This study investigated the method and clinical value of percutaneous needle biopsy of the thoracic region using a combination of cone-beam computed tomography (CBCT) equipped with a flat panel detector for digital subtraction angiography (DSA) and fluoroscopy. In 77 patients with a total of 79 lesions in the thoracic region (67 in the lung field, 6 in the mediastinum, and 6 in the chest wall), CT-like images of the lesions were acquired by CBCT, and needle biopsy was performed with fluoroscopic guidance. Puncture of the mass via the planned route was possible in all cases, and specimens of a sufficient size for pathological diagnosis could be biopsied. Only slight adjustments of the puncture site and angle were made under fluoroscopy. The final diagnosis of the biopsied specimen was malignant disease in 70 of the 77 patients (90.9%) ; 54 of the 77 patients (70.1%) had primary lung cancer and in 4 of the 77 patients (5.2%) had metastatic tumor. The histological type of the primary lung cancer was adenocarcinoma in 26 of the 77 patients (33.8%), squamous cell carcinoma in 22 of the 77 patients (28.6%), and small cell carcinoma in 6 of the 77 patients (7.8%). Complications occurred in 31 of the 77 patients (40.3%), comprising pneumothorax and pulmonary hemorrhage, but no fatal complications such as air embolism or the dissemination of malignant cells eventuated. In addition, unlike CT-guided biopsy, the described procedure requires only an angiography room. This method enables reliable biopsy using 3-dimensional data, and is a promising percutaneous biopsy method.

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Several cohort studies have reported that green tea extract has potential as a natural anti-tumor medicine. Catechins found in green tea, especially (-)-epigallocatechin-3-gallate (EGCG), are thought to be responsible for most of the anti-tumor activity. In a previous study, a green tea extract inhibited matrix metalloprotease (MMP) activity produced by Langerhans-like cells (ELD-1) to a greater extent than an equivalent amount of EGCG alone, suggesting that other factors might be involved in the inhibition of MMP and angiogenesis. Green tea contains not only EGCG but also various compounds such as theanine, caffeine, sugars and other polyphenols. We hypothesized that one of the other factors involved in MMP inhibition might be theanine. In the present study, we investigated the effects of theanine and EGCG on MMPs using cultured ELD-1 cells. ELD-1 cells treated with theanine did not show decreased MMP-9 mRNA levels but resulted in increased levels of tissue inhibitors of metalloproteinase-1 (TIMP-1) mRNA. To investigate tube formation in vitro, an angiogenesis assay kit of co-cultured human umbilical vein endothelial cells (HUVEC) with fibroblasts was employed. Macroscopically, tube formation with theanine and/or EGCG treatment was detected and an additive inhibitory effect of theanine and EGCG was observed. Our results demonstrated that the additive effect of theanine and EGCG from tea extract on tube formation occurred via MMP-9 and TIMP-1. This may be one of the reasons why green tea has potential as an anti-tumor natural medicine.

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Olfactory dysfunction is common in patients with Parkinson's disease (PD) and has been reported to be caused by early pathological deposition of Lewy bodies and Lewy neuritis in the olfactory areas. However, olfactory function in PD does not have a linear relationship with PD duration and with the level of other symptoms. For predicting disease onset and commencing treatment before classic signs of the disease appear, it is important to know the relationship between the degree of olfactory impairment and the duration of the disease, and between olfactory deficit and aging. In the present study, we tested odor detection acuity and odor recognition acuity in PD patients and age-matched controls to determine the relationship between olfactory test scores and aging in PD. All PD patients were able to detect odors similar to normal subjects, but had difficulty recognizing odor. However, odor recognition was better in younger PD patients. We found a positive correlation between recognition scores and age in PD patients, indicating that odor recognition in PD patients declined with age even if the patients' severity of symptoms remained the same. We have not investigated the relationship between levels of brain activation in the memory-related areas such as the entorhinal cortex and the hippocampus and age during odor recognition in PD patients; however, there might be additional pathological changes, such as olfactory dopaminergic status in the hippocampus, involved in age-related olfactory deficit in PD patients.

