[The expression and function of PD-L1 in CD133(+) human liver cancer stem-like cells]

Objective: To investigate the expression of programmed death protein-ligand 1 (PD-L1) in liver cancer stem-like cells (LCSLC) and its effect on the characteristics of tumor stem cells and tumor biological function, to explore the upstream signaling pathway regulating PD-L1 expression in LCSLC and the downstream molecular mechanism of PD-L1 regulating stem cell characteristics, also tumor biological functions. Methods: HepG2 was cultured by sphere-formating method to obtain LCSLC. The expressions of CD133 and other stemness markers were detected by flow cytometry, western blot and real-time quantitative polymerase chain reaction (RT-qPCR) were used to detect the expressions of stemness markers and PD-L1. The biological functions of the LCSLC were tested by cell function assays, to confirm that the LCSLC has the characteristics of tumor stem cells. LCSLC was treated with cell signaling pathway inhibitors to identify relevant upstream signaling pathways mediating PD-L1 expression changes. The expression of PD-L1 in LCSLC was down regulated by small interfering RNA (siRNA), the expression of stem cell markers, tumor biological functions of LCSLC, and the changes of cell signaling pathways were detected. Results: Compared with HepG2 cells, the expression rate of CD133 in LCSLC was upregulated [(92.78±6.91)% and (1.40±1.77)%, P<0.001], the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were also higher than those in HepG2 cells (P<0.05), the number of sphere-formating cells increased on day 7 [(395.30±54.05) and (124.70±19.30), P=0.001], cell migration rate increased [(35.41±6.78)% and (10.89±4.34)%, P=0.006], the number of transmembrane cells increased [(75.77±10.85) and (20.00±7.94), P=0.002], the number of cloned cells increased [(120.00±29.51) and (62.67±16.77), P=0.043]. Cell cycle experiments showed that LCSLC had significantly more cells in the G(0)/G(1) phase than those in HepG2 [(54.89±3.27) and (32.36±1.50), P<0.001]. The tumor formation experiment of mice showed that the weight of transplanted tumor in LCSLC group was (1.32±0.17)g, the volume is (1 779.0±200.2) mm(3), were higher than those of HepG2 cell [(0.31±0.06)g and (645.6±154.9)mm(3), P<0.001]. The expression level of PD-L1 protein in LCSLC was 1.88±0.52 and mRNA expression level was 2.53±0.62, both of which were higher than those of HepG2 cells (P<0.05). The expression levels of phosphorylation signal transduction and transcription activation factor 3 (p-STAT3) and p-Akt in LCSLC were higher than those in HepG2 cells (P<0.05). After the expression of p-STAT3 and p-Akt was down-regulated by inhibitor treatment, the expression of PD-L1 was also down-regulated (P<0.05). In contrast, the expression level of phosphorylated extracellular signal-regulated protein kinase 1/2 (p-ERK1/2) in LCSLC was lower than that in HepG2 cells (P<0.01), there was no significant change in PD-L1 expression after down-regulated by inhibitor treatment (P>0.05). After the expression of PD-L1 was knockdown by siRNA, the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were decreased compared with those of siRNA-negative control (NC) group (P<0.05). The number of sphere-formating cells decreased [(45.33±12.01) and (282.00±29.21), P<0.001], the cell migration rate was lower than that in siRNA-NC group [(20.86±2.74)% and (46.73±15.43)%, P=0.046], the number of transmembrane cells decreased [(39.67±1.53) and (102.70±11.59), P=0.001], the number of cloned cells decreased [(57.67±14.57) and (120.70±15.04), P=0.007], the number of cells in G(0)/G(1) phase decreased [(37.68±2.51) and (57.27±0.92), P<0.001], the number of cells in S phase was more than that in siRNA-NC group [(30.78±0.52) and (15.52±0.83), P<0.001]. Tumor formation in mice showed that the tumor weight of shRNA-PD-L1 group was (0.47±0.12)g, the volume is (761.3±221.4)mm(3), were lower than those of shRNA-NC group [(1.57±0.45)g and (1 829.0±218.3)mm(3), P<0.001]. Meanwhile, the expression levels of p-STAT3 and p-Akt in siRNA-PD-L1 group were decreased (P<0.05), while the expression levels of p-ERK1/2 and β-catenin did not change significantly (P>0.05). Conclusion: Elevated PD-L1 expression in CD133(+) LCSLC is crucial to maintain stemness and promotes the tumor biological function of LCSLC.

