MR fluid-attenuated inversion recovery imaging as routine brain T2-weighted imaging

We tried to investigate if magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) imaging can be used as a routine brain screening examination instead of spin-echo T2-weighted imaging. Three hundred and ninety-four patients with clinically suspected brain diseases were randomly selected and examined with both brain MR FLAIR and T2-weighted imaging on the axial plane. These two imaging techniques were evaluated by two neuroradiologists as to which imaging was better for routine brain T2-weighted imaging. In 123 of 394 cases (31%), FLAIR imaging was superior to spin-echo T2-weighted imaging. Especially in cases with inflammatory diseases, traumatic diseases and demyelinating diseases, FLAIR imaging was particularly useful. Small lesions bordering cerebrospinal fluid (CSF) are often detected only by FLAIR imaging. In 259 cases (66%), including 147 normal cases (37%), they were equally evaluated. Only in 12 cases (3%) was conventional T2-weighted imaging superior to FLAIR imaging. Cerebrovascular lesions like cerebral aneurysm and Moyamoya disease could not be detected on FLAIR images because these structures were obscured by a low signal from the CSF. Also, because old infarctions tend to appear as low signal intensity on FLAIR images, the condition was sometimes hard to detect. Finally, FLAIR imaging could be used as routine brain T2-weighted imaging instead of conventional spin-echo T2-weighted imaging if these vascular lesions were watched.

[The detection of apoptosis cells by TUNEL stain in peripheral blood smears]

We have determined the fixative conditions for TUNEL stain in peripheral blood smears. Murine IL-3 dependent B cell line (BAF-3) was used as positive control. The intensity of fixing solutions effected on the positivity/negativity for TUNEL stain. Alive cells showed positivity for TUNEL stain (false positive), when 70% methyl alcohol, acetone or carnoy fluid was used. In contrast to the strong fixation by high concentrated glutaraldehyde and the phosphate buffer, denatured cells showed to be negative (false negative). The fixation by 0.4% glutaraldehyde and 70% methyl alcohol for 15 min at room temperature, followed by the treatment by 20 micrograms/ml proteinase K for 15 min at 37 degrees C was most suitable for TUNEL stain to detect the apoptotic cells in peripheral blood smears. The frequency of TUNEL positive cells increased significantly in peripheral blood cells treated by apoptosis induced reagents, or infected by CMV. This is a new approach for the techniques to detect the apoptotic cells in peripheral blood smears.

Permeability of iodinated and MR contrast media through two types of hemodialysis membrane

The clearance of three iodinated contrast media (CM) and three MR-CM through two kinds of hemodialysis (HD) membranes were investigated in vitro. All three MR-CM are not only injected intravenously and mainly secreted through the kidney, but also now commercially available. Each of the six CM showed significantly higher clearance with one kind of HD membrane, with a larger pore size, than that with the other. There were also large differences in clearance between the three iodinated CM with both kinds of HD membranes, but not between the three MR-CM with either kind of membrane. Thus, in order that iodinated CM be removed from the body as soon as possible in HD patients, it is important to consider the choice not only among the iodinated CM, but also between the type of HD membrane that is used. Concerning MR-CM, only the choice of HD membrane is important.

[Changes in transforming growth factor-beta and platelet-derived growth factor in the optic nerve head in monkey experimental glaucoma]

PURPOSE

Remodeling of the extracellular matrix occurs in the lamina cribrosa in progressed glaucomatous optic nerve damage including disc cupping. We examined immunohistochemical changes in the transforming growth factor (TGF)-beta and platelet derived growth factor (PDGF) in the optic nerve heads in experimentally induced glaucoma.

METHODS

We used 3 cynomolgus and 2 Japanese monkey eyes. Glaucoma was induced by repeated argon laser photocoagulation of the chamber angle. Eyes were enucleated after disc cupping had formed 3 to 5 months after treatment. The optic nerve head was examined for expression of TGF beta 1, beta 2, and beta 3, and PDGF A and B in frozen sections and by the biotin-ExtrAvidin-Alkali Phosphatase method.

