bluuebunny/crossref_metadata_2025 huggingface dataset:
Catatonic features: Differential diagnosis and treatments at an emergency unit
Authors: Huang Tiao‐Lai , Ree Shao‐Chun , Huang Yu‐Chu , Liu Hia‐Yih , Yang Yong‐Yi
Published: March 2003

During a 2‐year period, 34 patients of catatonic features in Chinese ethnic background Taiwanese were brought to the emergency unit of Chang Gung Memorial Hospital at Linkou. The ratios of the causes of catatonic features by schizophrenic disorders, mood disorders, neuroleptic‐induced disorders, and general medical conditions were 26, 9, 24 and 41%, respectively. After the treatments of antipsychotics, benzodiazepam, or electroconvulsive therapy (ECT), 24 patients (70.6%) showed complete remission, seven patients (20.6%) showed partial remission, and three patients (8.8%) showed no response (two died). Additionally, a suggestive period is proposed in order to distinguish acute and insidious onset catatonic conditions to help clinicians in deciding on probability immediately. The patients were grouped into four diagnostic categories; namely, schizophrenic disorders, mood disorders, neuroleptic‐induced disorders, and general medical conditions for comparison. One‐way ANOVA and Duncan’s multiple‐range test were used for continuous variables, and the Chi‐squared test was used for categorical variables. The mean duration of ‘insidious onset catatonic condition’ (including schizophrenic disorders and general medical conditions) before seeking medical help was longer than 3.33weeks, while the mean duration of ‘acute catatonic condition’ (including mood disorders and neuroleptic‐induced disorders) was shorter than 1.83weeks. These findings suggest that 2–3weeks would be a cut‐off point for acute or insidious onsets of catatonic conditions.
Demonstration of ganglioside GD3 in human reactive astrocytes
Authors: Kawai Kensuke , Watarai Shinobu , Takahashi Hitoshi , Ishizu Hideki , Fukai Kosuke , Tanabe Yasuyuki , Yokota Osamu , Kuroda Shigetoshi
Published: March 2003

Astrocytes are the cells that actively participate in the process of lesion repair in the central nervous system (CNS), and reactive astrocytosis of varying degrees becomes apparent with time in any pathological condition occurring in the normally developed postnatal CNS. Ganglioside GD3 (II3a(NeuAca2‐8NeuAc)‐LacCer, GD3) in reactive astrocytes from autopsied patients with Creutzfeldt–Jakob disease (CJD) and old cerebral infarction was investigated immunocytochemically, using mouse IgM anti‐GD3 monoclonal antibody (DSG‐1). Reactive astrocytes in CJD and cerebral infarction demonstrated GD3‐immunoreactivity within the cytoplasm. Normal astrocytes were negative. The present data raise the possibility that GD3 in reactive astrocytes has biological implications for the properties of the cells, such as cellular motility.
Quantitative analysis of neurofilament proteins in Alzheimer brain by enzyme linked immunosorbent assay system
Authors: Hashimoto Ryota , Nakamura Yu , Tsujio Ichiro , Tanimukai Hitoshi , Kudo Takashi , Takeda Masatoshi
Published: March 2003

The abnormality of cytoskeletal proteins is related to Alzheimer’s disease. Because neurofilament proteins (NF) are major cytoskeletal components of neurones, abnormality of NF may be involved in the pathology of disease. In this study, insoluble NF in the grey matter of temporal lobes of Alzheimer and control brains were dissolved in a urea buffer and quantitatively measured by an enzyme linked immunosorbent assay system. No apparent quantitative changes of NF‐L and NF‐H were found between the Alzheimer and control brains, and there were also no significant differences in the mean molar ratio of NF‐L to NF‐H between them. However, the relative amount of phosphorylated NF‐H in Alzheimer brains was increased in comparison with that in control brains. These results suggest that the increase of phosphorylated NF‐H might be accompanied with Alzheimer’s disease.
Digital psychiatry
Authors: Tang Siu , Helmeste Daiga
Published: March 2003

The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer‐based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer‐reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health‐care industry. Patient–physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in‐person office‐based therapy to digital clinical products, from in‐person library search and classroom didactic instruction to interactive on‐line searches and distance learning. In this time of value migration, psychiatrists have to determine what their ‘distinctive competence’ is and where best to add value in the health‐care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world.
Survey of sleep‐health and lifestyle of the elderly in Okinawa
Authors: Uezu Eiko , Taira Kazuhiko , Tanaka Hideki , Arakawa Masashi , Urasakii Chisae , Toguchi Hiroki , Yamamoto Yukari , Hamakawa Eri , Shirakawa Shuichiro
Published: March 2003