[Effect of superfine powder and aqueous extract of Polygonati Rhizoma on rats with natural perimenopausal syndrome]

This study aims to examine the effect of superfine powder and aqueous extract of Polygonati Rhizomaon on natural perimenopausal syndrome in rats and explore the underlying mechanism. To be specific, a total of 60 female SD rats(14-15 months old) with estrous cycle disorder were screened by the vaginal smear and randomized into model control group, β-estradiol 3-benzoate group(0.1 mg·kg~(-1)), superfine powder of Polygonati Rhizoma group(0.25, 0.5 g·kg~(-1)) and aqueous extract of Polygonati Rhizoma group(0.25, 0.5 g·kg~(-1)), and another 10 female SD rats(14-15 months old) were selected as the youth control group. The administration lasted 6 weeks. Then the perimenopausal syndrome-related indexes such as body temperature, microcirculatory blood flow of face and ear, vertigo period, salivary secretion, grip force, and bone strength were determined and open field test was conducted. The immune system-related indexes such as the wet weight and index of thymus and spleen, percentage of T lymphocytes and subgroups in peripheral blood, and hematological indexes were measured. In addition, the ovary-related indexes such as estrous cycle, the wet weight and index of uterus and ovary, ovarian tissue morphology, and cell apoptosis were determined. Moreover, hypothalamus-pituitary-ovary axis(HPO)-related indexes such as serum sex hormone levels, cytochrome P450 family 11 subfamily A member 1(CYP11A1), cytochrome P450 family 19 subfamily A member 1(CYP19A1), and cytochrome P450 family 17 subfamily A member 1(P450 17A1) in ovarian tissue were measured. The results showed that the superfine powder and aqueous extract of Polygonati Rhizoma significantly decreased body temperature(anal, facial and dorsal temperature), microcirculatory blood flow in the ear, and vertigo period, increased salivary secretion, grip force, bone strength, total distance and total speed in the open field test, wet weight and index of thymus and spleen, lymphocyte ratio, CD3~+ level, and CD4~+/CD8~+ ratio, reduced neutrophil number and ratio, estrous cycle disorder ratio, and number of ovarian apoptotic cells, raised wet weight and index of uterus, wet weight of ovary, levels of inhibin B(INHB), estradiol(E_2), anti-müllerian hormone(AMH), and ovarian CYP11A1 and CYP19A1, decreased follicle-stimulating hormone(FSH) and luteinizing hormone(LH) content, and improved ovarian tissue morphology. It is suggested that the superfine powder and aqueous extract of Polygonati Rhizoma can improve the symptoms associated with natural perimenopausal syndrome in rats and enhance ovarian function and immune function. The mechanism is that they regulate HPO axis function by increasing estrogen synthesis.

Thalidomide combined with endoscopy in the treatment of Cronkhite-Canada syndrome: A case report

BACKGROUND

Cronkhite-Canada syndrome (CCS) is a rare non-hereditary disease with a poor prognosis and a mortality rate of up to 55%. Currently, there is no standard treatment for CCS. The department of gastroenterology of our hospital admitted a patient with CCS whose symptoms improved significantly after treatment with thalidomide combined with endoscopy, and there was no obvious adverse reaction during the 2-year follow-up.

