Relationship of Grade of Malignant Brain Tumor to Cancer Stem Cells and Survivin Expression

Glioblastoma (GBM) is difficult to completely cure by surgical treatment alone, and it is generally treated with a combination of surgery, radiotherapy, and chemotherapy. However, GBM is resistant to radiotherapy and chemotherapy, and complete cure cannot be achieved. Cancer stem cells (CSC) and survivin, which inhibit apoptosis, are considered as factors underlying tumor recurrence and the radiation- and drug-resistance of these tumors. We analyzed CSC and survivin expression in surgically excised specimens of malignant brain tumors to establish the relationships between the grades and CSC and survivin expression and between MIB-1 (Ki-67) expression and resistance. No relationship was noted between the grades and CSC or survivin expression, or between MIB-1 and CSC expression or between Grade 3 and 4 MIB-1 and survivin expression, although a correlation was noted between MIB-1 and survivin expression in Grade II tumors. These findings suggested that CSC are consistently contained in tumor tissue at a specific rate regardless of the histological grade, and the apoptosis of cells with low-level proliferative and cell cycling activities does not occur because these cells do not respond to chemotherapy or radiation, being resistant to treatment

A Retrospective Study in the Diagnosis of 301 Jaundiced Cases

In the past 12 years, 301 patients with a total serum bilirubin over 2 mg/dl (reference interval 0.2-0.8 mg/dl) were admitted to the Second Department of Surgery, Nagasaki University School of Medicine, Japan. The purpose of this paper is to analyse the jaundiced cases and to evaluate the diagnostic accuracy of the following imaging techniques: Computed Tomography (CT), Ultrasonography (US), Drip Infusion Cholangiography (DIC), Endoscopic Retrograde Cholangio- pancreatography (ERCP), Percutaneous transhepatic Cholangiography (PTC) and Selective Celiac Angiography (SCAG). Of the 301 patients, 63 had carcinoma of the bile duct, 48 carcinoma of the pancreas, 26 carcinoma of the gallbladder, 16 hepatoma, 8 carcinoma of the ampulla of Vater, 83 cholelithiasis, 27 parenchymal liver disease, 9 congenital bile duct disease, 5 chronic pancreatitis, 14 other diseases, and 2 had no final diagnosis. CT was attempted in 33 of 170 patients with malignancy, and 22 of 129 patients with benignancy. A correct finding was obtained in 23 (69.7%) of the 33 patients and 18 (81.8%) of the 22 patients, respectively. US gave a correct finding in 28 (59.6 %) of 47 patients with malignancy, and 36 (69.2%) of 52 patients with benignancy. DIC gave a correct finding in 1 (5.6%) of 18 patients with malignancy, and 16 (42.1%) of 38 patients with benignancy. ERCP gave a correct finding in 33 (76.7%) of 43 patients with malignancy, and 38 (74.5%) of 51 patients with benignancy. PTC gave a correct finding i

Sudden-onset nonhemorrhagic Rathke’s cleft cyst mimicking apoplexy: A case report and literature review

Most Rathke’s cleft cysts （RCCs） are asymptomatic. Of the symptomatic RCCs, those that rapidly develop and cause hemorrhagic RCC apoplexy are particularly rare. In this study, we report a case of nonhemorrhagic RCC apoplexy that is an acute-onset RCC without intracystic hemorrhage. This study included a 21-year-old male patient. His chief complaints were severe headache with sudden disturbance of consciousness, visual disturbance, and double vision. Head computed tomography （CT）/magnetic resonance imaging （MRI） and clinical course indicated a hemorrhagic RCC apoplexy that is an acute-onset RCC with intracystic hemorrhage, a nonhemorrhagic RCC apoplexy, or a pituitary apoplexy. We then performed endoscopic transsphenoidal surgery. Histopathological examinations revealed a nonhemorrhagic RCC apoplexy. The preoperative diagnosis makes it difficult to distinguish between acute-onset hemorrhagic RCC apoplexy, nonhemorrhagic RCC apoplexy, and pituitary apoplexy. We compared 26 cases of hemorrhagic RCC apoplexy with cases of nonhemorrhagic RCC apoplexy by reviewing previous literatures. Furthermore, we have determined the characteristics of nonhemorrhagic RCC apoplexy. Knowledge on these characteristics may be useful in the differential diagnosis. For the differential diagnosis and treatment of RCC apoplexy and pituitary apoplexy, it is important to appropriately perform surgical treatment and make an accurate diagnosis based on surgical and pathological findings