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Iron is essential in regulating the proliferation/differentiation of normal and tumor cells. Transferrin receptor 1 (TfR1) and TfR2-alpha are important proteins for iron transport in leukemia cells. However, the regulation of TfRs remains controversial. This study used real-time PCR to evaluate the levels of TfR1 and TfR2-alpha mRNA in samples from various hematological diseases: 76 acute myeloid leukemia, 38 myelodysplastic syndrome, 9 chronic lymphocytic leukemia, 13 chronic myeloid leukemia in the chronic phase, and 6 benign hematological diseases. A positive correlation was observed between the TfR1 and the TfR2-alpha mRNA levels and all conditions. The mRNA levels for both TfRs were low in acute monocytic leukemia (M5) and high in erythroleukemia (M6). These results suggested that TfR mRNA is affected by heme synthesis and the leukemia cell lineage. In contrast, the TfR mRNA levels were both inversely correlated with initial white blood cell counts in acute myeloid leukemia cases. These findings point to a TfR-independent iron mechanism involved in leukemia cell proliferation.

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Leukotriene receptor antagonists (LTRAs) are routinely used to treat bronchial asthma and are thought to act mostly by inhibiting leukotriene receptors. However, there is no preclinical or clinical evidence of the direct effect of LTRAs on histamine release from and leukotriene (LT) C₄ production by basophils. We used anti-IgE antibody (Ab), FMLP, and C5a to induce histamine release, and anti-IgE Ab and FMLP to stimulate LTC₄ production. Basophils were exposed to different concentrations of pranlukast and montelukast, and then to anti-IgE Ab, FMLP, and C5a. Culture supernatant histamine and LTC₄ levels were measured by using a histamine ELISA kit and a LTC₄ EIA kit, respectively. Histamine release was expressed as a percentage of the total histamine content (%HR) induced by anti-IgE Ab, FMLP, or C5a. To evaluate the effects of pranlukast and montelukast on histamine release and LTC₄ production, we calculated the percent inhibition of histamine release and LTC₄ production, expressed as percent inhibition, at different concentrations of pranlukast and montelukast. Pranlukast significantly inhibited histamine release stimulated by FMLP and C5a, but had no effect on histamine release stimulated by anti-IgE Ab. By comparison, montelukast significantly inhibited histamine release stimulated by FMLP, C5a, and anti-IgE Ab, in a concentration-dependent manner. Both pranlukast and montelukast significantly inhibited LTC₄ production stimulated by anti-IgE Ab and FMLP. Together, these findings demonstrate that LTRAs have a direct inhibitory effect against histamine release and LTC₄ production from basophils and provide new insight into the potential clinical application of LTRAs for the treatment of allergic disease.

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In this study, we retrospectively compared the usefulness of cone beam CT (CBCT) with that of digital subtraction angiography (DSA) in the identification of the origin of the cystic artery during arterial embolization for hepatocellular carcinoma. Subjects were sixty-four patients who underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma, in whom both CBCT and DSA were performed. Two radiologists independently examined CBCT and DSA images, and attempted to identify the origin of the cystic artery in each image. For DSA, en face views were reviewed on the monitor. For CBCT, 5 mm thick horizontal sections were generated using Workstation software, and the MPR method was used for coronary sections. These were then investigated with OsiriX. Of the sixty-four patients, the cystic arterial origin could be identified using DSA in 21 (32.8%) and CBCT in 62 (96.8%). The cystic artery was shown to originate in the proper, right, middle, and left hepatic artery in one, 58, two, and one patient, respectively. These results show that CBCT was more useful than DSA for identifying cystic arterial origin. Therefore CBCT should be positively applied during TAE.

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This study used immunohistochemical staining for cytokeratin (CK) 7, 18, 19, 20, hepatocyte paraffin 1 (Hep Par 1), and albumin (Alb) to determine differences in the mechanisms by which hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular carcinoma and cholangiocarcinoma (cHC-CC) arise. The subjects comprised 48 cases with HCC, 23 cases with ICC, and 2 cases with cHC-CC. Differences were evaluated according to marker staining intensities. Microscopic examination revealed that Hep Par 1-negative HCC was more prevalent in the poorly differentiated samples than in the well-differentiated and moderately differentiated cases (P = 0.006 and P = 0.02, respectively). Moreover, CK19-positive HCC was observed at a higher rate for the poorly differentiated types compared to the well-differentiated cases (P = 0.03). Hep Par 1-positive ICC was observed in one case, but no significant difference was observed in the staining intensity for each differentiation type in the ICC cases. These results suggested that Hep Par 1 is an effective indicator of HCC dedifferentiation, CK19 expression could be used as an index of HCC transformation, and Hep Par 1-negative/CK19-positive HCC are most likely to differentiate into biliary epithelial cells. In addition, the results suggested a high probability that some HCC transformed into ICC during the generation of cHC-CC, and that Hep Par 1-positive ICC might represent ICC that is differentiating into hepatocytes.

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