Synthesis and characterization of methoxy- or cyano-substituted thiophene/phenylene co-oligomers for lasing application

As new candidates of thiophene/phenylene co-oligomer (TPCO) species, 5,5′′-bis(4′-methoxy-[1,1′-biphenyl]-4-yl)-2,2′:5′,2′′-terthiophene (BP3T-OMe) and 4′,4′′′-([2,2′:5′,2′′-terthiophene]-5,5′′-diyl)bis(([1,1′-biphenyl]-4-carbonitrile)) (BP3T-CN) were synthesized for lasing applications. Although most unsubstituted TPCO species crystallize in monoclinic form, BP3T-OMe and BP3T-CN crystallized in orthorhombic and triclinic forms, respectively. Since the unsubstituted species, 5,5′′-bis(4-biphenylyl)-2,2′:5′,2′′-terthiophene (BP3T), shows unique and superior lasing performance in single crystals, the newly synthesized BP3T-OMe and BP3T-CN have possibilities to show different or improved optoelectronic characteristics. Amplified spontaneous emission (ASE) and optically pumped lasing were observed from both of the single crystals based on their well-shaped crystalline cavity and high group refractive index values of 3.7–5.3 for excellent light confinement. The lasing threshold for the BP3T-OMe crystal was lower than that for the BP3T-CN crystal, which was attributed to their different molecular orientation, standing in the former and inclining in the latter.

As new candidates of thiophene/phenylene co-oligomer (TPCO) species, methoxy- or cyano-substituted compounds were synthesized for lasing applications.

π-Electronic Co-crystal Microcavities with Selective Vibronic-Mode Light Amplification: Toward Förster Resonance Energy Transfer Lasing

π-conjugated organic microcrystals often act as optical resonators in which the generated photons in the crystal are confined by the reflection at the crystalline facets and interfere to gain lasing action. Here, we fabricate microcrystals from a mixture of carbon-bridged oligo- para-phenylenevinylenes (COPVs) with energy-donor (D) and energy-acceptor (A) characters. Upon weak excitation of the single D-A co-crystal, Förster resonance energy transfer (FRET) takes place, exhibiting spontaneous emission from A. In contrast, upon strong pumping, stimulated emission occurs before FRET, generating lasing action from D. Lasing occurs with single- and dual-vibronic levels, and the lasing wavelength can be modulated by the doping amount of A. Time-resolved spectroscopic studies reveal that the rate constant of lasing is more than 20 times greater than that of FRET. Furthermore, microcrystals, vertically grown on a Ag-coated substrate, reduce the lasing threshold by one-fourth. This study proposes possible directions toward organic solid FRET lasers with microcrystalline resonators.

High-gain and wide-band optical amplifications induced by a coupled excited state of organic dye molecules co-doped in polymer waveguide

We investigated optical gain and lasing characteristics of a polymer thin film co-doped with Rhodamine 6G and 4-(Dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran dye molecules. By the co-doping of these dyes, the optical gain coefficient and its spectral range were enhanced and widened, respectively. These results cannot be accounted for by the linear combination of the optical gain properties of single-doped films. Owing to this high-gain and wide-band optical amplification property, a distributed feedback lasing with a low threshold of 70  μJ/cm² as well as a widely tunable wavelength range of 587-613 nm was achieved. We attribute this amplification property of the co-doped film, which cannot be achieved with the single-doped films, to the appearance of a coupled excited state between the two molecules.

High Speed Clinical Data Retrieval System with Event Time Sequence Feature

Objectives: This paper illustrates a high speed clinical data retrieving system, from 10 years of data of operating hospital information system for the purposes of research, evidence creation, patient safety, etc., even incorporating time sequence of causal relations.

Methods: Total of 73,709,298 records of 10 years at Hamamatsu University Hospital (as of June 2008) are sent from HIS to retrieval system in HL7 v2.5 format. Hierarchical variable length database is used to install them.

Results: A search for “listing patients who were prescribed Pravastatin (Mevalotin and generic drugs, any titer)” took 1.92 seconds. “Pravastatin (any) prescribed and recorded AST >150 within two weeks” took 112.22 seconds. Searching conditions can be set to be more complex, connected by Boolean operator and/or. This system called D*D is in operation at Hamamatsu University Hospital since August 2002. It is used for 48,518 times (monthly average of 703 searches). Neither searching, nor background export of data from HIS caused delay of routine operating CPOE.

Conclusions: Search database outside of routine operating CPOE, with daily export of order data in HL7 v2.5 format, is proved to provide excellent search environment without causing trouble. Hierarchical representation gives high-speed search response, especially with time sequence of events.

SS-MIX: A Ministry Project to Promote Standardized Healthcare Information Exchange

Objectives: To promote healthcare information exchange between providers and to allow hospital information systems (HIS) export information in standardized format (HL7 and DICOM) in an environment of widespread legacy systems, which only can export data in proprietary format.

Methods: Through the Shizuoka prefecture EMR project in 2004–2005, followed by the ministry’s SS-MIX project, many software products have been provided, which consist of 1) a standardized storage to receive HL7 v2.5 mes sages of patient demographics, prescription orders, laboratory results, and diagnostic disease in ICD-10, 2) a referral letter creation system, 3) a formatted document creation system, 4) a progress note/nursing record system, and 5) an archive/viewer to incorporate incoming healthcare data CD and allow users to view on HIS terminal. Meanwhile, other useful applications have been produced, such as adverse event reporting and clinical information retrieval. To achieve the above-mentioned objectives, these software products were created and propagated, because users can use these software products, provided that their HIS can export the above information to the standardized storage in HL7 v2.5 format.

Results: In 20 hospitals of Japan, the standardized storage has been installed and some applications have been used. As major HIS vendors are shipping HIS with HL7 export function since 2007, HIS of 594 hospitals in Japan became capable of exporting data in HL7 v2.5 format (as of March 2010).

