In Vivo 19F Mr Spectroscopic Study of Metabolism of 5-Fluorotryptophan in Rat Liver

The metabolism of 5-fluorotryptophan in rat liver was examined by in vivo 19F MR spectroscopy. After i.v. injection of 200 mg/kg b.w. of 5-fluorotryptophan the substance was noted immediately as a strong peak, which decreased gradually. Another peak appeared about 40 min after the injection. The chemical shift value of this peak was 1.6 ppm from that of 5-fluorotryptophan. Kynurenine is known to be a major metabolite of tryptophan in the liver. We synthesized 5-fluorokynurenine from 5-fluorotryptophan by ozonolysis. The chemical shift value of 5-fluorokynurenine was confirmed to be coincident with that of the metabolite peak. This strongly suggests that the metabolite peak of 5-fluorotryptophan observed in this study was the 5-fluorokyrurenine signal. We also applied this method for the CCl4-injured liver. In the liver injury group, the metabolite peak appeared slowly and the intensity was low compared to that of the normal group, though the peak of 5-fluorotryptophan decreased similarly as in the normal liver. These results suggest that the decrease of 5-fluorotryptophan is due mainly to the renal excretion, as the injured liver could not metabolize 5-fluorotryptophan.

Quantitative Evaluation of Intraarterial Lymphocyte Injection Therapy for Lymph Edema Using MR Imaging

Five patients with unilateral leg lymph edema had intraarterial injections of lymphocytes in the affected leg with consequent improvement in 3. To assess the degree of lymph edema, T2 and intensity ratio between the 2 legs in STIR images were used. Mean and SD of T2 values in the subcutaneous tissue were measured using a triple echo sequence and found larger on the edematous side than in the opposite extremity. The mean T2 shortening obtained after the lymphocyte therapy correlated well with the reduction of limb circumference. Mean T2 reflects the fluid content, and SD of T2 the fluid distribution in the subcutaneous tissue. The degree of lymph edema and the effect of therapy can be evaluated quantitatively by measuring the value of the T2 relaxation time.

Decreased bone mineral density in diabetic patients on hemodialysis

Renal osteodystrophy in hemodialyzed patients with DM-HD shows different features from that in non-DM,HD. Two studies were done. One was a comparison of BMD in 30 non-DM,HD patients and 30 DM-HD patients. The second was a comparison of possible factors affecting calcium metabolism in the higher and lower BMD groups (n = 20/21) in the DM-HD patients. BMD was measured by dual-energy X-ray absorptiometry (DEXA; Hologic QDR 1,000/W) in the third lumbar vertebra (L3), head, pelvis, and whole body. The BMDs of the DM-HD group were lower in these areas and whole body than that in the non-DM,HD group. A significant difference was found in the head BMD (p less than 0.05). In the second study, factors which may contribute to the differences in BMD were compared in the DM-HD patients divided into higher and lower BMD of the head. The group with higher head BMD had a value 110% of the mean value or more. Clinical and biochemical test results (age, the time since the first dialysis, body weight, the degree of obesity, height, serum calcium, serum phosphate, serum aluminum, serum c-PTH level and the dose of 1 alpha-OH-D3) were compared. The degree of obesity of the patients with higher BMD was significantly larger than that with lower BMD (p less than 0.005).

Temporomandibular joint and 3.0 T pseudodynamic magnetic resonance imaging. Part 2: evaluation of articular disc obscurity

OBJECTIVES

This study examined the relationship between temporomandibular joint (TMJ) dysfunctions and obscurity grades of interpreted anterior and posterior borders of the articular disc (Da and Dp, respectively) by 3.0 T pseudodynamic MRI.

METHODS

Da and Dp were classified into seven obscurity grades, and the Dp contour was classified into three types. The grades, types and TMJ function were compared by 3.0 T pseudodynamic MRI.

RESULTS

Unobscured Da images at condylar positions posterior to the articular eminence were associated with normal TMJ function (P = 0.046 < 0.05). Unobscured Dp images at condylar positions anterior to the articular eminence were associated with normal TMJ function (P = 0.033 < 0.05). In addition, unobscured Dp images following flap insertion were associated with normal TMJ function (P = 0.043 < 0.05). There was no statistical relationship between Dp contour types and TMJ movement, but any change observed in the Dp contour during mouth opening was associated with abnormal TMJ function (P = 0.040 < 0.05).

CONCLUSIONS

Grading of Da and Dp obscurity based on how well the areas were defined in the images, identifying the condylar positions in relation to the glenoid fossa and articular eminences, and observing the changes in Dp contour types were useful for diagnosing TMJ abnormalities.

Temporomandibular joint and 3.0 T pseudodynamic magnetic resonance imaging. Part 1: evaluation of condylar and disc dysfunction

OBJECTIVES

This study describes an improved method for examining and diagnosing temporomandibular joint (TMJ) dynamics by 3.0 T pseudodynamic MRI.

METHODS

Clinical observation and conventional static MRI of volunteers (one without and eight with TMJ arthrosis) were followed by 3.0 T pseudodynamic MRI in positions ranging from the mouth closed to mouth fully opened. Condylar head (Cd), articular disc anterior border (Da) and articular disc posterior border (Dp) were digitized on sagittal images to determine trajectory and velocity patterns.

RESULTS

Patients were divided into three groups based on the presence or absence of dysfunction: Group 1, no dysfunction on the right or left side of the TMJ; Group 2, dysfunction on the right or left side of the TMJ; and Group 3, dysfunction on both the right and left sides of the TMJs. In 75% of patients (12 of 16 joints), pseudodynamic TMJ analysis was useful for determining a functional abnormality. Using a points system based on three trajectory and seven velocity patterns, discs with adhesion and perforation had significantly fewer points than discs with anterior displacement (with and without reduction) and discs with no abnormality (P = 0.019 < 0.05).

CONCLUSIONS

Trajectory and velocity patterns based on 3.0 T pseudodynamic MRI identified the affected side and determined the extent of morbidity in the Cd as well as the Da and Dp. The typical abnormal movement pattern of discs with anterior displacement (with and without reduction) and pathological structural changes of the articular disc (such as adhesion and perforation) could be identified.

Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion

BACKGROUND

Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis.