FINDINGS

Normal monkey eyes showed TGF beta 1, beta 2, and beta 3, and PDGF A, and B in the optic nerve head including the nerve fibers, glial cells, and vascular cells. Glaucomatous eyes showed stronger expression of TGF beta 1 and beta 2 in the glial cells around the lamina cribrosa. The staining intensities for TGF beta 3, PDGF A, and PDGF B were the same as in normal eyes.

CONCLUSION

Eyes with experimental glaucoma showed higher expressions of TGF beta 1 and beta 2 around the lamina cribrosa. This finding may show upregulation of extracellular matrix production as related to remodeling of the lamina cribrosa in glaucoma.

Auxin polar transport and flower formation in Arabidopsis thaliana transformed with indoleacetamide hydrolase (iaaH) gene

Involvement of auxin polar transport in flower formation of Arabidopsis thaliana was studied using a pinformed (pin) mutant (Rpin) transformed with the indoleacetamide hydrolase (iaaH) gene and the phenocopy of the pin mutant, which was induced by 9-hydroxyfluorene-9-carboxylic acid (HFCA). The application of indoleacetamide (IAM) did not change aberrant structure of the aerial part of Rpin (pin/pin), but extremely inhibited its root growth. Treatment with IAM increased the endogenous concentrations of free and conjugated IAA in Rpin normal (pin/+ or +/+) due to the expression of the iaaH gene, to 140% and 428% of those in non-treated plants, respectively, and those in Rpin to 378% and 120%, respectively. The activity of IAA polar transport in the inflorescence axis of Rpin remained low even in the presence of IAM, the activity being almost similar, to that in the pin mutant. The activity of IAA polar transport in the HFCA-induced phenocopy of the pin mutant was also extremely low, and it was not restored by the simultaneous application of IAA. Arabidopsis thaliana responded to HFCA applied from 7 to 11 d and from 25 to 29 d after germination in the wild-type plant (Enkheim ecotype) and the late flowering mutant (fb mutant), respectively. These results suggest that the construction of the system of auxin polar transport and its normal activities are essential for the differentiation and the formation of floral meristem in the early growth stage of Arabidopsis thaliana.

Peritoneal serous papillary carcinoma: radiological appearance

BACKGROUND

The radiological appearance of peritoneal serous papillary carcinoma (PSPC) is described.

METHODS

Three cases of PSPC were analyzed retrospectively with regard to the radiological appearance and histopathological features.

RESULTS

All three patients were women, aged 44-71 years. Massive ascites and a greater omentum tumor were observed on computed tomography in all patients. Double-contrast enema performed in one patient showed irregularity on the upper aspect of the transverse colon. Radiological examinations excluded primary tumors in both gastrointestinal and genital organs in all patients. Histological diagnosis was made from the surgical specimen in two patients and from an autopsy specimen in one patient. All patients had a large omental tumor involving the transverse colon, but the ovaries were not involved or only minimally involved on the surface. Serum CA125 was markedly elevated, and immunohistochemical staining for CA125 was positive within the tumor cell cytoplasm in all three patients.

CONCLUSION

PSPC cannot be diagnosed from radiological findings alone because of its similarity to metastatic peritoneal carcinomatosis and peritoneal mesothelioma. Marked elevation of serum CA125 may help with PSPC diagnosis. Response to treatment is promising, and exploratory laparotomy is thus justified when a patient shows characteristic radiological findings and high CA125 level.

Auxin polar transport in Arabidopsis under simulated microgravity conditions--relevance to growth and development

Activity of auxin polar transport in inflorescence axes of Arabidopsis thaliana grown under simulated microgravity conditions was studied in relation to the growth and development. Seeds were germinated and allowed to grow on an agar medium in test tubes on a horizontal clinostat. Horizontal clinostat rotation substantially reduced the growth of inflorescence axes and the productivity of seeds of Arabidopsis thaliana (ecotypes Landsberg erecta and Columbia), although it little affected seed germination, development of rosette leaves and flowering. The activity of auxin polar transport in inflorescence axes decreased when Arabidopsis plants were grown on a horizontal clinostat from germination stage, being ca. 60% of 1 g control. On the other hand, the auxin polar transport in inflorescence axes of Arabidopsis grown in 1 g conditions was not affected when the segments were exposed to various gravistimuli, including 3-dimensional clinorotation, during transport experiments. Pin-formed mutant of Arabidopsis, having a unique structure of the inflorescence axis with no flower and extremely low levels of the activity of auxin polar transport in inflorescence axes and endogenous auxin, did not continue its vegetative growth under clinostat rotation. These facts suggest that the development of the system of auxin polar transport in Arabidopsis is affected by microgravity, resulting in the inhibition of growth and development, especially during reproductive growth.