Conclusions: In high CPOE installation rate (85% in 400+ bed hospitals), though most of them only capable of exporting data in proprietary format, prefecture and ministry projects were effective to promote healthcare information exchange between providers. The standardized storage became an infrastructure for many useful applications, and many hospitals started using them. Ministry designation of proposed healthcare standards was effective so as to allow vendors to conform their products, and users to install them.

Emission Behavior of Crystalline 1,4-Bis(4-phenylthiophene-2-yl)benzene Film Under Optical Excitation with Ultra Short Pulses

We evaluated emission behaviors of crystallized films of 1,4-bis(5-phenylthiophene-2-yl)benzene (AC5) in detail which was a representative thiophene/phenylene co-oligomer. The crystallized AC5 films were prepared by vapor deposition onto a substrate and thermal treatment. The AC5 films consisted of a crystalline domain with the size of several tens of micrometers. We used femtosecond laser pulses for the excitation of the AC5 films. As a result, the femtosecond laser pulses did not induce re-absorption above excitation energy densities of their laser threshold. The obtained gain value for AC5 crystallized film was large, over 150 cm-1. Furthermore, the emission cross section of the crystallized AC5 film was nearly 10(-16) cm2.

Amplified Emission and Field-Effect Transistor Characteristics of One-Dimensionally Structured 2,5-Bis(4-biphenylyl)thiophene Crystals

One-dimensional (1D) structures of 2,5-bis(4-biphenylyl)thiophene (BP1T) crystals are fabricated for light amplification and field-effect transistor (FET) measurements. A strip-shaped 1D structure (10 µm width) made by photolitography of a vapor-deposited polycrystalline film shows amplified spontaneous emission and lasing oscillations under optical pumping. An FET fabricated with this 1D structure exhibits hole-conduction with a mobility of µh = 8.0 x 10(-3) cm2/Vs. Another 1 D-structured FET is fabricated with epitaxially grown needle-like crystals of BP1T. This needle-crystal FET exhibits higher mobility of µh = 0.34 cm2/Vs. This improved hole mobility is attributed to the single-crystal channel of epitaxial needles while the grain boudaries in the polycrystalline 1 D-structure decrease the carrier transport.

Organic Light-Emitting Diodes with Heterojunction of Thiophene/Phenylene Co-Oligomer Derivatives

Organic light-emitting diodes are fabricated by heterojunction of thiophene/phenylene co-oligomer films using biphenyl-capped bithiophene (BP2T) and its cyano-substituted derivative (BP2T-CN). Strong electron-withdrawing cyano-groups in BP2T-CN transform the p-type BP2T into n-type. Photoluminescence and electroluminescence from their bilayered films dominantly result from the BP2T-CN layer since the lying molecular orientation of BP2T-CN facilitates surface emission while the standing orientation of BP2T is not suitable for the device configuration. The current density and electroluminescence intensity are considerably increased by carrier doping with MoO3 and Cs2CO3 into the BP2T and BP2T-CN films, respectively.

In vitro and in vivo evaluation of tissue-cultured mountain ginseng on penile erection

Background

Progressed tissue culture techniques have allowed us to easily obtain mass products of tissue-cultured mountain ginseng over 100 yr old (TCMG-100). We investigated the effects of TCMG-100 extract on erectile function using in vitro and in vivo studies.

Methods

To examine the relaxation effects and mechanisms of action of TCMG-100 on rabbit cavernosal strips evaluated in an organ bath. To investigate the long-term treatment effect of TCMG-100, 8-wk administration was performed. After administration of TCMG-100, intracavernosal pressure, cyclic guanosine monophosphate and nitric oxide (NO) levels of cavernosal tissue, serum testosterone level, histological observation of collagen fiber, endothelium, smooth muscle cell, and transforming growth factor-β1 were investigated.

Results

TCMG-100 extract displayed dose-dependent relaxation effects on precontracted rabbit corporal smooth muscle. The TCMG-100-induced relaxation was significantly reduced by removing the endothelium, and treatment with an NO synthase inhibitor or NO scavenger. Eight weeks of TCMG-100 administration increased intracavernosal pressure in a rat model. The levels of cyclic guanosine monophosphate and NO in the corpus callosum and serum testosterone level were also increased by TCMG-100 treatment. Furthermore, histological evaluation of collagen, smooth muscle, and endothelium showed increases in endothelium and smooth muscle, and a decrease in transforming growth factor-β1 expression.

Conclusion

These relaxation effects on corporal smooth muscle and increased erectile function suggest that TCMG-100 might be used as an alternative herbal medicine to improve erectile function.

Streamline phenomena in liver metastasis of gastrointestinal tumors - a clinical-study based upon 172 patients

Location and number of liver metastasis of gastrointestinal tumors were detected preoperatively and intraoperatively. The distribution of the liver segment(s) occupied by metastatic tumors varied significantly (p<0.05). Significantly more frequent distributions were demonstrated in the lateral segment with gastric cancer (p<0.05), in the posterior segment with left colic cancer (p<0.001), in the medial segment with rectal cancer (p<0.01), in the anterior segment with bile duct cancer (p<0.05) and the whole of the liver with pancreatic cancer (p<0.05). Significantly less frequent distribution was demonstrated in the posterior segment with gastric cancer (p<0.01). When the liver was divided into the right and the left halves, the distribution of each half of the liver occupied by metastatic tumors varied significantly (p<0.05). Liver metastases of whole colic cancer were significantly more frequent in the right half of the liver (p<0.05). The results suggest that the tumor distribution in liver metastases of gastrointestinal tumors differ depending upon the primary tumors, basically in accordance with the 'streamline' phenomena.