A total of 788 people (aged from 60 to 93 years) living in the Okinawa prefecture, renowned for the long life expectancy of its citizens, were randomly chosen as subjects. A questionnaire based on lifestyle and sleep‐health was distributed. Following this, subjects were chosen in groups of nine from the good sleep‐health group and then from the poor sleep‐health group based on the results of the survey; their physical activities were then recorded using actigraphs for 1 week. This study suggested that lifestyle, such as exercise, walking and short naps, occupies an important position in the maintenance and improvement of sleep‐health. It also verified the reliability of the sleep‐health risk index and the questionnaire.
Clinical significance of negative esophageal pressure in sleep apnea syndrome
Authors: Higami Shigeru , Inoue Yuichi , Takeuchi Hiromi , Ikoma Hisaaki , Kanba Masayuki
Published: March 2003

The authors investigated the relationship between esophageal pressure fluctuation (DPes) during sleep and the following parameters: respiratory disorder variables and daytime sleepiness manifested as the Epworth sleepiness scale (ESS). In the younger patient group under 60 years of age (n = 33), DPes was correlative to both the apnea‐hypopnea index and ESS. However, in the elderly group of 60 years and over (n = 16), the variables showed smaller values than did those in the younger group. These results suggest that DPes may be associated with the aggravating process of sleep apnea syndrome (SAS) in the younger patient.
A comparative study of genetic and neurobiological findings in disintegrative psychosis and infantile autism
Authors: Mouridsen Svend Erik , Rich Bente , Isager Torben
Published: March 2003

Abstract Although disintegrative psychosis (DP) was first described in 1908, the validity of the syndrome has not yet been fully documented. To investigate the validity of DP as defined in ICD‐9, 13 cases of DP were compared with 39 cases of infantile autism with reference to lifetime parental psychopathology, neuroradiological findings and genetic abnormalities. The groups were matched for gender, age, intellectual level and social class. Apart from a significantly higher rate of electroencephalogram abnormalities in the disintegrative group there was very little in the neurobiological background to support a clear distinction between DP and infantile autism.
Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: A report of seven cases
Authors: Su Kuan‐Pin , Hsu Chung‐Yao , Hsieh Shu‐Chiang , Shen Winston W.
Published: March 2003

Abstract Delusions associated with cerebrovascular diseases have been sporadically reported. Although both psychiatrists and neurologists attempted to link delusions with anatomical locations of the brain lesion, comorbid psychiatric and neurological disorders make the interpretation of delusions difficult. The purpose of the present paper is to report the clinical features and magnetic resonance imaging (MRI) characteristics in patients with delusional disorder due to diffuse cerebrovascular diseases, and to redefine the concept of ‘vascular delusion’. The clinical features and MRI findings were reviewed retrospectively in a series of seven patients with ‘delusional disorder due to cerebrovascular disease’ as defined in Diagnostic and Statistical Manual of Mental Disorders (DSMIV). The average age of onset is 64. No patient had a prior personal or family history of major psychiatric illness. The illness is presented as acute, subacute or stepwise course. Hypertension was present in all patients. Two had diabetes mellitus, and one had atrial fibrillation. Three had clinical evidence of previous cerebrovascular attacks, only one showed minor neurological deficits. Three had diffuse cortical slow wave in electroencephalogram. No patient had significant cognitive impairment but had multiple cortical and subcortical cerebrovascular lesions in MRI, with white‐matter lesions (WML) in bilateral frontal areas. Delusional disorder due to diffuse cerebrovascular change is characterized by late‐onset, stepwise course, and comorbid medical and neurological diseases. The results of vascular changes in the present study did not establish a cause–effect relationship and should be considered as multifactorial in pathogenesis. The findings suggested the hypothesis of neural circuit theory. Further studies in larger numbers of patients and newer neuroimaging techniques are needed to expand the knowledge learned from these findings.
Narcolepsy and other non‐SAS hypersomnia in sleep breathing disorders clinic
Authors: Banno Katsuhisa , Shiomi Toshiaki , Sasanabe Ryujiro , Hasegawa Rika , Otake Kazuo , Yamakawa Hiroki , Kobayashi Tadashi , Horiba Kiyoshi , Nishino Seiji
Published: March 2003

Four of the 708 snorers (0.56%), referred to our sleep breathing disorders clinic for the past 2 years were diagnosed as having narcolepsy‐cataplexy. Detecting HLA DRB1*1501/DQB1*0602 positive was informative for differentiating genuine narcolepsy from non‐sleep apnea syndrome (non‐SAS) hypersomnia in our clinic. A non‐SAS obese boy, diagnosed as having essential hypersomnia syndrome, was found to be HLA DRB1*1502/DQB1*0601 positive. His hypocretin concentration was 206 pg/mL in the cerebrospinal fluid.
Prevalence of dementia in the older Japanese‐Brazilian population
Authors: Yamada Tatsuo , Kadekaru Hatsuko , Matsumoto Shoiku , Inada Hiromichi , Tanabe Mitunori , Moriguchi Emilio H , Moriguchi Yukio , Ishikawa Paulo , Ishikawa Alvina Goncalves , Taira Kazuhiko , Yamori Yukio
Published: March 2003

