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Two human clinical studies were performed. One was an open-label non-controlled study involving 30 healthy female subjects for 8 weeks. Significant improvements were observed by combining 6 mg per day oral supplementation and 2 ml (78.9 μM solution) per day topical application of astaxanthin. Astaxanthin derived from the microalgae, Haematococcus pluvialis showed improvements in skin wrinkle (crow's feet at week-8), age spot size (cheek at week-8), elasticity (crow's feet at week-8), skin texture (cheek at week-4), moisture content of corneocyte layer (cheek in 10 dry skin subjects at week-8) and corneocyte condition (cheek at week-8). It may suggest that astaxanthin derived from H. pluvialis can improve skin condition in all layers such as corneocyte layer, epidermis, basal layer and dermis by combining oral supplementation and topical treatment. Another was a randomized double-blind placebo controlled study involving 36 healthy male subjects for 6 weeks. Crow's feet wrinkle and elasticity; and transepidermal water loss (TEWL) were improved after 6 mg of astaxanthin (the same as former study) daily supplementation. Moisture content and sebum oil level at the cheek zone showed strong tendencies for improvement. These results suggest that astaxanthin derived from Haematococcus pluvialis may improve the skin condition in not only in women but also in men.

As less-invasive treatments for small bowel obstruction, such as laparoscopic surgery or small incision therapy, have become common, there is a growing demand for preoperative assessment of the cause and location of the small bowel obstruction. Thus, the role of computed tomography (CT) in the evaluation of small bowel obstruction is expanding. CT imaging of internal hernias (IHs) has been extensively described and is well established; however, CT imaging of IH after abdominal surgeries is not well recognized because of their anatomical complexity. The aims of this pictorial review are (1) to evaluate the causes of internal IHs in relation to previous abdominal surgery (e.g., IH associated with Roux-en-Y reconstruction, Billroth II reconstruction, peritoneal adhesive band, perineal hernia, and IH after gynecological procedures), (2) to demonstrate the spectrum of imaging findings on multidetector CT (MDCT), and (3) explain the key features for CT diagnosis of IHs related to previous surgical procedures, with emphasis on the multi-planar reformation (MPR) image. We also demonstrate the dynamic changes in the progression of mesenteric strangulation revealed by CT. Understanding the imaging appearance on MDCT can help radiologists guide therapy for patients with a small bowel obstruction after abdominal surgery.

A patient who had previously undergone retrosternal gastric tube reconstruction for esophageal cancer presented with an aortic arch aneurysm. The patient was treated with endovascular stent-graft placement without median sternotomy, followed by revascularization of the brachiocephalic trunk using percutaneous in situ graft fenestration. A 9-month follow-up examination revealed marked regression of the aneurysm with patency of the stent-graft, without any complications. This in situ fenestration technique may extend the limits of thoracic endovascular therapy for patients who are unsuitable for sternotomy or aortic side-clamping., (Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.)

Dual-energy imaging is a promising new development in computed tomography (CT) that has the potential to improve lesion detection and characterization beyond levels currently achievable with conventional CT techniques. In dual-energy CT (DECT), the simultaneous use of two different energy settings allows the differentiation of materials on the basis of their energy-related attenuation characteristics (material density). The datasets obtained with DECT can be used to reconstruct virtual unenhanced images as well as iodinated contrast material-enhanced material density images, obviating the standard two-phase (unenhanced and contrast-enhanced) scanning protocol and thus helping minimize the radiation dose received by the patient. Single-source DECT, which is performed with rapid alternation between two energy levels, can also generate computed monochromatic images, which are less vulnerable to artifacts such as beam hardening and pseudoenhancement and provide a higher contrast-to-noise ratio than polychromatic images produced by conventional CT. Familiarity with the capabilities of DECT may help radiologists improve their diagnostic performance.