Single crystals of 5,5'-Bis(4'-methoxybiphenyl-4-yl)-2,2'-bithiophene for organic laser media

Room temperature lasing was stably observed in air from an orthorhombic crystal of 5,5'-bis(4'-methoxybiphenyl-4-yl)-2,2'-bithiophene (BP2T-OMe). A pair of parallel {110} facets of the single crystal acted as effective Fabry-Pérot mirrors. This prominent lasing is based on high group refractive index (3.5) and Q factor (4500) of the orthorhombic crystal resonator indicating a promising potential of BP2T-OMe for organic laser media.

Streamline phenomena in liver metastasis of gastrointestinal tumor - an experimental-study using rats

The establishment of liver metastasis from gastrointestinal tumor is mainly considered to be via the portal vein, but its precise mechanism is still unknown. The purpose of this study is to evaluate the significance-of 'streamline' phenomena in liver metastasis of gastrointestinal tumor by means of an experimental model. An animal model for the metastatic liver tumor was made in the Donryu rat. Five million cells of AH-66 strain, alpha-fetoprotein (AFP) producing hepatoma cells maintained as an ascites type strain, were administered via portal vein. The superior mesenteric vein (group A), the inferior mesenteric vein (group B) and the splenic vein (group C) were used as the sites of injection. In every group, serum AFP levels were elevated after administration of AH-66 cells and no significant differences were revealed between each group. In the pathological specimens of the liver taken after 7 days, many tumorous lesions were seen microscopically with islet formations, but no definitive difference was seen in each lobe. The serum AFP concentration in group A was significantly higher than that in group C. The tissue AFP concentrations of the right lobe were significantly higher than those of the left in groups A and B, but significantly lower than those of the left lobe in group C. The results indicate that the distribution and proliferation of tumor cells administered via portal vein differed depending upon the site of tumor injection in accordance with the 'streamline' phenomena.

Lasing from epitaxially oriented needle crystals of a thiophene/phenylene co-oligomer

Optically pumped lasing of epitaxially oriented molecular crystals is presented. Needle-like crystals of a thiophene/phenylene co-oligomer is grown along the [110] direction of a KCl substrate. The fluorescence light is one-dimensionally confined and amplified by the self-waveguiding effect in the elongated needles. The Fabry-Pérot resonation by the terminated ends results in laser oscillations corresponding to the needle length.

[Patient skin injury in cardiac intervention procedures]

PURPOSE

To discuss the circumstances of patient skin injury in cardiac interventional radiology (IVR). To demonstrate the importance of evaluating the patient radiation dose in IVR. To show the need for the appropriate patient follow-up after IVR to identify radiation effects. To highlight the incidence of skin injuries during IVRs.

CONTENT ORGANIZATION

Evaluation of 400 consecutive percutaneous coronary interventions (PCIs). The radiation dose, number of cine runs, and fluoroscopic time were recorded for all patients. The skin on the patients' backs was reviewed periodically after PCI to identify radiation injury. The relationships between patient skin effects and factors such as the radiation dose were investigated. Reviewing previous reports of patient radiation injury occurrence rate, fluoroscopic time, radiation dose (if available), etc.

SUMMARY

Although increasing numbers of case reports of patient radiation injury resulting from IVR are being published, these reports likely represent a small fraction of actual cases. Radiation skin injury in IVR is overlooked clinically in many patients. Patients who receive a high radiation dose while undergoing IVR should be followed to identify radiation skin effects, and physicians should seek to establish whether a patient has had previous IVR, together with the entrance site and radiation dose.

Temporally and spatially resolved measurements of the number density of water droplets in an intermittent aerosol

Temporally and spatially resolved measurements of the number density of water droplets in an intermittent aerosol were experimentally demonstrated by a laser-induced breakdown technique. The temporal number density distribution is clearly explained by temporal variations in the air pressure at the nozzle caused by an electric valve, the number density of droplets in the steady-state aerosol as a function of air pressure applied to the nozzle, and the steady-state air flow speed as a function of the air pressure applied to the nozzle. The spatial resolutions in the radial and axial directions are also discussed; they were determined from the breakdown threshold intensities of water droplets and air.

Microbial flora alterations in jejunum and colon after chemical bowel preparation before Kasai hepatoportojejunostomy

AIM

There is little reported evidence on the effect of preoperative chemical bowel preparation by the administration of oral antibiotics in patients with biliary atresia (BA). This study was designed to examine and compare the alterations of microbial flora in feces cultures before and after the administration of oral antibiotics, and to examine fluid cultures from the tip of the jejunal limb at bile duct reconstruction by Kasai hepatoportoenterostomy (HPJ), and to evaluate the effects of preoperative oral antibiotics on postoperative cholangitis.

MATERIAL AND METHODS

Between January 2003 and July 2005, 6 infants with BA underwent surgical correction, and were treated preoperatively with polymyxin B (80 000 U/kg/day in 3 divided doses for 2 days) and metronidazole (10 mg/kg/day in 2 divided doses for 2 days). Quantitative feces cultures, both before administration of oral antibiotics and at Kasai HPJ, were obtained in patients with BA. Furthermore, fluid cultures from the tip of the jejunal limb at bile duct reconstruction by Kasai HPJ were obtained to examine alterations of bacteria and fungi.

RESULTS

Bacterial colonization of the tip of the jejunal limb did not occur at the Kasai HPJ. The most commonly encountered organisms were ENTEROCOCCUS and intestinal bacterial flora. Fungus was not detected in the feces before or after the administration of oral antibiotics. CANDIDA was detected in the tip of the jejunal limb after Kasai HPJ in only one patient.

CONCLUSIONS

The authors propose that colonic-type flora are generally found in the feces before and after the administration of oral antibiotics, and no bacteria are detected in the bilioenteric conduits.

Cystic thymoma in a child: a rare case and review of the literature

Thymomas are rare mediastinal tumors in pediatrics and cystic thymoma, is characterized by a predominantly cystic formation, is extremely rare. This report describes a 13-year-old girl with cystic thymoma, who was treated by video-assisted thoracoscopic surgery. The microscopic findings were characteristic of cystic thymoma. The literature on cystic thymoma is reviewed here and the clinical characteristics of cystic thymoma are discussed.

