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This study aimed to report clinical courses of patients who had mild coronavirus disease 2019 (COVID-19), defined as SpOWe conducted a retrospective cohort study in Toyota Regional Medical Center, Toyota, Japan, from August 31, 2021, to September 27, 2021. We included all patients with COVID-19 who were diagnosed at the hospital's family medicine department. Our primary outcome was admission to the hospital due to COVID-19 and secondary outcome was mortality due to COVID-19. We compared those who received casirivimab/imdevimab and those who did not.A total of 104 patients were included, of whom 30 received casirivimab/imdevimab and 74 did not receive casirivimab/imdevimab. The mean age of the patients was 47.8 ± 15.6 (standard deviation {SD}) years, 57 (54.8%) patients were male. During a median follow-up period of 12 days (interquartile range: 10-16 days), 19 (18.3%) patients were admitted to the hospital and none died. Patients who received casirivimab/imdevimab had similar rate to admission (p = 0.87). The hazard ratio (HR) of admission tended to be lower for those who received casirivimab/imdevimab (HR: 0.76, 95% confidence interval {CI}: 0.23-2.49, p-value = 0.65), but not statistically significant compared to those who did not, after adjusting for age, gender, risk factors, including obesity. Our study demonstrated that patients with COVID-19 had similar disease progression rates regardless of casirivimab/imdevimab administration.

Follicular lymphoma (FL) is an indolent lymphoma that often transforms into a high-grade lymphoma, mostly diffuse large B-cell lymphoma. A case of FL suggested to transform into plasmablastic lymphoma is presented. A 59-year-old man was admitted to our hospital because of right lower abdominal pain and vomiting. Computed tomography showed a mass in the ileocecum. Colonoscopy showed a mass with an ulcer in the ascending colon, and surgery was performed. Immunohistochemical staining of the biopsied mass showed infiltrated lymphocytes that were positive for CD38, CD45, CD138, and λ chain, and negative for CD4, CD5, CD8, CD10, CD20, CD56, and κ chain. Flow cytometric analysis of the ascites showed similar results. FISH analyses performed using lymph node biopsy specimens, ascite fluid and pleural effusion fluid identified the presence of an IGH/BCL2 translocation. FL was suggested to transform into PBL. Although the patient received three courses of R-CHOP chemotherapy and salvage chemotherapy, the patient died because of lymphoma progression less than 6 months after the diagnosis of PBL. Transformation of FL to PBL is highly unusual. The lack of a standard treatment for PBL results in the poor outcome of this entity. Novel therapeutic approaches are needed.

Advanced carcinoma of the lower female reproductive tract is rare during pregnancy and the postpartum period. We here present a case of a 32-year-old Japanese woman, whose entire lower reproductive tract had been invaded by carcinomas as of 2 months after childbirth. She had been infertile, and pregnancy had been established by repeated embryo transfer. The gynecological cancer screening, which included Pap smear tests, was negative during the periods she underwent infertility treatment or during the first trimester. At 26 gestational weeks, the patient noticed uterine contractions concomitant with genital bleeding. Labor progressed slowly and steadily; thus, the pregnancy was ended by cesarean section at 29 weeks. At 2 months after childbirth, the patient experienced increased left abdominal pain and underwent a pelvic examination, revealing multiple pelvic masses and diffuse vaginal tumors causing stenosis. Vaginal tumors were biopsied, and histochemical analysis showed undifferentiated carcinoma with possible adenocarcinoma. Imaging modalities including CT, MRI, and PET-CT suggest that the carcinoma had invaded the entire reproductive tract, especially the uterine body, metastasized into the lungs and the ischial bones, and disseminated onto the peritoneum. She received multiple rounds of chemotherapy but died 6 months after childbirth. Taking into consideration the clinical feature and immunohistochemical profiles of the cancer cells, the endometrium is the most likely origin.