NKT cells are characterized by their production of both T(h)1 and T(h)2 cytokines immediately after stimulation with alpha-galactosylceramide (alpha-GalCer), which is composed of alpha-galactopyranose linked to ceramide (itself composed of sphingosine and fatty-acyl chains); the chain length of the ceramide varies and this affects the ability of alpha-GalCer to stimulate cytokine production. However, the contribution of its galactopyranose sugar moiety remains unclear. We synthesized alpha-carba-GalCer, which has an alpha-linked carba-galactosyl moiety; here, the 5a'-oxygen atom of the D-galactopyranose ring of alpha-GalCer is replaced by a methylene group. The alpha-carba-GalCer was more stable and showed higher affinity to the NKT receptor. It thus enhanced and prolonged production of IL-12 and IFN-gamma compared with alpha-GalCer, resulting in augmented NKT cell-mediated adjuvant effects in vivo. The alpha-carba-GalCer, which has an ether linkage, was more resistant to degradation by liver microsomes than was alpha-GalCer, which has an acetal bond. Modulation of the sugar moiety in glycolipids might therefore provide optimal therapeutic reagents for protective immune responses against tumor or pathogens.

Background: Chronic pancreatitis and pancreatic adenocarcinoma often show similar clinical and imaging appearances. This study aims to differentiate chronic pancreatitis from pancreatic adenocarcinoma by defining enhancement patterns in both pathologic conditions during triple-phase helical CT., Methods: The study included 42 patients with chronic pancreatitis and 85 patients with pancreatic adenocarcinoma. CT images obtained according to protocol A (scan delays, 30, 60, and 150 s; 300 mg I/mL contrast material) or protocol B (scan delays, 40, 70, and 150 s; 370 mg I/mL contrast material) were retrospectively evaluated., Results: Mean contrast enhancement value of normal pancreas peaked in the first phase (early-washout pattern) while that of chronic pancreatitis peaked in the second phase (delayed-washout pattern), and that of pancreatic adenocarcinoma gradually rose (increasing pattern) in both protocols. Diagnostic indices for pancreatic adenocarcinoma were 82.4% and 94.1% for sensitivity, 83% and 83% for specificity, 82.7% and 90.4% for accuracy in protocols A and B, respectively, when differentiation between chronic pancreatitis and pancreatic adenocarcinoma was performed based on time-attenuation curve patterns., Conclusion: Our results indicate that time attenuation curves obtained from triple-phase helical CT in protocol B provide useful information in differentiating chronic pancreatitis from pancreatic adenocarcinoma.

Objective: To assess the conspicuity of invasive carcinomas (solid masses) originating from pancreatic intraductal papillary mucinous neoplasms (invasive IPMNs) and the primary sites of the solid masses on thin-slice dynamic CT., Methods: Twenty patients with pathologically proven invasive IPMNs underwent triple-phase dynamic CT examinations (arterial, portal, and delayed phases). Qualitative and quantitative analyses of conspicuity of the solid masses were performed for all phases. The primary sites [branch duct and/or main pancreatic duct (MPD)] of the solid masses were evaluated on CT in comparison to the pathologic findings., Results: The qualitative and quantitative analyses of the conspicuity of the solid masses showed that the arterial phase images were superior to those of the portal and delayed phases. The primary sites of the solid mass were histopathologically diagnosed as branch ducts in 6 (30%) patients, MPD in 13 (65%), and both branch ducts and the MPD in one (5%). The sensitivity and specificity of the CT evaluation of the primary sites were 100% for the branch ducts, and for the MPD 93% and 100%, respectively., Conclusion: Arterial phase images are useful for the diagnosis of invasive IPMNs, and attention should be paid to pancreatic parenchyma surrounding the MPD when detecting invasive carcinomas.