Abstract The prevalence of dementing disorders in Campo Grande of a community of Japanese‐Brazilians who immigrated from Okinawa was studied. Previous reports showed that the dietary pattern in Japanese immigrants in Brazil, which characterized by a low fish and large meat intake, is possibly responsible for increased risk of cardiovascular diseases compared with Japanese in Okinawa. A total of 157 persons over 70‐year‐old were examined, and 19 cases were diagnosed as having dementia. The prevalence (cases/100 aged 70‐year‐older) was 12.1 for all types of dementia, 5.7 for Alzheimer's disease (AD), 0.6 for vascular dementia (VD), 4.5 for mixed dementia (AD/VD) and 1.3 for other types of dementia. There was no case of dementia with Lewy bodies or frontotemporal lobar degeneration. These results are similar to many previous studies in Western countries and some recent surveys in Japan, and clearly show that more AD than VD appears even in the Japanese‐Brazilian population. The higher prevalence rate of dementia in Japanese‐Brazilians compared with several studies in Japan may indicate the importance of dietary factors rather than genetic factors.
Endoscopic classification of pharyngeal stenosis pattern in obstructive sleep apnea hypopnea syndrome
Authors: HIGAMI SHIGERU , INOUE YUICHI , HIGAMI YUMIKO , TAKEUCHI HIROMI , IKOMA HISAAKI
Published: March 2003

Abstract Twenty‐one patients with obstructive sleep apnea–hypopnea syndrome (OSAHS)

were classified into three categories according to their pharyngeal stenosis patterns

during sleep, as determined from endoscopic findings: (i) a falling type (n

= 6); (ii) an all‐round type (n = 11); and (iii) a bilateral type (n = 4). In all patients with the bilateral type, the palatine tonsils were hypertrophied, and the apnea–hypopnea indexes (AHI) were improved markedly by surgery. Conversely, the AHI of patients with the falling and all‐round types were reduced by a smaller percentage. Surgical therapy is only to be recommended to patients with OSAHS whose pharynx is bilaterally stenotic.
Monitoring sleep hours using a sleep diary and errors in rotating shiftworkers
Authors: KAWADA TOMOYUKI , SUZUKI SHOSUKE
Published: March 2003

Abstract The sleep hours of male workers on rotating shift schedules were measured using a sleep diary. The mean age of workers was 40.3 years. Work shifts were rotated on a weekly basis and fell into three periods: morning, evening, and night. One working week consisted of 5 days. Errors that occurred during the work were also evaluated. A significant difference in the mean length of sleep was observed for each of the three shifts. Compared with the morning shift, the length of sleep for workers working evening and night shifts were significantly longer. The error of workers was not recognized in three rotating shift schedules in the survey period. Rotating shiftwork affects the amount of sleep, but not the event of error.
Hypnotic effects of total aqueous extracts of Vervain hastata (Verbenaceae) in rats
Authors: AKANMU MOSES A. , HONDA KAZUKI , INOUÉ SHOJIRO
Published: March 2003

Abstract The in vivo sedative property of the total aqueous extract of the aerial

portion of Vervain hastata (Verbenaceae) (TAEV) was studied in male rats to establish its scientific basis in herbal medicine. The investigation was conducted using electroencephalogram (EEG) analysis, and the barbituric–hypnosis test. The results showed that TAEV potentiated the pentobarbital‐induced hypnosis significantly by reducing sleep latency and increased sleeping time in a dose‐dependent manner that was reversed by flumazenil. The EEG data demonstrated that extract administration augmented total sleep time, rapid eye movement (REM) sleep and non‐REM sleep at the expense of wakefulness. The study’s results clearly showed the scientific validity for the use of this plant as a sedative and possibly as a nerve tonic substance.
Nocturnal heart rate and volitional lifestyle in the elderly
Authors: SHIROTA AI , TAMAKI MUNEHISA , NITTONO HIROSHI , HAYASHI MITSUO , HORI TADAO
Published: March 2003

Abstract The relationship between the level of volitional lifestyle and nocturnal heart

rate (HR) in the elderly was investigated. Twenty high‐ and low‐volitional elderly

individuals (n = 10 each; mean age 73.2 years) participated in the study. Heart rate during nocturnal sleep was recorded at their homes using an ambulatory polysomnographic system. High‐volitional individuals showed a lower HR throughout the night and less variability during rapid eye movement sleep. These findings suggest that a volitional lifestyle of the elderly has a beneficial effect on autonomic activity during sleep.
Primary adenocarcinoma of the duodenum in the elderly: Clinicopathological and immunohistochemical study of 17 cases
Authors: Arai Tomio , Murata Tetsuya , Sawabe Motoji , Takubo Kaiyo , Esaki Yukiyoshi
Published: March 2003

