High CC chemokine receptor 7 expression improves postoperative prognosis of lung adenocarcinoma patients.

BACKGROUND: Chemokines and chemokine receptors not only have significant roles in cancer metastasis and tumorigenesis but also act as antitumour agents. The interaction between the Crk-like adaptor protein (CrkL), which is encoded by the CRKL gene, and non-receptor tyrosine kinase c-ABL is reported to transform many cells into malignant cells. We examined the effects of CC chemokine receptor 7 (CCR7), CCR7 ligands and CrkL and c-ABL in lung adenocarcinoma. METHODS: One hundred and twenty patients with lung adenocarcinoma were included in this historical cohort analysis. We examined CCR7 and CCR7 ligands and CrkL and c-ABL mRNA expressions in surgically resected lung adenocarcinoma specimens and evaluated their contribution to prognosis, and the relationship with epidermal growth factor receptor (EGFR) and TP53 mutations. RESULTS: High CCR7 mRNA expressions indicated better prognoses than those of the groups with low CCR7 mRNA expressions (P=0.007, HR=2.00, 95% CI of ratio: 1.22 -3.31). In lung adenocarcinoma, CrkL and c-ABL mRNAs were related to CCR7 mRNA expression (P<0.0001). CrkL and c-ABL mRNA expressions were influenced by EGFR mutations. A high expression of CCL19 was a good prognostic factor of lung adenocarcinoma. CONCLUSION: We propose that CCR7 and CCL19 are clinically good prognostic factors and that CCR7 is strongly related to CrkL and c-ABL kinase mRNA expression in lung adenocarcinoma.

FUS immunoreactivity of neuronal and glial intranuclear inclusions in intranuclear inclusion body disease.

AIMS: Recent studies have shown that fused-in-sarcoma (FUS) protein is a component of 'neuronal' intranuclear inclusion bodies (INIBs) in the brains of patients with intranuclear inclusion body disease (INIBD). However, the extent and frequency of FUS-immunoreactive structures in INIBD are uncertain. METHODS: We immunohistochemically examined the brain, spinal cord and peripheral ganglia from five patients with INIBD and five control subjects, using anti-FUS antibodies. RESULTS: In controls, the nuclei of both neurones and glial cells were intensely immunolabelled with anti-FUS and neuronal cytoplasm was weakly positive for FUS. In INIBD, neuronal and glial INIBs in the brain and spinal cord were positive for FUS. FUS-positive INIBs were also found in the peripheral ganglia. The proportion of FUS-positive neuronal INIBs relative to the total number of inclusion-bearing neurones ranged from 55.6% to 83.3% (average 73.2%) and that of FUS-positive glial INIBs ranged from 45.9% to 85.7% (average 62.7%). The nucleus and cytoplasm of inclusion-bearing neurones and glial cells showed no FUS immunoreactivity. CONCLUSIONS: These findings suggest that FUS is incorporated into INIBs in both neurones and glial cells and that loss of normal FUS immunoreactivity may result from reduced protein expression and/or sequestration within inclusions.

Feasibility of virtual surgical simulation in the head and neck region for soft tissue reconstruction using free flap: a comparison of preoperative and postoperative volume measurement.

In the head and neck region, preoperative evaluation of the free flap volume is challenging. The current study validated preoperative three-dimensional (3D) virtual surgical simulation for soft tissue reconstruction by assessing flap volume and evaluated fat and muscle volume changes at follow-up in 13 head and neck cancer patients undergoing anterolateral craniofacial resection. Patients received 3D virtual surgical simulation, and the volume of the planned defects was estimated by surgical simulation. Following en bloc resection of the tumor, the defect in the skull base was covered using a rectus abdominis myocutaneous flap. Following surgery, computed tomography scans were acquired at day 1 and at 6 and 12 months. Virtual planned defect was on average 227 ml (range, 154-315) and was 10% smaller than the actual flap volume in patients without skin involvement of the tumor. Between day 1 and 12 months post-surgery, the volume of fat and muscle tissue in the free flap dropped by 9% and 58%, respectively. Our results indicate that 3D virtual surgical simulation provides essential information in determining the accurate volume of the required free flap for surgical defect repair and may thus help improve surgical planning and functional and esthetic outcome.

Further observation of Japanese Creutzfeldt-Jacob disease with widespread amyloid plaques.

