The naturally occurring mutated form of the epidermal growth factor receptor, deltaEGFR (also named EGFRvIII and de2-7EGFR), greatly enhances glioblastoma (GBM) cell growth in vivo through several activities, such as down-regulating p27 and up-regulating BclX(L) while increasing signaling through the RAS-MAPK and PI3-K cascades. More than half of GBMs, especially of the de novo type, overexpress EGFR, and 50%-70% of these express deltaEGFR. However, little is known about the distribution of deltaEGFR-expressing tumor cells within surgical specimens. In order to address this clinically important issue, we performed immunohistochemical analyses of 53 GBMs obtained during surgery using the anti- deltaEGFR monoclonal antibody, DH8.3. We also simultaneously analyzed wild-type EGFR expression in these tissues using the anti-EGFR monoclonal antibody, EGFR.113. deltaEGFR and wild-type EGFR expression were observed in 20/53 (38%) and 29/53 (55%), respectively. Nineteen (95%) of the deltaEGFR-positive tumors also expressed wild-type EGFR; one case was deltaEGFR-positive but wild-type EGFR-negative. In 13/20 (65%) of the deltaEGFR-positive tumors, tumor cells were scattered diffusely within the tumors, 6/20 showed geographical distribution of deltaEGFR-positive tumor cells, and one case showed homogeneous staining. In the wild-type EGFR-positive cases, almost all tumor cells expressed EGFR. The differential distribution of cells expressing the two receptors observed here may suggest either that deltaEGFR arises at a low frequency from wild-type EGFR-expressing cells, perhaps during the process of gene amplification, or that there is a paracrine-type of interaction between them.

SummaryTwo hundred and twenty-one cases of IC dorsal aneurysm (ICDA) with subarachnoid hemorrhage (SAH) from 365 cases in the nationwide surveillance of ICDA (NSICDA) data bank were studied with special reference to the dissecting type. Dissection of the internal carotid artery (ICA) was confirmed in 50 out of 221 SAH cases. In 193 surgically treated cases, 40 were of the certified dissecting type. Including those with clinical features which strongly suggests the existence of dissecting changes in the ICA wall, 97 cases (55.6% of operated) were thought to be a dissecting type. Incidence of intraoperative bleeding is significantly higher and surgical outcome is significantly worse in the dissecting type than in the non-dissecting type. Treatment options for this peculiar and formidable aneurysm (An) are described.

The present findings suggest that sympathetic activation in patients in the acute phase of SAH reflects the severity of SAH, and is closely related to the development of delayed vasospasm, leading to the subsequent immune response and inflammatory reactions. Strategies for suppressing catecholamine at the hyper-acute phase may contribute to vasospasm prevention and improve patient outcome.

Bilateral adrenal infarction is an extremely rare disease, and it has been reported that some coagulation abnormalities, including essential thrombocythemia (ET), exist in the background. We herein report a 76-year-old patient in whom the platelet count had been in the normal range at the onset of adrenal infarction but subsequently increased to 102×10 4 /μL at 7 months later, leading to the diagnosis of JAK2V617F-positive ET. As the presence of the JAK2V617F mutation increases the risk of thrombosis, Janus kinase 2 (JAK2) genetic testing should be considered in some cases of nonspecific unknown thrombosis, even if there are no obvious hematological findings, such as clonal hematopoiesis of indeterminate potential (CHIP).

An important role of the zinc stearate (ZnSt2) activator in the sulfur cross-linking reaction of isoprene rubber is proved by combination of 1H double-quantum nuclear magnetic resonance spectroscopy and nanomechanical mapping of atomic force microscopy for the first time. The dinuclear-type bridging bidentate zinc/stearate complex (intermediate I) is well dispersed in the rubber matrix to result in the formation of a highly homogeneous network structure by reacting with N-(1,3-benzothiazol-2-ylsulfanyl)­cyclohexanamine and sulfur. Upon increasing the concentration of ZnSt2, the amount of generated intermediate I increases, and consequently, the molecular weight between the constraints (M c) decreases proportionally. However, a large amount of ZnSt2 widens the distribution of 1/M c and decreases the network uniformity. These results are based on the first qualitative agreement between the relative 1/M c values, and in particular the width of their inhomogeneous distributions, measured by the two techniques. High potential for controlling a network structure in a vulcanizate is shown, where an amount of the generated intermediate I plays a key role.