PURPOSE

To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer.

MATERIAL AND METHODS

Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer.

RESULTS

The ADC values (x10(-3) mm(2)/s) in cancer and benign lesions were 0.84+/-0.19 and 1.58+/-0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly.

CONCLUSION

DWI provides helpful information in evaluating benign and malignant endometrial lesions.

Diffusion-weighted magnetic resonance imaging of urinary epithelial cancer with upper urinary tract obstruction: preliminary results

BACKGROUND

Various malignant tumors of the body show high signal intensity on diffusion-weighted magnetic resonance imaging (DWI). In the genitourinary region, DWI is expected to have a role in detecting urinary epithelial cancer noninvasively.

PURPOSE

To demonstrate the feasibility of DWI for the diagnosis of urinary epithelial cancer with upper urinary tract obstruction.

MATERIAL AND METHODS

Twenty upper urinary tract cancers in 16 patients were evaluated by high-b-value DWI (b=800 s/mm(2)). The signal intensity was visually evaluated, and the apparent diffusion coefficients (ADCs) were measured.

RESULTS

All urinary epithelial cancers showed high signal intensity on DWI. The ADC in cancerous lesions was 1.31+/-0.27 x 10(-3) mm(2)/s, which was significantly lower than that of the lumens of the ureter or renal pelvis (3.32+/-0.44 x 10(-3) mm(2)/s; P<0.001). Maximum intensity projection images of DWI in combination with static-fluid MR urography provided three-dimensional entire urinary tract imaging with the extension of tumors.

CONCLUSION

DWI is useful in the tumor detection and in evaluating the tumor extension of urinary epithelial cancer in patients with upper urinary tract obstruction.

High-b-value diffusion-weighted magnetic resonance imaging of pancreatic cancer and mass-forming chronic pancreatitis: preliminary results

BACKGROUND

Mass-forming chronic pancreatitis may mimic a pancreatic cancer on dynamic computed tomography (CT) and magnetic resonance (MR) imaging, and preoperative differential diagnosis is often difficult. Recently, the usefulness of diffusion-weighted MR imaging (DWI) in the diagnosis of pancreatic cancer has been reported in several studies.

PURPOSE

To determine whether high-b-value DWI can distinguish pancreatic cancer from benign mass-forming chronic pancreatitis.

MATERIAL AND METHODS

Twenty pancreatic cancers and four cases of mass-forming chronic pancreatitis were evaluated by high-b-value DWI (b=800 s/mm(2)). The signal intensity on DWI was visually evaluated, and the isotropic apparent diffusion coefficients (ADCs) were measured.

RESULTS

All twenty pancreatic cancers showed high signal intensity (18 showed very high, two showed slightly high) on DWI. None of the mass-forming chronic pancreatitis cases showed very high intensity (three showed iso to low, one showed slightly high) on DWI. The ADCs in the pancreatic cancer and mass-forming chronic pancreatitis were 1.38 +/- 0.32 x 10(-3) mm(2)/s and 1.00 +/- 0.18 x 10(-3) mm(2)/s, respectively (P < 0.05).

CONCLUSION

On high-b-value DWI, most pancreatic cancers showed very high signal intensity, and may hence be distinguished from benign mass-forming chronic pancreatitis based on our preliminary results.

Hanging protocol and viewers for a dental full picture [corrected] archiving and communication system (PACS) [corrected]

OBJECTIVES

Study objectives were: to develop a hanging protocol for displaying digital transmission radiographic images of oral and maxillofacial regions using a dental DICOM (digital imaging and communication in medicine) viewer and a dental Web viewer; and to give information on a system that allows patients and health professionals to share image information.

METHODS

For the hanging protocol, alphanumeric tags were defined and used in a DICOM modality worklist. These tags consisted of layout information to display images on monitors by the type of projection method and assignment information to display images of template for intraoral full-mouth survey that were numbered and slotted according to tooth position. Tooth code and algorithm for assignment of images for intraoral full-mouth survey were determined. Expanded correspondence for viewers was used for modalities without tags. Images could be edited by quality control system. An electronic medical record (EMR) system, a radiological information system (RIS) and a picture archiving and communication system (PACS) with servers, terminals and viewers were set up in a patient-centred hospital environment.

RESULTS

Using the hanging protocol, the viewers displayed digital transmission radiographic images automatically on display areas on one or multiple monitors showing intraoral, panoramic and extraoral views produced during various examinations. The images were also displayed using the coupling function of EMR and RIS. Users can compare the images taken at various times more efficiently.

CONCLUSION

The new system using a dental DICOM viewer and a dental Web viewer is the most advanced for examining oral and maxillofacial regions compared with medical viewers. Our local but clinically operational hanging protocol should be a good model for DICOM Working Group 22.

Licensing regulators Geminin and Cdt1 identify progenitor cells of the mouse CNS in a specific phase of the cell cycle

Nervous system formation integrates control of cellular proliferation and differentiation and is mediated by multipotent neural progenitor cells that become progressively restricted in their developmental potential before they give rise to differentiated neurons and glial cells. Evidence from different experimental systems suggests that Geminin is a candidate molecule linking proliferation and differentiation during nervous system development. We show here that Geminin and its binding partner Cdt1 are expressed abundantly by neural progenitor cells during early mouse neurogenesis. Their expression levels decline at late developmental stages and become undetectable upon differentiation. Geminin and Cdt1 expressing cells also express Sox2 while no overlap is detected with cells expressing markers of a differentiated neuronal phenotype. A fraction of radial glial cells expressing RC2 and Pax6 are also immunoreactive for Geminin and Cdt1. The majority of the Geminin and Cdt1 expressing cell populations appears to be distinct from fate-restricted precursor cells expressing Mash1 or Neurogenin2. Bromo-deoxy-uridine (BrdU) incorporation experiments reveal a cell cycle specific expression in neural progenitor cells, with Geminin being present from S to M phase, while Cdt1 expression characterizes progenitor cells in G1 phase. Furthermore, in vitro differentiation of adult neurosphere cultures shows downregulation of Geminin/Cdt1 in the differentiated state, in line with our data showing that Geminin is present in neural progenitor cells of the CNS during mouse embryogenesis and adulthood and becomes downregulated upon cell fate specification and differentiation. This suggests a role for Geminin in the formation and maintenance of the neural progenitor cells.

