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Objective: This study aimed to elucidate the therapeutic effects of intra-articular administration of ultra-purified low endotoxin alginate (UPLE-alginate) on osteoarthritis (OA) using a canine anterior cruciate ligament transection (ACLT) model. Design: We used 20 beagle dogs. ACLT was performed on the left knee of each dog and a sham operation was performed on the right knee as a control. All animals were randomly divided into the control (saline) and therapeutic (UPLE-alginate) groups. Animals in the control and therapeutic groups received weekly injections with 0.7 mL normal saline or 0.7 mL 0.5% UPLE-alginate, respectively, from 0 to 3 weeks after ACLT or sham operation. At 9 weeks after ACLT, the knee joints of all animals were observed using arthroscopy. All animals were euthanized at 14 weeks after ACLT and evaluated using morphologic assessment, histologic assessment, and biomechanical testing. Results: Arthroscopic findings showed intact cartilage surface in both groups. Morphologic findings in the therapeutic group showed milder degeneration compared with those of the control group, but there were no significant differences between groups. Histologic scores of the medial femoral condyle (MFC) and lateral femoral condyle (LFC) were better in the therapeutic group than the control group (MFC: p = 0.009, LFC: p = 0.009). Joint lubrication did not differ significantly between groups. Conclusion: Intra-articular administration of UPLE-alginate in the early stage of OA slowed disease progression in canines. UPLE-alginate may have potential as a therapeutic agent for OA patients and reduce the number of patients who need to undergo total joint arthroplasty. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 3441–3448, 2015.

Aneurysm or pseudoaneurysm formation in the aortic patch containing the intercostal or visceral arteries is an unusual late complication after thoracoabdominal aortic surgery. We report the case of a 58-year-old woman who had previously undergone thoracoabdominal aortic replacement (Crawford extent II) for dissecting aneurysm. About 12 months after the operation repeated pseudoaneurysmal degenerations occurred at the intercostal or visceral artery reattachment site. They were repaired with open surgery or endovascular stent-graft. The patient recovered without major complications, and computed tomographic scans showed no recurrence of aneurysm or pseudoaneurysm at the sites of repair 1 year after the procedure.

Objective: We have developed an ultrapurified low endotoxin alginate (UPLE alginate), which can drastically reduce endotoxin levels. Our purposes were to examine the effects of UPLE alginate administration on osteoarthritis (OA) progression and to determine the adequate molecular weight of the UPLE alginate for therapeutic effects. Design: To induce knee OA, 35 Japanese White rabbits underwent anterior cruciate ligament transection. Intra-articular injections of 0.3 mL solution of each material were started at 4 weeks postoperatively for a total of 5 weekly injections. Seventy knees were divided into the following groups: AL430 (430 kDa molecular weight UPLE alginate), AL1000 (1,000 kDa), AL1700 (1,700 kDa), HA (hyaluronan), and NS (normal saline). At 9 weeks postoperatively, all knees were assessed macroscopically, histologically, and mechanically. Results: Macroscopically, the UPLE alginate groups exhibited milder cartilage degradation compared to that of the NS and HA groups. Histological findings of the UPLE alginate groups showed an obvious reduction in the severity of OA. The histological scores of Kikuchi et al. were superior in the alginate treatment groups compared to the NS group. The friction coefficient of the AL1000 group was significantly lower than that of the NS and HA groups. Conclusion: This study indicates that our UPLE alginates, especially AL1000, have promising potential as an effective agent in preventing OA progression.

74歳女性，両側性乳腺アポクリン癌の症例を経験した．右C領域に1.8cmの腫瘤を認め，穿刺吸引細胞診にて悪性であったため，右乳房円状部分切除術+センチネルリンパ節生検を施行した．病理所見は非浸潤性アポクリン癌で，リンパ節転移なし，ER(－)PgR(－)，HER2:3+であった．右乳癌手術1年後の超音波検査にて左CA領域に低エコー腫瘤影を認め，針生検にてアポクリン癌と推定した．MRIにて乳管内進展像をみとめ，左単純乳房切除術+センチネルリンパ節生検を施行した．病理結果はアポクリン癌，リンパ節転移なし，ER(－)PgR(－)，HER2:1+であった．術後9カ月経過するが再発は認めていない．乳腺アポクリン癌は比較的まれな疾患であるが，われわれの調べる限り両側性の報告は本症例が2例目であり，きわめて稀少なものと思われた．

Purpose: To investigate the feasibility of 3-dimensional rotational digital subtraction angiography (3D DSA) and the creation of virtual angioscopic images from its data before and after endovascular treatment. Technique: Data sets from 3D DSA studies were used to create intraluminal images simulating angioscopy for 36 patients with arterial stenosis, aneurysm, or endoleak after stent-graft deployment. A biplanar DSA unit was used to acquire rotational angiography data, which was then processed with a surface-rendering technique to create maximum intensity projections, shaded surface displays, multiplanar reconstructions, and virtual angioscopy. 3D reconstructions were created in 2 minutes after angiography and provided realistic views adequate for vessel measurement, morphology assessment, and endoleak evaluation. Conclusions: 3D DSA and virtual angioscopy are novel techniques that have been successful in recreating images of blood vessels immediately after angiography. These techniques could be useful as additional imaging modalities to complement computed tomography or magnetic resonance imaging in the evaluation of vascular diseases after endovascular therapy.