CASE SUMMARY

A 47-year-old Chinese man presented with diarrhea for more than 4 mo, accompanied by loss of taste, fatigue, and weight loss. Physical examination demonstrated that the patient’s skin and hands were hyperpigmented, the front edges of the nails of both hands were notably thickened and yellow, and the nails were partially atrophied. Gastrointestinal endoscopy identified a diffuse polypoid bulge, and the patient bore an albumin level of 27.3 g/L. The level of the calcium correction amount was (2.164 mM) which allowed for a comprehensive diagnosis of Cronkhite-Canada syndrome, combined with hypoalbuminemia and hypocalcemia. Thalidomide of 150 mg per day was administered to regulate immunity, and the symptoms were relieved after 1 wk. During the follow-up period, polyps were still found that had not been resolved by thalidomide treatment, and endoscopic therapy was performed. This resulted in further improvement of his condition and no particular discomfort during the 2 years of follow-up.

CONCLUSION

The patient’s symptoms were significantly relieved by thalidomide 2 years after treatment, proposing it as a potential treatment for CCS.

Buddleoside-Rich Chrysanthemum indicum L. Extract has a Beneficial Effect on Metabolic Hypertensive Rats by Inhibiting the Enteric-Origin LPS/TLR4 Pathway

As the number of patients with metabolic hypertension (MH) is increasing, there is an essential require for global measures to prevent and treat MH. Flavonoids such as buddleoside (BUD) from Chrysanthemum indicum L. are the main pharmacological components of cardiovascular activities. Previous studies have suggested that the buddleoside-rich Chrysanthemum indicum L. extract (BUDE) can reduce blood pressure in spontaneously hypertensive rats (SHR). However, its effect on MH and how it works remains to be researched. In this study, it was observed that BUDE could lower blood pressure, improve dyslipidemia, and decrease the level of plasma LPS in MH rats. Moreover, BUDE improved intestinal flora and increased the expression of occludin and claudin-1 in the colon, and improved the pathological injury of the colon. Western bolt and qRT-PCR experiments showed that BUDE could down-regulate TLR4 and MyD88 protein and mRNA expression and inhibit phosphorylation of IKKβ, IκBα and NF-κB p65 in vessels of MH rats. These results showed that BUDE could regulate intestinal flora, improve intestinal barrier function, reduce the production and penetration of LPS, thereby inhibiting the vascular TLR4/MyD88 pathway, improving vascular endothelial function, and ultimately lowering blood pressure in MH rats. This study provides a new mechanism of BUDE against MH by inhibiting the enteric-origin LPS/TLR4 pathway.

Luteolin inhibits the proliferation, adhesion, migration and invasion of choroidal melanoma cells in vitro

Choroidal melanoma is a devastating disease that causes visual loss and a high mortality rate due to metastasis. Luteolin, a potential anticancer compound, is widely found in natural plants. The aim of this study was to evaluate the antiproliferative, antiadhesive, antimigratory and anti-invasive effects of luteolin on choroidal melanoma cells in vitro and to explore its potential mechanism. Cell counting kit-8 (CCK-8) assays, 5-ethynyl-2'-deoxyuridine (EdU) assays, Cell adhesion, migration, and invasion assays were performed to examine the inhibitory effects of luteolin on cell cell viability, proliferation, adhesion, migration and invasion capacities, respectively. Considering the correlation between Matrix metalloenzymes and tumor metastasis, Enzyme-linked immunosorbent assays (ELISAs) were used to assess matrix metalloproteases MMP-2 and MMP-9 secretion. Western blotting was performed to detect p-PI3K P85, Akt, and p-Akt protein expression. The cytoskeletal proteins vimentin were observed with cell immunofluorescence staining. Luteolin can inhibit OCM-1 cell proliferation, migration, invasion and adhesion and C918 cell proliferation, migration, and invasion through the PI3K/Akt signaling pathway. Therefore, Luteolin may have potential as a therapeutic medication for Choroidal melanoma.

Effect of luteolin on apoptosis and vascular endothelial growth factor in human choroidal melanoma cells

AIM

To investigate the effects of luteolin on apoptosis, the cell cycle, and the expression and secretion of vascular endothelial growth factor (VEGF) in human choroidal melanoma cells (C918 and OCM-1).