Background: To date the anatomy of the intrapancreatic and peripancreatic veins using multidetector-row CT (MDCT) was not assessed. The object of this study is to establish 3D CT anatomy of these veins., Methods: A total of 100 consecutive patients who underwent abdominal triple-phase CT using 16-detector MDCT were retrospectively reviewed. The anatomical variations of the peripancreatic and intrapancreatic veins were assessed., Results: Among the 100 cases, 42 cases (42%) had a single posterior superior pancreaticoduodenal vein crossing the ventral side of the common bile duct, while 30 cases (30%) had an uncinate vein running upward behind the medial side of the pancreatic. In the pancreatic head and body/tail area, there were many small veins that directly entered the superior mesenteric or splenic vein. In 59 cases (59%), the centro-inferior pancreatic vein ran transversely along the inferior surface of the pancreatic body and drained the anterior or inferior parts of the pancreatic body, mainly into the splenic vein., Conclusion: Many variations exist in the running patterns of intrapancreatic veins as well as peripancreatic veins. Recognition of abnormalities of intrapancreatic veins on CT in the light of normal CT anatomy may contribute to the interpretation of pathological conditions of the pancreas.

Objective: To demonstrate the contrast-enhancement behavior of pancreatic carcinoma on dynamic contrast-enhanced CT (DCE-CT), and the relationship between the degree of contrast-enhancement and the vascularity (vessel density) and amount of fibrous stroma (fibrosis within the tumor) on pathological specimen., Methods: The contrast-enhancement values were measured by producing the subtracting images for obtaining largest region of interests to reduce measurement errors and variability. Vascularity was determined by immunostaining of the tissue sections with factor 8 and the fibrous stroma was determined by picrosirius staining. Correlation of the findings of DCE-CT with pathological findings was performed in 21 patients with pancreatic carcinoma., Results: All but one patient exhibited a gradually increasing enhancement, but there was considerably wide range in contrast-enhancement values of tumors. Examination of the overall relationship between vascularity and fibrous stroma with contrast-enhancement behavior showed that tumor with more fibrosis and higher vascularity had a higher contrast effect through all phases of dynamic study. Tumors having liver metastases tended to be less fibrotic than tumors without liver metastases., Conclusion: The contrast-enhancement behavior of pancreatic carcinoma may be helpful in estimating vascularity and the extent of tumor fibrosis and possibility of liver metastases.

Establishment of a system with efficient generation of natural killer T (NKT) cells from embryonic stem (ES) cells would enable us to identify the cells with NKT-cell potential and obtain NKT cells with desired function. Here, using cloned ES (NKT-ES) cells generated by the transfer of nuclei from mature NKT cells, we have established a culture system that preferentially developed functional NKT cells and also identified early NKT progenitors, which first appeared on day 11 as a c-kit(+) population in the cocultures on OP9 cells with expression of Notch ligand, delta-like1 (OP9/Dll-1) and became c-kit(lo/-) on day 14. Interestingly, in the presence of Notch signals, NKT-ES cells differentiated only to thymic CD44(lo) CD24(hi) NKT cells producing mainly interleukin-4 (IL-4), whereas NKT cells resembling CD44(hi) CD24(lo) liver NKT cells producing mainly interferon gamma (IFN-gamma) and exhibiting strong adjuvant activity in vivo were developed in the switch culture starting at day 14 in the absence of Notch. The cloned ES culture system offers a new opportunity for the elucidation of the molecular events on NKT-cell development and for the establishment of NKT-cell therapy.

Invariant NKT (iNKT) cells bridge innate and acquired immunity and play an important role in both protective and regulatory responses. The nature of the response is dictated by the initial cytokine environment: interaction with IL-10-producing cells induces negative regulatory T(h)2/regulatory T cell-type iNKT cells, while that with IL-12-producing cells results in pro-inflammatory T(h)1-type responses. Particularly, in the anti-tumor response, iNKT cells mediate adjuvant activity by their production of IFN-gamma, which in turn activates both innate and acquired immune systems. Thus, upon activation of iNKT cells, both MHC(-) and MHC(+) tumor cells can be efficiently eliminated. On the basis of these mechanisms, iNKT cell-targeted adjuvant cell therapies have been developed and have shown great promise in initial clinical trials on cancer patients.