Ovarian fibroma of high signal intensity on T2-weighted MR image

It has been reported that ovarian fibromas display low signal intensity on both T1- and T2-weighted magnetic resonance images. We report an ovarian fibroma exhibiting low signal intensity on a T1-weighted image and high signal intensity on a T2-weighted image. Microscopically pronounced myxomatous changes were shown in the fibroma. The signal intensity of ovarian fibromas differs with the degree of myxomatous change.

[Glaucoma with microcornea; morphometry and differential diagnosis]

To evaluate the characteristics of 10 glaucomatous cases with microcornea, we measured corneal diameter, curvature, axial length, and depth of anterior chamber, and examined the eyes with a specular microscope and an ultrasound biomicroscope. The ten cases examined in this study included 1 case of cornea plana, 2 cases of sclerocornea, 2 cases of nanophthalmos, and 5 cases of anterior microphthalmos. Three of the 10 cases were combined with open angle glaucoma, and the others with closed angle glaucoma. Open-angle glaucoma seemed like developmental glaucoma with angle maldevelopment. The closed angle type may appear at a younger age than in patients who have simple pupilary block. There are probably complex mechanisms related with closed angle glaucoma with microcornea. While differential diagnosis among these cases is relatively easy, we should evaluate how or why the intraocular pressure rises as far as possible before forming a treatment plan for each patient.

Permeability of gadolinium-DTPA through two types of hemodialysis membrane

RATIONALE AND OBJECTIVES

Gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) was injected intravenously for magnetic resonance imaging in patients with impaired renal function, and the permeabilities of two types of general hemodialysis (HD) membrane to this agent were compared.

METHODS

One of the HD membranes, Nipro FB-210-U membrane (U membrane), has a larger pore size than the other, Nipro FB-210-M membrane (M membrane). On the same day as magnetic resonance imaging was performed, the patient underwent a 4-hour HD session. Blood was sampled before and at five points after the start of HD.

RESULTS

Mean dialysance of Gd-DTPA was 175.8 to 185.8 mL/min with the U membrane and 120.5 to 130.1 mL/min with the M membrane. The elimination rate was 91.1% with the U membrane and 81.1% with the M membrane 4 hours after the start of HD. The permeability was significantly higher with the U membrane than with the M membrane.

CONCLUSION

Although it is more expensive, the U membrane should be chosen rather than the M membrane for HD to remove Gd-DTPA from the body as efficiently as possible.

Reactive oxygen species generated from the reaction of copper(II) complexes with biological reductants cause DNA strand scission

The generation of hydroxyl radicals (.OH) from the reaction of Cu(II) complexes with biological reductants such as ascorbic acid, glutathione, acetylcysteine, and hydroquinone was confirmed by spin-trapping experiments using electron spin resonance (ESR). The following Cu(II) complexes were used: Cu(II)-(CyHH)2 (CyHH, cyclo(L-histidyl-L-histidyl)), Cu(II)(OP)2 (OP, o-phenanthroline), Cu(II)(HGG) (HGG, L-histidyl-glycylglycine), and Cu(II)(en)2 (en, ethylenediamine). The methyl radical adduct of alpha-(pyridyl-4-N-oxide)-N-tert-butylnitrone (POBN-CH3) was obtained from the reaction of ascorbic acid with all Cu(II) complexes used here in the presence of a spin trap, POBN, and dimethyl sulfoxide, indicating the generation of .OH. Glutathione, N-acetylcysteine, and hydroquinone reacted with both Cu(II)(CyHH)2 and Cu(II)(OP)2 to generate POBN-CH3, while these reductants did not react with either Cu(II)(HGG) or Cu(II)(en)2. Interestingly, the formation of POBN-CH3 in the reaction of Cu(II)-(CyHH)2 with glutathione or N-acetylcysteine was found only at a Cu(II)(CyHH)2/glutathione or Cu(II)(CyHH)2/N-acetylcysteine ratio of 1. The DNA strand scission caused by reaction mixtures of Cu(II) complexes with reductants was investigated under the same conditions as the ESR spin-trapping experiments. Addition of ascorbic acid to mixtures of these four Cu(II) complexes and DNA resulted in DNA strand breakage. Hydroquinone plus Cu(II)(CyHH)2 also caused DNA strand scission. In addition, DNA strand breakage was observed with the reaction of Cu(II)(OP)2 with glutathione, N-acetylcysteine, and hydroquinone. In contrast, reaction mixtures of glutathione, N-acetylcysteine, or hydroquinone with Cu(II)-(HGG) or Cu(II)(en)2 did not cause DNA strand scission within the concentration range used. The results obtained here suggest that there is a good correlation between POBN-CH3 formation and DNA strand scission. Thus, DNA strand scission may be caused by .OH generated from the reaction of some Cu(II) complexes with biological reductants under aerobic conditions. Since ascorbic acid, glutathione, and N-acetylcysteine are present in living cells, some Cu(II) complexes may be capable of initiating DNA damage in the presence of these reductants.