Seventeen cases of primary duodenal adenocarcinoma occurring in the elderly (older than 65 years) were examined to clarify their clinicopathological features and biological behavior. The mean age was 77.4 years (range, 66–104), and there was no appreciable difference in the incidence between the sexes (female : male ratio, 8 : 9). Thirteen patients had tumors located in the first portion of the duodenum, three in the second portion and one in the third portion. Grossly, there were three varieties of lesions: six polypoid, four flat‐elevated and seven ulcerative‐invasive. Sixteen cases showed well‐differentiated adenocarcinoma, three of which were difficult to distinguish from adenoma, and one was poorly differentiated adenocarcinoma. Three of 16 tumors had poor differentiation in the invasive area, whereas mucosal lesions were well differentiated. Eight tumors had invaded the duodenal wall with occasional involvement of the pancreas. Immunohistochemistry demonstrated p53 protein overexpression in two intramucosal (22.2%) and five invasive (62.5%) cancers. In the intramucosal area the mean Ki‐67‐positive rate (PR) of the tumors with distant metastasis was significantly higher than that of the tumors without metastasis (46.0 vs 31.6%; P < 0.05), while there was no significant difference in the association between PR and gross feature or depth of the tumors. Clinical follow‐up showed three of the five patients with invasive cancer died of carcinoma within 28 months. Compared with published data from other investigators, the results of the present study indicate a proximal shift of duodenal carcinoma in the elderly. Furthermore, it is concluded that invasive duodenal adenocarcinomas with high PR should be considered as potentially aggressive tumors, although their histology may indicate a high degree of differentiation.
Distribution of cadmium and metallothionein in CdCl2‐exposed rat kidney: Relationship with apoptosis and regeneration
Authors: Tanimoto Akihide , Hamada Tetsuo , Higashi Ken , Sasaguri Yasuyuki
Published: March 2003

Male Sprague–Dawley rats were injected subcutaneously with 0.6 mg cadmium/kg bodyweight per day for 6 weeks. In each week of exposure, rats were killed and the localization of cadmium and metallothionein in the kidney was studied by histochemical and immunohistochemical methods. Although cadmium was localized throughout the proximal tubules during exposure, apoptosis and subsequent regeneration were observed mainly in the straight portion of the proximal tubules after 4 weeks of exposure. The distribution of tubular injury may thus not necessarily coincide with that of cadmium. Expression of metallothionein was also detected in the cytoplasm and nuclei of the convoluted and the straight portion of the proximal tubules, but the latter became positive in accordance with apoptosis and regeneration. These results suggest a close relationship between metallothionein distribution and tubular cell regeneration.
Asiatic Center of Pathology as a basis of progress of Asiatic pathology in the future
Authors: Zubritsky Alexander
Published: March 2003

Nowadays in the Asian continent the necessary conditions seem ripe for the creation of an Asiatic Center for Pathology which could function as a ‘brain’ center and, at the same time, be an office of the Asian continent’s pathologists. The process of organizing the Asiatic Center for Pathology is proposed in the form of brief outlines and considerations for scrutiny and analysis to be followed by a thorough discussion. The creation of such an Asiatic Center for Pathology, which would have no counterpart in the world’s pathoanatomical practice, will undoubtedly be a powerful breakthrough in Asiatic pathology.
Apoptosis in abortive hair follicular components in the organoid nevus
Authors: Nakamura Toshitsugu
Published: March 2003

A previously undescribed fact that a small number of apoptotic bodies are present in about 62% of abortive hair follicles of the organoid nevus is discovered. The immaturity and frequency of apoptosis in the hair follicles seemed to be closely related to the hairless condition of the organoid nevus.
Nasal chondromesenchymal hamartoma of infancy: The first Japanese case report
Authors: Kato Keisuke , Ijiri Rieko , Tanaka Yukichi , Hara Masamichi , Sekido Kennichi
Published: March 2003