[Quality control (QC) of CT on rail system (FOCAL Unit) with a micro-multi leaf collimator (mMLC) using new GafChromic film for stereotactic radiotherapy]

PURPOSE

Recent years, CT on rail system was reported to be useful as a tool for image-guided radiotherapy (IGRT). This system was clinically developed with the aim of stereotactic irradiation (STI) for brain, lung, liver, prostate and other sites. Quality assurance and quality control (QC) is an important issue in CT on rail system to assure geometric accuracies. The purpose of this study is to estimate the geometric accuracies of our CT on rail system using a detachable micro-multi leaf collimator (mMLC) with new type radiochromic films. Carrying out our original QC program, translational errors, setup reproducibility, beam misalignment and beam characteristics were evaluated.

METHODS AND MATERIALS

We have studied with CT on rail system (FOCAL unit, Toshiba Medical systems, Tokyo, Japan) and mMLC unit (Accuknife, Direx Inc., Tokyo, Japan). We have developed original alignment phantom and small steel markers (2 mm phi) were implanted on its surface at certain intervals. Firstly, we have evaluated the accuracy of self-moving CT gantry and CT resolutions for cranio-caudal directions by changing slice thickness. And then using the phantom, we have measured the accuracy and reproducibility of geometric isocenter of the linac side and the CT gantry side by scanning the phantom. We have also measured the geometric changes of the common treatment couch by weight-loaded test (up to 135 kgw). To estimate dosimetric and geometric accuracies with the mMLC unit, the misalignment of the beam axes (gantry, collimator and couch rotation axis), mMLC leaf positions, and dose distributions for the verification plan were measured with new type GafChromic films (GafChromic-RTQA, ISP Inc., USA) and cylindrical phantom. The dose characteristics of the GafChromic film were also evaluated.

RESULTS

The reproducibility of the self-moving CT gantry have a good agreement within 1 mm. Weight-load test have shown a good reliability within 2 mm at the common treatment couch. The translational precision of the common treatment couch was 0.0 +/- 0.1 mm at linac side and -0.2 +/- 0.5 mm at CT gantry side. The misalignments of beam axes have been kept within 0.4 mm at maximum. Gap test have shown the accuracies of the mMLC leaf positions, which is needed to keep within 1 mm by a routine calibration.

CONCLUSIONS

To practice quality control program for the FOCAL unit and the mMLC unit is essential for a regular interval to reduce systematic errors. New type radiochromic film would be useful for a verification tool as alternative to conventional film.

Expression of the licensing factors, Cdt1 and Geminin, in human colon cancer

Licensing of chromatin for replication is an evolu-tionarily conserved step in the control of cell division and genomic integrity. Proteins that participate in licensing have been recently documented to denote the proliferative state of cells and they have been proposed as diagnostic and prognostic markers in human cancer. Cdt1 was recently discovered as an important licensing factor, that is inhibited by Geminin. In the present study we analyzed Cdt1 and Geminin expression in human colon cancer. We showed that Cdt1 protein is highly expressed in human neoplastic lesions of the colon while its cell-cycle phase-specific expression profile appears preserved during human carcinogenesis. Similarly, Geminin, Cdt1's inhibitor, is also overexpressed in colon carcinomas and its expression correlates with significant clinicopathological parameters of the disease. Moreover, both Cdt1 and Geminin expression are severely downregulated upon differentiation of Caco-2 cells, an in vitro model of intestinal epithelial differentiation.

DNA replication licensing

The DNA replication licensing system ensures that chromosomal DNA is replicated precisely once before cell division occurs. A DNA helicase must be loaded on origin DNA for replication to initiate. Considerable evidence suggests that the MCM complex acts as a replicative helicase in eukaryotes. When the MCM complex is loaded on the chromatin, the replication origin is formally defined as being licensed for replication. Licensing takes place several hours before origins are activated to undergo replication in S-phase. Genetic and biochemical studies show that the licensing process is well conserved in eukaryotes. Cyclin Dependent Kinases (CDKs), the master regulators of the cell cycle, coordinate the initiation of the two key cell cycle events, replication of DNA and its segregation at mitosis. Eukaryotes have developed complex regulatory mechanisms to ensure that origin licensing is coordinated with these events so that genome integrity is preserved during successive cell divisions.

Imaging findings of urachal mucinous cystadenocarcinoma associated with pseudomyxoma peritonei

Pseudomyxoma peritonei is an uncommon neoplastic condition in which gelatinous fluid-like materials are observed in the peritoneal cavity caused by the dissemination of mucinous adenocarcinoma. Although ruptured appendiceal mucocele is the most common cause, tumors arising from other organs may also cause pseudomyxoma peritonei. We report the imaging findings of an extremely rare case of urachal mucinous adenocarcinoma associated with pseudomyxoma peritonei on computed tomography and magnetic resonance imaging with histopathologic correlation.

A novel nuclear protein, Twa1, and Muskelin comprise a complex with RanBPM

A truncated human RanBPM has been isolated as a protein binding to Ran, Ras-like nuclear small GTPase. Full-sized human RanBPM cDNA which was recently isolated, was found to encode a protein of 90 kDa which comprises a large protein complex. Consistent with this finding, several proteins were found to be co-precipitated with RanBPM by immunoprecipitation analysis. Accordingly, in the present study, we screened the human cDNA library by the two-hybrid method using RanBPM cDNA as bait. One novel protein designated as Twa1 (Two hybrid associated protein No. 1 with RanBPM), and two known proteins, a human homologue (hMuskelin) of mouse Muskelin and HSMpp8 were isolated repeatedly. Twa1 was well conserved through evolution and was localized within the nucleus. Interestingly, in addition to Muskelin and RanBPM, Twa1 was found to possess the LisH-CTLH motif which is detected in proteins involved in microtubule dynamics, cell migration, nucleokinesis and chromosome segregation. These functions overlap with functions suggested for the RanGTPase cycle. Immunoprecipitation and gel-filtration analyses indicated that both Twa1 and hMuskelin did indeed comprise a protein complex with RanBPM. Taken together with the fact that RanBPM interacts with Ran, our present findings suggested that there is an as yet uncovered function of the RanGTPase cycle.

