In Vivo Label-Free Observation of Tumor-Related Blood Vessels in Small Animals Using a Newly Designed Photoacoustic 3D Imaging System

Photoacoustic (PA) technology can be used for non-invasive imaging of blood vessels. In this paper, we report on our prototype PA imaging system with a newly designed ultrasound sensor and its visualization performance of microvascular in animal. We fabricated an experimental system for animals using a high-frequency sensor. The system has two modes: still image mode by wide scanning and moving image mode by small rotation of sensor array. Optical test target, euthanized mice and rats, and live mice were used as objects. The results of optical test target showed that the spatial resolution was about two times higher than that of our conventional prototype. The image performance in vivo was evaluated in euthanized healthy mice and rats, allowing visualization of detailed blood vessels in the liver and kidneys. In tumor-bearing mice, different results of vascular induction were shown depending on the type of tumor and the method of transplantation. By utilizing the video imaging function, we were able to observe the movement of blood vessels around the tumor. We have demonstrated the feasibility of the system as a less invasive animal experimental device, as it can acquire vascular images in animals in a non-contrast and non-invasive manner.

Real-time 3D Photoacoustic Visualization System with a Wide Field of View for Imaging Human Limbs

Background: A breast-specific photoacoustic imaging (PAI) system prototype equipped with a hemispherical detector array (HDA) has been reported as a promising system configuration for providing high morphological reproducibility for vascular structures in living bodies. Methods: To image the vasculature of human limbs, a newly designed PAI system prototype (PAI-05) with an HDA with a higher density sensor arrangement was developed. The basic device configuration mimicked that of a previously reported breast-specific PAI system. A new imaging table and a holding tray for imaging a subject's limb were adopted. Results: The device's performance was verified using a phantom. Contrast of 8.5 was obtained at a depth of 2 cm, and the viewing angle reached up to 70 degrees, showing sufficient performance for limb imaging. An arbitrary wavelength was set, and a reasonable PA signal intensity dependent on the wavelength was obtained. To prove the concept of imaging human limbs, various parts of the subject were scanned. High-quality still images of a living human with a wider size than that previously reported were obtained by scanning within the horizontal plane and averaging the images. The maximum field of view (FOV) was 270 mm × 180 mm. Even in movie mode, one-shot 3D volumetric data were obtained in an FOV range of 20 mm in diameter, which is larger than values in previous reports. By continuously acquiring these images, we were able to produce motion pictures. Conclusion: We developed a PAI prototype system equipped with an HDA suitable for imaging limbs. As a result, the subject could be scanned over a wide range while in a more comfortable position, and high-quality still images and motion pictures could be obtained.

Real-time 3D Photoacoustic Visualization System with a Wide Field of View for Imaging Human Limbs

Background: A breast-specific photoacoustic imaging (PAI) system prototype equipped with a hemispherical detector array (HDA) has been reported as a promising system configuration for providing high morphological reproducibility for vascular structures in living bodies. Methods: To image the vasculature of human limbs, a newly designed PAI system prototype (PAI-05) with an HDA with a higher density sensor arrangement was developed. The basic device configuration mimicked that of a previously reported breast-specific PAI system. A new imaging table and a holding tray for imaging a subject's limb were adopted. Results: The device's performance was verified using a phantom. Contrast of 8.5 was obtained at a depth of 2 cm, and the viewing angle reached up to 70 degrees, showing sufficient performance for limb imaging. An arbitrary wavelength was set, and a reasonable PA signal intensity dependent on the wavelength was obtained. To prove the concept of imaging human limbs, various parts of the subject were scanned. High-quality still images of a living human with a wider size than that previously reported were obtained by scanning within the horizontal plane and averaging the images. The maximum field of view (FOV) was 270 mm × 180 mm. Even in movie mode, one-shot 3D volumetric data were obtained in an FOV range of 20 mm in diameter, which is larger than values in previous reports. By continuously acquiring these images, we were able to produce motion pictures. Conclusion: We developed a PAI prototype system equipped with an HDA suitable for imaging limbs. As a result, the subject could be scanned over a wide range while in a more comfortable position, and high-quality still images and motion pictures could be obtained.

Narrow-margin excision is a safe, reliable treatment for well-defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan

BACKGROUND

Complete excision is the most promising treatment for basal cell carcinoma (BCC) and a surgical margin of at least 4 mm is recommended. However, little is known about the appropriate surgical margin of pigmented BCC.

OBJECTIVE

To investigate the reliability of narrower margin excision of well-defined, pigmented BCC.

METHODS

We identified a total of 263 patients with 288 well-defined, primary pigmented BCC at the Department of Dermatology, Kyushu University (Fukuoka, Japan), between January 2006 and December 2013. All lesions were surgically excised with 1-6-mm margins and analysed. For 30 recent lesions out of the 288 lesions, border gaps between dermoscopy and histopathology were assessed.