METHODS

C918 and OCM-1 cells cultured in vitro were treated with various concentrations of luteolin (0, 5, 10, 15 µmol/L). Cell growth was observed with an inverted microscope, and cell cycle arrest was detected by propidium iodide (PI) staining using flow cytometry. Apoptosis was detected by Hoechst33342 staining, and apoptosis rate was determined by Annexin V-FITC/PI experiments using flow cytometry. The expression of apoptosis-related proteins Bcl-2, Bax and VEGF was analyzed using Western blots. The levels of VEGF secreted by the cells into the supernatant was analyzed using ELISA.

RESULTS

After treating with 5 to 15 µmol/L luteolin for 48h, the fusion degree of C918 and OCM-1 cells decreased, and more floating apoptotic cells appeared. Luteolin treatment increased the G0-G1 phase ratio of the C918 and OCM-1 cells, blocked cell cycle progression, and increased the apoptosis rate of the C918 and OCM-1 cells. Western blot showed that luteolin decreased the expression of Bcl-2 and VEGF in the C918 and OCM-1 cells and increased the expression of Bax protein. The ELISA results showed that 10 to 15 µmol/L luteolin decreased the cell secretion of VEGF.

CONCLUSION

Luteolin may induce apoptosis by regulating the levels of apoptosis-related proteins in C918 and OCM-1 cells. Luteolin can induce cell cycle arrest, decrease the expression of VEGF.

Bone marrow mesenchymal stem cells differentiate into intestinal epithelioid cells through the ERK1/2 pathway

BACKGROUND/AIMS

Previous studies have found that the injection of rat bone marrow mesenchymal stem cells (rBMSCs) in a mouse model of acute hepatic failure significantly relieves intestinal damage and endotoxemia. However, the mechanism of this process remains unknown. This study demonstrated the differentiation of rBMSCs into enterocyte-like cells and possible molecular mechanisms for this with the aim of finding a new treatment for intestinal epithelial injury and endotoxemia during liver failure.

MATERIALS AND METHODS

rBMSCs were isolated from rat femurs and tibias. Differentiation was induced by co-culturing rBMSCs with rat intestinal epithelial cells (mIEC-6) using Transwell plates; after three, seven, and ten days of induction, expression of specific differentiation molecules were quantified. To inhibit the activity of the Mitogen-activated protein kinase 1/2 (ERK1/2) signaling pathway, an inhibitor of Mitogen-activated protein kinase kinase 1/2 (MEK1/2) was added to the co-culture medium, and western blot analysis was performed after 36 or 72 h to evaluate the expression of ERK1/2 signaling pathway markers (p-MEK1/2 and p-ERK1/2).

RESULTS

The rBMSCs differentiated into enterocyte-like cells when co-cultured with mIEC-6 cells. Inhibition of ERK1/2 signaling abrogated the activity of MEK1/2, but MEK increased after 72 h, and the epithelioid differentiation of rBMSCs was consistent with the change in MEK expression.

CONCLUSION

rBMSCs differentiate into intestinal epithelium after co-culture with mIEC-6 by regulation of the ERK1/2 signaling pathway. Further research is needed to elucidate the network of mechanisms.

Sequence analysis of CP and HC-Pro genes of Turnip mosaic virus isolates from China

Fourteen isolates of Turnip mosaic virus (TuMV) were obtained from the leaves of diseased cruciferous plants in China. According host tests, the isolates were classified into B-host and BR-host group. The nucleotide sequences of the coat protein (CP) and helper component proteinase (HC-Pro) genes of the isolates were determined. The CP genes consisted of 864 nucleotides encoding a polypeptide of 288 amino acids. The HC-Pro genes comprised 1374 nucleotides encoding a polypeptide of 458 amino acids. The genes CP and HC-Pro of the 14 isolates shared nucleotide sequence identities ranging from 89.2 to 99.5% and 79.1 to 99.9%, respectively. Amino acid sequence identities of CP and HC-Pro proteins ranged from 95.1 to 100% and 94.8 to 99.8%, respectively. Phylogenetic tree based on the CP gene indicated that 13 of the 14 TuMV isolates belonged to the world-B group, while the remaining isolate ZJ1 belonged to the basal-BR group. The phylogenetic tree based on the HC-Pro gene was similar to that of CP gene with the exception of the isolate JX that clustered with the Asian-BR group. Our results were consistent with the previous results demonstrating that a majority of the isolates collected from Brassica spp. belonged to the world-B group.