The first Japanese case of nasal chondromesenchymal hamartoma, a rare infantile nasal neoplasm, is presented. A 4‐month‐old Japanese boy was referred to our Centre because of intranasal mass and oculomotor disturbance. Radiological images showed the intranasal tumor extending to the paranasal sinus, orbit, and anterior frontal fossa. Subtotal resection and radiation therapy to residual tumor were performed. There has been no recurrence of the tumor for 13 years. Histologically, the lesion demonstrated admixture of various mesenchymal elements, including cellular spindle cell stroma with occasional myxoid change, nodules of mature/immature cartilaginous tissue, focal osteoclast‐like giant cells, and erythrocyte‐filled spaces resembling aneurysmal bone cyst. The histology was consistent with the findings presented by McDermott et al. 1986. Immunohistochemically, the spindle cells were positive for vimentin and smooth muscle actin. Chondrocytes in the mature cartilaginous tissue were positive for S‐100 and vimentin; chondrocytes in the immature cartilaginous tissue were positive for S‐100, vimentin, and smooth muscle actin. Ultrastructurally, the spindle cells showed features of either fibroblast or myofibroblast.
A case of anaplastic large cell (Ki‐1) lymphoma of B‐cell phenotype, occurring in Waldenström’s macroglobulinemia
Authors: Hamada Tomomi , Ishizuka Hikari , Asai Yasukiyo , Yamazaki Tetsuo , Sawada Umihiko , Hasegawa Hiromasa , Uchida Toshikazu
Published: March 2003

A case of anaplastic large cell (Ki‐1) lymphoma of B‐cell lineage occurred in a 59‐year‐old male with Waldenström’s macroglobulinemia. Immunostaining of the lymphoma cells showed sporadic positivity for IgM and occasional positivity for κ chain. This immunoglobulin specificity is the same as that of plasmacytoid lymphocytes in the bone marrow; therefore anaplastic transformation of Waldenström’s macroglobulinemia was strongly suggested. This seems to be the first reported case of anaplastic large cell lymphoma, confirmed by CD30 expression, arising in Waldenström’s macroglobulinemia.
Evidence of integrity of the follicular basement membrane in Hashimoto’s thyroiditis
Authors: Zantut‐Wittmann Denise Engelbrecht , Zollner Ricardo L. , Pinto Glauce A. , Vassallo José
Published: March 2003

The basement membrane as an antigenic structure in autoimmune diseases has been a matter of controversy. The purpose of our study was to determine possible structural changes in the follicular basement membrane (FBM) in thyroid autoimmune and non‐autoimmune diseases. Immunohistochemical staining for collagen IV and laminin showed that the continuity of the FBM was preserved in toxic adenoma (three cases), atoxic multinodular goiter (nine cases) as well as in autoimmune disease. Integrity of the FBM was observed in all 11 cases of Graves’ disease and Hashimoto’s thyroiditis (seven cases) studied. In some instances, the FBM was thinned in areas of contact with inflammatory infiltrate. We conclude that the auto‐antibodies, and possibly other factors present in autoimmune thyroid diseases, do not significantly alter the integrity of the FBM.
Mosaic‐like distribution of endothelial cell antigens in capillaries and juxta‐alveolar microvessels in the normal human lung
Authors: Kawanami Oichi , Jin Enjing , Ghazizadeh Mohammad , Fujiwara Masakazu , Jiang Li , Ohaki Yoshiharu , Gomibuchi Makoto , Takemura Tamiko
Published: March 2003

The distribution patterns of endothelial cell antigens, including thrombomodulin and von Willebrand factor (vWf), were studied in normal lung tissues obtained from distant areas of solitary nodules (seven adenocarcinomas and four hamartomas). By single immunoalkaline phosphatase and dual immunofluorescence stainings, the plasma membranes of alveolar capillary endothelium showed linear distribution of thrombomodulin, but their cytoplasm was rarely reactive for vWf (thrombomodulin‐dominant pattern). Microvessels with a diameter larger than 10 μm located in the connective tissue zones demonstrated band‐like reaction for vWf in their cytoplasm, and their plasma membranes often lacked reactivity for thrombomodulin (vWf‐dominant pattern). The juxta‐alveolar microvessels located along the borders between the alveolar‐ and connective‐tissue zones showed mosaic‐like pattern of distribution for these antigens. The pulmonary venules and peribronchial microvessels measuring up to 40 μm in diameter, demonstrated the expression of thrombomodulin along the plasma membrane, and that of vWf in the cytoplasm. Capillaries of the bronchial circulation were also characterized by mosaic‐like pattern of distribution. Both antigens were often expressed in a single cytoplasmic segment. The heterogeneous distribution pattern of these antigens suggests topographic difference in endothelial cell function to maintain coagulatory and anticoagulatory balance in the normal human lung.
Blastomatous tumor with teratoid features of nasal cavity: Report of a case and review of the literature
Authors: Deveci M. Salih , Deveci Güzin
Published: March 2003