Comparison between prenatally diagnosed choledochal cyst and type-1 cystic biliary atresia by CD56-immunostaining using liver biopsy specimens

Because it is difficult to distinguish preoperatively between a prenatally diagnosed choledochal cyst (CC) and type-1 cystic biliary atresia (BA) by ultrasound scanning or magnetic resonance imaging, some mode of discriminating between the 2 entities is required. The aim of this study was to investigate the immunohistological differences between prenatally diagnosed CC and type-1 cystic BA, using liver biopsy specimens immunostained for CD56. Five children with prenatally diagnosed CC and two children with prenatally diagnosed type-1 cystic BA were identified by fetal ultrasonography between 1985 and 2004. The control group included two children who were operated on at an earlier period due to postnatally diagnosed BA. Liver wedge biopsy in the right lobe was performed at the time of the radical operation. Histological findings of the CD56-stained liver biopsy specimens were classified into 4 categories each, with particular focus on staining distribution and intensity. The staining distribution was classified according to the scale 0 = no staining; 1 = some staining of bile ducts/ductules but staining in less than one-third of portal tracts; 2 = staining in one-third to less than two-thirds of portal tracts; and 3 = staining in more than two-thirds of portal tracts. Staining intensity was scored as follows: 0 = no staining, 1 = weak staining, 2 = moderate staining, and 3 = strong staining. The staining intensity and distribution in the CC group was zero in all 5 cases. The type-1 cystic BA group consisted of patients with scale 1 or 3 staining distribution and score 1 or 2 staining intensity. In the control group, staining distribution was 1 or 3, and staining intensity was 1 or 3. These results indicate that CD56-positive biliary duct cells are present in prenatally diagnosed type-1 cystic BA. The authors suggest that exploratory laparotomy might be avoided and, instead, immunohistological examination using liver biopsy specimens may be a reliable test for the differential diagnosis of CC and type-1 cystic BA in prenatally diagnosed neonates.

Management and algorithm for focal nodular hyperplasia of the liver in children

PURPOSE

The aim of this study was to determine an appropriate management plan for childhood and adolescent FNH, in particular to establish an algorithm for preoperative diagnosis and treatment.

PATIENTS AND METHODS

Between 1985 and 2003, 4 children with FNH were diagnosed. Of these 4 patients, 3 (Group A) underwent tumor resection, and 1 (Group B) was treated by conservative management. Clinical data, pathological findings and follow-up were evaluated retrospectively.

RESULTS

The 3 patients in Group A were symptomatic, while the 1 patient in Group B was asymptomatic. In 3 of 4 patients, a homogeneous tumor with a central stellate area was noted on abdominal ultrasonography, CT scan and MR imaging. In case 2, SPIO-enhanced MR imaging was useful for differentiating FNH from hepatocellular carcinoma. Though percutaneous needle biopsy was performed in case 3, a pathologically definitive diagnosis was impossible. An open biopsy was performed in case 4 and FNH was diagnosed. In case 4 treated by conservative management, the tumor size did not change during the 7 years after the diagnosis of FNH.

CONCLUSION

FNH is usually treated conservatively because of the good evolutionary outcome of the lesion. Surgery is indicated in cases of complications, compressed adjacent organs, lesion progression, or for symptomatic patients. We advocate the use of less invasive SPIO-enhanced MR imaging instead of open biopsy when the diagnosis of focal liver lesions is not clear after contrast-enhanced CT scan and non-enhanced MR imaging.

MYCN gene amplification is a powerful prognostic factor even in infantile neuroblastoma detected by mass screening

MYCN is the most powerful prognostic factor in cases of older children. However, how MYCN is related to the prognosis of infantile cases is not clear. A mass screening program was carried out by measuring urinary catecholamine metabolites (VMA and HVA) from 6-month-old infants. Of 2084 cases detected by the screening program, MYCN amplification (MNA) was examined by Southern blot analyses in 1533 cases from 1987 to 2000. Of the 1533 cases examined, 1500 (97.8%) showed no MNA, 20 cases (1.3%) showed MNA from three to nine copies, and 13 (0.8%) cases showed more than 10 copies. The 4-year overall survival rates of these three groups (99, 89 and 53%, respectively) were significantly different (P<0.001), indicating that MYCN copy number correlates with the prognosis. Cases with MNA more than 10 copies were more advanced than those without amplification (stage III, IV vs I, II, IVs; P<0.001). Patients with MNA more than 10 copies had significantly higher serum levels of neuron-specific-enolase (NSE) and ferritin than non-amplified patients (P=0.049, P=0.025, respectively). MYCN amplification was strongly correlated with a poor prognosis in infantile neuroblastoma cases. Therefore, for the selection of appropriate treatment, an accurate determination of MNA is indispensable.

Effective esophageal balloon dilation for esophageal stenosis in recessive dystrophic epidermolysis bullosa

Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited disorder of squamous epithelium that results in dystrophic scarring of the skin after minor trauma. RDEB is classified into two subtypes: Hallopeau-Siemens (HS) and non-Hallopeau-Siemens (nHS). Although severe scarring of the skin is the most common and obvious complication of the disease, esophageal scarring with formation of long strictures may also develop. Treatment options for esophageal stenosis in patients with RDEB include steroids, hyperalimentation, esophageal dilation and replacement. This report describes a child who was dilated immediately after diagnosis of severe esophageal stenosis subsequent to nHS-RDEB and managed successfully. Endoscopic esophageal balloon dilation under fluoroscopic control was very useful for detecting the region of stenosis and bougienage. The literature on such injuries is reviewed here, and the problems associated with the treatment of children with esophageal stenosis associated with RDEB are discussed.

