Abdominal wall desmoid mimicking intra-abdominal mass: MR features.

A case of abdominal wall desmoid which enlarged toward the liver and mimicked an intra-abdominal tumor is presented. T*2-weighted MR images clearly demonstrated the tumor's continuity with the rectus abdominis muscle. The case presented suggests MRI may provide more valuable information concerning the origin of a right-upper-quadrant mass than CT does. However, the nature of the signals and attachment which this case showed were so unusual for desmoids that this case has not been diagnosed accurately.

Suppressive effect of bradykinin to cellular immune responses in vivo and in vitro.

Bradykinin, as well as histamine, one of the mediators in IgE mediated immediate type allergic reactions or acute inflammation, may affect the in vitro and in vivo cell-mediated immune reactions of the immunized animals. It was demonstrated in our present experiment that the appearance of delayed type hypersensitivity (DTH) skin reaction in the immunized guinea pig was remarkably suppressed by treatment of bradykinin or histamine and the suppression of cutaneous DTH by bradykinin was inhibited by H-2 antagonist (burimamide) but not by H-1 receptor blocker (chlorpheniramine). It was also clearly demonstrated that bradykinin suppressed the production of antigen-induced macrophage migration inhibitory factor (MIF) of the immune guinea pig peritoneal exudate cells (PECs) and the production of MIF was blocked by H-2 antagonist (burimamide) or H-2 agonist (tolazolin) but not by H-1 antagonist (chlorpheniramine). Antigen-induced lymphocyte proliferation of the immunized mice, one of the indicators of the cellular immune response, was also suppressed by treatment of bradykinin. These results indicate that bradykinin as well as histamine may have some role in the subsequent expression of cellular immune reactions.

Isolated angiitis of the central nervous system first presenting as intracranial hemorrhage during cesarean section.

A case of isolated angiitis of the central nervous system (CNS) which first presented as intracranial hemorrhage during cesarean section is reported. Only one case of isolated angiitis of the CNS in post partum has been reported to date. Although a headache in labor and puerperium usually suggests subarachnoid hemorrhage, isolated angiitis of the CNS should be considered in the differential diagnosis.

Reversible irritative effect of acute 2.45GHz microwave exposure on rabbit eyes--a preliminary evaluation.

We have attempted to determine if there is a hazardous effect of acute microwaves at 2.45 GHz on the eye of a rabbit under lengthy exposure without anesthesia, the contralateral eye serving as a control. Unilateral eyes of 9 adult Japanese white rabbits (10-12 weeks of age) were irradiated by 2.45 GHz continuous wave (CW) microwave for 160 min. to 240 min. under restraint without anesthesia. The specific absorption rate (SAR: phantom material) was 26.5 W/kg. The corneal surface temperature increment was 3.0 degrees C for 15 min. on average. Miosis occurred in all rabbits within 15 min. Post-exposure ophthalmological signs, first detected as the effect of CW irradiation, included 1) miosis and pupillary congestion; 2) keratoleucoma and corneal edema; 3) endothelial cell detachment and floating in aqua oculi, 4) fibrinogenesis in the anterior chamber, and 5) conjunctiva edema, which disappeared one week after exposure. There was no cataract formation. The acute microwave irradiation to the rabbit eye, causing the miosis and pupillary congestion in all irradiated eyes, was the first to be detected.

Management of multiple cholesterol embolization syndrome--a case report.

A sixty-two-year-old man who underwent coronary angiography and received acute thrombolytic and anticoagulant therapy for acute myocardial infarction developed multisystemic injury, including renal insufficiency and cutaneous manifestations. Fundoscopic examination and skin biopsy specimen led to the diagnosis of multiple cholesterol embolization syndrome (MCES). Discontinuation of anticoagulants and administration of hemostatic (carbazochrome, tranexamic acid, reptilase, and vitamin K) and antihyperlipidemic (cholestyramine and probucol) drugs resulted in temporary improvement of cutaneous and renal disorders and extended survival for about one year. Besides severe aortic atherosclerosis, postmortem examination revealed numerous cholesterol emboli to multiple organs. MCES is a rare but serious complication of left heart catheterization and anticoagulant therapy, and the optimal treatment remains to be established. The authors suggest here that the above-mentioned therapy might be effective for management of MCES.