An autopsy case of Creutzfeld-Jacob disease with widespread amyloid plaques is reported. A 45-year-old Japanese man, whose father had died of a similar disease, had a 5-year illness characterized by progressive cerebellar signs. Mental changes and brain-stem signs developed in the late stage. Myoclonus frequently occurred. Akinetic mutism ensued. The autopsy revealed spongiform encephalopathy with widespread amyloid plaques and extensive degeneration of the white matter. This disease, Western Gerstmann-Sträussler-Scheinker disease and panencephalopathic type of Creutzfeld-Jacob disease are discussed.

Three categories of the degenerative appearance of the human cerebellar dentate nucleus. A morphometric and morphological study.

This morphometric and morphological study demonstrates 3 categories (types A, B and C) of degenerative feature in the cerebellar dentate nucleus. Type A is characterized by neuronal loss, astrocytosis and granular and/or amorphous argyrophilic change around the neurons and neuronal processes, and this type was thought to be synonymous with the so-called grumose degeneration of the DN. Type B is characterized by extensive neuronal loss and astrocytosis without argyrophilic change, and it was considered that many diverse factors were responsible for type B. Type C features marked swelling of the neurons without neuronal loss, astrocytosis or argyrophilic change. The Purkinje cells were not involved in type A and C, but severely damaged in type B. Clinically, type A was observed in progressive supranuclear palsy and dentatorubropallidoluysian atrophy, type B extensively in many diseases including anoxic, toxic and infectious disorders, and type C in tardive dyskinesia manifesting with oral hyperkinesia. Types A and C may be more or less specific signs of degeneration of the dentate nucleus, whereas type B appears to be non-specific.

Atypical GM1 ganglioside accumulation in a case of juvenile amaurotic idiocy.

The brain and liver from a 7-year-old Japanese girl with juvenile amaurotic idiocy were examined neuropathologically and biochemically. Visceromegaly and skeletal abnormalities were absent. Nerve cells in the central nervous system were swollen and contained fine fat granules. Electronmicroscopically, there were large numbers of irregular bodies in the perikarya and these corresponded to the curvilinear and membranous cytoplasmic bodies. Lipid analysis of the brain revealed that GM1 ganglioside was increased in the parietal and occipital areas, while the frontal lobe showed a normal ganglioside pattern. N-Acetyl neuraminic acid (NANA) content in all areas was not elevated. Determinations of beta-galactosidase activity were within normal ranges. The liver had no accumulation of GM1 ganglioside and showed a normal beta-galactosidase activity. These unusual findings in GM1 gangliosidosis were discussed.

Biochemical studies on tissues from a patient with Lafora disease.

Tissues from the cerebral cortex, liver and myocardium of a patient with Lafora disease were obtained at autopsy and were studied biochemically. 1. Glucose content in the myocardium and liver was almost nil while that in the controls was 0.66 mg/g wet weight in the former and 8.80 mg/g wet weight in the latter. Glycogen content in the cerebral cortex and myocardium was about 10 and 3 times more than in controls. 2. Polyglucosan extracted from the cerebral cortex, liver and myocardium had a longer exterior glucose chain than that in the liver of the control but a normal, alpha or beta 1,4-glucosidic linkage was observed. 3. The activities of glucose-6-phosphatase and amylo-1,6-glucosidase in the cerebral cortex, liver and myocardium were well preserved. The activities of acid maltase in the three organs mentioned above and of neutral maltase in the myocardium were elevated twice and one and half times more than the control. Phosphorylase levels in the myocardium were extremely small, while in the cerebral cortex and liver normal activities were observed. In light of these findings, glycogen metabolism in Lafora disease is discussed.

Computer system for craniofacial surgical planning based on CT images.

A system for craniofacial surgical planning utilizing stacks of 2-D tomographic images is described. The four parts of the system are image generation, 2-D surgical planning, 3-D plan confirmation, and rough prediction of face shape after an operation. The four parts are combined to provide a useful surgical planning system. Because a gradient shading technique is used for generating 3-D images, the bumpy shape of the voxel (volume element for 3-D objects) sometimes obscures the essential shape of the displayed objects. To smooth undesirable bumps without losing the essential object shape, 2-D filtering is applied. Arbitrary bone blocks can be specified and moved interactively with a graphic terminal to any derived location to aid surgical planning. The chosen plan can be confirmed by observing computer-generated 3-D images from arbitrary directions since the process necessary to generate a 3-D image for any one direction should be adequate for all directions. Postoperative face-shape prediction is available for evaluating the operation plan at the last stage of the planning sequence.

Development of small hepatocellular carcinoma 80 months after clearance of hepatitis C virus with interferon therapy.

