BACKGROUND In recent years, the incidence of carcinomatous meningitis (CM) in lung adenocarcinoma has been rising. However, it remains unclear which treatment strategies improve the outcome of these patients. PATIENTS AND METHODS We retrospectively reviewed data for 67 lung adenocarcinoma patients diagnosed with CM between September 2002 and March 2011 in order to identify factors which would improve prognosis. RESULTS In multivariate analysis, the female gender, a good performance status (PS) 0-2 and the mutant epidermal growth factor receptor (EGFR) gene were identified as factors associated with a favorable prognosis. The survival time was significantly prolonged for patients treated with EGFR-tyrosine kinase inhibitors (TKIs)(240 vs. 57 days, p<0.0001) and for patients who underwent radiotherapy of the central nervous system (CNS)(201 vs. 76 days, p=0.0038) after diagnosis of CM. The median survival time (MST) of patients treated with gefitinib before diagnosis of CM and with erlotinib after diagnosis was significantly longer than the MST of patients treated with gefitinib both before and after the diagnosis of CM (407 vs. 205 days, p=0.0015). Patients treated with both radiotherapy for CNS and EGFR-TKI had longer survival compared to patients without radiotherapy for the CNS (379 vs. 122 days, p=0.032). CONCLUSION EGFR-TKI combined with radiotherapy may be a therapeutic approach capable of improving the prognosis of patients with lung adenocarcinoma with CM harboring the EGFR gene mutation.

The study of organogenesis allows investigation of a variety of basic biological processes in the context of the intact organ. The ability to analyze teeth ex vivo during development has emerged as a powerful tool to understand how teeth are constructed and the signaling pathways that regulate these developmental processes. Here, we describe in detail our protocols for organ culture and kidney-capsule grafting of mouse tooth germs. These techniques allow us to reproduce the developmental process of tooth germs and estimate the effect of specific genes ex vivo, as well as are a tool for studies on the mechanisms of normal and abnormal tooth morphogenesis. They may also be applied to studies on other aspects of developmental biology and regenerative medicine.

Although crystalline silicon is widely used as substrate material for solar cell, many defects occur during crystal growth. In this study, the generation of crystalline defects in silicon substrates was evaluated. The distributions of small-angle grain boundaries were observed in substrates sliced parallel to the growth direction. Many precipitates consisting of light elemental impurities and small-angle grain boundaries were confirmed to propagate. The precipitates mainly consisted of Si, C, and N atoms. The small-angle grain boundaries were distributed after the precipitation density increased. Then, precipitates appeared at the small-angle grain boundaries. We consider that the origin of the small-angle grain boundaries was lattice mismatch and/or strain caused by the high-density precipitation.

Cystadenocarcinoma is a rare salivary gland tumour. Only a few case studies have provided pre-operative images of these tumours. This report demonstrates the case of a 28-year-old male with cystadenocarcinoma arising from an ectopic salivary gland with lymph node metastasis in the right upper neck. Ultrasound including Doppler images showed two masses with scant vascular flow. One was a hyperechoic mass enclosed within a low echoic cystic lesion and the other was a solid hypoechoic mass. Contrast enhancement CT scans demonstrated a ring enhanced mass and weakly homogeneous enhanced masses in the right upper neck. Dynamic studies showed increased enhancement in delayed phase CT that was the same as that in other malignant salivary gland tumours. Moderate to slightly high signal intensity was seen on T(1) weighted MR images and axial T(2) weighted MR images showed one heterogeneous mass in a high signal lesion and a moderate to high signal intensity mass. The authors discuss the pre-operative findings of ultrasound with Doppler imaging of this neoplasm, and CT findings including dynamic study images and MRI, comparing the findings with the post-operative pathological features of the tumour.

PURPOSE Successful kidney transplantation (KTx) can ameliorate bodily damage caused by end-stage renal disease (ESRD). Arterial stiffness (AS) is one of the critical factors that shorten the survival of patients due to cardiovascular events. KTx may reduce AS as well; however, this has not been investigated well. We therefore conducted a retrospective study using noninvasive pulse wave velocity (PWV), which is a useful index of aortic damage. PATIENTS AND METHODS Fifty-eight consecutive kidney recipients (34 men, 24 women) were enrolled in this study. Mean age at transplantation was 40.5 ± 12.3 years and the dialysis period was 73.1 ± 95.8 months. The brachial-ankle PWV was measured preoperatively and 6 months postoperatively. First, we investigated the relationship between the PWV and the other parameters related to AS. Second, we studied the pre- to posttransplant change in PWV to evaluate the amelioration of AS after successful KTx. RESULTS PWV showed significant positive correlations with age, systolic blood pressure (BP), diastolic BP, and abdominal aortic calcification index. After successful KTx, PWV significantly decreased (P <.01). In addition, systolic and diastolic BP significantly decreased (P <.01 and P <.05, respectively). CONCLUSION Successful KTx ameliorates AS in ESRD patients. This might explain the improved cardiovascular prognosis of ESRD patients who undergo KTx.