Retroperitoneal ganglioneuroma extending across the midline: MR features.

A rare adult case of retroperitoneal ganglioneuroma in which magnetic resonance imaging (MRI) clearly demonstrated unusual extension of the tumor across the midline is reported. Dynamic MR imaging was very useful to distinguish benign ganglioneuroma from other retroperitoneal tumors, especially neuroblastoma and pheochromocytoma.

Diffuse arteriovenous malformation involving jejunum and total colon with mesenteric varices. Case report.

Diffuse intestinal arteriovenous malformation (AVM) is very rare. We describe a case of diffuse AVM involving the jejunum and the total colon in an adult. In addition, mesenteric varices without portal hypertension is demonstrated on angiography of the superior mesenteric artery. The high flow through the AVMs may be a major component in the etiology of the mesenteric varices in our case.

[Isolated angiitis of the central nervous system with high immune complex titer, first presenting as intracranial hemorrhage during cesarean section].

A case of isolated angiitis of the central nervous system (IACNS) which first presented as intracranial hemorrhage during cesarean section was reported. The patient was a 27-year-old female who showed severe headache during cesarean section. CT scan disclosed hematoma in the right parieto-occipital area. Carotid and vertebral angiograms demonstrated striking areas of stenosis and irregularity of all intracranial arteries. There was no abnormality in the branches of the external carotid arteries. Systemic angiograms showed no evidence of systemic vasculitis. Biopsy of the temporal artery showed no abnormal findings. Titer of immune complex was elevated. Angiitis showed no improvement with corticosteroid alone, but improved markedly with corticosteroid plus cyclophosphamide. Elevated titer of immune complex became normal. Treatment with a combination of corticosteroid and cyclophosphamide is recommended in IACN.

[Expression of matrix metalloproteinases and tissue inhibitor of metalloproteinase by myofibroblasts--morphological study on corneal wound healing].

The matrix metalloproteinases (MMPs) and the tissue inhibitor of metalloproteinases (TIMPs) regulate the extracellular matrix and are important in the process of connective tissue remodeling. In this study, we investigated the expression of MMPs and TIMP-2 by myofibroblasts (MF) originating from keratocytes during the healing of alkali-burned and lacerated rabbit corneas. In light and/or electron microscopic immunohistochemistry, the MMP-1, 2, 9 and TIMP-2 antibodies reacted with MF in both types of corneal wounds. The clear expression of MMP-1 and the relatively faint immunoreaction of MMP-2 were observed in both types of healing from one week after wounding, while MMP-9 appeared from 3 weeks after injury. In addition, the levels of MMP-2 and 9 were increased from 4 weeks after alkali-burned injury. The clear expression of TIMP-2 was observed from 1 week after both types of wounds. These findings indicate that MF is deeply involved in degrading some of the key matrix proteins (such as type I collagen), and may play an important role in tissue remodeling in corneal wounds through production of MMPs and TIMP.

[Lipoprotein (a) and sclerotic changes in retinal arterioles].

Lipoprotein (a) (Lp(a)) has been considered an independent risk factor for arteriosclerotic disease and its role in retinal vascular changes was studied in this report. The study was made on 160 patients of age 54 and above. They were divided into four groups depending upon their clinical background with or without the presence of diabetes mellitus (DM) and cerebral infarction (CI). The retinal vascular status of the patients was studied by ophthalmoscopic examination and the findings were graded according to Scheie's classification. We found that all the patients with retinal arterial hypertension and arteriosclerosis had a significant by high level of serum Lp (a). Similarly, serum Lp (a) level was higher in the patients with DM and CI than in the control subjects. These findings suggested that Lp (a) might influence the pathological changes of senile retinal arterioles. Moreover, we found a positive linear correlation between Lp (a) and plasminogen in patients with CI.

[Pleomorphic adenoma of the lung].