A characteristic feature of acute haematomas in the brain on echo-planar diffusion-weighted imaging

Diffusion-weighted MRI (DWI) is used in the diagnosis of acute ischaemic disease of the brain, but it is not clear whether or not it can be used to differentiate an acute haematoma from an infarct. Our purpose was to identify any characteristic feature of acute haematomas which can be recognised on DWI and to evaluate the usefulness of DWI in acute cerebral stroke. We examined nine patients with acute haemorrhage using CT and MRI including DWI. We measured the volume and apparent diffusion coefficient (ADC) of the haematomas. All showed heterogeneous signal on DWI, and the centre of the large (>20 ml) haematomas especially a mixed pattern with high and low signal. The characteristic feature of acute haematomas was a peripheral low-signal region, found in all subjects regardless of the size of the haematoma; acute infarcts did not show this. This low-signal rim on DWI may be useful for differentiating an acute haematoma from an infarct.

The human licensing factor for DNA replication Cdt1 accumulates in G1 and is destabilized after initiation of S-phase

S-phase onset is controlled, so that it occurs only once every cell cycle. DNA is licensed for replication after mitosis in G(1), and passage through S-phase removes the license to replicate. In fission yeast, Cdc6/18 and Cdt1, two factors required for licensing, are central to ensuring that replication occurs once per cell cycle. We show that the human Cdt1 homologue (hCdt1), a nuclear protein, is present only during G(1). After S-phase onset, hCdt1 levels decrease, and it is hardly detected in cells in early S-phase or G(2). hCdt1 can associate with the DNA replication inhibitor Geminin, however these two proteins are mostly expressed at different cell cycle stages. hCdt1 mRNA, in contrast to hCdt1 protein, is expressed in S-phase-arrested cells, and its levels do not change dramatically during a cell cycle, suggesting that proteolytic rather than transcriptional controls ensure the timely accumulation of hCdt1. Consistent with this view, proteasome inhibitors stabilize hCdt1 in S-phase. In contrast, hCdc6/18 levels are constant through most of the cell cycle and are only low for a brief period at the end of mitosis. These results suggest that the presence of active hCdt1 may be crucial for determining when licensing is legitimate in human cells.

Full-sized RanBPM cDNA encodes a protein possessing a long stretch of proline and glutamine within the N-terminal region, comprising a large protein complex

Previously isolated RanBPM, a Ran-binding protein in the microtubule-organizing center, which had been thought to play a role in Ran-stimulated microtubule assembly, turned out to be a truncated protein. To clarify the function of RanBPM, we cloned the full-sized RanBPM cDNA that encodes a 90 kDa protein, compared to the previously isolated cDNA that encoded a 55 kDa protein. The newly cloned 5' coding region contains a great number of cytidine and guanidine nucleotides, like the CpG island. Thus, full-sized RanBPM cDNA encodes a long stretch of proline and glutamine residues in the N-terminal region. It comprises a protein complex of more than 670 kDa. Ran was detected in this complex when RanBPM and Ran were both ectopically expressed. New antibodies to RanBPM were prepared against three different regions of RanBPM. All of them detected a 90 kDa protein that is predominantly localized both in the nucleus and in the cytoplasmic region surrounding the centrosome, but none of them stained the centrosome. In this context, our previous notion that RanBPM is a centrosomal protein should be discarded. RanBPM is well conserved in the animal kingdom. It may play an important role in uncovering Ran-dependent nuclear events.

Status of PACS and technology assessment in Japan

The situation of PACS installations in Japan from 1987 to 1999 has been investigated. By 1999, 751 PACS units have been installed. Of these, 613 are small-size PACS with less than four image display terminals, 96 are medium-size with 5-14 terminals and 42 are large-size with 15 up to 300 terminals. The 42 hospitals with large sized PACS have been retrospectively investigated from 1984 for PACS experiments and from 1989 for PACS operation. Most of these 42 hospitals have increased the number of PACS terminals by installing additional PACS units instead of reinforcing the existing single PACS. Some (23%) PACS installations have obviously not been successful because of low image transfer speed and inadequate image quality. The use of DICOMM interfaces has increased the number of modalities connected to PACS and influenced the spread of PACS installations in Japan. The status of HIS and RIS coupling to PACS and the use of PACS in primary diagnosis or in image referral are discussed. Assessment of PACS is now in a very early stage. Baseline studies of HIS/RIS/PACS effectiveness have been carried out to assess quantitatively the PACS merit. Radiologists' answers to the questionnaire on PACS usage do not fully support the finding that the number of PACS installations is growing in Japan.

Thrombin promotes fibroblast proliferation during the early stages of experimental radiation pneumonitis

Huang, L., Ogushi, F., Tani, K., Ogawa, H., Kawano, T., Endo, T., Izumi, K., Ueno, J., Nishitani, H. and Sone, S. Thrombin Promotes Fibroblast Proliferation during the Early Stages of Experimental Radiation Pneumonitis. Radiat. Res. 156, 45-52 (2001). To clarify the role of thrombin in the pathogenesis of radiation-induced pneumonitis, we measured the thrombin activity and fibroblast growth-inducing activity in bronchoalveolar lavage fluid obtained from the irradiated lungs of rats at 1, 2, 4, 8 and 18 weeks after irradiation. Thrombin activity was not detected in the bronchoalveolar lavage fluid from unirradiated rats, but the bronchoalveolar lavage fluid from irradiated rats showed significantly increased thrombin activity which reached a maximum at 4 weeks after treatment. Higher fibroblast growth-inducing activity was detected in the bronchoalveolar lavage fluid from irradiated rats at 4 and 18 weeks than in fluid from unirradiated rats. Bronchoalveolar lavage fluid from irradiated rats that were pretreated with the thrombin inhibitors antithrombin III and argatroban showed significantly inhibited fibroblast growth-inducing activity and thrombin activity at 4 weeks. However, these thrombin inhibitors did not inhibit fibroblast growth-inducing activity in bronchoalveolar lavage fluid from irradiated rats at 18 weeks. Purified rat thrombin similarly induced proliferation of fibroblasts derived from irradiated and unirradiated rats. These findings suggest that thrombin may play an important role as a fibroblast growth-inducing factor during the early stages of radiation pneumonitis.