Epidermal nevus syndrome (ENS) is a congenital disorder characterized by widespread linear epidermal lesions consisting of epidermal nevus and extracutaneous involvements, especially of the central nervous system and skeletal system. Garcia–Hafner–Happle syndrome, also known as fibroblast growth factor receptor 3 (FGFR3)-ENS, is characterized by a systematized keratinocytic EN of soft and velvety type with neurological abnormalities such as seizures, intellectual impairment, and cortical atrophy. We present a case of a 9-year-old Japanese boy afflicted with Garcia–Hafner–Happle syndrome associated with dwarfism and atopic dermatitis. We show the results of physical examination, DNA analysis, and imaging studies and discuss the mutation underlying the child’s disorder.

Strict restriction of carbohydrates can induce symptomatic ketoacidosis. We herein report a 76-year-old demented woman who developed ketoacidosis after 1 month of abnormal eating behavior involving selectively eating hamburger steak (estimated carbohydrate =12.7 g/day). Laboratory tests showed high-anion-gap metabolic acidosis with elevated blood ketone levels. She was successfully treated with intravenous fluids followed by oral intake of a regular diet. She remained relapse-free after correcting her eating habits. Healthcare providers should know that abnormal eating behavior in demented people can lead to an extremely-low-carbohydrate diet and cause atypical ketoacidosis unexplained by diabetes, heavy alcohol intake, or starvation conditions.

Acute funisitis is characterized by the infiltration of fetal neutrophils from the umbilical vessels into Wharton’s jelly and presents as fetal inflammation. However, no reports about its prenatal diagnosis using ultrasonography have been published. We encountered one case of oligohydramnios at 26 weeks and another case of threatened premature delivery at 27 weeks of gestation with ultrasonographic findings of non-uniform thickening of Wharton’s jelly, a heterogeneous internal echo, and a high echoic line of the umbilical vessel wall. Acute funisitis was diagnosed, and the postpartum histopathological examination revealed severe funisitis in both cases. To our knowledge, this is the first case report of prenatal diagnosis of funisitis determined using ultrasonography. When we find such ultrasonographic features under the circumstances of intrauterine infection, severe funisitis should be included in the differential diagnosis.

A 58-year-old man presented with right-sided chest pain. Radiography and computed tomography showed a pleural effusion in the right chest and a mass in the right hilum. Thoracentesis showed a hemothorax. The carbohydrate antigen (CA) 19-9 level in the pleural effusion was very high, requiring differentiation from malignancy. Positron emission tomography showed no significant fluorodeoxy glucose (FDG) accumulation. Magnetic resonance imaging revealed a cystic lesion. The tumor was resected for both a diagnosis and treatment. A pathological examination demonstrated a bronchogenic cyst. An immunohistochemical study suggested that the cyst was the source of the hemothorax and the high CA19-9 level.

Mantle cell lymphoma (MCL) is a unique subtype of B-cell non-Hodgkin's lymphoma characterized by chromosomal translocation t(11;14)(q13;q32), positive CD5, and nuclear cyclin D1 overexpression with unfavorable prognosis. We report herein a case of MCL in a 73-year-old male diagnosed with diffuse large B-cell lymphoma (ileal tumor) at another hospital, who subsequently relapsed with CD5-negative MCL. At the 1st relapse, he developed neck lymph node swelling, of which biopsy showed proliferation of atypical large pleomorphic cells with CD5-negativity by both immunohistochemistry and flow cytometry. At the 2nd relapse, he again developed an ileal tumor, of which biopsy showed positivity for CD5, CD20, and cyclin D1. In MCL, CD5-negative expression has sometimes been reported as having pleomorphic and blastoid variants. The present case was also histologically the pleomorphic type, but the CD5 expression changed from negative at the onset and the 1st relapse to positive at the 2nd relapse. This is a rare and interesting case because of the different expression of CD5 at all stage. This phenomenon made the diagnosis of MCL difficult.

Green onion and cabbage certified reference materials for the analysis of pesticide residues were issued by the National Metrology Institute of Japan, part of the National Institute of Advanced Industrial Science and Technology. Green onion and cabbage samples were grown so as to contain several kinds of organophosphorus and pyrethroid pesticides, and those were collected from a field in the Kochi Prefecture in Japan. The certification was carried out by using multiple analytical methods to ensure the reliability of analytical results; the values of target pesticides (diazinon, fenitrothion, cypermethrin, etofenprox, and permethrin for green onion and chlorpyrifos, fenitrothion, and permethrin for cabbage) were obtained by isotope dilution mass spectrometry. Certified values of target pesticides were 0.96-13.9 and 2.41-6.9 mg/kg for green onion and cabbage, respectively. These are the first green onion and cabbage powder certified reference materials in which organophosphorus and pyrethroid pesticides are determined.