We report herein a 5-year survivor after the resection of peritoneal metastases from pedunculated hepatocellular carcinoma (HCC). A 42-year-old man underwent lateral segmentectomy of the liver, with a diagnosis of pedunculated HCC, on October 10, 1994. The lesion was associated with intratumoral hemorrhage and was covered by the greater omentum, but there were no peritoneal metastases. The patient was readmitted to our hospital 4 months later with right upper quadrant pain. His serum alpha-fetoprotein level was 3ng/dl. Hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (HCV-Ab) were both negative. Abdominal computed tomography (CT) revealed two nodular lesions in the right upper abdominal cavity. He was diagnosed with peritoneal metastases from HCC. Because there were no other distant metastases, laparotomy was performed to resect these tumors. We found two other tumors, located in the mesentery of the appendix and ileum. All four tumors were resected by partial transverse colectomy and appendectomy. The histopathology of the tumors showed poorly differentiated HCC (Edmondson-Steiner's grade III). The patient has been doing well without recurrent disease for more than 5 years after the second operation. The prognosis of patients with pedunculated HCC is poor. Furthermore, resection for peritoneal metastases from HCC is rare because of the presence of multiple seeding in the abdominal cavity and distant organ metastases. To our knowledge, our patient is the longest survivor after resection of peritoneal metastases from pedunculated HCC.

OBJECTIVE To evaluate the estrogenic effect of tamoxifen (TAM) therapy in postmenopausal women. STUDY DESIGN The subjects were 26 postmenopausal women. The maturation index (MI), maturation value (MV) and karyopyknotic index (KPI) were evaluated based on hormonal cytology. Endometrial cytologic examinations and transvaginal ultrasonography were also performed. RESULTS Of the 26 patients, 16 had low estrogenic activity from the viewpoint of hormonal cytology before TAM administration. During administration, their mean MV rose significantly, from 25.8 +/- 17.7 to 68.8 +/- 13.2, (mean +/- SD) and their mean KPI rose from 9.0 +/- 8.3 to 47.1 +/- 23.1. In contrast, among the 10 patients with high estrogenic activity, mean MV and KPI decreased from 62.9 +/- 8.4 and 27.2 +/- 16.9 to 58.4 +/- 7.7 and 17.7 +/- 16.1, respectively, with TAM administration. Mean endometrial thickness increased more significantly with TAM administration in the low estrogenic activity group than in the high estrogenic activity group. CONCLUSION TAM had a reciprocal effect; no additional estrogenic effect was seen in patients with high estrogenic activity. Conversely, an estrogenic effect was seen in those with low estrogenic activity. An individualized gynecologic evaluation based on hormonal cytology is useful in selecting patients who will be more susceptible to TAM-induced endometrial abnormality.

Breath-hold 2D phase-contrast (PC) cine MR angiography with a phased-array coil and 2D time-of-flight (TOF) MR angiography were performed in the renal arteries and their findings were compared. Breath-hold 2D thin slice PC and TOF MR angiography were performed in 10 normal volunteers for renal arteries. A PC technique with k-space segmentation was utilized with the phased-array coil. A PC technique provided visualization of the renal artery more distally than a TOF technique (4.8 +/- 0.5 cm vs. 3.7 +/- 0.8 cm). With cardiac triggering, distal renal arteries were well demonstrated in PC MR angiography. On PC images, up- or downward movements of the mid to distal renal arteries with aortic pulsatility were recognized. The quality of the images was better with the PC than with the TOF technique (3.4 vs. 2.7). The mid to distal portions of the renal arteries translationally move with aortic pulsatility. To consistently visualize and evaluate them on MR angiography, cardiac triggering might be required to reduce the effects of pulsatile motions of the renal artery in the use of a phased-array coil.

1984～1993年の10年間に香川医科大学附属病院で治療された子宮体癌68例中, 術中腹膜細胞診施行例は47例であり, うち5例 (10.6%) が陽性であった. これを臨床進行期1期のみについてみると, 腹膜細胞診陽性例は41例中4例 (9.8%) であった. ただし, この中には手術進行期分類IIIの1例が含まれていた. 腹膜細胞診陽性例は, 腺扁平上皮癌, 未分化腺癌や推計学的有意差はなかったものの子宮筋層浸潤の深いものとの関連が示唆された. 腹膜細胞診陽性5例中1例は, 細胞形態学的に悪性細胞と判別できたものの子宮体癌由来と診断することは難しい細胞像を呈していた.術前に子宮鏡診を施行した46例中, わずか4例のみが腹膜細胞診陽性であった.