Multivariate analysis of regional metabolic differences in normal ageing on localised quantitative proton MR spectroscopy

We performed multivariate analysis of regional differences and normal age-related changes in metabolites in the lentiform nucleus and frontal lobe, as measured by proton MRS. The cerebrospinal fluid (CSF) in the measurement area was estimated and the metabolite concentration adjusted. The concentration of N-acetylaspartate (NAA) in the lentiform nucleus decreased with ageing (F = 4.11, P < 0.01), but that in the frontal lobe did not change (F = 0.93, P = 0.45). This is in marked contrast with pathological dementia, such as Alzheimer's disease. In this multivariate analysis, the normal change in metabolism with ageing differed depending on the cerebral region, suggesting that metabolite concentrations, especially that of NAA may be useful metabolic indices for discriminate normal ageing from pathological dementia.

Evaluation of female intrapelvic tumors by clinical proton MR spectroscopy

We measured metabolites in large tumors of the female pelvis (23 cases total: 6 malignant cases, 17 benign cases) using single-voxel proton magnetic resonance (MR) spectroscopy and evaluated the clinical significance of this method in the differential diagnosis of female pelvic tumors. The characteristically obtained signal was lactate, which was detected not only in all the malignant tumors but also in some of the benign tumors. However, the lactate signals of the malignant tumors tended to form higher peaks than those of benign tumors, which was a finding consistent with the result of the earlier in vitro study reported in ovarian tumors. The signal of choline-containing compounds (Cho) was found only in solid tumors, and the signal intensity varied among different histological types of tumors, possibly reflecting metabolic activity of the cell membrane. We considered that proton MR spectroscopy (MRS) of intrapelvic tumors would be useful for the diagnosis of the nature of female intrapelvic tumors. J. Magn. Reson. Imaging 2001;13:912-917.

Regional magnetic resonance spectroscopy of the brain in autistic individuals

We studied the variations in the concentration of metabolites with brain region and age in autistic individuals and normal controls using multiple analysis of covariance. We examined 55 autistic individuals (2-21 years old, 47 male and eight female) and 51 normal children (3 months-15 years old, 26 boys and 25 girls). Single volumes of interest were placed in the frontal, parietal and temporal region on both sides, the brain stem and cingulate gyrus. The concentration of each metabolite was quantified by the water reference method. The concentration of N-acetylaspartate in the temporal regions (Brodmann's areas 41 and 42) in the autistic individuals were significantly lower than those in the controls (P < 0.05), but concentrations in other regions were not significantly different between the autistic individuals and controls. This suggests low density or dysfunction of neurones in Brodmann's areas 41 and 42 in autistic individual, which might be related to the disturbances of the sensory speech centre (Wernicke's area) in autism.

Localization of human airway trypsin-like protease in the airway: an immunohistochemical study

Human airway trypsin-like protease (HAT) has been isolated from mucoid sputum of patients with chronic airway diseases. In order to clarify the cellular source of this novel protease in the human airway, we examined the localization of immunoreactive HAT in bronchial tissues obtained at surgery and fixed in 4% paraformaldehyde using an extremely sensitive immunohistochemical technique called a catalyzed signal amplification method and a monoclonal antibody against recombinant HAT. HAT immunoreactivity was demonstrated in cytoplasm of ciliated cells of bronchial epithelium and/or at the basal part of cilia. No positive reaction was found in submucosal glands or mast cells. The heterogeneous distribution of HAT immunoreactivity within the bronchial epithelium indicates that its expression might be changeable and that it might be closely related to the physiological status of the airway epithelium. Non-specific but intense reaction caused by endogenous avidin-binding activity (EABA) was selectively detected in submucosal glands, but was effectively blocked by successive treatments with avidin and biotin. These results indicate that HAT may be synthesized in the ciliated cells and that it may play some physiological roles within the epithelial layer and on the airway surface. It is necessary to keep in mind that some cells show strong EABA, especially when a highly sensitive immunohistochemical technique is applied.

Premature chromatin condensation caused by loss of RCC1

Hamster rcc1 mutant, tsBN2, prematurely enter mitosis during S phase. RCC1 is a guanine nucleotide exchanging factor for a small G protein Ran and localised on the chromatin, whereas RanGTPase activating protein is in the cytoplasm. Consistently, Ran shuttles between the nucleus and the cytoplasm, carrying out nucleus-cytosol exchange of macromolecules, which regulates the cell cycle. The finding that loss of RCC1 which disturbs nuclear protein export due to loss of RanGTP, abrogates the check point control suggests that RCC1 senses the status of the chromatin, such as replication, and couples it to the cell cycle progression through Ran.

[Clinical evaluation of the diagnosis of neuronal reversibility with acute cerebral infarction using ADC by diffusion weighted echo planar imaging]

The possibility of diagnosing neuronal reversibility with acute cerebral infarction was studied using ADC measured by diffusion weighted imaging (DWI). The subjects were eleven patients who underwent DWI within 24 hours of onset. The area of abnormal signal on DWI during the acute stage was visually compared with that on T2-WI in the subacute phase. ADC was calculated in the two different abnormal areas on DWI, which were differentiated by the presence or absence of abnormality on T2-WI in the subacute phase. The abnormal signals of three cases showed an obviously narrowed area on DWI in the acute phase compared with the abnormality on T2-WI in the sub-acute phase. ADCs of the ischemic areas in DWI abnormalities that showed no abnormality on subacute T2-WI were slightly higher than those of the infarct areas with remaining abnormal signals on T2-WI. However, no statistically significant difference was found between these two regions, because there were large variations within each pixel. We considered that the diagnosis of neuronal reversibility in acute cerebral infarction was difficult using ADC values only and that other parameters such as perfusion or blood volume will be necessary to improve diagnostic quality prior to determining therapy.