症例は39歳主婦, 3～4年前より下腹部 (右) に皮下硬結の存在に気づいたが, 何ら自覚症状のないために放置していた。最近, 除々に増大し, 3ヵ月前より自発痛を来したので, 2003年7月17日に当科受診した。既往歴には特記すべきことなく, 家族歴では母が58歳時に脳出血で死亡している。初診時に右下腹部に径8cmと径5cmの2個のドーム状隆起性腫瘤を認め, 表面は淡紅褐色調を呈していたが, 波動は触れなかった。2個の病変部から各々皮膚生検を施行したが, 両者共真皮深層から皮下組織にかけてstoriform patternを示すspindle cellの増殖を認め, 核分裂像も散見され, 特殊染色ではビメンチン, CD34陽性で, C-kit, S-100やNSEは陰性であったことより隆起性皮膚線維肉腫 (DFSP) を考えた。同年8月1日MRIにて子宮部に多発性腫瘍巣が認められたために9月11日に子宮全摘出術を施行, 病理組織学的に子宮筋腫と診断された。9月30日2個の腫瘍部を5cm離して一塊に全摘出し, 下部は筋膜を含めて切除後, メッシュ植皮を行った。その後, イフォオマイドとアドリアマイシンによる化学療法を3クール施行後, 10ヵ月を経過するが, 現在再発はない。

We reported an 86-year-old female who visited out department on Sept. 14, 1998. She was diagnosed with malignant lymphoma which developed in the right inguinal region. She was in good health except for her lymphoma. First, a biopsy was performed after a diagnosis of SCC because of a nonsymptomatic dome-shaped tumor with granulomatous tumor. Histopathology showed that the tumor nest consisted of a clearly delineated proliferation of atypical and pleomophic T cells with multinuclei. After the diagnosis of T cell lymphoma, a wide local excision was carried out on Dec. 8, 1998. However, pulmonary metastasis occurred six weeks after the excision, and she died 10 weeks later of dyspnea. [Skin Cancer (Japan) 2002; 17: 201-204]

A boy in his early teens visited our hospital with chief complaints of hematemesis and tarry stools. Upper gastrointestinal endoscopy identified a hemorrhagic duodenal ulcer, for which hemostasis was performed using a clip. Proton pump inhibitor (PPI) administration diminished the ulcer but relapse occurred after PPI discontinuation. The esophagus showed concentric rings and longitudinal linear furrows considered to be characteristic of eosinophilic esophagitis. Biopsies of the duodenal ulcer and the esophagus revealed marked infiltration of eosinophils, leading to a diagnosis of eosinophilic gastroenteritis with esophageal involvement. Steroid treatment was initiated, and the duodenal ulcer and esophagitis resolved. Endoscopic findings characteristic of eosinophilic esophagitis were key to the diagnosis of eosinophilic gastroenteritis.

© 2016 The Authors. doi: 10.2340/00015555-2387 Journal Compilation © 2016 Acta Dermato-Venereologica. ISSN 0001-5555 Cyclosporine (Cys) is used as an oral therapy for psoriatic patients with moderate to severe eruptions (1). Pseudolymphoma has been reported in psoriatic patients treated with Cys (2), infliximab (3, 4) or adalimumab (4). Cys is an immunosuppressant that acts via binding to the T-cell cytosolic protein, cyclophilin, and several cases of Cys-related T-cell pseudolymphoma have been reported (3, 5). We report here a psoriatic patient who received long-term Cys treatment and developed B-cell pseudolymphoma on his face and ear. After discontinuing Cys treatment, the eruptions rapidly disappeared and did not recur during 18 months of follow-up.