Experimental glaucoma model in the rat induced by laser trabecular photocoagulation after an intracameral injection of India ink

A simple and reproducible rodent glaucoma model is required to elucidate the pathophysiology of damage to the optic nerve. We developed chronically elevated intraocular pressure (IOP) unilaterally in rats by injecting india ink into the anterior chamber of one eye using a 30-gauge needle. One week later, trapped carbon particles in the chamber angle formed a black band along the corneal limbus in the injected eyes. We performed direct laser photocoagulation without a gonio lens, and selectively burned the trabecular meshwork. Intraocular pressure was measured every week and laser photocoagulation was repeated until mean IOP in the experimental eyes rose above 25 mmHg. Unilateral IOP elevation was attained in all rats within 4 weeks. Twelve weeks after ink injection, we sacrificed the rats and excised the eyes for histologic analysis. The anterior chamber angle showed peripheral anterior synechia caused by laser photocoagulation, and carbon particles were engulfed by macrophages that infiltrated the ciliary cleft. In the optic nerve head, a remarkable decrease in the nerve fiber layer and cavernous degeneration were observed, suggesting glaucomatous optic nerve damage. This experimental rodent model should facilitate the study of the complex mechanisms involved in glaucoma.

MR imaging of meniscal tears with discoid lateral meniscus

OBJECTIVE

To study MR findings of meniscal tears with discoid lateral menisci (DLMs) and to evaluate the incidence and accuracy of MRI compared to arthroscopical surgery.

MATERIAL AND METHODS

MR appearances of surgically proved torn discoid lateral menisci (DLM) were studied in 57 knees (40 patients). They were all performed with a 1.5T MR before surgery. MR sequences included T1- and T2* weighted images on both coronal and sagittal planes and 3D-axial images with a slice thickness of 0.7 mm.

RESULT

Of 57 DLMs, there were 32 complete DLMs and 25 incomplete DLMs. Twenty-five of 32 complete DLMs had tears; including seven with intrasubstance tear, five with radial tear, five with other kinds of tears and eight with severe tears involving whole meniscus. On the other hand, 13 of 25 incomplete DLMs had tears; including two with intrasubstance tear, six with radial tear, four with other kinds of tears and one with severe tears. All DLMs were correctly diagnosed on MR images. Twenty-seven of 38 tears with DLM were correctly identified on conventional 2D MR images. This yielded 71.1% sensitivity, 100% specificity and 80.7% overall accuracy. When adding axial 3D MR images to 2D MR images, 36 of 38 tears were correctly diagnosed. A combination of both techniques yielded a sensitivity of 94.7% and a specificity of 100%. Ten of 11 radial tears with DLM were correctly identified on 3D axial images, where only three of them could be diagnosed on conventional 2D images. Eight of nine intrasubstance tears were correctly identified on 3D axial images, where six of them could be diagnosed on conventional 2D images.

CONCLUSION

DLMs had a much higher incidence of meniscal tears than normally shaped lateral menisci and MR is the only modality of choice to evaluate them before surgery. Especially 3D axial MR images were quite useful in the detection of intrasubstance and radial tears often associated with DLMs.

