The hyper-vascular form of solitary fibrous tumors (SFTs) is rare and there have been few therapeutic evaluations of this entity. We encountered a hyper-vascular SFT and had difficulty removing it surgically. Following radiotherapy, both tumor size and feeder vessels were reduced and we could proceed with gross total removal. A 29-year-old woman was admitted with a 1-year history of decreasing visual acuity on the right side. Magnetic resonance imaging with gadolinium enhancement showed a homogenous enhancing mass (6x5x5 cm) which expanded the superior and inferior tentorium cerebelli. The tumor was fed by the left posterior cerebral artery, bilateral middle meningeal arteries and the right occipital artery. The first operation employed an occipital transtentorial approach and a highly vascular tumor was found. Tumor resection was limited due to severe bleeding. Histologically, the tumor showed focal hypercellularity with spindle cells and numerous capillaries. Immunohistochemically, the tumor was diffusely positive for CD34 and a diagnosis of SFT, hyper-vascular subtype, was made. After the first operation, local irradiation of a total of 40 Gy was performed. Both the tumor size and vascularity decreased dramatically. At the second operation, gross total removal was able to be performed. Radiotherapy appears effective in reducing the hyper-vascular subtype of SFT and would be one possible therapy to deal with these tumors, given their propensity of excessive bleeding during initial surgery.
Itaconic acid is an important organic acid used in the chemical industry. Aspergillus terreus strain TN-484 is a high-itaconic-acid-productivity mutant derived from strain IFO6365. Here, we report the draft genome sequence of strain TN-484, advancing the understanding of the biosynthesis of itaconic acid in filamentous fungi.
The Ki-67 labeling index and p53 overexpression determined with immunohistochemistry are both useful indicators of the cellular proliferative potential of brain tumors. We compared the immunohistochemical expression of Ki-67 and p53 proteins in samples of 20 astrocytomas obtained from 19 patients which had been pretreated with three different methods of antigen activation: 95°C heating, 121°C autoclaving, and exposure to target unmasking fluid. The Ki-67 labeling index of specimens pretreated with autoclaving and 95°C heating was positively correlated with the degree of malignancy of astro-cytomas (simple regression analysis, p<0.002 for autoclaving and p<0.03 for 95°C heating) . p53 overexpression was identified in 7 astrocytomas (2 cases of low-grade astrocytomas, 2 cases of anaplastic astrocytomas, and 3 cases of glioblastoma multif ormes) ; however, p53 expression was not correlated with the degree of malignancy of astrocytomas.
OBJECTIVE AND IMPORTANCE We describe the case of an epidural arteriovenous fistula (AVF) in the cervical spine draining only into the epidural and paravertebral plexus. An entirely epidural AVF having such drainage is extremely rare. CLINICAL PRESENTATION A 24-year-old man presented with a 4-month history of gradually progressive sensory and motor disturbances of the upper and lower extremities. Magnetic resonance imaging and magnetic resonance angiography revealed a peridural vascular lesion within the canal compressing the spinal cord from C5 to T2. Diagnostic angiography revealed a perimedullary and/or dural high-flow AVF, fed mainly by branches of ascending cervical and deep cervical arteries. The fistula drained into the epidural and paravertebral venous plexus without reflux into intradural venous systems. INTERVENTION Multiple feeders of the AVF were embolized with a Liquid coil and n-butylcyanoacrylate via a two-step procedure. One week after embolization, the AVF was surgically removed. CONCLUSION Interesting points of this case were the exclusively epidural location of the lesion, the exclusively epidural drainage of the AVF, and the etiology of the symptoms. Venous drainage of the fistula had no relation to any dural or intradural veins. Initially, spinal cord and nerve root compression by extradural veins with varicose dilation seemed to cause the radiculopathy and/or the myelopathy, and subsequent myelopathy caused by spinal venous hypertension was believed to be the main etiology in this case.