Leiomyosarcomas, occurre in middle age and most common on the extremities, develop as solitary painful or tender intra-or subcutaneous nodules showing a relatively benign biologic course. We reported a 39-y-old female with intracutaneous leiomyosarcoma seen in the left inguinal region. She was in good health. First total resection was done under the diagnosis of infectious atheroma because of painful subcutaneous nodule, but histopathological feature showed that tumor nest consist of a poorly delineated proliferation of spindle-shaped atypical myomatous cells arranged in interlacing fascicle with positive smooth muscle actin stain. Wide local excision was carried out after the diagnosis. No recurrence was noted one year after the excision. [Skin Cancer (Japan) 2001; 16: 128-131]

Nowadays, minimum invasive surgery using intravascular surgical tools is getting greater attention in the medical field. This technique allows us to reduce physical pain and sequelae from patients. For example, a catheter is one of the medical tools which is used in endovascular surgeries. The catheter is frequently used for neurosurgical operations. We propose a new type of force sensor for intravascular neurosurgery. This micro force sensor can be installed in the tip of the catheter. We developed a prototype micro force sensor whose diameter is 1.6 mm and length is 12 mm. Using this micro force sensor, we can measure the contact force between the catheter and blood vessels. This is quite important to reduce the unnecessary contact force between the catheter and blood vessels. In this paper, we show the structure of the micro force sensor and its characteristics, and we also show the results of in vivo experiment.

A soybean certified reference material for pesticide residue analysis was developed by the National Metrology Institute of Japan. Three organophosphorus (diazinon, fenitrothion, chlorphyrifos) and one pyrethroid (permethrin) pesticides were sprayed on soybeans three times before harvest. These soybeans were freeze pulverized, homogenized, bottled, and sterilized by γ-irradiation to prepare the candidate material. Three isotope-dilution mass spectrometric methods that varied in terms of the solvents used for extraction of the target pesticides, the clean-up procedure, and the injection techniques and columns used for quantification via gas chromatography/mass spectrometry were applied to the characterization. Each target pesticide was quantified by two of these analytical methods, and the results were in good agreement. Homogeneity and stability assessment of the material demonstrated that the relative standard uncertainties due to the inhomogeneity and the instability for an expiry date of 55 months were 1.89-4.00% and 6.65-11.5%, respectively. The certified pesticide concentrations with expanded uncertainties (coverage factor k=2, approximate 95% confidence interval) calculated using the results of the characterization and the homogeneity and stability assessment were 21.7 ± 3.2 μg/kg for diazinon, 88 ± 21 μg/kg for fenitrothion, 11.1 ± 3.2 μg/kg for chlorpyrifos, and 20.1 ± 4.3 μg/kg for permethrin (as the sum of the constituent isomers).

Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare neoplasm characterized by an atypical, unique stromal proliferation of the prostate. Two patients consulted our hospital with the complaint of urinary retardation. We performed holmium laser enucleation of the prostate since by digital rectal examination, magnetic resonance imaging and needle biopsy suggested benign prostatic hyperplasia. The pathologic examination of the surgical specimens revealed prostatic STUMP. Urologic and radiologic examinations have revealed no abnormalities after more than 2 years of follow-up.

An apple certified reference material for the analysis of pesticide residues was issued by the National Metrology Institute of Japan. Organophosphorus and pyrethroid pesticides were sprayed on apples, and these were used as raw materials of certified reference material. The harvested apples were cut into small pieces, freeze-dried, pulverized, sieved, placed into 200 brown glass bottles (3g each), and sterilized by γ-irradiation. Stability and homogeneity assessment was performed, and the relative uncertainties due to instability (for an expiry date of 32 months) and inhomogeneity were 10.3-25.0% and 4.0-6.8%, respectively. The characterization was carried out using multiple analytical methods to ensure the reliability of analytical results; the values of target pesticides were obtained by isotope dilution mass spectrometry. Certified values were 2.28 ± 0.82 mg/kg for diazinon, 3.14 ± 0.79 mg/kg for fenitrothion, 1.55 ± 0.81 mg/kg for cypermethrin, and 2.81 ± 0.70 mg/kg for permethrin.