Histological differentiation between prenatally diagnosed choledochal cyst and type I cystic biliary atresia using liver biopsy specimens

Because it is difficult to distinguish preoperatively between prenatally diagnosed choledochal cyst (CC) and type I cystic biliary atresia (BA) by ultrasound scanning or magnetic resonance imaging (MRI), some modality of discrimination for the 2 entities is required. The aim of this study was to investigate the histological differences between prenatally diagnosed CC and type I cystic BA using liver biopsy specimens. Four children with prenatally diagnosed CC and two children with prenatally diagnosed type I cystic BA were identified by fetal ultrasonography between 1985 and 2003. The control group included two children who were operated on at an earlier period due to postnatally diagnosed BA. Liver wedge biopsy in the right lobe was performed at the time of the radical operation. Histological findings of the H & E-stained liver biopsy specimens were classified into 4 grades (Grade 0, no abnormality; Grade 1, ductular proliferation without bridging fibrosis; Grade 2, ductular proliferation with bridging fibrosis; and Grade 3, liver cirrhosis). The CC group consisted of one case of Grade 0 and three cases of Grade 1. The type I cystic BA group consisted of one case each of Grade 2 and Grade 3. In the control group, both cases were Grade 2. The authors suggest that exploratory laparotomy might be avoided and, instead, histologic examination using liver biopsy specimens can be a reliable test for the differential diagnosis of CC and type I cystic BA in prenatally diagnosed neonates.

Management of childhood and adolescent thyroid carcinoma: long-term follow-up and clinical characteristics

AIM

This analysis was performed to evaluate clinical factors such as local tumor control, control of distant metastasis, survival, and complications in children and adolescents with thyroid carcinoma.

MATERIALS AND METHODS

From 1960 to 2003, 21 children and adolescents (16 girls and 5 boys, aged 4 to 15 years) were treated for thyroid carcinoma in our departments. Clinical data, operative findings, pathological findings, operative procedures, intra- and postoperative complications and follow-up were evaluated. Follow-up of patients ranged from 3 to 42 years (median, 20 years).

RESULTS

Papillary carcinoma was found in 20 patients (95%) and follicular carcinoma in one patient. Cervical lymph node metastases were found in 12 out of 21 patients (57.1%) when thyroid carcinoma was diagnosed, and 5 patients (23.8%) had pulmonary metastasis. In patients with pulmonary metastasis, total thyroidectomy and bilateral radical lymph node resection was performed in 3 patients, lobectomy of the thyroid and radical lymph node resection in one patient, and partial thyroidectomy in one patient. All three patients who underwent total thyroidectomy are still alive. Internal irradiation by 131I and thyroid hormone replacement therapy was administered to 2 of 3 patients with pulmonary metastasis.

CONCLUSION

Despite metastasis in the lymph nodes and even the lungs, the prognosis for patients with papillary carcinoma is good. Total thyroidectomy and positive 131I therapy are recommended for childhood and adolescent thyroid carcinoma with pulmonary metastasis.

Bleeding disorder as the first symptom of biliary atresia

Biliary atresia (BA) is occasionally diagnosed in infants whose first symptom is a bleeding disorder, such as intracranial bleeding, nasal bleeding or gastrointestinal bleeding. The authors describe 3 cases in which a bleeding disorder was the first symptom of BA. The presenting symptom was intracranial bleeding in a male on day 55 after birth, nasal bleeding in a female at 65 days, and gastrointestinal bleeding in a female at 25 days. Coagulation studies revealed a vitamin K deficiency in all patients. After the administration of vitamin K, the results of coagulation tests normalized and the bleeding tendency of the infants ceased. Subsequently, BA was suspected to be the cause of these bleeding disorders based on imaging findings. BA should therefore be considered in all infants with sudden onset of a tendency to bleed.

Delay of gastric emptying measured by 13C-acetate breath test in neurologically impaired children with gastroesophageal reflux

Delayed gastric emptying often occurs in patients, including children, with gastroesophageal reflux (GER) due to neurological impairment (NI). The aim of this study was to evaluate gastric emptying of liquids in children with symptomatic GER using the (13)C- acetate breath test (ABT), and to compare the gastric emptying rates between children without and with NI. Thirteen patients were divided into 2 groups: group I without NI (5 patients) and group II with NI (8 patients). The liquid test meal consisted of Racoltrade mark (5 ml/kg) mixed with (13)C- acetate (50 mg for infants, 100 mg for children, and 150 mg for adolescents). Breath samples were collected for (13)CO (2) measurement before the intake of the meal, every 15 minutes during the first 2 hours after the meal and every 30 minutes thereafter to assess the ingestion of (13)C- acetate and Racoltrade mark. (13)CO (2) was measured using a gas chromatograph-isotope ratio mass spectrometer. The results were expressed as % of (13)C expired per hour and cumulative (13)C excretion over a 3-hour period. The half excretion time in (13)C- ABT(t (1/2) ex) was 1.095 hour for group I and 1.817 hour for group II (p = 0.0045). The lag time (t lag), which reflected the initial delay of gastric emptying, was 0.666 h for group I and 1.002 h for group II (p = 0.0045). Gastric emptying studies can be easily and reliably carried out in children with NI using (13)C- ABT. We showed that we were able to determine the gastric emptying rate by (13)C- ABT in patients with GER due to NI.

Equivalent cross-relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Sentinel lymph node biopsy (SLNB) is an important technique for detecting axillary lymph node metastasis in breast carcinoma patients. However, false-negative results are a problem. Equivalent cross-relaxation rate (ECR) imaging (ECRI) is a measurement method that can be used to quantitatively evaluate a change in the structural organization of lymph nodes by magnetic resonance imaging (MRI). We performed axillary ECRI in an attempt to decrease the false-negative results of SLNB. Regions without metastases showed a higher ECR value. On the other hand, regions with metastases showed a lower ECR value. The ECR images were compared with macroscopic histology images in which the presence or absence of axillary lymph node metastasis could be evaluated. ECRI is a potentially useful method for evaluating the efficacy of SLNB.

