Influenza-associated encephalopathy has been identified as a new subtype of acute encephalopathy in childhood about 10 years ago. The mortality rate of the encephalopathy is as high as 30% at the time. The researches on the encephalopathy have revealed that the affected children had hypercytokinemia and NF-κB activation in peripheral blood mononuclear cells. Therefore methylprednisolone pulse therapy and intravenous immunoglobulin therapy as anti-proinflammatory cytokine therapies have been recommended as the treatment for the encephalopathy. The mortality rate of the encephalopathy is 10% in recent years. Further researches have demonstrated that the pathophysiology of influenza-associated encephalopathy was not single. Recently, acute encephalopathy with febrile convulsive status epilepticu (AEFCSE) has been identified as a new subtype of influenza-associated encephalopathy. The main pathogenesis of AEFCSE is not hypercytokinemia, and the sequelae rate of this type is high. The question is how to treat for AEFCSE effectively.

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Background: Centrosome is an organelle which forms bipolar spindle pole, and its replication is strictly regulated during cell cycle. Recently, centrosome amplification, defined as three or more centrosomes per cell, has been reported to occur frequently in a variety of malignancies. We investigated the role of centrosome amplification for the prognosis of bladder cancer patients. Materials and Methods: Eight established bladder cancer cell lines were studied to clarify the relation among centrosome amplification, genomic alterations, and cell cycle-related proteins. Additionally, 102 specimens from bladder cancer patients were studied for the clinical significance of centrosome amplification in bladder cancer. To detect centrosome amplification, genomic alterations, and cell cycle-related proteins, immunofluorecent staining using anti-pericentrin antibody, comparative genomic hybridization (CGH) or fluorescence in situ hybridization (FISH) , and immunohistchemical staining were applied, respectively. Results: Basic studies from established cell lines demonstrated that centrosome amplification was defied as cases with more than 5% fraction of cells with three or more centrosomes per cell, and that the centrosome amplification was significantly associated with overexpression of aurora-A kinase protein as well as the copy number gain of its gene loci (20q13. 2) , alterations of chromosome copy number including 7, 9, and 17, and several cell cycle-related proteins including p53, BubR1. Clinical investigations demonstrated the centrosome amplification occurred in 59 cases (57. 8%) , and proved to be an independent prognostic factors for tumor progression (Risk ratio: 3. 12, 95% CI: 1. 36-13. 4, p=0. 0039) for bladder cancer. Conclusion: Centrosome amplification seems to occur through the genetic mechanisms of p53 alterations, or aurora-A overexpression by chromosomal gain of 20q23. 2, and become a potential prognostic marker for the tumor progression in bladder cancer.

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Pro-inflammatory cytokines and nitric oxide (NO) are considered responsible for exacerbating brain injury. Activated microglia produce these potentially cytotoxic factors during neuron destruction. The beneficial effects of hypothermia on neuroprotection are considered to be due, in part, to suppression of post-injury inflammatory factors by microglia. However, the underlying mechanisms remain unclear. In particular, the hypothermia's role in modulating anti-inflammatory cytokines is unknown. We examined whether altering culture temperature modifies microglial production of cytokines and NO. Microglia isolated from neonatal rats were cultured with lipopolysaccharide (LPS) under hypothermic, normothermic, and hyperthermic conditions for 72 h. Compared to normothermia, hypothermia decreased LPS-induced interleukin (IL)-6 production at 6 h of culture. IL-10 production was reduced by hypothermia but augmented by hyperthermia at 24-72 h. NO production was reduced by hypothermia throughout culture. In this study, hypothermia reduced production of IL-6, IL-10, and NO by LPS-activated microglia, suggesting that the neuroprotective effects of hypothermia might involve not only the inhibition of inflammatory factors, but also anti-inflammatory factor (s). Hyperthermia specifically increased IL-10 production in these cells. These temperature-dependent changes in IL-10 production may imply an important clinical marker for this cytokine in hypothermia-related neuronal protection and in hyperthermia-related neuronal injury.

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Cancer surveillance after 1980 has revealed that the incidence of second primary cancers (SPC) is 1.53-8.5% in patients with known malignant lesions and is being increased because of increasing population of elder patients and prolonged survival rate resultant from advanced effective treatment. Detection of SPC is important, since these cancers highly impact treatment algorithms. 2- [¹⁸F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) /CT scan enables systemic survey of malignant tumors and has been expected to be a powerful tool for detecting SPC. The present study analyzed SPC detected by FDG PET/CT scan in 3374 patients who underwent this scan to evaluate known or suspected first primary cancers at our institution. A total of 18 SPC in 17 patients, including 10 synchronous and 8 metachronous cancers in other organs, were detected by FDG PET/CT scan. These cancers were most frequently found in patients with head and neck cancers, and in the lung and stomach. 6 (35.2%) of these cancers were not identified prior to FDG PET/CT scan. 7 (41.1%) of these SPC were operable. FDG PET/CT scan can play an important role for non-invasively detecting SPC in various organs. The knowledge of primary cancers and organs which have a relative high incidence of SPC is important for interpretation of this examination.

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The case of a seventies-years-old woman with malignant gastric lymphoma who developed recurrence 1 year after partial curative resection is described. The patient first presented to our hospital in April 2006 with cervical lymphadenopathy, and lymph node biopsy revealed the diagnosis of follicular lymphoma. PET examination showed accentuated accumulation at multiple sites of the body, therefore, the patient was started on systemic chemotherapy with rituximab, which yielded "complete response". The patient then presented to our hospital again in June 2007 with hematemesis. Partial resection of the stomach was performed, considering the poor general condition of the patient. The patient was discharged 14 days after the surgery. The pathological diagnosis was diffuse B-cell lymphoma of the stomach, however, no additional chemotherapy was administered. Subsequently, the patient was again admitted in June 2008 with melena of sudden onset. Gastrointestinal endoscopy revealed an ulcerative tumor in the lesser curvature of the stomach, below the cardia. Therefore, we performed total gastrectomy with D2 lymph node dissection in July 2008. Pathological examination of the resected tumor revealed the same findings as those in the previous year. The patient then developed widespread recurrence of malignant lymphoma throughout the body and died in September 2008.

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