Differences in water diffusion and lactate production in two different types of postinfectious encephalopathy

We compared two different types of postinfectious encephalopathy using magnetic resonance imaging (MRI), including diffusion-weighted images and MR spectroscopy. Acute disseminated encephalomyelitis (ADEM) and acute necrotizing encephalopathy (ANE) showed different distribution of abnormal intensity areas and different diffusion of water measured by diffusion-weighted imaging (DWI). Proton MR spectroscopy (MRS) showed lactate production in both cases, which returned to a normal range; the rate of increased lactate production was much lower in the ANE case. Water diffusion showed a difference in pathophysiological background between the two encephalopathies, but the lactate elevation observed by proton MRS did not correlate with clinical severity.

The Cdt1 protein is required to license DNA for replication in fission yeast

To maintain genome stability in eukaryotic cells, DNA is licensed for replication only after the cell has completed mitosis, ensuring that DNA synthesis (S phase) occurs once every cell cycle. This licensing control is thought to require the protein Cdc6 (Cdc18 in fission yeast) as a mediator for association of minichromosome maintenance (MCM) proteins with chromatin. The control is overridden in fission yeast by overexpressing Cdc18 (ref. 11) which leads to continued DNA synthesis in the absence of mitosis. Other factors acting in this control have been postulated and we have used a re-replication assay to identify Cdt1 (ref. 14) as one such factor. Cdt1 cooperates with Cdc18 to promote DNA replication, interacts with Cdc18, is located in the nucleus, and its concentration peaks as cells finish mitosis and proceed to S phase. Both Cdc18 and Cdt1 are required to load the MCM protein Cdc21 onto chromatin at the end of mitosis and this is necessary to initiate DNA replication. Genes related to Cdt1 have been found in Metazoa and plants (A. Whitaker, I. Roysman and T. Orr-Weaver, personal communication), suggesting that the cooperation of Cdc6/Cdc18 with Cdt1 to load MCM proteins onto chromatin may be a generally conserved feature of DNA licensing in eukaryotes.

Overexpression of wild-type Akt1 promoted insulin-stimulated p70S6 kinase (p70S6K) activity and affected GSK3 beta regulation, but did not promote insulin-stimulated GLUT4 translocation or glucose transport in L6 myotubes

We have developed a simple, direct and sensitive method to detect GLUT4 on the cell surface. Using this system, we found that PI3-kinase plays a key role in the signaling pathway of insulin-stimulated GLUT4 translocation. One of the down stream effectors of PI3-kinase is serine-threonine kinase Akt (protein kinase B, RAK-PK), but the involvement of Akt in insulin-stimulated GLUT4 translocation is controversial. To investigate whether Akt1 regulates insulin-stimulated GLUT4 translocation and glucose uptake in L6 myotubes, we established L6 myotubes stably expressing c-myc epitope-tagged GLUT4 (GLUT4myc) and mouse wild type (WT) Akt1. We found that overexpression of WT Akt1 promoted insulin-stimulated p70S6 kinase (p70S6K) activity and increased the basal activity of GSK3 beta, but did not promote insulin-stimulated GLUT4 translocation or glucose uptake. These data supported the result that Akt is not a main signaling molecule to transmit the signal of insulin-stimulated GLUT4 translocation or glucose uptake from insulin-activated PI3-kinase.

Neuronal impairment of adult moyamoya disease detected by quantified proton MRS and comparison with cerebral perfusion by SPECT with tc-99m HM-PAO: a trial of clinical quantification of metabolites

We evaluated neuronal impairment of adult moyamoya patients by proton magnetic resonance spectroscopy (MRS) and cerebral perfusion scintigraphy. After evaluating two methods for compensating relaxation times, we selected a long TR, short TE sequence to achieve better reproducibility. The cerebral blood flow (CBF) value was measured by scintigraphy following the method of quantification reported in the previous literature. N-acetyl aspartate (NAA) concentrations and CBFs value were decreased statistically (P < 0. 05) compared with those of the age-matched normal controls. However, the decreased rate of NAA concentration was changed more than the CBF value, and no linear correlation was found between the two values. We considered that the NAA concentration was not always correlated with that of the present cerebral perfusion. The NAA concentration showed a more dispersive distribution in patients than in controls, indicating a large individual variation in neuronal impairment. We concluded that proton MRS may provide useful information about neuronal impairment in individual patients. J. Magn. Reson Imaging 1999;10:124-129.

Brain metabolites in the hippocampus-amygdala region and cerebellum in autism: an 1H-MR spectroscopy study

Histological abnormalities of the brain in autism have been investigated extensively. We studied metabolites in the hippocampus-amygdala (HA) region and cerebellum. We examined the right HA region and left cerebellar hemisphere of 27 autistic patients 2-18 years old, 21 boys and 6 girls and 10 normal children 6-14 years old, 4 boys and 6 girls, using the STEAM sequence. This sequence was used to minimise the influence of relaxation times. The N-acetyl aspartate (NAA) concentration was significantly lower (P = 0.042) in autistic patients than in normal children (9.37 and 10.95 mM, respectively). There was no significant difference in other metabolites. The correlation coefficient (r value) of NAA between the HA region and cerebellum was 0.616. The decreased NAA concentration may be due to neuronal hypofunction or immature neurons. The NAA concentration in the HA region and cerebellum may be related, because of neuronal circuits or networks.

Regional left ventricular myocardial contraction abnormalities and asynchrony in patients with hypertrophic cardiomyopathy evaluated by magnetic resonance spatial modulation of magnetization myocardial tagging

Global left ventricular (LV) pump function is generally preserved in patients with hypertrophic cardiomyopathy (HCM). However, it is unknown whether regional myocardial contractility is impaired, especially in nonhypertrophied regions. The purpose of this study was to evaluate regional LV myocardial contraction in patients with HCM using magnetic resonance (MR) spatial modulation of magnetization (SPAMM) myocardial tagging. The study group comprised 20 patients with asymmetric septal hypertrophy (HCM group) and 16 age-matched normal patients (control group), and data were collected using transthoracic M-mode and 2-dimensional echocardiography, and MR SPAMM myocardial tagging. The systolic strain ratio, maximum systolic strain velocity, and time from end-diastole to maximum systolic strain (deltaT) in the anterior, ventricular septal, inferior and lateral regions for 2 LV short-axis sections at the levels of the chordae tendineae and papillary muscles were measured at 50-ms intervals by MR myocardial tagging. The end-diastolic anterior and ventricular septal wall thicknesses and LV mass index were significantly different between the HCM and control groups. The systolic strain ratio for all 4 walls, particularly the anterior and ventricular septal regions, was significantly lower in the HCM group. In the HCM group, the maximum systolic strain velocity was significantly lower and deltaT was significantly shorter for all 4 walls, particularly the anterior and ventricular septal regions. The standard deviation for the deltaT, calculated from the deltaT for the 8 regions of the 2 LV short-axis sections, was significantly greater in the HCM group. In conclusion, regional LV myocardial contraction is impaired in both hypertrophied and nonhypertrophied regions, and systolic LV wall asynchrony occurs in patients with HCM.