Plasminogen activator inhibitor-1 in brain tumors: relation to malignancy and necrosis

Tumor necrosis is a common feature of malignant neoplasms. The pathogenesis of tumor necrosis remains poorly documented. Recent evidence has shown a correlation between the presence of tumor necrosis and low content of tissue plasminogen activator in brain tumors and significantly higher levels of plasminogen activator inhibitor-1 (PAI-1) in human glioblastomas. We subjected fresh brain tumor tissue samples (n = 197) to an enzyme-linked immunosorbent assay to determine PAI-1 content. The results were correlated with the presence of edma and necrosis on imaging studies. The samples studied were from normal brain (n = 10), low-grade gliomas (n = 26), meningiomas (n = 47), acoustic neuromas (n = 18), glioblastomas (n = 45), metastases (n = 45), and areas of tumor necrosis (n = 6). The benign tumor samples (n = 96) had 3.5 times less PAI-1 than did the malignant tumors (n = 101). Tumor necrosis samples contained 3.8 times more PAI-1 than did the nonnecrotic malignant tumor samples (P < 0.000001). The benign meningioma samples showed a similar ratio compared with their malignant counterparts (0.35 versus 1.59 ng/mg, respectively, P = 0.0004). Regression analysis results showed a strong correlation between PAI-1 and necrosis (r = 0.47, P < 0.0000028) and, to a lesser extent, brain edema (r = 0.26, P = 0.001). A negative correlation between PAI-1 and tissue plasminogen activator levels almost reached statistical significance (P = 0.07). There was no correlation between PAI-1 content and the tumor size, duration of symptoms, or the sex or age of the patients. The results of this study indicate that malignant transformation is associated with a significant increase in PAlI1 and that PAI-1 may play an integral role in the pathogenesis of tissue necrosis, perhaps via the inhibition of tissue plasminogen activator and the promotion of microthrombosis.

[Computed tomography of the retroperitoneum following nephrectomy for renal cell carcinoma]

CT of the retroperitoneum in 70 patients (98 scans) who had undergone previous nephrectomy for renal cell carcinoma was reviewed. The interval between surgical operation and CT scanning were 15 days-7 years. In 59 cases (84%), CT scans were performed within the first 2 years. After nephrectomy, the emptied renal fossae were filled with adjacent organs, such as colon (27), small intestine (21), liver (14), inferior vena cava (3), adrenal gland (2) on the right side, and spleen (28) small intestine (33), colon (15), tail of pancreas (11), adrenal gland (2) on the left. In 47 cases, where CT scans were done within 4 months after operation, there were abscess/hematoma (8) and soft tissue thickening caused by post-operative edema and or inflammation (6). Most of the early post-operative complications gradually reduced in size in the follow-up scans. Local recurrences or metastases were detected by CT scan in 15 cases, with recurrence at the excision site (5), renal bed (6), adrenal gland (4), retroperitoneal lymph nodes (7) and contralateral kidney (1). 7 patients had solitary lesions and 8 patients had multiple recurrences. In 2 patients, local recurrences were detected by routine follow-up CT scanning. In 4 cases, recurrences were proved by surgery, and the others by clinical follow-up. Local recurrences were assessed within 2 years in 10/15 cases (67%), and 4 cases within 6 months. 9 cases had venous thrombosis (IVC 9, renal vein 3), the size of which was reduced after radiotherapy in 1 case. CT is the most preferred imaging technique in evaluating post-nephrectomy patients for renal cell carcinoma.

