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Solitary neurofibromas arising from cranial nerves are rare, and those arising from the peripheral divisions of the trigeminal nerve are even rarer. Although infratemporal fossa (ITF) masses are challenging to remove, certain approaches are considered feasible for this region. The present study reports a rare case of an ITF neurofibroma arising from the inferior alveolar nerve. The 27-year-old male patient presented with numbness of the right jaw. A radiological examination revealed a large mass occupying the ITF, from the mandible to the foramen ovale, originating from the inferior alveolar nerve in the mandible. The tumor was successfully excised via a transtemporal approach followed by a transoral-retromolar approach. A histological examination confirmed the diagnosis of neurofibroma. The present case demonstrates that a combination of the transtemporal and transoral-retromolar approaches may provide wide access to the ITF region. [ABSTRACT FROM AUTHOR]

Objective: To investigate clinical effectiveness of prednisolone (PSL) and cyclosporin A (CyA), particularly continuous intravenous administration of the latter, in patients with interstitial pneumonia (IP) associated with polymyositis/dermatomyositis (PM/DM). Methods: We reviewed the clinical findings and therapeutic outcomes of patients with PM/DM who had received PSL and CyA (PSL + CyA, n = 21 for DM and 2 for PM) or the former alone (n = 12 for DM and 7 for PM). All patients receiving PSL + CyA had active IP. Results: Fifteen of the 21 DM patients receiving PSL + CyA showed favorable therapeutic outcomes of IP (recovery group), while the remaining 6 died of respiratory failure (death group). Before treatment PaO2 in room air and %VC were significantly lower, and the total CT score was significantly higher in the death group than in the recovery one. Continuous intravenous administration of CyA was performed in 6 patients for severe IP requiring oxygen therapy, and of these 2 showed complete recovery from it. Conclusions: Coadministration of PSL and CyA, particularly continuous intravenous infusion of the latter, from the early phase of illness may be a potent therapeutic option for PM/DM patients with decreases in PaO2 and %VC and/or a high total CT score suggestive of a poor prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate peripheral blood lymphocyte subpopulations, particularly helper T (Th) cells and cytokine expression before and after treatment in polymyositis (PM) and dermatomyositis (DM). Patients and Methods: Ten patients with PM and 15 with DM were enrolled in this study. As a control we used 11 age-matched healthy subjects. We analyzed peripheral blood lymphocytes using flow cytometry. Serum cytokines were determined by enzyme-linked immunosorbent assay. Results: Th2/Th1 and Th2/Th17 ratios were significantly higher in both PM and DM than in controls and this Th2-predominancy is marked in DM associated with interstitial pneumonia. IL-1β, IL-6 and TGF-β were significantly higher in both PM and DM and IL-4 showed a significant increase in DM when compared to controls. There was no significant correlation between either any lymphocyte subpopulations or serum cytokines and clinical severity markers such as the manual muscle strength test, serum creatine kinase, and the total CT score. Th2/Th17 in both PM and DM, as well as Th2/Th1 in the latter, significantly decreased after clinical remission compared with before treatment. Conclusions: Th2-predominancy as shown by the increase in Th2/Th1 and Th2/Th17 ratios may suggest active disease in PM/DM but does not reflect clinical severity. [ABSTRACT FROM AUTHOR]

We report a patient with psoriatic arthritis (PsA) who was successfully treated with adalimumab even while under hemodialysis therapy for associated chronic renal failure. Flow cytometry of circulating lymphocytes revealed an obvious decrease in both Th1 and Th17 cells after starting adalimumab. The latter returned to the pretreatment level in the course of adalimumab therapy, while the former did not. Adalimumab is a potent therapeutic option for PsA patients with chronic renal failure on hemodialysis, and Th1 in peripheral blood may reflect the disease activity. [ABSTRACT FROM AUTHOR]

In the hyperthermal treatment, the wild type (wt) p53 plays an important role in apoptosis induction in the tumor cells. In human gliomas, p53 frequently has some form of mutation. The mutant type (mt) p53 does not work properly as a tumor suppressor and this may result in poor responses during treatment. We investigated the relationship between apoptosis-inducing factor (AIF) and apoptosis under various thermal conditions (43, 45, and 47 °C for 1 h) using four p53-wild or -mutant human glioma cell lines (A172, T98G, U251MG, and YKG-1). AIF translocation from the mitochondria to the nucleus under hyperthermal conditions was demonstrated by confocal laser microscopy. The percentage of AIF-positive nuclei increased significantly in comparison with the control in all cell lines and in all temperature groups except for YKG-1 at 47 °C. Immunoblot analyses of the nuclear fraction of each cell line revealed temperature-dependent increases in AIF. A simultaneous release of cytochrome c from the mitochondria to the cytosol was noted. A flow cytometric analysis showed that apoptosis induction occurred more often in a temperature-dependent manner in the 45 and 47 °C groups than in the control group. These findings indicate that the hyperthermal conditions can lead to AIF translocation and apoptotic cell death in the p53-mutant human glioma cells. The present report is the first description of AIF-induced apoptosis in hyperthermia. [ABSTRACT FROM AUTHOR]

Although the expression O6-methylguanine-DNA methyltransferase (MGMT) is an important hallmark for decision of nitrosourea chemotherapy for glioma patients, no immunohistochemical method for analysis of MGMT has been standardized yet. Gliomas usually contain non-neoplastic cells even deep in the tumor. It is not known which of these components expresses MGMT. To clarify this point, we investigated MGMT expression in the non-neoplastic cells in autopsy and surgical specimens by immuno-histochemistry. High grade gliomas were also studied to find a cut-off point for treatment decision. MGMT immunohistochemistry in the normal brain or brain with non-neoplastic disease revealed nuclear staining in some endothelial cells, inflammatory cells, ependymal cells, astrocytes and oligodendroglias. Some cells were double stained with CD68 (macrophages or microglias). The neurons were consistently MGMT-negative. High grade gliomas always contained an MGMT-positive non-neoplastic component. Although the endothelial cells were easily distinguished from the neoplastic cells, other cells were often mistaken for tumor cells. The population of MGMT-positive non-neoplastic cells was usually less than 10%. We set a cut off-point at 10% between the positive and negative groups because the statistical difference in the overall survival was most distinct at this value. In 51 high grade glioma patients, who received both radiotherapy and chemotherapy with nimustine (ACNU), the median overall survival of the MGMT-negative group (23months) was significantly longer than that of the MGMT-positive group (14months) (P<0.009). Multivariate analysis revealed that the negative MGMT expression was a significant prognostic variable next to the degree of surgical removal for the overall survival. In the MGMT-positive group, addition of platinum-based chemotherapy did not improve the survival. [ABSTRACT FROM AUTHOR]