We describe a patient who had a complete and sustained response to interferon (IFN) therapy for chronic hepatitis C but developed small hepatocellular carcinoma (HCC) 80 months later. A 55-year-old Japanese man with hepatitis C virus (HCV) infection and histological features of chronic active hepatitis was treated with recombinant IFN alpha-2a, 9,000,000 U daily for 2 weeks followed by three times a week for 22 weeks. He successfully responded to IFN therapy with a normalization of serum alanine aminotransferase and continuous disappearance of serum HCV-RNA. However, 80 months after the cessation of IFN therapy, the patient's alpha-fetoprotein (AFP) level became elevated for the first time and HCC, 12 mm in diameter, was detected by routine ultrasonographic screening. Laparotomy revealed a small HCC with no metastasis, and the nontumorous liver demonstrated chronic inactive hepatitis. This case indicates the need for careful follow-up using ultrasonography and AFP testing for at least 7 years after completing IFN therapy in all patients with chronic hepatitis C, even if the patients have a complete response to the therapy.

11C-glucose metabolism in manic and depressed patients.

The authors used positron emission tomography (PET) and 11C-labeled glucose to study 15 unmedicated patients with affective disorders and 7 control subjects. Diagnoses of affective disorders were based on DSM-III criteria, and symptomatology was evaluated by the Hamilton Rating Scale for Depression. Blood counts of 11C in both unipolar and bipolar patients did not differ from those in controls after oral administration of 11C-glucose. By contrast, brain counts of 11C in unipolar depressed patients were significantly lower, whereas those in bipolar manic patients were significantly higher, than in normal controls.

Latency of plantar grasp.

Latency of plantar grasp was measured in 437 normal infants from the first day to 6 months of age with a special instrument for measurement of the latency. The latency was prolonged during the birth shock period and returned to the previous value and remained at almost the same value until 7 days, then gradually shortened during the first four months. After 5 months, the values were not reliable. Our method is simple and not only is useful for assessment of maturation of the nervous system, but also helpful for better understanding of the pathophysiology of the nervous system.

Pedoscope studies on neonatal activity and center of gravity after delivery.

Seventeen normal term infants delivered at the Jikei University School of Medicine were placed daily on a pedoscope in the supine and prone position after birth, and the movement of the gravity center and changes in the activities of the extremities were assessed. The results indicated that both the activity of the extremities and the movement of the gravity center were sluggish after birth, that both increased to reach peaks within 1 to 3 days, and that then temporary decreases occurred before they increased again. The probable reason for the temporary decrease in activity may be habituation or a decrement in the infant, and it is also presumed that the increase in activity after the transitory decrease reflects natural development.

Tapetum-specific expression of theOsg6B promoter-ß-glucuronidase gene in transgenic rice.

The promoter of an anther tapetum-specific gene,Osg6B, was fused to aß-glucuronidase (GUS) gene and introduced into rice byAgrobacterium-mediated gene transfer. Fluorometric and histochemical GUS assay showed that GUS was expressed exclusively within the tapetum of anthers from the uninucleate microspore stage (7 days before anthesis) to the tricellular pollen stage (3 days before anthesis). This is the first demonstration of an anther-specific promoter directing tapetum-specific expression in rice.

A nuclear magnetic resonance spectroscopic and conformational study of eight pseudo-trehaloses (D-glucopyranosyl 5a-carba-D- and -L-glucopyranosides).

N.m.r. data (1H and 13C) are presented for eight pseudo-trehalose derivatives in which the D-glucopyranosyl moiety is alpha or beta and the 5a-carbaglucopyranoside moiety is alpha-D, beta-D, alpha-L, or beta-L. The differences in the chemical shifts and then n.O.e. effects have been correlated with the preferred conformations estimated from empirical force-field calculations (HSEA), which have been used to calculate the average parameters over the whole energy surface. Of the four alpha-D-glucopyranosyl derivatives, only that with a 5a-carba-beta-D-glucopyranoside moiety (3) was a substrate for glucoamylase.

Chronic progressive leukoencephalopathy with systemic arteriosclerosis in young adults.