High expression of telomerase is an independent prognostic indicator of poor outcome in hepatoblastoma

Telomerase, an enzyme related with cellular immortality, has been extensively studied in many kinds of malignant tumours for clinical diagnostic or prognostic utilities. Telomerase activity is mainly regulated by the expression of hTERT (human telomerase reverse transcriptase), which is a catalytic component of human telomerase. To evaluate whether the levels of hTERT mRNA provides a molecular marker of hepatoblastoma malignancy, we examined hTERT mRNA expression levels in the primary hepatoblastoma tissues by fluorescent RT–PCR using LightCycler technology and followed up the clinical outcomes in 63 patients listed in the Japanese Study Group of Pediatric Liver Tumor between 1991 and 2002. The hTERT mRNA expression was detected in 61 (96.8%) specimens and their expression levels ranged between 0.1/1000 and 745.1/1000 copies of PBGD gene that was used as an internal control. Among these cases, frozen 39 tumour samples and 14 adjacent noncancerous liver tissues were analysed for semiquantitative telomerase assay. In the 39 tumour samples, the levels of telomerase activity ranged between 0.11 and 2709 TPG and 12 (30.7%) had high telomerase activity (>100 TPG), whereas only nine of 14 noncancerous liver tissue samples showed telomerase activity which was less than 1.0 TPG. The levels of telomerase activity were significantly correlated with the levels of hTERT mRNA expression (P<0.001). The frequency of high hTERT mRNA expression and/or high telomerase activity did not significantly associate with the clinicopathological factors except for stage of disease. The prognosis of the patients with high hTERT mRNA expression was significantly worse than that of others (P<0.01), as was the patients with high telomerase activity (P<0.01). Multivariate analysis indicated that high levels of hTERT mRNA expression as well as telomerase activity are independent prognosis-predicting factors in patients with hepatoblastoma.

Perforation of the piriform recessus by a swallowed glass splinter presenting as pneumomediastinum in a child

The swallowing of sharp glass splinters is rare due to the difficulty of swallowing such objects, and perforation of the piriform recessus and mediastinitis are unusual complications. Perforation of the piriform recessus due to a swallowed sharp glass splinter requires prompt treatment. This report describes a child who was operated on immediately after the diagnosis of perforation of the piriform recessus and was managed successfully. Light-guided pharyngoscopy was very useful for detecting the region of perforation. The literature on such injuries is reviewed here, and the problems associated with treating children with perforation of the piriform recessus and mediastinitis caused by swallowed glass splinters are discussed.

Equivalent cross relaxation rate image for decreasing a false negative case of sentinel lymph node biopsy

In the breast carcinamas, sentinel lymph node biopsy (SLNB) attracts attention as technique to be settled by axillary lymph node metastasis, but existence of a false negative case is a problem. Equivalent cross relaxation rate image (ECRI) is the measurement method that we can evaluate a change of organization structure quantitatively by magnetic resonance imaging. We executed axillary ECRI as a purpose with decreasing a false negative case of SLNB. ECRI related to a macroscopic image, and it was possible to evaluate yes or no of axillary lymph node metastasis. ECRI is the useful method to evaluate adaptability of SLNB.

Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1: A report from the Japanese Study Group for Pediatric Liver Tumor

PURPOSE

Hepatoblastoma is the most common malignant liver tumor in childhood. Multicenter studies elucidate the optimal pre- or postoperative chemotherapeutic regimens. This report reviews the results of the Japanese Study Group for Pediatric Liver Tumor Protocol-1 (JPLT-1) and compares its outcomes with published reports of other studies.

METHODS

From March 1991 to December 1999, 154 patients with malignant liver tumor including 145 cases of hepatoblastomas were enrolled in the JPLT study. Data from 134 cases were analyzed in this study. JPLT-1 protocol 91A was used for patients with stage I or II hepatoblastoma. The chemotherapy regimen consisted of repeated courses of cisplatin (CDDP), 40 mg/m(2), and tetrahydropyranyl (THP)-Adriamycin, 30 mg/m(2). JPLT-1 protocol 91B was administered to patients with stage IIIA, IIIB, or IV hepatoblastoma. The chemotherapy regimen consisted of repeated courses of CDDP, 80 mg/m(2), and THP-Adriamycin, 30 mg/m(2)/day for 2 days. Courses were repeated every 4 weeks as tolerated.

RESULTS

Seven patients died of chemotherapy-related side effects. Six of them died of sepsis caused by leukopenia and 1 case of liver failure. Overall survival rate (3-year/6-year) was 100%/100% for stage I (n = 9), 100%/95.7% for stage II (n = 32), 76.6%/73.8% for stage IIIA (n = 48), 50.3%/50.3% for stage IIIB (n = 25), 64.8%/38.9% for stage IV (n = 20), and 77.8%/73.4% overall. For stage IIIA and B disease, intravenous chemotherapy was better than intraarterial chemotherapy (66.4% v 38.1% for event-free survival and 69.3% v. 57.1% for overall survival). Patients less than 1 year of age had a better prognosis than older patients, but age was not a significant prognostic factor by multivariate analysis.

CONCLUSIONS

The overall and event-free survival rates of the JPLT-1 study of hepatoblastoma were comparable with the results of other multicenter studies in Europe and the United States. The event-free survival rate at 3 years for stage IIIB and IV disease was under 50%. New treatment strategies are needed for patients with advanced hepatoblastoma.