A 70-year-old man was admitted to our hospital because a mass was incidentally found in the body of the pancreas. The mass was suspected to be serous cystadenoma from the findings of abdominal enhanced computed tomography, magnetic resonance imaging and endoscopic ultrasonography. In addition, another solid mass was detected in the pancreatic head on imaging tests. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography showed stenosis both of the main pancreatic duct at the head and bile duct, but the brushing cytology of the bile duct at ERCP showed no malignant cells. However, the findings of several examinations strongly suggested the coexistence of a serous cystadenoma and a pancreatic cancer, therefore we conducted spleen-preserving total pancreatectomy, and the pathological findings of the resected specimen showed serous cystadenoma coexistence with pancreatic adenosquamous carcinoma.

The induction of c-fos and c-myc expression in the pyloric mucosa of 8-week-old F344 male rats after oral administration of the glandular stomach carcinogen, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), or the tumor-promoter, taurocholate, was examined by Northern blotting. MNNG at doses of 5-50 mg/kg body weight dose-dependently induced transient increase of up to 30-fold c-fos expression with a maximum after 30 min, and of 8-fold c-myc expression with a maximum after 3 h. It also induced up to 3-fold increase in S-phase cells in the proliferation zone of the pyloric mucosa after 16 h. Similar effects were observed with sodium taurocholate at doses of 200-800 mg/kg body weight. These results suggest that c-fos and c-myc oncogenes play a role in stomach carcinogenesis.

Establishment of an animal model of stomach carcinogenesis in mice was attempted using N-methyl-N-nitrosourea (MNU) in the drinking water. One hundred and forty-eight male 6-week-old C3H mice were given MNU in their drinking water at a concentration of 120 ppm (group 1), 60 ppm (group 2), 30 ppm (group 3) or 0 ppm (group 4) for 30 weeks. At the end of this time, dose-related induction of adenomatous hyperplasias was found. From weeks 31 to 54 adenocarcinomas developed in a dose-dependent manner in groups 1, 2 and 3. In total, 6 well differentiated and 5 poorly differentiated adenocarcinomas as well as 6 signet ring cell carcinomas arose in 15 stomach cancer-bearing animals in group 1, 4 well differentiated and 2 poorly differentiated adenocarcinomas with one signet ring cell carcinoma in 5 mice of group 2 and one well differentiated adenocarcinoma in group 3. In the forestomach, only one squamous cell carcinoma was found at week 54 in group 1 along with a single well differentiated adenocarcinoma in the duodenum. Thus, MNU in the drinking water selectively induced neoplastic lesions in the glandular stomach epithelium of mice.

Cellular differentiation of gastric cancer cells allows the classification of cell type into surface mucous cell, pyloric gland cell, intestinal absorptive cell and goblet cell types by mucin histochemistry and pepsinogen (Pg) immunohistochemistry. Surface mucous cell differentiation of gastric cancers of each histologic type has previously been detected by the galactose oxidase-Schiff (GOS) reaction although this is not always positive in all cases. Mucus granules of surface mucous cells of normal gastric mucosa show an intense reactivity for SH-9 (monoclonal antibody against CA125-bearing antigenic molecule fragments). Cathepsin E is also expressed in the cytoplasm of surface mucous cells, weakly in absorptive cells of duodenal villi and occasionally in pyloric gland cells. Expression of SH-9 reactive mucin and of cathepsin E were therefore investigated as possible additional markers to distinguish between the gastric cancer cell type in 203 primary stomach cancers. SH-9 reactive mucin was found selectively in GOS positive cancer cells of surface mucous cell type and/or cancer cells unclassified by mucin histochemistry. These latter cells were therefore classified into the surface mucous cell category. Cathepsin E was found mainly in cancer cells of the GOS positive surface mucous cell type and occasionally, in intestinal absorptive and pyloric gland cell types. Galactose oxidase-Schiff, SH-9 and cathepsin E reactive or positive cancer cells were found in 145 (71.4%), 151 (74.4%) and 144 (70.9%), respectively, of the 203 primary stomach cancers investigated.