Self-organization of microtubule asters induced in Xenopus egg extracts by GTP-bound Ran

The nucleotide exchange activity of RCC1, the only known nucleotide exchange factor for Ran, a Ras-like small guanosine triphosphatase, was required for microtubule aster formation with or without demembranated sperm in Xenopus egg extracts arrested in meiosis II. Consistently, in the RCC1-depleted egg extracts, Ran guanosine triphosphate (RanGTP), but not Ran guanosine diphosphate (RanGDP), induced self-organization of microtubule asters, and the process required the activity of dynein. Thus, Ran was shown to regulate formation of the microtubule network.

Effects of hepatic impairment on the metabolism of fructose and 5-fluorouracil, as studied in fatty liver models using in vivo 31P-MRS and 19F-MRS

The purpose of this study was to observe the effects of hepatic impairment on the metabolism of fructose and 5-fluorouracil (5-FU) in fatty liver models using in vivo 31P-MRS and 19F-MRS and to compare the results. In addition, we compared the results to those of other conventional tests such as laboratory examinations, imaging and pathology. Male SIc:Wistar rats were examined on BEM170/200 (4.7 T, Otsuka Electronics, USA) with 17-mm diameter surface coil. Fatty liver was induced by a choline deficient diet (CD diet) for 2 weeks. 31P-MRS were obtained for 90 min after intravenous (i.v.) injection of 1 g/kg of fructose and 19F-MRS were measured for 100 min after i.v. injection of 100 mg/kg of 5-FU. 1H-MRS and 1H-MRI were also performed. On 31P-MRS, there was no statistical difference in the time course of phosphomonoester (PME), adenosine triphosphate (ATP), and inorganic phosphate (Pi) between CD diet group and control group. On 19F-MRS, we detected high peak of fluoronucleotide (Fnct) and suppressed peak of alpha-fluoro-beta-alanine (FBAL) in CD diet group. We showed the metabolism of fructose and 5-FU by 31P-MRS and 19F-MRS, respectively. There was no difference in fructose metabolism but we observed increased fluoronucleotide and decreased a-fluoro-b-alanine in 5-FU metabolism of fatty liver. We speculate that the effects of hepatic impairment in fatty liver may be more severe on 5-FU metabolism and the increased fluoronucleotide may reflect cell proliferation.

When overexpressed, a novel centrosomal protein, RanBPM, causes ectopic microtubule nucleation similar to gamma-tubulin

A novel human protein with a molecular mass of 55 kD, designated RanBPM, was isolated with the two-hybrid method using Ran as a bait. Mouse and hamster RanBPM possessed a polypeptide identical to the human one. Furthermore, Saccharomyces cerevisiae was found to have a gene, YGL227w, the COOH-terminal half of which is 30% identical to RanBPM. Anti-RanBPM antibodies revealed that RanBPM was localized within the centrosome throughout the cell cycle. Overexpression of RanBPM produced multiple spots which were colocalized with gamma-tubulin and acted as ectopic microtubule nucleation sites, resulting in a reorganization of microtubule network. RanBPM cosedimented with the centrosomal fractions by sucrose- density gradient centrifugation. The formation of microtubule asters was inhibited not only by anti- RanBPM antibodies, but also by nonhydrolyzable GTP-Ran. Indeed, RanBPM specifically interacted with GTP-Ran in two-hybrid assay. The central part of asters stained by anti-RanBPM antibodies or by the mAb to gamma-tubulin was faded by the addition of GTPgammaS-Ran, but not by the addition of anti-RanBPM anti- bodies. These results provide evidence that the Ran-binding protein, RanBPM, is involved in microtubule nucleation, thereby suggesting that Ran regulates the centrosome through RanBPM.

Radiation Complications Following Breast Conserving Therapy

BACKGROUND: Breast conserving therapy is being established as a standard therapeutic procedure for early breast cancer in Japan. However, the indications of radiotherapy and a standardized therapeutic procedure have not been established yet. In this study, complications following radiotherapy were evaluated in patients who had previously undergone breast conserving therapy at Tokushima University Hospital. METHODS From October 1989 to March 1996, 60 women with stage I or II breast cancer underwent radiation therapy after breast conserving surgery, and all patients were followed-up for a median of 27 months. Radiation morbidity scoring of the breast and adjacent organs was performed using the toxity criteria of the Radiation Therapy Oncology Group (RTOG) and European Organization for Research andTreatment of Cancer (EORTC). RESULTS: Only 1 patient developed local recurrence, and no distant metastasisor death was observed. The cause of recurrence in 1 case was considered to be due to extended intraductal component. Although transient dermal reaction was induced by irradiation of the breast, no side effects that may cause cosmetic problems were found. No serious radiation complications were found in the lungs, ribs, heart or other adjacent organs. CONCLUSION: The adverse reactions caused by irradiation does not reduce the merit of combined use of radiation therapy in breast conserving therapy, and therefore, are not the hesitation factor in application of radiotherapy.

Cdc18p can block mitosis by two independent mechanisms

The DNA replication checkpoint is required to maintain the integrity of the genome, inhibiting mitosis until S phase has been successfully completed. The checkpoint preventing premature mitosis in Schizosaccharomyces pombe relies on phosphorylation of the tyrosine-15 residue on cdc2p to prevent its activation and hence mitosis. The cdc18 gene is essential for both generating the DNA replication checkpoint and the initiation of S phase, thus providing a key role for the overall control and coordination of the cell cycle. We show that the C terminus of the protein is capable of both initiating DNA replication and the checkpoint function of cdc18p. The C terminus of cdc18p acts upstream of the DNA replication checkpoint genes rad1, rad3, rad9, rad17, hus1 and cut5 and requires the wee1p/mik1p tyrosine kinases to block mitosis. The N terminus of cdc18p can also block mitosis but does so in the absence of the DNA replication checkpoint genes and the wee1p/mik1p kinases therefore acting downstream of these genes. Because the N terminus of cdc18p associates with cdc2p in vivo, we suggest that by binding the cdc2p/cdc13p mitotic kinase directly, it exerts an effect independently of the normal checkpoint control, probably in an unphysiological manner.