The purpose of this article is to determine the effectiveness of MRI for visualizing spiculated breast cancer lesions that were previously identified using mammography and to compare the diagnostic quality of 3- and 1.5-T dynamic MRI by assessing the visualization of spiculation in such lesions.One hundred twenty MRI studies of breast cancers clearly identified as spiculated masses using mammography (71 MRI studies at 3 T that included both bilateral axial and unilateral sagittal images and 49 MRI studies at 1.5 T that included bilateral axial images only) were independently reviewed by three radiologists. The three different radiologists scored the visualization of the spiculation with respect to 3-T sagittal, 3-T axial, or 1.5-T axial images.The diagnostic quality of sagittal 3-T dynamic MRI studies, as determined by assessing the visualization of spiculation, was significantly better than that of axial 3-T (p = 0.009) and 1.5-T (p = 0.004) studies. For small (1 cm) lesions, the diagnostic quality of sagittal 3-T studies determined by assessing the visualization of spiculation was significantly better than that of axial 1.5-T studies (p = 0.029).Unilateral sagittal in-plane and through-plane high-spatial-resolution 3-T images can offer particularly higher spatial resolution for improved assessment of spiculation than do axial in-plane high-spatial-resolution images obtained at 1.5 and 3 T.

Ytterbium (Yb) doped glass is expected as next generation high-performance solid laser material. However, the laser glasses have a problem that the ions-doping-concentration is much lower than crystals. In this study, we make highly-doped Ytterbium-ions glasses (YbF 3 -BaF 2 -AlF 3 -GeO 2 , YbBAG), and succeeded laser oscillations of 20 mol.% Ytterbium-ions glass. The highly-doped Ytterbium-ions glasses are much suitable for short-fiber or waveguide lasers.

われわれは1984年から1992年に香川医科大学産婦人科において経験した原発性外陰癌22例についてその擦過細胞診所見を検討し, 有用性について考察した.組織i型は, 扁平上皮癌14例, 腺癌3例, 乳房外Paget病5例であった.病変擦過細胞診を採取したものは20例であり, 外陰癌全体での細胞診陽性率は75.0%(15/20), 疑陽性を加えると90.0%(18/20) であった.組織型別にみた細胞診陽性率は, 腺癌では33.3%(1/3) と低いものの, 扁平上皮癌では84.6%(11/13), 乳房外Paget病でも75.0%(3/4) と高い陽性率を示した.擦過方法別では, ヘラで83.3%(10/12), 綿棒で62.5%(5/8) と, ヘラの方が綿棒に比べ採取細胞数が多く, 陽性率がやや高い傾向にあった.外陰癌における擦過細胞診は従来いわれているより陽性率が高く, 補助的診断法として有用であると考えられた.

We report here a case of an unusual extrahepatic portosystemic venous shunt in a 37-year-old woman without liver cirrhosis or portal hypertension, who developed portal systemic encephalopathy. Angiography demonstrated an inferior mesenteric-caval shunt characterized by the presence of direct communication of the inferior mesenteric vein with the left internal iliac vein. After the treatment with percutaneous transcatheter embolization of the shunt via a femoral vein approach using coils, she had no episode of portal systemic encephalopathy.

Purpose Right-to-left shunts of pulmonary arteriovenous malformation (PAVM) can be detected and measured by pulmonary perfusion scans using Tc-99m MAA. In PAVM with a relatively small right-to-left shunt, however, measurement of the shunt ratio may not be reliable. This study re-evaluated pulmonary perfusion scans for a small right-to-left shunt of PAVM. Methods Tc-99m MAA lung scans were performed in five patients with proved PAVM before and after percutaneous transcatheter embolization. The right-to-left shunt ratio was calculated and extrapulmonary uptake was assessed on total-body images. Results Lung perfusion scans obtained before embolization revealed brain uptake in four patients, and the shunt ratio ranged from 4.4% to 22.9%. In two patients with a small single PAVM, the shunt ratio was less than 15% before treatment and did not change significantly after successful embolotherapy. The brain uptake, which had been clearly visible before therapy, disappeared after embolization. Renal uptake was seen on pre- and post-therapy scans. Conclusions Changes in brain activity visible on Tc-99m MAA scans might be a more reliable sign than a decreased shunt ratio or a change in renal uptake when evaluating embolization therapy in patients with PAVM who have a small right-to-left shunt.

Microwave coagulation therapy (MCT) is one of the treatment modalities for patients with hepatocellular carcinoma (HCC). A 67-year-old man with liver cirrhosis underwent MCT during a laparotomy for a deeply located HCC (2.5 cm in diameter) at the border of the anterior and posterior segments of the right hepatic lobe. Two weeks after MCT, he complained of abdominal fullness. Portal vein thrombosis (PVT) was diagnosed because he had massive ascites and an echogenic mass in the portal vein on abdominal ultrasonography. PVT was successfully treated by fibrinolytic therapy with a selective infusion of urokinase via the superior mesenteric artery (SMA). There have been few reports on PVT as a complication of MCT. Attention should be paid to the possible occurrence of PVT as a critical complication after MCT for liver tumors adjacent to the portal vein. Fibrinolytic therapy via the SMA is thus considered to be an effective approach for PVT after MCT.