Previously we reported the majority of lesions induced by bile reflux, in the absence of chemical carcinogens, in the rat remnant stomach to consist primarily of gastric type and secondarily of intestinal type cells, and that they are reversible after diversion of bile reflux. The present study was designed to evaluate changes in proliferative activities in cells of each type under these conditions. The frequency of adenomatous hyperplasia (AH) induced in the gastric stump mucosa by duodenal content reflux after Billroth II partial gastrectomy (BII) increased until the 54th week of the experiment. Roux-en-Y (RY) surgical procedure which prevents duodenal reflux performed at the 24th or 36th week after BII led to a decrease in AH. Cell content of the lesions was analyzed using routine H&E staining, immunohistochemical staining for pepsinogen isoenzyme 1 and histochemical procedures for mucins (paradoxical concanavalin A, galactose oxidase Schiff and sialidase galactose oxidase Schiff reactions) and proliferation in each compartment evaluated by an immunohistochemical method using bromodeoxyuridine (BrdU) and a monoclonal antibody against BrdU. At the 54th week the number of BrdU-labeled cells per normal pyloric column was significantly (P < 0.05) increased to 10.63/pit after the BII operation, while it diminished to 5.23/pit after RY diversion, this being the same level as with the RY procedure alone. AH maintained a high rate of BrdU incorporation at 12.7% after BII operation, which was also significantly reduced (P < 0.01) to 7.0% by the RY surgery. The intestinal type cell showed highest (22.2%), the surface mucous type cell showed the next (16.5%) and the pyloric gland type cell showed lowest (5.2%) BrdU labeling indices after BII operation. All the cell types in AH showed similar proportional decreases in BrdU incorporation after RY diversion. Thus surgical intervention reverses the cell proliferation caused by bile reflux in the gastric stump.

A case of osteosarcoma that metastasized to the mandibular ramus from the femur in a 36-year-old man is presented. The patient was referred to us for the diagnosis and treatment of swelling of the left cheek. Radiologic examination showed a radiolucent lesion containing radiopaque areas within the left mandibular ramus. The patient previously suffered from a femoral small cell osteosarcoma, which was resected 71 months before our first examination. After induction of general anesthesia, a unilateral mandibulectomy and a simultaneous reconstruction using a titanium plate and an artificial condyle were performed. The postoperative course was uneventful, with satisfactory facial appearance and jaw function. The histopathologic features of the mandibular tumor were identical to those of the femoral tumor. Thus the mandibular lesion was diagnosed as a metastatic small cell osteosarcoma. At 27 months after the operation there had been no recurrence.

✓ Brain arteriovenous malformations are considered to originate from a congenital maldevelopment of the brain vessels. Although there have been occasional reports suggesting a familial incidence of these lesions, data for only 10 families have been accumulated in the literature. The authors report on six such cases in three families. This high rate of occurrence of familial cases suggests an involvement of genetic factors.

The synergistic potential of 1-hydroxyanthraquinone (1-HA) on methylazoxymethanol (MAM) acetate-induced carcinogenesis was investigated in rats. A total of 154 inbred ACI/N rats (73 males and 81 females), six weeks old at the start of the experiment, were divided into four groups: group 1 was given i.p. injections of MAM acetate (25 mg/kg body wt), once per week for 2 weeks and then fed the diet containing 1% 1-HA for 42 weeks; group 2 received MAM acetate and was kept on the basal diet alone; group 3 was given 1-HA containing diet alone as for group 1; group 4 was treated as a control. At the termination of the experiment, the carcinogenic effect of MAM acetate and 1-HA in the large bowel or liver exceeded the sum of effects when given alone, indicating that the two chemicals act synergistically in the carcinogenesis of these organs.

We have established a new cell line (C-1509) producing a glycoprotein, CA 54/61 derived from a large cell undifferentiated carcinoma of the lung (LCUCL). A long-term and stable proliferation has been maintained for more than 150 successful passages over a 5-year period. The C-1509 cell population doubling time (DT) was 25-38 h, saturation density was 1.6×105 cells/cm2. The microscopic features of the tumors which were formed in athymic mice by subcutaneous injection of C-1509 cells were histologically similar to the original large cell carcinoma.In culture, the production of the glycoprotein, CA 54/61, increases with cell proliferation and reaches a peak level just before the plateau phase proliferation.

A case of maxillary metastasis from abdominal hepatocellular carcinoma, occurred in a 59-year-old male, is reported in this paper with literature review. In this case, a maxillary gingival mass with occasional bleeding was his chief complaint at reference from his dentist. Biopsy was carried out and the histology revealed maxillary metastasis of the hepatocellular carcinoma. Later, sarcomatous change of the tumor was detected in the specimens taken from the primary site and the metastatic lesions in other parts of the body.

