Development of primary central nervous system lymphoma associated with human immunodeficiency virus and JC virus infection

We report here a case of a 37-year-old man with human immunodeficiency virus (HIV) infection followed by JC virus (JCV) infection and primary central nervous system lymphoma (PCNSL). The patient had been infected with HIV type 1 due to blood products for hemophilia A during infancy. He had progression of nervous symptoms and was diagnosed with progressive multifocal leukoencephalopathy (PML) clinically at the age of 36, when his CD4-positive lymphocyte counts ranged between 350 and 450/μl. Oral mefloquine, intravenous methylprednisolone pulse therapy, and intravenous immunoglobulin were not effective for the PML, and the patient entered a vegetative state. Brain biopsy revealed JCV infection without pathological findings of PML. Eight months after the clinical diagnosis of PML, he developed respiratory failure and brain magnetic resonance imaging revealed a mass lesion in the brain stem. The patient died 19 months after the diagnosis of PML. Autopsy findings were compatible with PCNSL. EBV-encoded small RNA-1-positive cells were not detected. We present a case of JCV-positive PCNSL with HIV infection complicated with clinical PML.

Two Cases of Thymic Carcinoma Initially Presenting as Bone Metastasis: A Clinical Report and the Usefulness of CD5 Immunohistochemistry for Assessing Bone Lesions

Thymic carcinoma frequently spreads to the pleural space, regional lymph nodes, liver and lungs. However, an initial clinical presentation involving spinal or multiple bone metastases in patients with thymic carcinoma is extremely rare. We experienced two cases of thymic carcinoma that initially presented with spinal compression and severe pain due to multiple bone metastases, respectively. Both patients were histologically diagnosed with metastatic thymic squamous cell carcinoma based on the findings of specimens resected from the metastatic bone lesions. We herein describe the clinical courses of these cases and review the characteristics of bone metastasis of thymic carcinoma.

Sub-two-cycle, carrier-envelope phase-stable, intense optical pulses at 1.6 μm from a BiB3O6 optical parametric chirped-pulse amplifier

We report on the generation of 9.0 fs, 550 μJ, carrier-envelope phase (CEP)-stabilized optical pulses around 1.6 μm at 1 kHz. Few-cycle IR pulses are obtained from a BiB(3)O(6) optical parametric chirped-pulse amplifier. The amplification of nearly octave-spanning ultrabroad pulses without spectral broadening results in good stability in output energy (0.85% rms) and CEP (160 mrad rms). We observed high harmonics in the water window from a neon cell that corresponds to a laser intensity of 4.1×10(14) W/cm(2).

Highly precise and compact ultrahigh vacuum rotary feedthrough

The precision and rigidity of compact ultrahigh vacuum (UHV) rotary feedthroughs were substantially improved by preparing and installing an optimal crossed roller bearing with mounting holes. Since there are mounting holes on both the outer and inner races, the bearing can be mounted directly to rotary and stationary stages without any fixing plates and housing. As a result, it is possible to increase the thickness of the bearing or the size of the rolling elements in the bearing without increasing the distance between the rotating and fixing International Conflat flanges of the UHV rotary feedthrough. Larger rolling elements enhance the rigidity of the UHV rotary feedthrough. Moreover, owing to the structure having integrated inner and outer races and mounting holes, the performance is almost entirely unaffected by the installation of the bearing, allowing for a precise optical encoder to be installed in the compact UHV rotary feedthrough. Using position feedback via a worm gear system driven by a stepper motor and a precise rotary encoder, the actual angle of the compact UHV rotary feedthrough can be controlled with extremely high precision.

TS-071 is a novel, potent and selective renal sodium-glucose cotransporter 2 (SGLT2) inhibitor with anti-hyperglycaemic activity

BACKGROUND AND PURPOSE

The renal sodium-glucose cotransporter 2 (SGLT2) plays an important role in the reuptake of filtered glucose in the proximal tubule and therefore may be an attractive target for the treatment of diabetes mellitus. This study characterizes the pharmacological profile of TS-071 ((1S)-1,5-anhydro-1-[5-(4-ethoxybenzyl)-2-methoxy-4-methylphenyl]-1-thio-D-glucitol hydrate), a novel SGLT2 inhibitor in vitro and in vivo.

EXPERIMENTAL APPROACH

Inhibition of glucose uptake by TS-071 was studied in CHO-K1 cells stably expressing either human SGLT1 or SGLT2. Single oral dosing studies were performed in rats, mice and dogs to assess the abilities of TS-071 to increase urinary glucose excretion and to lower plasma glucose levels.

KEY RESULTS

TS-071 inhibited SGLT2 activity in a concentration-dependent manner and was a potent and highly selective inhibitor of SGLT2. Orally administered TS-071 increased urinary glucose excretion in Zucker fatty rats and beagle dogs at doses of 0.3 and 0.03 mg·kg(-1) respectively. TS-071 improved glucose tolerance in Zucker fatty rats without stimulating insulin secretion and reduced hyperglycaemia in streptozotocin (STZ)-induced diabetic rats and db/db mice at a dose of 0.3 mg·kg(-1).

CONCLUSION AND IMPLICATIONS

These data indicate that TS-071 is a potent and selective SGLT2 inhibitor that improves glucose levels in rodent models of type 1 and 2 diabetes and may be useful for the treatment for diabetes mellitus.