A case of blastomatous tumor with teratoid features is presented. The polypoid mass was observed in the left nasal cavity of a 72‐year‐old man. Histologically, the lesion was composed of neuroepithelial cells with blastomatous appearance, cystic squamous nests filled with keratin materials, many mucous glands, complex tubular and glandular structures with edematous fibroblastic stroma. Sinonasal neoplasms including teratoid components and immature neuroepithelium are exceedingly rare. We suggest that the term ‘immature teratoma’ is more suitable than blastoma or blastomatous tumor when there is no carcinomatous or sarcomatous component besides the immature neuroepithelium and teratoid elements.
Atypical hyperplasia of choledocho‐pancreatic duct epithelium in an Otsuka Long Evans Tokushima Fatty strain of rats
Authors: Kondo Mari , Kanemoto Naohide , Taniguchi Yoshihiro , Iwanaga Tomoyuki , Arita Norimasa , Nose Masato , Tanigami Akira
Published: March 2003

Epithelial papillary hyperplasia of choledocho‐pancreatic duct, associated with cellular atypism, was observed in Otsuka Long Evans Tokushima Fatty (OLETF) rats, a strain originally established as an animal model for non‐insulin‐dependent diabetes mellitus (NIDDM). To investigate the potential feasibility of OLETF rats as an animal model for pancreatic ductal carcinoma, we examined the pathological characteristics of ductal lesions in OLETF rats aged from 5 to 50 weeks. Hyperplastic lesions in OLETF rats became apparent after 10 weeks of age and increased in severity and frequency of atypical changes in hyperplastic epithelium appearing after 20 weeks. We compared ductal lesions from OLETF rats with those from age‐matched Long Evans Tokushima Otsuka (LETO) rats, which share a similar genetic background with OLETF rats but do not develop NIDDM. While LETO rats also display a tendency toward ductal hyperplasia, lesions from OLETF rats were more numerous and larger in size than those from age‐matched LETO rats. In addition, lesions from OLETF rats contained a significantly higher number of proliferating cell nuclear antigen‐positive cells than those from LETO rats. Finally, lesions in OLETF rats were accompanied by inflammation, and the observed morphological alteration of lesions correlated well with the grade of inflammation.
A case of atypical granular cell tumor of the neurohypophysis
Authors: Kasashima Satomi , Oda Yoshio , Nozaki Jun‐ichi , Shirasaki Masaki , Nakanishi Isao
Published: March 2003

A case of granular cell tumor (GCT) arising in the neurohypophysis of a 63‐year‐old woman is reported. The tumor consisted of ovoid, polygonal or spindle‐shaped cells in a sheet‐like or fascicular arrangement. Its abundant cytoplasm contained granules positive for diastase‐resistant periodic acid–Schiff reaction. Ultrastructurally, the tumor cells contained numerous polymorphic lysosomes of various densities. Immunohistochemically, the tumor cells were positive for S‐100 protein, glial fibrillary acidic protein and Leu7, suggesting that the tumor originated from pituicytes that were thought to be modified astrocytes in the neurohypophysis and its stalk. The granular cells showed nuclear atypia, pleomorphism and increased mitotic activity. Therefore, the present tumor was considered as a histologically atypical GCT. Interestingly, proliferating cell nuclear antigen, Ki‐67 and p53 were stained in a few tumor cells of this case. These findings indicate that the present tumor had a malignant potential.
Clinicopathological features of solitary fibrous tumor of the meninges: An immunohistochemical reappraisal of cases previously diagnosed to be fibrous meningioma or hemangiopericytoma
Authors: Suzuki Satoshi O. , Fukui Masashi , Nishio Shunji , Iwaki Toru
Published: March 2003

Cases of solitary fibrous tumor (SFT) of the meninges are increasingly being reported. However, the real incidence of SFT among meningeal tumors has yet to be determined. We therefore clinicopathologically re‐examined 64 meningeal tumors originally diagnosed to be either fibrous meningioma (FM group, n= 46) or hemangiopericytoma (HPC group, n= 18) while paying special attention to SFT. We thus reclassified one case from the FM group (2%) and one case from the HPC group (6%) to be SFT, both of which showed diffuse CD34‐immunoreactivity and dense intercellular reticulin fibers but neither epithelial membrane antigen nor S‐100 protein expression. The MIB‐1 staining index of these cases were 6.2% and 3.9%, respectively. The former recurred 15 years after the initial surgery and the patient underwent a second removal of the tumor. The patient has been alive with no evidence of recurrence for 7 years after the second surgery. The latter patient has been alive with no evidence of recurrence for 3 years postoperatively. The results confirmed that the incidence of SFT among meningeal tumors is relatively low, however, because of its clinically indolent nature, a careful histochemical examination is necessary to differentiate SFT from other neoplasms with a more aggressive nature. Our findings emphasize the need to clinically recognize this lesion as a distinct entity.
Carcinosarcoma with rhabdoid features of the urinary bladder in a 2‐year‐old girl: Possible histogenesis of stem cell origin
Authors: Inagaki Tomoko , Nagata Michio , Kaneko Michio , Amagai Teruyoshi , Iwakawa Mayumi , Watanabe Teruo
Published: March 2003