Equivalent cross-relaxation rate imaging in the synthetic copolymer gels and invasive ductal carcinomas of the breast

The values of equivalent cross-relaxation rate (ECR) correlated well with [i] water conditions in various copolymer gels and [ii] nature of malignant cells with regard to nuclear dysplasia and mitotic potential in breast carcinomas. The synthetic copolymer gels composed of any two or three monomers among 2-hydroxyethyl methacrylate (HEMA), glycidyl methacrylate (GMA), N-vinyl-2-pyrrolidinone (N-VP), methyl methacrylate (MMA) and benzyl methacrylate (BMA). The ECR measurement was performed by using an off-resonance saturation pulse under conventional field-echo imaging at frequency within +/- 75 ppm apart from the water resonance frequency. The ECR values were readily to determine and non-time consuming parameter for cross relaxation rate. The ECR values at the frequency offset by 7-ppm (ECR-7) were divided the sample gels two classes, which must correspond to hydrophilic or hydrophobic ones. The sensitivity in the gels was nearly equivalent to the cross-relaxation rate itself. In the breast carcinomas, the ECR-7 correlates with the nature of malignant cells with regard to nuclear dysplasia and mitotic potential. The ECR-7 is better or more accurate than the STR-7 because the SDNRs between carcinoma and glandular tissue increased by approximately 50% on the ECR-7 compared with the STR-7. Thus the ECR values could be a new parameter for malignancy and cell proliferative activity of the breast carcinomas with non-invasive modalities by magnetic resonance imaging.

Frequent beta-catenin mutation and cytoplasmic/nuclear accumulation in pancreatic solid-pseudopapillary neoplasm

Significance of Wnt signaling with beta-catenin mutations on solid-pseudopapillary neoplasm (SPN) of the pancreas was studied by immunohistochemistry and molecular analysis. On immunohistochemistry, all 18 SPNs tested showed diffuse cytoplasmic/nuclear positivity for beta-catenin. Upon direct DNA sequencing of exon 3 of the beta-catenin gene, 15 (83%) of the 18 SPNs showed 1-bp missense mutation in codons 32 (5 cases), 33 (3 cases), 34 (3 cases), 37 (3 cases), and 41 (1 case). Immunoreactivity for cyclin D1, one of the intranuclear targets of beta-catenin complexes, was found in tumor cells of more than half the tumor cells of all of the 18 SPNs. The present study strongly suggested a significant role of Wnt signaling, mostly associated with beta-catenin mutations in the tumorigenesis of SPN.

Expression and adhesive ability of gicerin, a cell adhesion molecule, in the pock lesions of chorioallantoic membranes infected with an avian poxvirus

The expression and adhesive activities of gicerin, a cell adhesion protein, in the pock lesions on chicken chorioallantoic membranes (CAM) infected with an avian poxvirus were studied. In normal CAMs, gicerin was found on the flattened epithelial cells, and neurite outgrowth factor (NOF) was in the basement membrane. However, in the pock lesions on infected CAMs, gicerin was overexpressed on the cell membranes of hyperplastic epithelial cells forming thick epithelial layers. Neurite outgrowth factor was also found mainly in the basement membrane, but occasionally showed aberrant expression among hyperplastic cells. In vitro analyses, using the dissociated cells from pock lesions, demonstrated that an anti-gicerin polyclonal antibody inhibit cell aggregation activity and cell adhesion to NOF. These results suggest that gicerin might promote the cell-cell and cell-extracellular matrix protein bindings of the hyperplastic epithelial cells by its homophilic and heterophilic adhesive activities, and contribute to pock formation on the infected CAMs.

Japanese red-bellied newts in Space--AstroNewt experiment on Space Shuttle IML-2 and Space Flyer Unit

Biological effects of gravity was examined in embryonic development of Japanese red bellied newt. Two space newt missions were conducted in 1994 and 1995. The Second International Microgravity Laboratory was flown in 1994 as one of the SpaceLab missions. Space Flyer Unit, a Japanese space platform, was delivered to the earth orbit by the third launch of the H-II rocket and retrieved by Space Shuttle in 1996. Female newts were induced to lay eggs in orbit at these two space missions. Eggs were successfully obtained on both missions, and exposed to space environment from its early developmental stages. Morphology of the embryos was found not deviated from those developed on ground, as long as in the images taken in orbit or the examined specimen retrieved to ground. On the other hand, pathological changes were discovered in several organs of the adult newts that returned alive from their space flight.

Caveolar and intercellular channels provide major transport pathways of macromolecules across vascular endothelial cells

Serum macromolecules are transported through the vascular endothelial layer to the interstitium via the caveolae and interendothelial clefts, but the nature of the permeability of these structures is unknown, and the manner of caveola-vesicle transport is controversial. We have developed a method of detecting macromolecular channels using an in situ HRP perfusion into arteries previously perfused with aldehyde and random conventional sectioning for electron microscopy. Using unbiased morphometry, 4.75% of the abluminal caveolae and 15.13% of the intercellular clefts were the tracer-positive in rat aortic endothelium. In rat aortas treated with N-ethylmaleimide, all caveolae and most free vesicles in the cytoplasm except those around the Golgi area were HRP-positive in the endothelial cells; 1.48% of abluminal caveolae were structurally recognized as caveolar channels through the endothelial layer in a plane of single section. The length density of the abluminal caveolae was decreased to about 80% to the physiological control level whereas the larger invaginations were more frequently observed. Moreover 96.17% of the intercellular clefts were HRP-positive. We suggest that a flexible channel-system functions extensively as a macromolecular transport pathway in the arterial endothelium in vivo because the tracer-labeled abluminal caveolae and intercellular clefts should be opened to the luminal surfaces methodologically. We therefore propose that caveolar channels, rather than transcytosis, provide a mechanism of caveola-vesicle transport in the endothelial cells, because free vesicles involved in transcytosis were few in number.

Acute severe alcohol-induced bronchial asthma

We report the case of a severe bronchial asthma attack 15 minutes after the ingestion of food containing small amounts of alcohol. Although an ethanol inhalation test was negative, an acetaldehyde inhalation test was positive. Furthermore, it was discovered that the patient was homozygous for a mutation of the aldehyde dehydrogenase-2 (ALDH-2) gene. We subsequently diagnosed his attack as acute severe alcohol-induced asthma. Since bronchial asthma patients who are homozygous for mutant ALDH-2 genes are susceptible to acute severe alcohol-induced asthma attacks, strict clinical attention is thought a necessity.