[Unusual imaging findings of renal angiomyolipoma with giant pseudoaneurysm and intrarenal perirenal hemorrhage]

Two patients with unusual findings of renal angiomyolipoma (AML) were reported. One had intratumoral giant pseudoaneurysm with mural thrombus and hemorrhage, the other had intrarenal and perirenal hemorrhage, due to vascular malformation, rupture of small aneurysms and pseudoaneurysms within the tumor. Since imaging techniques such as CT, ultrasonography, MRI are being so commonly used, the detectability of renal AML is increased. Understanding of the various composition of renal AML and their accompanied pathology is most helpful in improving the accuracy of imaging diagnoses.

[Comparison between actions of shiquandabu pills and shiquandabu liquor on immunological parameters in mice]

The comparison shows that both Shiquandabu pills and Shiquandabu liquor are efficacious in strengthening the immunological functions of mice. No significant difference has been found between the two forms of preparation. There exists a good dose-efficacy relationship for the pills in immunological functions.

Biological significance of tissue plasminogen activator content in brain tumors

Fresh brain-tumor samples were obtained at operation and analyzed for their content of tissue type plasminogen activator (tPA) using an activity assay (gel chromatography zymogram) and an enzyme-linked immunospecific assay. The specimens were taken from 23 glioblastomas, 35 metastatic tumors, 42 meningiomas, 16 low-grade gliomas, and seven acoustic neurinomas; seven specimens were from normal brain. A strong correlation was found between the results of the two assays (r = 0.77, p less than 0.0001). There was a threefold difference in the tPA content of the benign tumors as compared to malignant tumors (p = 0.0006), the latter having less tPA. Histologically benign meningiomas contained higher tPA than malignant meningiomas (p = 0.01); however, the difference between low-grade gliomas and high-grade gliomas was less evident. Overall regression analysis data have shown an inverse relationship between the tissue content in tPA and the presence and degree of tumor necrosis and peritumoral brain edema (p = 0.004 and p = 0.0004, respectively). This finding was most consistent in the glioblastoma group where the correlation coefficient values were r = 0.53 and r = -0.55, respectively. There was no significant correlation between the tissue tPA content and the age and sex, steroid use, or plasma tPA of the patients or the duration of symptoms. In summary, this is the first demonstration of tPA in a large series of human brain tumors and in normal brain. The differences observed have clear biological significance and, although the source of tPA in tumor tissue is still unknown, a relative reduction in tPA in tumor tissue may play an integral role in the development of tissue necrosis and tissue edema. The lack of tPA in tumor necrosis was not due to tissue destruction and cell death since urokinase was readily detectable in that tissue.

[Image diagnosis of small renal carcinoma--a report of 7 cases]

Seven cases (8 tumors) of small renal carcinoma (less than 3 cm in diameter) proven by pathology were reviewed. It accounted for 7% of patients with renal cell carcinoma during the same period. Sonogram was hypoechogenic in 3 tumors, isoechogenic in 2 and slightly hyperechogenic in 3. Heteroechogenicity was shown in 3 cases and homoechogenicity in 5. None of the margins was sharp. CT scan showed 4 isodense, 1 hypodense and 1 slightly hyperdense masses. After contrast enhancement, increased attenuation to different degrees but still lower than the normal renal parenchyma was observed. The sensitivity of IVP was low because of the small size of the tumor, peripheral location and rare involvement of the renal calyces and pelvis. MRI is helpful in differential diagnosis of hilar adenopathy and small vessels for tumor staging. Yet, the value of MRI for renal masses should be further studied. On cost benefit, sonography and CT are more practical in the diagnosis of renal carcinoma.