RESULTS

Of the 288 lesions, 218 (75.7%) were excised with a narrow margin (≤ 3 mm) and 60 lesions (24.3%) with a wide margin (≥ 4 mm). Only two lesions (0.7%), which were excised with 2-mm margins, were associated with tumour-positive margins. Narrow-margin excision showed a complete removal rate of 99% (2-mm margins, 95.3%; 3-mm margins, 100%). Dermoscopically determined borders almost exactly corresponded to the histopathological ones; 71.2% of border gaps between dermoscopy and histopathology were within 1 mm and there were no cases in which tumours spread beyond 1 mm of their dermoscopic borders.

CONCLUSION

Surgical excision with a 2-3-mm margin is reliable treatment for well-defined, primary pigmented BCC, with a complete removal rate of 99%.

[Pulmonary hypertension associated with refractory hyperthyroidism: a case report]

A 25-year-old woman was admitted to our hospital with goiter. The diagnosis was Grave's disease. Diagnostic transthoracic echocardiography revealed a hyperdynamic stage of the heart with right ventricular dilation. Doppler echocardiography showed mild to moderate tricuspid regurgitation and elevated systolic right ventricular pressure. Right heart catheterization revealed high cardiac output (9.49 l/min) and pulmonary hypertension (57 mmHg) with increased pulmonary vascular resistance and total pulmonary resistance. No intracardiac shunts were detected. Since neither thiomazole nor propylthiouracil was effective and both caused side effects, she underwent subtotal thyroidectomy. After the surgery, pulmonary hypertension improved and cardiac output normalized, but without normalization of pulmonary vascular resistance and total pulmonary resistance. Reversible pulmonary hypertension may occur in patients with hyperthyroidism. Increased pulmonary blood flow and sustained high pulmonary artery resistance were suspected as the causes of pulmonary hypertension. In addition, pulmonary endothelial dysfunction as a result of sustained increased pulmonary blood flow could be another cause of pulmonary hypertension.

Change in blood levels of vitamin B-6 derivatives in pregnant and lactating rats

By using an HPLC method which we have developed, concentration changes of vitamin B-6 derivatives in blood of pregnant and lactating rats were studied. PLP and PL were the main derivatives in plasma and erythrocytes, and occasionally, PMP was found in the plasma of rats fed a normal solid diet which contained 8.3 mg PN.HCl/kg diet. Upon pregnancy, the plasma PLP concentration decreased significantly (p < 0.01), whereas plasma PL tended to increase (p < 0.05). PLP concentration in erythrocytes tended to increase upon pregnancy. These results suggest that metabolism or utilization of vitamin B-6 is altered upon pregnancy and that plasma PLP concentrations alone may not be a good indicator of nutritional status. Further confirmation was needed for so from erythrocyte samples under our analytical conditions was not so from erythrocyte samples under our analytical conditions was not converted to PIC-P via PLP, after the sample was treated with glyoxylic acid and then with KCN.

Morphological studies of the neuromuscular mechanism shifting from sucking to biting of mice

In order to give a neuroanatomical evidence to the mechanism of shifting from sucking to biting, we investigated in prenatal, newborn and postnatal mice whether there is a time difference in the neurogenesis of the neurons relative to sucking and biting or in the histogenesis of their peripheral effector organs by the HRP labeling technique and electron microscopy. The results obtained are as follows. (1) At birth the facial motoneurons exceed the trigeminal motoneurons in cell area and development. (2) After birth, the trigeminal motoneurons grow rapidly and outstrip the growth of the facial motoneurons at the age of 6 days. (3) Thereafter, the cell area of both neuron types continues to increase gradually. (4) The initial sign of the alpha motor end plates is found in the orbicularis oris muscle innervated by the facial nerve in 17-day-old fetuses, while that of the trigeminal nerve is delayed in the masseter muscle of 18-day-old fetuses. (5) The initial sign of the muscle spindle appears with the sensory terminals in the masseter muscle of 17-day-old fetuses and the fundamental structure of the muscle spindle is formed in 4-day-old youngs. (6) Myelination of the facial nerve begins in 3-day-old youngs, while that of the trigeminal nerve becomes apparent in 4- or 5-day-old youngs. From these bases, it is obvious that the facial nerve elements related to sucking are firstly developed at birth and that the differentiation of the trigeminal nerve elements related to biting is rapidly accelerated after birth.

Mirror movement: application of movement-related cortical potentials

In a patient with Kallmann's syndrome (hypogonadotropic hypogonadism and anosmia) manifesting mirror movement, cortical potentials associated with unilateral and bilateral simultaneous voluntary middle finger extensions were studied. Premovement negative slope, which has been shown to reflect preparatory excitation of motor cortex corresponding to the voluntary movement, was recorded bilaterally in this patient in spite of intended unilateral hand movement. It is suggested that mirror movement in this particular patient is generated by unintended excitation of the opposite motor cortex.