[Experimental glaucoma model in the rat with laser trabecular photocoagulation after intracameral injection of India ink]

We tried to create an experimental glaucoma which is simple and highly reproducible in rodents. India ink was injected into the anterior chamber with a 30-gauge needle. The carbon particles were trapped in the chamber angle and formed a black band along the corneal limbus one week later. This area was then photocoagulated anteroposteriorly with an argon laser. Photocoagulation was repeated until the intraocular pressure was elevated to 25 mmHg or more by pneumotonometry performed at a one-week interval. The above procedure was applied to one eye of 7 rats with the fellow eye serving as control. Chronic elevation of intraocular pressure was obtained in all the 7 treated eyes. The eyes were then enucleated and examined by light microscopy. Carbon particles were phagocytosed by macrophages in the intertrabecular spaces. Peripheral anterior synechias were also present. The optic nerve-head showed remarkable decrease in nerve fibers and cavernous degeneration suggestive of glaucomatous optic nerve damage. This experimental model promises to be of value in further studies of glaucomatous optic nerve damage.

Iodine concentrations in the rat kidney measured by X-ray microanalysis. Comparison of concentrations and viscosities in the proximal tubules and renal pelvis after intravenous injections of contrast media

PURPOSE

To measure the iodine concentrations in the proximal tubules and renal pelvis after i.v. injections of contrast media (CM) at 1600 mg I/kg b.w., using a micropuncture technique and X-ray microanalysis.

MATERIAL AND METHODS

The correlation between the viscosity of each CM and its iodine concentration was evaluated and the viscosity of the fluid in the proximal tubule and renal pelvis was estimated in rats.

RESULTS

After iotrolan injection, the iodine concentration in the proximal tubular fluid had increased to values about three times higher than those reached with diatrizoate, iohexol and ioxaglate. Similarly, iotrolan tended to produce a higher iodine concentration in the renal pelvis than did the other CM. The urine viscosity in the renal pelvis was much higher after the iotrolan injection than after the other CM injections.

CONCLUSION

High urine viscosity after iotrolan injection can at least partly explain our previous findings of a prolonged increase in tubular hydrostatic pressure and a prolonged decrease in the single nephron glomerular filtration rate after administration of this CM.

A case of enlarged cavernous sinus mistaken for petrous apex tumor

We experienced a case of abnormally enlarged cavernous sinus extending into the petrous apex, which was confused with a petrous apex tumor or an enlarged Meckel cave. The CT and MR appearances were of expansile lesions in the petrous apex with water signal intensities on both T1- and T2-weighted MR images. Unfortunately, these findings were not specific. Cerebral angiography was only suggestive of enlarged cavernous sinus involving the petrous apex because of opacification of the petrous apex in the venous phase. Our case was confirmed by surgery as enlarged cavernous sinus involving the petrous apex.

Urine viscosity after injections of iotrolan or iomeprol

PURPOSE

Previous observations in rats caused us to speculate whether the injection of iotrolan, a nonionic dimeric contrast medium (CM), would increase urine viscosity enough to obstruct urine outflow in the collecting duct.

MATERIAL AND METHODS

The urine viscosity in dogs was measured directly with a viscosimeter after injections of iotrolan or of iomeprol, a nonionic monomeric CM.

RESULTS AND CONCLUSION

The injection of iotrolan increased urine viscosity considerably whereas iomeprol had little effect on this variable. The osmolality-dependent adverse reactions of CM have previously been emphasized but viscosity-dependent adverse reactions must also be considered when the CM is a polymer with a low osmolality.

Pheochromocytoma growing exophytically from the right adrenal gland and invaginating into the liver

A 5-cm pheochromocytoma located in segment 7 of the liver was found incidentally in a 45-year-old man with mild diabetes mellitus and hypertension, and resected. The tumor was demonstrated by computed tomography and magnetic resonance imaging to have completely invaginated itself into the liver and to be receiving blood from a dilated right hepatic artery alone. Surgery revealed the hepatic mass to be tightly adherent to the right adrenal gland. The histopathologic diagnosis was pheochromocytoma growing exophytically from the right adrenal gland. There was no association with multiple endocrine neoplasia type 1 and type 2. A postoperative 131I metaiodobenzylguanidine scan revealed no accumulation, and the patient is currently doing well without recurrence or hypertension one year after the operation. A pheochromocytoma deeply invaginating into the liver should be considered in the differential diagnosis of primary hypervascular hepatic tumors.