[Prognostic factors of primary non-Hodgkin's lymphoma of the stomach--clinicopathologic study of 21 cases]

Clinical, X-ray and pathological materials of 21 cases of primary non-Hodgkin's lymphoma (NHL) of the stomach were reviewed. According to NHL classification--working formulation for clinical usage sponsored by NCI, USA, there were 13 (61.9%) intermediate grade, 6 (28.6%) high grade and 2 (9.5%) low grade malignant lymphomas. By X-ray manifestations, they were classified into 5 types: multinodular type (4 cases), infiltrative (4), ulcerative (3), giant rugal (1) and mixed (9). Clinically, 10 lesions were stage I, 4 stage II, 1 stage III and 4 stage IV, 2 unclassified. The median survivals were 101 months for stage I, 15 months for stage II and less than 6 months for stages III and IV. The 5 and 10 year survival rates were 70% and 40% in stage I patients. The prognosis is related to clinical stage, depth of the tumor infiltration and histology type but not related to the tumor size or X-ray manifestations.

[X-ray features of primary non-squamous cell carcinoma and other malignant neoplasms in the trachea and main bronchi--analysis of 23 cases]

X-ray features of 23 cases (25 foci) of non-squamous cell carcinoma and other malignant neoplasms in the trachea and main bronchi were reviewed. They were 15 (17 foci) adenoid cystic carcinomas, 3 carcinoids, 2 mucoepidermoid carcinomas, 1 well-differentiated adenocarcinoma, leiomyosarcoma and extramedullary plasmocytoma each. The symptoms were non-specific leading to a delayed diagnosis more than one year in 52% of cases. The X-ray findings were classified into 3 types: intraluminal polypoid (11 tumors), sessile mass without and with extraluminal invasion (3 and 11 tumors). These tumors were prone to extraluminal invasion and can be demonstrated by X-ray. The air lumen involved appeared as localized expansion in 3 adenoid cystic carcinomas, 1 of which was proved by operation. Routine chest films were of limited value with 30% false negative chest film, 26% mediastinum mass and 30% obstructive pneumonitis/atelectasis. Lesions of posterior tracheal wall and carina were better revealed by lateral tomography. Of the 10 cases with lateral tomography, images were superior to those of AP tomography in 5. Three cases had CT scan, by which intra-tracheal/bronchial lesions, invasions of mediastinum and regional lymph nodes were shown. CT scan is more accurate compared with the other imaging modalities in visualizing these lesions and more helpful in selecting treatment.

[Malignant fibrous histiocytoma (MFH) of the maxilla--an analysis of 7 cases]

Malignant fibrous histiocytoma is a rare tumor of the soft tissue or bone, especially if located in the head and neck. Up to the present, only 7 cases have been reported (6 in the mandible and only one in the maxilla). From Mar. 1958 to Mar. 1985, 7 patients with maxillary MFH, proved by pathology, were treated in our hospital. The X-ray manifestations were studied and analysed. The main X-ray characteristics are as follows: A large soft tissue mass in the maxilla, extending into the infratemporal fossa, pterygopalatina fossa, orbit, ethmoid sinuses, nasal cavity and cheek. Marked and extensive destruction of the maxilla with some amorphous reactive ossification. The bone appears like melting ice or ground glass. The value of computerized tomography in differential diagnosis and clinical staging of the maxillary malignant fibrous histiocytoma are discussed.

Cranial computed tomography of breast carcinoma

Cranial computed tomographic (CCT) manifestations of brain metastases were reviewed in 304 patients with carcinoma of the breast. Metastases were demonstrated in 103 patients; 13 had other significant abnormalities. Single lesions were found in 55 (54%) patients (cerebral hemisphere, 48; cerebellar hemisphere, 4; pineal, 1; pituitary and optic chiasm, 1; vermis, 1) and multiple metastases were found in 48 patients. Continuity with bony metastases was seen in 4 patients. Prior to contrast infusion, 13 (12.5%) patients with metastases had a normal CCT, and 13 (12.5%) showed lesions of increased attenuation. All metastases demonstrated enhancement following contrast infusion; 74 (72%) had a zone of surrounding "edema." Histopathologic-CCT correlation was available in 54 patients. Precontrast, increased attenuation of metastases was associated with hemorrhage or calcification, or both. Calcification accompanied by necrosis was the result of previous treatment. Following therapy, 3 patients demonstrated lesions that were impossible to differentiate from metastases by CCT, but proved histologically to have no viable tumor cells present.