We report an extremely rare case of hepatocellular carcinoma accompanied by sarcoid reaction in regional lymph nodes. A 67-year-old man with chronic hepatitis C admitted for back pain had serum ...α-fetoprotein elevated to 60ng/ml. Abdominal ultrasonography showed a hyperechoic tumor about 4cm in diameter in segment 5 of the liver. Dynamic bolus computed tomography (CT) showed peripheral enhancement of the tumor, accompanied by enlarged lymph nodes around the common hepatic artery and the inferior vena cava. Hepatic arteriography showed tumor staining, and CT during arterioportography showed a perfusion defect, yielding a diagnosis of hepatocellular carcinoma. Transcatheter arterial embolization (TAE) of the right hepatic artery was conducted, followed by microwave coagulation therapy to the liver tumor with lymph node dissection under laparotomy. Microscopically, biopsy specimens of the liver tumor showed poorly differentiated hepatocellular carcinoma, and dissected lymph nodes involved tumor metastasis including marked epithelioid granulomas.
Osteoclasts are bone-specific multinucleated cells generated by the differentiation of monocyte/macrophage lineage precursors. Regulation of osteoclast differentiation is considered an effective ...therapeutic approach to the treatment of bone-lytic diseases. Periodontitis is an inflammatory disease characterized by extensive bone resorption. In this study, we investigated the effects of sodium fluoride （NaF） on osteoclastogenesis induced by Porphyromonas gingivalis, an important colonizer of the oral cavity that has been implicated in periodontitis. NaF strongly inhibited the P. gingivalis-induced alveolar bone loss. That effect was accompanied by decreased levels of cathepsin K, interleukin （IL）-1β, matrix metalloproteinase 9 （MMP9）, and tartrate-resistant acid phosphatase, which were up-regulated during P. gingivalis-induced osteoclastogenesis. Consistent with the in vivo anti-osteoclastogenic effect, NaF inhibited osteoclast formation caused by the differentiation factor RANKL （receptor activator of nuclear factor KB ligand） and macrophage colony-stimulating factor （M-CSF）. The RANKL-stimulated induction of the transcription factor nuclear factor of activated T cells （NFAT） cl was also abrogated by NaF. Taken together, our data demonstrate that NaF inhibits RANKL-induced osteoclastogenesis by reducing the induction of NFATcl, ultimately leading to the suppressed expression of cathepsin K and MMP9. The in vivo effect of NaF on the inhibition of P. gingivalis-induced osteoclastogenesis strengthens the potential usefulness of NaF for treating periodontal diseases.
Objective: We report the case of a patient in whom arterial spin labeling (ASL) was useful for assessing the effects of treatment for a transverse–sigmoid sinus dural arteriovenous fistula ...(TSS-dAVF).Case Presentation: The patient was a 65-year-old man. Cerebral angiography demonstrated an aggressive dAVF involving the TSS, superior sagittal sinus (SSS), and the sinus confluence, with severe cortical and deep venous reflux. We performed multiple transarterial and transvenous embolizations for the TSS and sinus confluence lesion. The shunt disappeared almost completely after embolization. A high signal intensity that had been apparent in the SSS and straight sinus (StS) on ASL imaging before embolization disappeared after embolization. ASL imaging 3 months after embolization revealed slightly a high signal intensity in the StS, which was considered to be due to recurrence of the lesion. Moreover, recurrence of the confluence and TSS-dAVF was observed on cerebral angiography 6 months after embolization. As additional embolization was considered difficult, radiation therapy was recommended, but the patient refused; therefore, follow-up was performed. As ASL imaging findings were consistent with cerebral angiography findings, careful examination and monitoring of changes on ASL imaging were subsequently performed.Conclusion: Follow-up using ASL imaging is useful to assess the effects of treatment performed for a dAVF.