Thirty rabbits were injected with 0.7mg/kg of sodium arachidonate into the right carotid artery to produce intravascular aggregation of platelets. Cerebral surface was observed through the skull window, and blood pressure, respiration, electrocardiogram and electroencephalogram were recorded continuously, platelet count and volume were studied before, immediately, 10, 30 and 60 minutes after the injection. Evans blue was injected 10 minutes after the injection. One hour after, animals were perfused with formaldehyde or glutaraldehyde solution for light or scanning electron microscopic examination. Shortly after the injection, white thrombi were noticed in the vessels. Prominent blue staining of the brain were observed on the injected side. Histologically, extravasation of plasma substances from arteries, thick wall with convoluted internal elastic lamina and degeneration of the vascular walls were noticed on the injected side. The scanning electron micrograms showed disarrangement of arterial endothelial lining associated with remarkable platelet adhesion. The result suggests that intravascular aggregation of platelets produced not only the simple obstruction but constriction and damage of the cerebral arteries. The result suggests the paticipation of potent platelet aggregating and vasoconstricting substances, prostaglandin endoperoxides, thromboxane A2 and serotonin released from the activated platelets in the genesis of cerebral insufficiency.
We conducted an open-label, randomized controlled trial evaluating the appropriate treatment duration of leuprorelin acetate 3-month depot, TAP-144-SR (3M), administered postsurgically every 3 months for 2 years versus 3 or more (up to 5) years, in combination with tamoxifen, for 5 years in premenopausal endocrine-responsive breast cancer patients and reported similar survival benefit in the two treatment groups. We hereby present patient-reported quality of life (QOL) data obtained from this trial. Three self-administered QOL questionnaires (QOL-ACD, QOL-ACD-B, FACT-ES subscale) were used, and the difference in QOL score changes between the two groups was analyzed using a mixed-effects model for repeated measures. Eligible patients (N = 222) were randomly assigned to a 2-year (2YG, N = 112) or 3-or-more-year treatment group (3YG, N = 110). The time courses of the three QOL scores during the trial period were similar in the two groups. The mean changes in the QOL scores from week 96 were largely stable through week 240 in the 3YG, but showed significantly greater improvement in the score changes from week 96 in the 2YG than the 3YG. Symptoms associated with menopause such as hot flashes and sweating contributed to these results. Menstruation recovery was associated with significantly greater improvement of these symptoms in the 2YG than the 3YG. Patient-reported menopause-associated symptoms and QOL improved after discontinuation of the LH-RH agonist administration and menstruation recovery. QOL information should be a consideration in long-term treatment.
Indication and limits of TCD for diagnosis and treatment were evaluated in 20 normal subjects and 15 patients with arteriovenous malformations 5 (AVM), Blood flow velocity of AVM supplying arteries (feeders), namely the middle cerebral artery and others were measured, and pulsatility index (PI) and resistance index (R) were calculated. To see pCO2 reactivity, hyperventilation was perfarmed (deep breath, twice/5s for 30s) .In patients, flow velocity increased remarkably and both of PI and R decreased significantly. Reactivity against hypocapnia also showed significant decrease. These changes varied according to the relationship between the artery and the nidus, and cases were divided into three groups, namely: main (Group A), partial (Group B) and poor (Group C) angioma supplying arteries. Significant changes were seen in Group A.Postoperatively, these changes recovered to the normal range. After removal of the AVM, flow velocity and vascular reactivity were closely related with the condition of the brain tissue which surrounded the nidus before the removal. NPPB tends to occur in such areas especially in Group A.As a conclusion, characteristic changes were recognized in hemodynamics and pCO2 reactivity of feeders, especially on mainly angioma supplying arteries. In such cases, care should be taken to guard against the normal perfusion pressure breakthrough phenomenon during and after surgery.
Itaconic acid is an important organic acid used in the chemical industry. Aspergillus terreus strain IFO6365 is one of the highest-yielding itaconic acid-producing wild-type strains. Here, we report the draft genome sequence of IFO6365, enhancing the understanding of the role and biosynthesis of itaconic acid in this fungus.
