient underwent a ventriculoperitoneal shunt and recovered well.

Circulating oxidized LDL, measured with FOH1a/DLH3 antibody, is associated with metabolic syndrome and the coronary heart disease risk score in healthy Japanese.

BACKGROUND AND PURPOSE: The objective of this study was to clarify the relationship between circulating oxidized LDL (oxLDL) and metabolic syndrome (MS) and the coronary heart disease (CHD) risk score. METHODS: We conducted a cross-sectional study of healthy volunteers who had no signs, symptoms or history of cardiovascular or cerebrovascular disease and took no medications. We studied 382 Japanese volunteers, 190 men and 192 women (median age 41 and 38 years, respectively). We used an ELISA kit and a monoclonal oxLDL antibody, FOH1a/DLH3, to measure circulating oxLDL. RESULTS: The odds ratio (OR) for elevated oxLDL in individuals with MS compared to those without MS, adjusted for age and sex, was 1.94 (range 1.00-3.78). In individuals with a predicted Framingham 10-year risk for CHD>5% (corresponding with the highest quartile), compared to those with a predicted 10-year risk<5%, the OR, adjusted for age, sex, smoking, and LDL cholesterol, was 2.51 (1.17-5.36). The age-, sex-, smoking- and LDL cholesterol-adjusted OR for a 10-year CHD risk score >5% was 1.03 (1.01-1.04) for LDL cholesterol and 11.7 (4.69-29.0) for smoking. CONCLUSIONS: Elevated oxLDL is associated with the presence of MS and the CHD risk score in healthy people.

[The evaluation of preoperative and postoperative frontal lobe functions in three operative cases of meningioma].

We report three cases of frontal meningioma with their pre- and post-operative evaluations of higher brain functions, especially of frontal lobe functions. All of the cases showed the improvement of the frontal lobe functions after the tumor removal. The evaluations of frontal lobe functions in benign brain tumors such as a meningioma are reported only in a few cases. The evaluations of frontal lobe functions in the operative cases of benign brain tumors provide many interesting and valuable informations about frontal lobe functions. So we must be more interest in evaluations in higher brain functions and accumulate cases for the further analysis of higher brain functions.

[A case report of the chondroma arising from the falx cerebri].

We have reported a case of chondroma arising from the falx cerebri in a 60-year-old female with no neurological symptom. The tumor was revealed as a round mass, attached to the falx cerebri, with marginally scattered calcification on CT scan and with slight enhancement on MRI images. And cerebral angiogram presented a mass with no tumor stain on the external carotid angiography against our preoperative diagnosis of falx meningioma. A subtotal removal of the mass was performed with the diagnosis of chondroma on pathological examination. The chondroma arising from the falx cerebri is extremely rare with only 15 reported cases in the literature. We have presented the first case in Japan and reviewed the previous reports.