Adrenomedullin suppresses fMLP-induced upregulation of CD11b of human neutrophils

In this study we investigated the effect of adrenomedullin (AM) on fMLP-mediated activation of human neutrophils. AM partially, but significantly, suppressed fMLP-induced upregulation of CD11b expression. The inhibitory effects of AM upon fMLP-induced upregulation of CD11b expression were completely blocked by CGRP [8-37], a CGRP receptor antagonist. AM significantly increased cAMP content in neutrophils and SQ-22,536, an adenylate cyclase inhibitor, and KT-5720, a PKA inhibitor, significantly blocked the inhibitory effects of AM upon fMLP-induced upregulation of CD11b expression. This study indicates that binding of AM to the CGRP receptor suppresses fMLP-induced upregulation of CD11b expression of human neutrophils by increasing intracellular cAMP levels. AM may play an important role in the regulation of inflammatory processes, especially in the binding of neutrophils to vascular endothelial cells and subsequent neutrophil emigration evident in acute pulmonary inflammation.

Frequent deletions and mutations of the beta-catenin gene are associated with overexpression of cyclin D1 and fibronectin and poorly differentiated histology in childhood hepatoblastoma

Hepatoblastoma (HBL) is the most common malignant liver tumor in young children. Recent reports have shown that the beta-catenin gene was frequently mutated or deleted in HBLS: To elucidate the role of beta-catenin abnormalities in HBLs, we searched for mutations of beta-catenin and APC as well as expression of the target genes, cyclin D1, c-myc, and fibronectin, in 68 primary HBLS: The mutation analysis revealed that 44 (65%) tumors carried missense mutations or deletions of beta-catenin, all of which were somatic and targeted to the exon 3 encoding the amino acid residues involved in its degradation. However, no loss of function mutation of the APC gene was detected by the yeast functional assay. Of interest, beta-catenin mutation was significantly correlated with overexpression of the target genes, cyclin D1 and fibronectin, but not with that of c-myc in HBLs as measured by quantitative real-time reverse transcription-PCR. The immunohistochemical studies in 15 HBLs demonstrated that the nuclear/cytoplasmic accumulation of beta-catenin was positive in 13 tumors, 9 of which had the deletion or mutation of the gene. The significant correlation between the beta-catenin gene abnormality and the positive staining of cyclin D1 was also confirmed. Furthermore, the nuclear accumulation of beta-catenin was strongly associated with the poorly differentiated tumor cell components as well as with the positive staining of cyclin D1 within the tumor. Thus, our present results suggested that the gain of function mutation of beta-catenin played a crucial role in the malignant progression of HBL in vivo.

The role of gicerin, a novel cell adhesion molecule, in development, regeneration and neoplasia

Neurite outgrowth factor (NOF) is an extracellular matrix (ECM) protein in the laminin family and its ligand, gicerin, is a novel cell adhesion molecule in the immunoglobulin superfamily. Gicerin has a homophilic adhesive activity as well as a heterotypic manner to NOF. In the nervous systems, gicerin is expressed during developmental stage when neurons migrate or extend neurites to form a neural network. Gicerin promotes neurite extension and migration of embryonic neurons in vitro by its homophilic and heterophilic adhesion activities. Introduction of antigicerin antibody into early developing eyes perturbs the layer formation of neural retina. These data suggest that gicerin participates in the formation of neural tissues. Gicerin is also expressed in other non-neural tissues; in epithelia of trachea, kidney and oviduct, gicerin expression is restricted in the developmental period. In contrast, muscular tissues and endothelial cells express gicerin continuously even after maturation. Interestingly, gicerin re-appears strongly in the regenerating epithelia of trachea, kidney and oviduct, and also anti-gicerin antibody disrupts the healing process of trachea. Furthermore, gicerin and NOF are overexpressed in the chicken nephroblastomas (Wilm's tumor) and oviductal adenocarcinomas. In vitro analyses show that gicerin adhesive activities can promote binding among tumor cells and adhesion of tumor cells to NOF. A polyclonal antibody against gicerin also perturbs the re-attachment of cancer cells onto metastasizing sites. It is clear from these studies that gicerin is a potential effector for pathological tissue formation as well as for normal development.

Role of the gonads in sex differentiation of growth hormone-releasing hormone and somatostatin neurons in the mouse hypothalamus during postnatal development

We clarify the mechanism of sexual dimorphism of growth hormone releasing hormone (GHRH) neurons in the arcuate nucleus (ARC) and somatostatin (SS) neurons in periventricular nucleus (PeN), by studying the role of the gonads during the neonatal period and after puberty using immunohistochemical and morphometric methods. As in our previous works the numbers of ARC GHRH-ir and PeN SS-ir neurons were significantly greater in adult normal male (NM) mice than in adult normal female (NF) mice. Adult female mice that were ovariectomized neonatally (NOF) increased the expression of GHRH-ir neurons to the male pattern, but adult female mice ovariectomized after puberty (APO) did not change. Adult male mice castrated neonatally and after puberty (NCM and APC, respectively) were not significantly different from NM mice. However, NCT male mice, which were castrated neonatally and transplanted with ovary just before puberty, showed a significantly reduced number of GHRH-ir neurons compared with NCM mice, but no significant difference from NM and NF mice. On the other hand, the PeN SS-ir neuron expression in NCM mice and APC mice showed a significant reduction compared with NM mice, but no significant difference from NF mice. The number of PeN SS-ir neurons in NOF increased to match that of NM mice. Our results suggest that the presence of the ovary during postnatal life inhibits the development of ARC GHRH-ir neurons. The presence of the testis during postnatal life may stimulate the development of PeN SS-ir neurons, while the presence of the ovary during neonatal period may inhibit the development of PeN SS-ir neurons; the presence of ovary after puberty does not inhibit.