A case of carcinosarcoma of the urinary bladder in a 2‐year‐old girl is reported. The tumor, measuring 34 × 20 × 18 mm, was located in the peri‐trigone area of the urinary bladder with polypoid features. Histologic examination revealed transitional cell carcinoma at the tumor surface with downward invasion. Concurrently, a sarcomatous area was found beneath the carcinoma, with these two different malignant components sharing on apparent transition without dis‐tinct boundaries. Sarcomatous components included immature round cells focally showing rhabdoid features. No rhabdomyomatous component was observed. Immunohistochemistry disclosed vimentin and cytokeratin‐double positive cells at the transposition between carcinoma and sarcomatous components. In addition, ultrastructural analysis revealed that the epithelial cells had a distinct junctional complex, and the sarcomatous cells occasionally had a meshwork of cytoplasmic intermediate filaments, indicat‐ing bidirectional cytodifferentiation to epithelial and mesenchymal elements. The extremely young age at which this case of carcinosarcoma occurred suggests that the tumor may be of mesodermal stem cell origin.
IDENTIFICATION OF MOLECULAR MARKERS IN DCIS RECURRENCE
Authors: E Provenzano , A Kavanagh , G Marr , G Giles , D Venter , J Armes
Published: March 2003

Background: DCIS represents preinvasive malignant change. With screening mammography DCIS has become a common entity. Its natural history is poorly understood and treatment remains controversial. Using a retrospective population based cohort, we have identified histological and molecular variables predictive of recurrence.

Methods: All cases of DCIS reported in Victoria between 1988 and 1992 were entered into the Victorian Cancer Registry. In Situ and Small Cancer Register (ISSIBCR) and followed up annually regarding treatment, the event of recurrence and its nature and location. From this register a cohort of 66 DCIS lesions with subsequent recurrence as in situ or invasive disease were studied histologically, immunohistochemically and with CGH‐based genetic analyses comparing them to a nested randomized control group of DCIS without recurrence matched for patient age and year of diagnosis. Recurrences have been analysed by the same techniques to compare them to the primary lesion.

Results: 13 histological features were evaluated and lesion size, nuclear pleomorphism, cellular polarity, micropapillary architecture and central necrosis were all significant predictors of recurrence (p < 0.05). Immunohistochemistry showed p21 overexpression, bcl2 negativity and ERBB2 positivity to be markers of recurrence. In the case of ERBB2, positivity was a predictor of recurrence even when its overexpression was focal. Primary and recurrent DCIS lesions had similar morphological appearances, and grade of primary DCIS correlated with grade of subsequent invasive cancer. This morphological similarity was paralleled by similar protein expression and genomic changes in both in situ and invasive recurrences.

Conclusion: We have identified histological and immunohistochemical markers of recurrence in DCIS, and shown similarities in morphology, protein expression and genetic changes between primary DCIS and its recurrence.
CORE IMPRINT CYTOLOGY: A USEFUL METHOD FOR SAME‐DAY REPORTING
Authors: FA Frost , GF Sterrett , D Whitaker , WB DeBoer , A Segal
Published: March 2003

INTRODUCTION: Core biopsy of the breast has become the method of choice for tissue diagnosis of screen detected microcalcifications and some mass lesions in many breast assessment centres. Biopsy results are not available until the following day. Imprint cytology of fresh breast core samples allows same‐day reporting and patient counselling.

AIM: To determine the accuracy of core imprint cytology when compared with core biopsy diagnosis when used in a breast assessment centre setting.

METHODS: Core imprints (CI) were prepared and reported on all fresh core biopsies (CB) performed at the Sir Charles Gairdner Hospital Breast Centre from May to December 2000. Fresh core samples were placed on a glass microscope slide. Core radiographs were taken for microcalcification lesions (MC). A laboratory technician gently and quickly rolled the cores on the slide with fine forceps. The cores were fixed in formalin, processed and reported next day. The imprint slide was air dried and stained with DiffQuik. CI were reported using four categories: Insufficient, Benign, Indeterminate and Malignant. Counselling and planning for management were possible on the same day in women with malignant diagnoses. Clinicians were advised not to discuss negative or indeterminate CI results with women and to defer to the final CB report.

RESULTS: Cores were performed on 381 lesions. There were 83 carcinomas (38 in MC and 45 in masses) and 56 were called malignant on CI (absolute sensitivity 67.5%; 78.9% for MC and 57.8% for masses). 3 malignancies on CB were negative on CI giving a false negative rate of 3.6%. There were no false positive diagnoses. The predictive value of a benign diagnosis was 95.3%. There were no adverse effects in the histology of CB.