[Multiple presentation of undifferentiated pleomorphic sarcoma in the mediastinum]

A case of undifferentiated pleomorphic sarcoma in the mediastinum is presented. A 74-year-old man with no complaint was referred to our department for treatment of mediastinal mass pointed out by chest X-ray. Chest computed tomography (CT) revealed 3 tumors located in the left mediastinum. The largest one was adjacent to the esophagus with 10 cm in diameter. The other one was located beneath the left inferior pulmonary vein, and the last adjacent to the pulmonary artery trunk. Complete extirpation of the tumors was unsuccessful because of the invasion to the pulmonary artery trunk. A diagnosis of undifferentiated pleomorphic sarcoma was made with negative immunohistochemical staining for markers except for vimentin. Tumor cells were found to be scattered in the partially resected thymus. We assume this is a rare presentation of mediastinal dissemination of the tumor.

[Thymoma with synchronous pulmonary metastasis; report of a case]

We report a resected case of thymoma with a solitary pulmonary metastasis. A 63-year-old woman had pointed out a solitary nodule in right lung field on chest X-ray. Computed tomography (CT) scan showed an anterior mediastinal tumor and a solitary lung nodule in the right lower lobe. Extended thymectomy and partial resection of right lung was performed. Pathological diagnosis showed an invasive thymoma (type B3) and a pulmonary metastasis. Post operative radiotherapy was administered and she is doing well 19 months following the resection. Thymoma with a solitary synclonous pulmonary metastasis is rare and is classified into Masaoka stage IVb. Generally, thymoma cases with distant metastasis are not indication for operation. But, if radical resection is possible, operation is recommended for good prognosis.

A case of granulocyte-colony stimulating factor-producing hepatocellular carcinoma confirmed by immunohistochemistry

Granulocyte-colony stimulating factor (G-CSF) is a naturally occurring glycoprotein that stimulates the proliferation and maturation of precursor cells in the bone marrow into fully differentiated neutrophils. Several reports of G-CSF-producing malignant tumors have been published, but scarcely any in the hepatobiliary system, such as in hepatocellular carcinoma (HCC). Here, we encountered a 69-yr-old man with a hepatic tumor who had received right hepatic resection. He showed leukocytosis of 25,450/microL along with elevated serum G-CSF. Histological examination of surgical samples demonstrated immunohistochemical staining for G-CSF, but not for G-CSF receptor. The patient survived without recurrence for four years, but ultimately passed away with multiple bone metastases. In light of the above, clinicians may consider G-CSF-producing HCC when encountering patients with leukocytosis and a hepatic tumor. More cases are needed to clarify the clinical picture of G-CSF-producing HCC.

Effects of a complex balance task on soleus H-reflex and presynaptic inhibition in humans

Spinal modulation of motoneuron excitability has been extensively investigated during various tasks in humans. Previous studies have revealed that balance tasks induce a decrease in Ia-motoneuron communication which has been attributed to increased levels of presynaptic inhibition (PI). Moreover, this depression in Ia-motoneuron connectivity takes place subsequent to the elevation of muscle activity. Therefore, it is hypothesized that motor learning has inhibitory effects on the spinal mechanisms in spite of the increased muscle activity during a motor task. The purpose of this study was to explore the effects of a complex balance task on the H-reflex. Soleus H-reflexes were measured from 11 healthy adult subjects both before and after 20 minutes of a complex balance task. A commonly reported H-reflex conditioning technique was applied in order to measure changes in spinal PI: an electrical volley to the heteronymous Ia (common peroneal nerve conditioning, CPN). Subjects stood on a custom designed balance board and performed a continuous series of plantar and dorsiflexion. To ensure that the task was performed similarly between subjects, auditory cues for movement were given by a metronome with a frequency of 1 Hz. The initial amplitude of the unconditioned soleus H-reflex was set at 50% of H-max, and unconditioned and conditioned (PI) reflexes were recorded before, during, and after the balance task. The unconditioned soleus H-reflex was significantly decreased 59% after the balance task and PI was increased by 50%. Further, during a period of rest following the task (20 minutes) the unconditioned H-reflex returned to near baseline levels whereas the PI conditioned H-reflex was not altered The results suggest that the initial depression in motoneuron excitability immediately after the balance task is accompanied by an increase in PI, but also that the recovery of the depressed H-reflex after the task appears to be independent of PI.

Primitive neuroectodermal tumor as a differential diagnosis of CD56-positive tumors in adults

A 33-year-old Japanese man was referred to our hospital after a huge intrapelvic tumor with bilateral hydronephrosis was found following persistent lumbago. Natural killer/T-cell lymphoma was suspected due to positive immunostaining for CD56, but CHOP therapy was ineffective. Re-evaluation of the tumor cells showed that they were positive for CD99, neuron-specific enolase, and synaptophysin and had a t(11 ; 22) (q24 ; q12) translocation, leading to the revised diagnosis of primitive neuroectodermal tumor (PNET). Systemic chemotherapies and radiation therapy were added to surgical resection, and no recurrence has been detected for 3 years. Taken together, PNET may be considered in adult patients with CD56-positive tumors.

Granulocyte-colony stimulating factor-producing pancreatic adenosquamous carcinoma showing aggressive clinical course

Herein, we encountered an 89-year-old woman with pancreatic cancer who presented with fever without infective focus, leukocytosis of 45,860 /microL, and elevation of serum granulocyte-colony stimulating factor (G-CSF). The patient could not receive any curative therapy due to an extremely aggressive clinical course. Specimens taken at necropsy revealed an adenosquamous carcinoma positive for G-CSF by immunohistochemistry; it was only the second reported case to date. She was finally diagnosed with G-CSF-producing pancreatic cancer. In light of the above, clinicians should consider the presence of G-CSF-producing tumors, including pancreatic cancer, when presented with patients showing leukocytosis of unknown origin and fever without infective focus.