BACKGROUND Successful kidney transplantation (KT) can theoretically reconstitute body composition of a patient with chronic kidney disease (CKD). However, the practical changes have not been well documented. We evaluated changes in body composition among candidates before and 1 year after KT. METHODS We enrolled 37 male and 18 female kidney recipients eligible for comparison of their body mass index (BMI), body composition, and lipid metabolism before and 1 year after KT. Twenty-one patients had been induced with a calcineurin inhibitor, mycophenolate mofetil, steroid, and basiliximab, and 34 others underwent steroid withdrawal on postoperative day 3. The body composition was analyzed using bioelectrical impedance. We also analyzed changes in BMI and lipid profiles. RESULTS There was no significant change in BMI (21.4 ± 3.1 vs 21.7 ± 3.5 kg/m(2)). Regarding body composition, the water level decreased significantly (61.2 ± 4.9% vs 58.3 ± 5.3%; P <.05). In contrast, fat significantly increased (16.4 ± 6.7% vs 20.3 ± 7.1%; P <.05). More interestingly, successful KT significantly decreased the muscle and bone mass at 1 year after KT (37.3 ± 5.1% vs 34.8 ± 4.7%; 16.3 ± 2.1% vs 15.2 ± 2.1%; respectively; P <.05). Serum lipid profiles of total cholesterol, low-density lipoprotein cholesterol, and triglyceride worsened after KT. Comparing the 2 protocols, there was no difference in any item. CONCLUSIONS Care must be taken even after successful KT to avoid dyslipidemia, which is a risk factor for cardiovascular disease. Well programmed dietary and/or exercise protocols to prevent muscle atrophy and fat gain should be considered even after successful KT.

Protein is an important nutrient in foods. The classical nitrogen analysis method is the Kjeldahl technique, which is time-consuming and inconvenient. As a convenient method to quantify protein content in biological samples, the feasibility of application of multiple prompt gamma-ray analysis (MPGA) to the quantification was studied. Results for protein content are reported for several reference materials and prove the method to be reliable.

Fibroblast growth factor 8 (FGF8) functions as a local organizing signal for the tectum and cerebellum. FGF8 activates Ras-ERK signaling pathway to induce cerebellar development. We paid attention to the difference in the expression pattern of the molecules that are induced by FGF8 in the mid-hind brain region during normal development and after FGF8 misexpression; some are expressed in the area corresponding to the ERK activation domain but the others are expressed corresponding to the Fgf8 expression domain. Since some of the FGF family members are localized in the nucleus, we wondered if FGF8 could localize in the nuclei and function in the nucleus. We first show that in cultured NIH3T3 cells transfected FGF8b could localize in the nucleus. Transfected FGF8b could also localize in the nucleus of the cells in the chick neural tube. In mouse embryonic neural tube, we detected endogenous FGF8 in the nuclei. Implantation of an FGF8b-soaked bead showed that exogenous FGF8b could be translocated to the nuclei in the isthmus. Furthermore, signal-peptide-deletion mutant of FGF8b mainly localized in the nuclei, and induced Sprouty2 without activating ERK in the mesencephalon. Signal-peptide-deletion mutant of FGF8b could not induce Pax2 expression. Taken together, we concluded that FGF8b could be translocated to the nuclei, and that the nuclear FGF8 could function as transcriptional regulator to induce Sprouty2 in the isthmus.

Resistance to thyroid hormone (RTH) is a rare, predominantly inherited syndrome that involves impaired tissue responsiveness to thyroid hormones. We describe the perioperative management of a patient with RTH who underwent total thyroidectomy. Although surgery performed under general anesthesia was uneventful, after the surgery the patient developed difficult-to-treat hypocalcemia that lasted until postoperative day 4. Moreover, thyroid function even after discharge remained unstable despite replacement therapy. We suggest that the parathyroid and thyroid function of patients with RTH be followed very closely and that nociceptive stimulus of the surgery and postoperative pain be reduced as much as possible.

PURPOSE: To determine the current patterns of practice in Japan and to investigate factors that may make clinicians reluctant to use single-fraction radiotherapy (SF-RT). METHODS AND MATERIALS: Members of the Japanese Radiation Oncology Study Group (JROSG) completed an Internet-based survey and described the radiotherapy dose fractionation they would recommend for four hypothetical cases describing patients with painful bone metastasis (BM). Case 1 described a patient with an uncomplicated painful BM in a non-weight-bearing site from non-small-cell lung cancer. Case 2 investigated whether management for a case of uncomplicated spinal BM would be different from that in Case 1. Case 3 was identical with Case 2 except for the presence of neuropathic pain. Case 4 investigated the prescription for an uncomplicated painful BM secondary to oligometastatic breast cancer. Radiation oncologists who recommended multifraction radiotherapy (MF-RT) for Case 2 were asked to explain why they considered MF-RT superior to SF-RT. RESULTS: A total of 52 radiation oncologists from 50 institutions (36% of JROSG institutions) responded. In all four cases, the most commonly prescribed regimen was 30 Gy in 10 fractions. SF-RT was recommended by 13% of respondents for Case 1, 6% for Case 2, 0% for Case 3, and 2% for Case 4. For Case 4, 29% of respondents prescribed a high-dose MF-RT regimen (e.g., 50 Gy in 25 fractions). The following factors were most often cited as reasons for preferring MF-RT:"time until first increase in pain"(85%),"incidence of spinal cord compression"(50%), and "incidence of pathologic fractures"(29%). CONCLUSIONS: Japanese radiation oncologists prefer a schedule of 30 Gy in 10 fractions and are less likely to recommend SF-RT. Most Japanese radiation oncologists regard MF-RT as superior to SF-RT, based primarily on the time until first increase in pain.