Background: Carcinoid tumor of the pancreas is rare, and there are few reports that described its CT or magnetic resonance imaging (MRI) findings. We describe the characteristic CT and MRI findings in four cases of carcinoid tumor of the pancreas., Methods: Radiologic and pathologic features were analyzed in four patients. All patients underwent triple-phase dynamic CT and MRI., Results: The tumor size in the four cases ranged 15-20 mm and intratumoral calcification was detected in one case. On triple-phase dynamic CT, the peak enhancement of the tumors was seen at the arterial dominant phase in three cases; the remaining one was at the portal venous phase with prolonged contrast-enhancement effect. The tumors showed low to high signal intensity on T2-weighted images. Dilatation of the main pancreatic ducts (MPDs) distal to the tumors was seen in three cases, in which tumor invasion into the MPDs was pathologically confirmed. Furthermore, the tumors having mild to severe fibrosis pathologically invaded into the peripancreatic lymphatics or nerves., Conclusion: It would be characteristic of carcinoid tumor of the pancreas to be well enhanced at the arterial dominant phase on dynamic CT, and to highly invade into the MPDs and the peripancreatic lymphatics or nerves.

Background: Influenza A viral infection is concerned with induction of asthma. CD11c+ pulmonary antigen presenting cells (APCs) play a central role in sensitization with inhaled antigens during the acute phase of influenza A viral infection and also reside on bronchial epithelium for the long term after sensitization. To investigate the role of CD11c+ pulmonary APCs in the inhaled antigen sensitization during the acute phase of influenza A viral infection, we analyzed their function., Methods: Mice were infected with influenza A virus and were sensitized intranasally with BSA/alum during the acute phase of influenza A viral infection. Expression of surface antigens on CD11c+ pulmonary APCs was analyzed by FACS. Cytokine production from CD11c+ pulmonary APCs, and interaction between CD11c+ pulmonary APCs and naïve CD4+ T cells was assessed by ELISA. Ability of antigen presentation by CD11c+ pulmonary APCs was measured by proliferation assay., Results: BSA antigen sensitization during the acute phase of influenza A viral infection induced eosinophil recruitment into the lungs after BSA antigen challenge and moderately increased expression of MHC class II molecules on CD11c+ pulmonary APCs. The interaction between the CD11c+ pulmonary APCs and naïve CD4+ T cells secreted large amounts of IL-10., Conclusions: BSA antigen sensitization during the acute phase of influenza A viral infection enhanced IL-10 production from naïve CD4+ T cell interaction with CD11c+ pulmonary APCs. The IL-10 secretion evoked Th2 responses in the lungs with downregulation of Th1 responses and was important for the eosinophil recruitment into the lungs after BSA antigen challenge.

RCAI-17, 22, 24-26, 29, 31, 34-36, 38-40, and 88, the analogs of KRN7000 with a sulfonamide linkage instead of an amide bond, were synthesized to examine their bioactivity for mouse natural killer (NK) T cells. RCAI-17, 22, 24-26, 29, 31, 34-36, and 88 are the aromatic sulfonamide analogs, while RCAI-39 and 40 are the aliphatic ones. RCAI-38 is a C-galactoside analog of RCAI-26, which is the p-toluenesulfonamide analog of KRN7000. According to their bioassay, these sulfonamide analogs were shown to be the stimulants of mouse NKT cells to induce the production of Th2-biased cytokines in vitro, while RCAI-38 did not induce any cytokine production.