A 41 year-old male was admitted to our hospital, because a suspicious shadow in the right lower lung field was on X-ray. Investigations could not confirm cancer but were highly suggestive of it. Finally, right lower lobectomy was performed, and the histopathological finding of the tumor resected were a mixture of epithelial components in myxomatous tissue, so a diagnosis of pleomorphic adenoma of the lung was made.

[Prevalence rate of allergy to Japanese cedar pollen in Tokyo--from field investigation in 1996 by Tokyo Japanese Cedar Pollen Allergy Measurements and Review Committee].

Prevalence rate of allergy to Japanese cedar pollen was investigated by means of questionnaires and immunological examinations in residents of 3 regions in Tokyo (Akiruno city, Chofu city, and Ota ward). The results were as follows: 1) the prevalence rate of allergy to Japanese cedar pollen in Tokyo was 25.7% in Akiruno city, 21.1% in Chofu city, and 17.7% in Ota ward in 1996; 2) stratification by the age reveal that the prevalence rate was the highest in the age group of 30 to 44, and the group showed prevalence rate of above 40% in Akiruno city; 3) overall prevalence rate of Tokyo was 19.4% in 1996, which was approximately twice as much as that in 1985; 4) increase in prevalence rate in the recent decade was most significant in Akiruno city where the largest number of Japanese cedar pollen was detected in the air, and prevalence rate tended to rise in the young group of 14 or less.

[Inflammatory tumor of the hepatic hilus mimicking bile duct cancer--report of a case].

A 73-year-old man was admitted to our hospital because of jaundice. Ultrasonography and computed tomography showed a tumor of the hepatic hilus causing obstructive jaundice. Angiography revealed a stenosis of the right hepatic artery. Under the diagnosis of carcinoma of the hepatic hilus, extended right hepatectomy with resection of the caudate lobe was performed. A tumor showing expophytic growth, 2.1 x 1.9 x 1.5cm in size, was seen in the hepatic hilus. Histologically, the tumor was proved to be a non-neoplastic fibrous tissue simulating the inflammatory pseudotumor.

[Activated eosinophils in vernal keratoconjunctivitis].

A recent study showed that eosinophil basic proteins in eosinophil granules tend to cause severe lesions in allergic disease. Eosinophil cationic protein (ECP) (an eosinophil basic protein), released from activated eosinophils, damages the epithelial mucosa. Vernal keratoconjunctivitis (VKC) always accompanies salient eosinophil infiltrations in the conjunctiva. To evaluate the role of activated eosinophils during VKC, we studied conjunctival specimens from VKC patients, using an immunohistochemical technique with monoclonal antibody (EG2) and electron microscope. We also determined ECP content in the patient tears. Immunocytochemical study showed a significant number of activated and degranulated eosinophils in the conjunctiva (giant papilla), including its epithelia and subepithelial tissue. Electron microscopy showed that the tear mucoid layer contained a number of exfoliated conjunctival epithelial cells with eosinophil granules. ECP content in the tears of these patients was 1361.4 +/- 1053.4 ng/ml, significantly higher than that of a normal subjects (< 20.0 ng/ml) (p < 0.01). These results suggest that the activated eosinophils and ECP contribute to the development of the lesion during VKC.

Tear volume in early and late phases of ocular anaphylaxis in guinea pigs.

Three models of ocular anaphylaxis containing 6 guinea pigs each were used to examine their effect on tear volume. In the first model, IgG1-rich anti-dinitrophenol (DNP) bovine gamma-globulin serum was injected subconjunctivally, and the animals were challenged 4 h later with topically applied di-DNP-lysine. In the second model, IgE-rich anti-egg albumin serum was injected subconjunctivally, and the animals were challenged 8 days later with topical instillation of egg albumin. In the third model, IgE-rich anti-egg albumin serum was injected intravenously, and animals were challenged 8 days later with topically applied egg albumin. Tears were collected before the procedure, 0.5 h after anaphylaxis was initiated, and then hourly for 8, 10, 12, 24, and 48 h after challenge. All animal eyes undergoing ocular anaphylaxis had significantly increased tearing. Tear volumes remained elevated in the first model beyond the observation period of 48 h.