Clinicopathological studies of four cases of chronic progressive leukoencephalopathy with systemic arteriosclerosis are reported. Two patients were siblings. In all of our patients, the illness began in early adulthood (25-29 years of age), with gait and speech disturbance as the first symptoms. At about the same time, the patients complained of lumbago, caused by intervertebral disc hernia, and had a tendency toward baldness. They gradually developed disturbance of memory, dementia, spastic paraplegia, and positive pathological reflexes. After a few years, they could neither stand nor walk and became decerebrate. Blood pressures ranged from 120/60 to 140/80 mm Hg. Laboratory data were within normal limits, including serum cholesterol. EEG showed a generalized slowing. The illness ended in death after 9 years in one case and 3-4 years in the other three cases. A general autopsy was done in three cases and only the brain was autopsied in one case. The visceral organs and the brains were fixed in 10% formalin for macroscopic and histological studies. The general autopsies revealed arteriosclerosis in the small arteries of the heart, spleen, and kidneys in three cases and in addition, moderate arteriosclerosis of the coronary arteries in one. Remarkably uniform changes were found in the brains of all four cases, involving diffuse demyelination of the cerebral white matter, with some preservation of U-fibers, and small cystic and softening foci in the white matter and the basal ganglia. The cytoarchitecture of the cerebral cortex was well-preserved. The degeneration of the white matter was caused by arteriosclerotic changes of the small arteries: fibrous intimal proliferation and hyaline degeneration and splitting of the internal elastic membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

On generalized distance transformation of digitized pictures.

In this paper, we present a generalization of the distance transformation of a digitized picture in two different aspects. First, we define the generalized distance transformation of a binary picture (GDTB). A subclass of GDTB, called a local minimum filter family of GDTB (LMF-GDTB), characterized by a series of local minimum filters with varying neighborhoods, is discussed in detail. A skeleton is defined for LMF-GDTB, and it is proved that any binary picture can be reconstructed exactly from its skeleton with the distance value on it. Second, the gray weighted distance transformation (GWDT) is extended to a generalized GWDT (GGWDT) by introducing an arbitrary initial picture. After the fundamental equation of GGWDT and its solution are derived, it is proved that an arbitrary gray picture is generated by iterative application of GGWDT from a uniquely determined elementary picture and a sequence of initial value pictures.

Frantz's tumor (solid and cystic tumor of the pancreas) with liver metastasis: successful treatment and long-term follow-up.

A rare case of Frantz's tumor with liver metastasis is reported. An 11-year-old girl had local resection of a Frantz's tumor in the head of the pancreas. Ten years later, she had a recurrence in the pancreatic head, and two liver metastases were also disclosed at reoperation. Pancreaticoduodenectomy and enucleation of metastatic lesions in the liver were performed. Six years after the second operation, she is well and free of disease. A review of 174 cases of Frantz's tumor disclosed that metastatic disease in the pediatric age group is extremely rare and yet the prognosis is favorable. On the other hand, the outcome in older patients, especially those over 40 years old, is very poor.

A simulation system for craniofacial surgeries based on 3D image processing.

A practical simulation system based on analysis of clinical surgical procedures is described. The system provides fundamental manipulation operations to simulate actual surgical activities. There is a simulated cutting operation for sectioning a bone into various arbitrary shapes, a movement operation to transport a bone block to a desired position, and a restricted-movement operation to move a bone block until it comes into contact with other bone. The system also generates a skin surface image of a postoperative patient based on a simulated plan of bone manipulation. An operational system to enable physicians handling the system to work at ease has been devised. The structure and function of the system are described, and examples of its use in simulation are given.

A case of hypocontractile neurogenic bladder associated with agenesis of corpus callosum.

A case of hypocontractile neurogenic bladder associated with agenesis of the corpus callosum is presented. Not only detrusor pressure but the urethral and anal pressures were also very weak. Although no abnormality could be detected on cervical, thoracic and lumbar magnetic resonance imaging and myelography, dysgenesis of the spinal cord or peripheral nerves associated with agenesis of corpus callosum was thought to be the cause of the neurogenic bladder.

Computer-aided interactive surgical simulation for craniofacial anomalies based on 3-D surface reconstruction CT images.

We developed a computer-aided interactive surgical simulation system for craniofacial anomalies based on three-dimensional (3-D) surface reconstruction CT imaging. This system has four functions: 1) 3-D surface reconstruction display with an accelerated projection method; 2) Surgical simulation to cut, move, rotate, and reverse bone-blocks over the reference 3-D image on the CRT screen; 3) 3-D display of the simulated image in arbitrary views; and 4) Prediction of postoperative skin surface features displayed as 3-D images in arbitrary views. Retrospective surgical simulation has been performed on three patients who underwent the fronto-orbital advancement procedures for brachycephaly and two who underwent the reconstructive procedure for scaphocephaly. The predicted configurations of the cranium and skin surface were well simulated when compared to the postoperative images in 3-D arbitrary views. In practical use, this software might be used for an on-line system connected to a large scale general-purpose computer.