[Plateau iris configuration as a risk factor for malignant glaucoma]

To provide evidence for diagnosing malignant glaucoma, as well as to elucidate the pathogenetic mechanism of the disease, ultrasound biomicroscopy (UBM) is a useful tool. We examined the anterior segments of three patients with post-operative malignant glaucoma with UBM regarding the state before operation, the state of the opposite eye, and the state after the release of the cilio-lenticular block. Case 1 was a 76-year-old female who was diagnosed as having chronic angle-closure glaucoma (CACG) and was treated by trabeculectomy, phacoemulsification, aspiration (PEA), and simultaneous intraocular lens (IOL) implantation. Case 2 was a 22-year-old male diagnosed as having CACG secondary to plateau iris syndrome and was treated by trabeculectomy. Case 3 was a 73-year-old female diagnosed as having normal-tension glaucoma with narrow angle and was treated by PEA and IOL implantation. Slit-like anterior chamber angle and anteriorly positioned ciliary body were observed in all 3 cases, which were identical to those Pavlin reported in 8 cases with plateau iris syndrome. UBM seems to be an important pre-operative examination to evaluate the risk of malignant glaucoma and to consider which surgical procedure and post-operative management is proper. The pre-operative configuration of the ciliary body may be associated with the onset of malignant glaucoma in some patients with CACG or narrow angle.

Permeability of contrast media through hemodialysis membrane

PURPOSE

To compare the permeability of 10 contrast media (CM) through the hemodialysis membrane.

MATERIAL AND METHODS

An experimental model was constructed from clinical hemodialysis equipment. The 10 CM that were used were: diatrizoate, iothalamate, iopamidol, iohexol, iopromide, ioversol, iomeprol, ioxaglate, iodixanol and iotrolan. They were dissolved into the dialysate. Each solution ran into the blood circuit of the dialyzer at a rate of 200 ml/min and into the dialysate circuit of the dialysis machine at a rate of 500 ml/min. Permeability was expressed as clearance, calculated from the iodine concentration at the afferent and efferent lines of the dialyzer, and from the blood-flow rate.

RESULTS

The clearance of all the monomeric CM was superior to that of all the dimeric CM. Values of clearance and molecular weight correlated well.

CONCLUSION

The molecular weight of a contrast medium is the main factor that influences the efficiency of CM removal by hemodialysis.

Potent protective effect of melatonin on chromium(VI)-induced DNA single-strand breaks, cytotoxicity, and lipid peroxidation in primary cultures of rat hepatocytes

Incubation of primary cultures of rat hepatocytes with K2Cr2O7 plus the pineal hormone melatonin resulted in a marked decrease in cellular levels of DNA single-strand breaks caused by K2Cr2O7. Cellular treatment with melatonin also suppressed both dichromate-induced cytotoxicity, as evaluated by the leakage of lactate dehydrogenase, and lipid peroxidation, as monitored by malondialdehyde formation. In addition, treatment with melatonin attenuated the suppression of the levels of vitamins E and C as well as the inhibition of catalase activity attributed to K2Cr2O7. However, melatonin had no influence on cellular level of glutathione and the activity of glutathione reductase, glutathione peroxidase, superoxide dismutase, and alkaline phosphatase suppressed by dichromate. Under the same experimental conditions, cellular uptake and distribution of Cr were not affected by melatonin. Electron spin resonance (ESR) studies showed that melatonin did not affect the formation of Cr(V) complexes in the reaction of K2Cr2O7 with reduced glutathione; however, melatonin caused a 25% decrease in the levels of Cr(V)-related hydroxyl radicals in vitro. These results indicate that melatonin protects cells from Cr(VI)-induced DNA strand breaks, cytotoxicity, and lipid peroxidation, possibly through its ability to increase cellular levels of vitamins E and C as well as catalase activity and/or to directly scavenge toxic hydroxyl radicals in cells.