Echocardiographic features of bioprosthetic valve endocarditis

Abnormal echocardiographic findings in seven cases of bioprosthetic valve endocarditis were confirmed in six at operation. The echocardiograms showed three cases with thickening and increased echo intensity (group 1) and four (group 2) in which vegetations were seen initially without either of the two features in group 1. Two patients in group 1 had vegetations, the causative organism being a streptococcus. Staphylococcus epidermidis was the causative organism in three of the four cases in group 2; in two of these rapidly growing vegetations were detected. The large vegetations obstructed the ostium of the bioprosthetic valve. Thus if vegetations are detected in cases in which staphylococci are the causative bacteria surgery should be performed as soon as possible. In patients who develop a fever after bioprosthetic valve replacement and especially in those with evident bacteraemia echocardiography should be repeated frequently so that lesions may be detected early.

[Mitral regurgitation in hypertrophic cardiomyopathy: an analysis with two-dimensional ultrasonic Doppler echocardiography]

Intracardiac blood flow pattern in the left ventricle and left atrium was noninvasively studied by the ultrasonic pulsed Doppler flowmeter incorporated with a real-time, phased array two-dimensional echocardiography in 28 cases of hypertrophic cardiomyopathy. Emphasis was placed on the incidence and characteristic features of mitral regurgitation in this condition. The relationship of mitral regurgitation with an early systolic murmur was also studied. The results were as follows: 1) A mitral regurgitant signal by Doppler technique was noted in all cases of hypertrophic obstructive cardiomyopathy and in half of the cases of hypertrophic nonobstructive cardiomyopathy. 2) The Doppler signal of mitral regurgitation began immediately after the first heart sound. 3) The mitral regurgitant flow spread over the left atrium or directed toward the posterior half of the left atrium in the obstructive cases. However, it was localized in the vicinity of the mitral orifice in the nonobstructive cases. These findings were different from those in rheumatic mitral regurgitation or idiopathic mitral valve prolapse. 4) The findings on mitral regurgitation by the Doppler technique exhibited a satisfactory correspondence to those by left ventriculography. 5) The early part of the systolic murmur in hypertrophic cardiomyopathy was considered to be more closely related to mitral regurgitation than a turbulent forward flow due to outflow obstruction. Therefore, mitral regurgitation might have some contribution in causing a murmur in the latter period of systole.

Changes of ventricular monophasic action potential duration by stellate ganglion stimulation in dogs

Left or right stellate ganglion stimulation resulted in changes of ST segments and T waves of electrocardiogram. The present experiments were performed in an attempt to elucidate alpha-and beta-adrenergic actions, and calcium action on the monophasic action potential duration (APD), that is, the repolarizing phase of myocardium. During experiments in open-chest dogs, right ventricular pacing was performed for avoiding the acceleration of heart rate by stellate ganglion stimulation. Administration of phentolamine, propranolol or D600 prolonged APD, while hydrazine shortened it. However, stellate ganglion stimulation caused a prolongation of APD after infusion of propranolol or hydrazine, and a shortening of APD after infusion of phentolamine, D600 or hydrazine. These results indicate that alpha-and beta-adrenergic actions as well as calcium ions can be related to APD in the ventricular myocardium of dogs; apparently, alpha-adrenergic action prolongs APD and beta-adrenergic action shortens it.

Horseradish peroxidase-labelled cells in cervical sympathetic and trigeminal nervous systems after injection of HRP into tooth pulp in monkeys and tree shrews (a preliminary report)

The neurons that project to the tooth pulp were examined by the HRP-retrograde transport technique, using 4 monkeys (3 Japanese monkeys and a crab-eating monkey) and 6 tree shrews. The present investigation showed that a large number of sympathetic cervical ganglion neurons, small and medium in size, project to the molar teeth from the superior, middle and inferior ganglia and a small number of Gasserian gangilon neurons (small in size) to the molar teeth ipsilaterally.

Congenital oculoskeletal myopathy with abnormal muscle and liver mitochondria

We report a 22-year-old very thin man, who showed various symptoms and signs of oculoskeletal muscle weakness, episodes of myalgia, prolonged diarrhea, severe myopia, perceptive deafness, electrocardiographic and electroencephalographic abnormalities, and endocrinological abnormality. The onset was at about 3 months of age and a positive family history was strongly suggested. The light-microscopic, histochemical and electron-microscopic findings showed abnormal mitochondria not only in the skeletal muscle, but also in liver cells. From the clinical as well as morphological points of view, this case was suspected to be one of congenital oculoskeletal myopathy probably due to an unidentified systemic metabolic disorder.

Familial occurrence of multiple intracranial aneurysms. Case report

✓ A 48-year-old man and his 66-year-old mother had multiple intracranial saccular aneurysms visualized by angiography or verified at autopsy. Histological examination of the arteries at the base of the brain in the case autopsied showed a caterpillar tread-like appearance (“Raupenketten Elastica”) of the internal elastic lamina, which may indicate thinning of the elastic lamina and deserve consideration as a causative factor in the development of intracranial saccular aneurysms.