Purpose: KL-6 is an extracellular epitope of MUC1, a membrane-penetrating glycoprotein, and its overexpression has been reported in pancreatic cancer. The aim of this study was to examine whether radiolabeled anti-KL-6/MUC1 antibody could be used for molecular imaging of pancreatic cancer in vivo., Materials and Methods: Anti-KL-6/MUC1 antibody was labeled with 99mTC by the stannous reduction method. Immunoreactivity of the 99mTc-labeled anti-KL-6/MUC1 antibody was evaluated by a whole-cell binding study. In vivo experiments were performed by injecting the 99mTc-labeled anti-KL-6/MUC1 antibody into athymic nude mice bearing the KP-1NL pancreatic cancer cell line., Results: A whole-cell binding study showed that the radiolabeled antibody retained its immunoreactivity. On scintigrams, the density of the tumors remained unchanged during the 16-32 h after injection, whereas that of the kidneys decreased time-dependently. The radioactivity levels of the kidneys and tumors were measured densitometrically, and we found that the intensity in the tumors relative to that in the kidneys increased time-dependently. Radioactivity levels were the highest in the blood 32 h after injection, and those in the liver, kidney, lung, and tumor were also rather high., Conclusion: 99mTc-labeled anti-KL-6/MUC1 antibody appears to be a promising agent as a tumor-specific radiotracer for pancreatic cancer.

Conformationally restricted analogues of KRN7000, an alpha-d-galactosyl ceramide, were synthesized to examine their bioactivity for mouse natural killer (NK) T cells to produce cytokines. RCAI-8, 9, 51, and 52 are the analogues with a pyrrolidine ring, and RCAI-18, 19, 49, and 50 are those with an azetidine ring. RCAI-18 was shown to be a potent inducer of cytokine production by mouse NKT cells, while RCAI-51 was a moderately active inducer.

Objective: To describe computed tomography (CT) findings of invasive carcinoma derived from intraductal papillary mucinous neoplasms (IPMNs) of the pancreas during long-term follow-up., Methods: Follow-up CT findings of 5 patients with IPMNs progressing to invasive carcinomas were respectively reviewed for 12 to 63 months. All patients underwent thin-section 3-phase helical and/or multislice CT., Results: Invasive carcinomas were detected as hypo- (n = 3) or hyperattenuating (n = 2) solid masses in the pancreatic parenchyma on contrast-enhanced CT. Hypoattenuating masses were mostly visualized on arterial dominant phase images. In 4 branch-duct type IPMNs, the solid masses appeared with (n = 3) or without (n = 1) dilatation of the main pancreatic duct after 3 to 5 years. In the remaining combined-type IPMN, a solid mass was detected on initial CT and progressively increased during the follow-up., Conclusions: Arterial dominant phase CT is useful for detecting invasive carcinoma derived from IPMNs and is an effective follow-up method.

Study Design: The electrophysiologic responses of wide dynamic range neurons in the spinal dorsal horn by compression of the dorsal root or of the dorsal root ganglion were investigated., Objectives: This study identified differences between the compression of the dorsal root against the compression of the dorsal root ganglion by examining the responses of wide dynamic range neurons., Summary of Background Data: The wide dynamic range neurons studied were known to be excited by primary afferent fibers, not only combined A delta and C-nociceptive fibers but also low threshold mechanoreceptive A beta fibers and A delta fibers of down hairs. Thus, the wide dynamic range neurons are classified as nociceptive neurons., Methods: Extracellular activities of 32 wide dynamic range neurons were recorded from the laminae 4-6 of the seventh lumbar cord in anesthetized cats. A microvessel clip (40 g) was applied to compress the dorsal root or the dorsal root ganglion., Results: Dorsal root compression produced only an initial burst (about 10-40 seconds). Prolonged repetitive firings were rarely maintained. In contrast, dorsal root ganglion compression resulted in a maintained repetitive firing throughout the period of compression. After release of compression of the dorsal root and the dorsal root ganglion, responses to brushing were facilitated, and the low threshold center of the receptive field expanded., Conclusions: These findings are consistent with the previous report that the radicular pain associated with a herniated intervertebral disc initially results from compression of the dorsal root ganglion.