A 33-year-old female patient was admitted to our department with bladder tumor. It was detected by a magnetic resonance imaging (MRI) in an examination for hysteromyoma. She had neither hypertention, gross hematuria nor the classic symptoms of cathecholamine excess during micturition. The diameter of the tumor was 33 mm. Cystoscopic examination showed a submucosal tumor in the left anterior wall of the bladder. Percutaneous needle biopsy was performed. Biopsy specimens revealed as a pheochromocytoma. 131 I-MIBG scintigraphy showed abnormal accumulation in the bladder, and no abnormal accumulation in the other lesion. Endocrinologic examination disclosed increased levels of serum and urinary noradrenalin. On May 18, 2005, partial cystectomy was performed. The catecholamine levels normalized after partial cystectomy. The patient has been followed up for 9 months and shown no recurrence.

We investigated the potential donors from cases without lung procurement in spite of considering procurement as the donor. We reviewed 207 cases considered for lung procurement. Donors were divided into 2 groups according to whether or not their lungs were harvested: 50 did and 157 did not. We investigated their age, gender, donor management periods, blood pressure, heart rate, P/F ratio, PCO2, HCO3, positive end-expiratory pressure (PEEP), respiratory rate, abnormal findings in the chest X-ray, blood chemistries, sputum culture, and intravenous administration of steroid. Univariable or multivariable logistic regression analysis was used to predict lung harvesting by various factors. Univariable logistic regression analysis revealed maximum heart rate (HR) and respiratory rate (RR), maximum, minimum, and average P/F ratio, and abnormal findings in the chest X-ray, to be predictors to perform transplant. The maximum HR and RR of the non-harvest group are higher than those of the harvest group. Multivariable logistic regression analysis revealed average P/F ratio only to be a predictor to transplant. We divided the non-harvest group into 2 groups according to whether or not their P/F ratio was >300: 55 did (P/F 300 group) and 102 did not (P/F 299 group). Between P/F 299 group and the harvest group, univariable logistic regression analysis revealed maximum HR, maximum and minimum RR, maximum PEEP, maximum, minimum, and average P/F ratio, and abnormal findings in the chest X-ray to be predictors to transplant. Maximum HR, PEEP, and maximum and minimum RR of the P/F 299 group are higher than those of the harvest group. Maximum, minimum, and average P/F ratio of the P/F 299 group are lower than those of the harvest group. The average PCO2 of P/F 299 group is higher than that of the harvest group. The rate of abnormal findings in the chest X-ray of the P/F 299 group is higher than that of the harvest group. Multivariable logistic regression analysis revealed average P/F ratio only to be a predictor to transplant. There were no predictors between the P/F 300 group and the harvest group in both univariable and multivariable logistic regression analyses. Furthermore, there were no different factors between the P/F 300 group and the harvest group. Our study showed that 35.5% of the non-harvest group had a P/F ratio of >300 and had no difference compared with the harvest group. Our data suggest that potential donors existed in the non-harvest group and increased the number of lung procurement to 27.3% from 13.0% of all donors.

Although a variety of gene transfer methods to the liver have been designed, there are some problems such as the transfection efficiency and safety. In the present study, we developed a modified method of gene transfer into the liver by infusion of plasmid DNA via the portal vein followed by electroporation. After green fluorescence protein gene transfer, transgene expressions were detected in 24 h, and then maximally at 3 days, and persisted for 3 weeks. Histological analysis revealed that very mild tissue damage was induced in the liver to which electroporation was applied. In the second study, human hepatocyte growth factor (HGF) was more detected in the liver injected with 500 microg of human HGF gene than 100 microg of human HGF gene. However, serum HGF did not increase with 100 or 500 microg of human HGF gene. Moreover, 500 microg of HGF gene transfer into the liver by using this method could achieve the long survival of all dimethylnitrosamine-treated rats and attenuate the fibrous regions in the liver. These results suggest that HGF gene transfer into the liver via the portal vein using electroporation might be one of the useful methods for the treatment of various liver diseases.