Purpose: Brain MRI with high spatial resolution allows for a more detailed delineation of multiple sclerosis (MS) lesions. The recently developed deep learning-based reconstruction (DLR) technique ...enables image denoising with sharp edges and reduced artifacts, which improves the image quality of thin-slice 2D MRI. We, therefore, assessed the diagnostic value of 1 mm-slice-thickness 2D T2-weighted imaging (T2WI) with DLR (1 mm T2WI with DLR) compared with conventional MRI for identifying MS lesions.Methods: Conventional MRI (5 mm T2WI, 2D and 3D fluid-attenuated inversion recovery) and 1 mm T2WI with DLR (imaging time: 7 minutes) were performed in 42 MS patients. For lesion detection, two neuroradiologists counted the MS lesions in two reading sessions (conventional MRI interpretation with 5 mm T2WI and MRI interpretations with 1 mm T2WI with DLR). The numbers of lesions per region category (cerebral hemisphere, basal ganglia, brain stem, cerebellar hemisphere) were then compared between the two reading sessions.Results: For the detection of MS lesions by 2 neuroradiologists, the total number of detected MS lesions was significantly higher for MRI interpretation with 1 mm T2WI with DLR than for conventional MRI interpretation with 5 mm T2WI (765 lesions vs. 870 lesions at radiologist A, < 0.05). In particular, of the 33 lesions in the brain stem, radiologist A detected 21 (63.6%) additional lesions by 1 mm T2WI with DLR.Conclusion: Using the DLR technique, whole-brain 1 mm T2WI can be performed in about 7 minutes, which is feasible for routine clinical practice. MRI with 1 mm T2WI with DLR enabled increased MS lesion detection, particularly in the brain stem.
Purpose
It is sometimes difficult to differentiate between high signals originating from a reverse flow on magnetic resonance angiography (MRA) and occult arteriovenous shunting. We attempted to ...determine whether arterial spin labeling (ASL) can be used to discriminate reversal of venous flow from arteriovenous shunting for high-signal venous sinuses on MR angiography.
Methods
Two radiologists evaluated the signals of the venous sinus on MRA and ASL obtained from 364 cases without arteriovenous shunting. In addition, the findings on MRA were compared with those on ASL in an additional 13 patients who had dural arteriovenous fistula (DAVF).
Results
In the 364 cases (728 sides) without arteriovenous shunting, a high signal due to reverse flow in the cavernous sinuses (CS) was observed on 99 sides (13.6%) on MRA and none on ASL. Of these cases, a high signal in the sigmoid sinus, transverse sinus, and internal jugular vein was seen on 3, 3, and 8 sides, respectively. All of these venous sinuses showed a high signal from the reverse flow on MRA images.
Conclusion
ASL is a simple and useful MR imaging sequence for differentiating between reversal of venous flow and CS DAVF. In the sigmoid and transverse sinus, ASL showed false-positives due to the reverse flow from the jugular vein, which may be a limitation of which radiologists should be aware.
We used lipopolysaccharide (LPS) to activate microglia that play an important role in the brain immune system. LPS injected into the rat hippocampus CA1 region activated microglial cells resulting in ...an increased production of interleukin (IL)-1beta and tumor necrosis factor (TNF)-alpha in the hippocampus during the initial stage of treatment. Immunostaining for IL-1beta was increased at 6 hr after LPS injection. IL-1beta-immunopositive cells were co-localized with immunostaining for CD11b. Subacute treatment with LPS by the same route for 5 days caused long-term activation of microglia and induced learning and memory deficits in animals when examined with a step-through passive avoidance test, but histochemical analysis showed that neuronal cell death was not observed under these experimental conditions. The increased expression of the heme oxygenase-1 (HO-1) gene, an oxidative stress maker, was observed. However, the genetic expression of brain-derived neurotrophic factor (BDNF) and its receptor, TrkB, decreased during the course of LPS treatment. We found decreases in 3HMK801 binding in the hippocampus CA1 region by LPS-treatment for 5 days. The data shows that glutamatergic transmission was attenuated in the LPS-treated rats. These results suggest that long-term activation of microglia induced by LPS results in a decrease of glutamatergic transmission that leads to learning and memory deficits without neuronal cell death. The physiologic significance of these findings is discussed.