Cdc18 transcription and proteolysis couple S phase to passage through mitosis

In fission yeast, cdc18p plays a critical role in bringing about the onset of S phase. We show that cdc18p expression is subject to a complex sequence of cell cycle controls which ensure that cdc18p levels rise dramatically as cells exit mitosis, before the appearance of CDK activity in G1. We find that transcription of cdc18, together with the transcription of other cdc10p/res1p targets, is first initiated as cells enter mitosis and continues even in cells arrested in mitosis with highly condensed chromatin. However, cdc18p cannot accumulate during mitosis because it is targeted for proteolysis by mitotic cdc2p-protein kinase-mediated phosphorylation. On exit from mitosis, the cdc2p mitotic kinase activity falls, stabilizing cdc18p, which then rapidly accumulates. This combination of mitotic transcription and CDK-mediated proteolysis ensures that progression through mitosis simultaneously prepares cells for DNA replication. During S phase, cdc18 transcription is then switched off, preventing the re-initiation of DNA synthesis until the completion of the next round of mitosis.

Early clinical experience on cone-beam CT

This system is really non-invasive, relatively low in X-ray exposure, and is able to obtain fruitful informations from many directions. Therefore conebeam CT is considered as a suitable modality for the demonstration of high contrasted structures and subsequently provides the beneficial informations to the therapeutic approaches. This system may take place of conventional X-ray tomography if the cost-down becomes feasible.

Dihydropyridine type calcium channel blocker-induced turbid dialysate in patients undergoing peritoneal dialysis

We previously reported that manidipine, a new dihydropyridine type calcium channel blocker, produced chylous peritoneal dialysate being visually indistinguishable from infective peritonitis in 5 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) [Yoshimoto et al. 1993]. To study whether such an adverse drug reaction would also be elicited by other commonly prescribed calcium channel blockers in CAPD patients, we have conducted postal inquiry to 15 collaborating hospitals and an institutional survey in International Medical Center of Japan as to the possible occurrence of calcium channel blocker-associated non-infective, turbid peritoneal dialysate in CAPD patients. Our diagnostic criteria for drug-induced turbidity of dialysate as a) it developed within 48 h after the administration of a newly introduced calcium channel blocker to the therapeutic regimen, b) absence of clinical symptoms of peritoneal inflammation (i.e., pyrexia, abdominal pain, nausea or vomiting), c) the fluid containing normal leukocyte counts and being negative for bacterial and fungal culture of the fluid, and d) it disappeared shortly after the withdrawal of the assumed causative agent. Results showed that 19 out of 251 CAPD patients given one of the calcium channel blockers developed non-infective turbid peritoneal dialysis that fulfilled all the above criteria. Four calcium channel blockers were suspected to be associated with the events: benidipine [2 out of 2 (100%) patients given the drug], manidipine [15 out of 36 (42%) patients], nisoldipine [1 out of 11 (9%) patients] and nifedipine [1 out of 159 (0.6%)] in descending order of frequency. None of the patients who received nicardipine, nilvadipine, nitrendipine, barnidipine and diltiazem (25, 7, 2, 1 and 8 patients, respectively) exhibited turbid dialysate. In conclusion, we consider that certain dihydropyridine type calcium channel blockers would cause turbid peritoneal dialysate being similar to that observed in patients developing infective peritonitis. To avoid unnecessary antibiotic therapy the possibility of this adverse reaction should be ruled out whenever a CAPD patient receiving a dihydropyridine type calcium channel blocker develops turbid dialysate.

Three dimensional solid model reconstruction for neurosurgical approach

Two different types of solid models of neurosurgical pathologies by 3-D reconstruction were presented and examined, and their clinical usefulness was appraised by neurosurgical simulation. Cranial vessel models were proposed by solidifying liquid photopolymer based on 3-D MR angiography data. These models provided total visual and tactile perceptions of the anatomy. Aneurysm model well demonstrated the root of its origin and was useful in preoperative planning. Three dimensional demonstration of arterial angles gave more informations for performing transarterial embolization of aneurysm. This method had advantages in visualising more complicated or minute structures such as cerebral vessels. Intracranial pathologies and the skull base anatomy were demonstrated by milling urethane block based on CT data. These models were useful in deciding the appropriate direction of surgical approach for lesions located in the middle fossa. This method had another advantage to demonstrate the details of anatomical relationships between macroscopic pathologies and surrounding structures. Milled models were useful for the practice of preoperative simulation because urethane was easily processed in comparison with solidified polymer.

[Cone beam CT utilizing a rotational digital radiographic system: early clinical experience on pulmonary and skeletal lesions]

Utilizing a rotational digital radiographic system (SF-VA 100, Hitachi) 289 digital images were obtained during a 360-degree rotation in 4.8 seconds. The images were transferred to a high-speed workstation and post-processed to create volume data in 9 minutes. The multi-planar reconstruction method reconstructed high-quality tomographic images with equal resolution in any direction. We applied this system as a cone beam CT in order to demonstrate pulmonary and spinal lesions. Early clinical experience suggested the usefulness of the method in the evaluation of diseases in organs with high radiographic contrast.

Coronary-pulmonary artery fistulae depicted by multiplanar reconstruction using magnetic resonance imaging

We compared the imaging capability of magnetic resonance angiography (MRA) with that of conventional coronary angiography in a patient with coronary-pulmonary fistulae. Using the latter procedure, it is difficult to measure abnormal tortuous blood vessels in one section. However, the course of blood vessels could be evaluated quite well by rearranging serial cross-sectional MRA images using multiplanar reconstruction (MPR). This procedure allowed us to determine the anatomic positional relationship of these vessels to the peripheral cardiac great vascular system. MPR may detect sites of influx and outflow of abnormal blood vessels.