The options for medical use of signaling molecules as stimulators of tissue regeneration are currently limited. Preclinical evidence suggests that fibroblast growth factor (FGF)-2 can promote ...periodontal regeneration. This study aimed to clarify the activity of FGF-2 in stimulating regeneration of periodontal tissue lost by periodontitis and to evaluate the safety of such stimulation.
We used recombinant human FGF-2 with 3% hydroxypropylcellulose (HPC) as vehicle and conducted a randomized double-blinded controlled trial involving 13 facilities. Subjects comprised 74 patients displaying a 2- or 3-walled vertical bone defect as measured > or = 3 mm apical to the bone crest. Patients were randomly assigned to 4 groups: Group P, given HPC with no FGF-2; Group L, given HPC containing 0.03% FGF-2; Group M, given HPC containing 0.1% FGF-2; and Group H, given HPC containing 0.3% FGF-2. Each patient underwent flap operation during which we administered 200 microL of the appropriate investigational drug to the bone defect. Before and for 36 weeks following administration, patients underwent periodontal tissue inspections and standardized radiography of the region under investigation. As a result, a significant difference (p = 0.021) in rate of increase in alveolar bone height was identified between Group P (23.92%) and Group H (58.62%) at 36 weeks. The linear increase in alveolar bone height at 36 weeks in Group P and H was 0.95 mm and 1.85 mm, respectively (p = 0.132). No serious adverse events attributable to the investigational drug were identified.
Although no statistically significant differences were noted for gains in clinical attachment level and alveolar bone gain for FGF-2 groups versus Group P, the significant difference in rate of increase in alveolar bone height (p = 0.021) between Groups P and H at 36 weeks suggests that some efficacy could be expected from FGF-2 in stimulating regeneration of periodontal tissue in patients with periodontitis.
ClinicalTrials.gov NCT00514657.
The effect of oxygen and additional oxygen providers on furfuryl alcohol polymerization was investigated through chemical analyses and mechanical evaluation. NMR, UV–vis, Fourier transform infrared, ...and gas chromatography–mass spectrometry (GC–MS) results suggested that atmospheric oxygen and the further addition of an oxygen source functioned as an activator for the entire network polymerization. Interestingly, the construction of a conjugated structure on the furan linear chain, which is key to three‐dimensional cross‐linking, also appears to be accelerated in the presence of oxygen. Furthermore, the introduction of oxygen providers into the curing system successfully enhanced the mechanical properties of the cured furan resin.
This paper presents a parameter-free shape optimization method for the strength design of stiffeners on thin-walled structures. The maximum von Mises stress is minimized and subjected to the volume ...constraint. The optimum design problem is formulated as a distributed-parameter shape optimization problem under the assumptions that a stiffener is varied in the in-plane direction and that the thickness is constant. The issue of nondifferentiability, which is inherent in this min-max problem, is avoided by transforming the local measure to a smooth differentiable integral functional by using the Kreisselmeier-Steinhauser function. The shape gradient functions are derived by using the material derivative method and adjoint variable method and are applied to the
H
1
gradient method for shells to determine the optimal free-boundary shapes. By using this method, the smooth optimal stiffener shape can be obtained without any shape design parameterization while minimizing the maximum stress. The validity of this method is verified through two practical design examples.
This paper deals with interface shape optimum design of multi-material structures for the delamination strength problem. The optimum design problem is formulated as a non-parametric shape ...optimization problem in which the interface variation in the normal direction is considered as a design variable. The maximum value of a delamination function, an index of the delamination strength, is defined as an objective function subject to a volume constraint. The shape sensitivity, called shape gradient function, is derived by using the material derivative method and the adjoint variable method, and is applied to the H1 gradient method to determine the optimal interface shape. With this method, the maximum value of the delamination function can be minimized while the smooth optimal interface shape can be obtained without any shape design parametrization. Several interface shape design examples are presented to verify the validity and practical utility of the proposed method.
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