CONCLUSION: CI was an accurate method of providing an immediate diagnosis of malignancy in two thirds of malignancies confirmed on CB.
TP53 deleted cells in de novo glioblastomas using fluorescence in situ hybridization
Authors: Horiguchi Hidehisa , Sano Toshiaki , Hirose Takanori
Published: March 2003

Glioblastoma (GBM) has been known to have two distinct genetic pathways of tumorigenesis. Secondary GBM shows frequent TP53 mutation, but de novo (primary) GBM is usually independent of TP53 alteration. However, the subpopulation of TP53 altered cells in the latter tumor is obscure. In order to assess TP53 deleted cells in de novo GBM quantitatively, we performed dual color fluorescence in situ hybridization (FISH) for TP53 and centromere 17 in nine cases of de novo GBM with frozen surgical materials. Single TP53 signal cells indicating TP53 deletion were recognized in 8.7–35.6% (mean, 21.3%) among the nine cases. In addition, immunohistochemistry was performed for the Ki‐67 antigen (MIB‐1) and p53 protein in all nine cases. Labeling indices (LI) of MIB‐1 ranged from 2.8 to 46.9% (mean, 20.8%). Between the group with the more dense subpopulation of TP53 deleted cells (15% or more) by FISH and the group with less subpopulation than the former, these LI of MIB‐1 demonstrated statistically significant difference (respective means, 28.2% and 6.1%; P < 0.05). Conversely, LI of p53 protein shown to be 0–50.9% (mean, 24.9%) had no correlation with the subpopulation of TP53 deleted cells by FISH. Four cases who had higher LI of p53 protein (mean, 39.7%) than the subpopulation of TP53 deleted cells (mean, 12.7%), respectively, indicated the presence of many p53 protein immunoreactive cells without TP53 deletion. These results suggest that: (i) de novo GBM also has subpopulation of TP53 deleted cells; (ii) TP53 alteration, which may not be a major event, participates in cell proliferation of de novo GBM; and (iii) de novo GBM tends to have accumulation of wild‐type p53 protein.
Detection of numerical alterations of chromosome 1 in cytopathological specimens of breast tumors by chromogen in situ hybridization
Authors: Takarabe Teruko , Tsuda Hitoshi , Okada Satoshi , Fukutomi Takashi , Hirohashi Setsuo
Published: March 2003

To investigate the effectiveness of chromogen in situ hybridization (CISH) in the diagnosis of breast tumors, numerical alterations of chromosome 1 were examined by CISH and fluorescence in situ hybridization (FISH) methods, and the presence of der(16)t(1;16) was also examined by FISH in imprinted cytology specimens from resected tissues of 14 carcinomas and five non‐malignant lesions. The modal signal counts of chromosome 1 were compared between the specimens processed by CISH and FISH for each case. Aneusomies of the long arm of chromosome 1 were detected in 10 (71%) carcinomas as the major clones by both methods. In addition, one atypical papilloma demonstrated tetrasomy of 1q12 as a major clone by CISH, but such a clone was at first overlooked by FISH. Four other benign lesions showed disomic 1q12 signals as a major clone by both CISH and FISH. As additional information from FISH, eight cancers showed structural or numerical alterations of chromosome 16, and four showed der(16)t(1;16). In total, 10 carcinomas showed chromosome 16 alterations, and all of these overlapped with the carcinomas with 1q12 aneusomies. The CISH method provided almost the same results as the FISH method, and both methods were considered applicable in supportive diagnosis of cytological specimens of breast tumors. In addition, the CISH method was superior in the detection of numerical alterations in carcinoma cells by referring to the morphology of cells and in the detection of significant clones which might be missed under dark‐field microscopy.
Ciliated epithelia in the urethra: Case report and literature review
Authors: Che Mingxin , Ro Jae Y. , Ordonez Nelson G. , Miller Richard W. , Ayala Alberto G.
Published: March 2003

The presence of ciliated epithelial cells in the urethra has not been well recognized. Only two reports in the literature, both of which used scanning microscopy studies, have described this phenomenon. In this report, we illustrate the presence of scattered, ciliated epithelial cells in penile urethral biopsy specimens from a 38‐year‐old man with a history of bladder calculi and hematuria, by both light and transmission electron microscopy studies. The cilia in the urethra showed typical light microscopic and ultrastructural features of those seen in other organs. These ciliated cells are present in association with urothelial papilloma, condyloma acuminatum and acute inflammation of the urethra. These findings suggest that ciliated cells in the penile0 urethra might be a consequence of metaplastic change of the urothelium, secondary to local stimulation or irritation.
Olfactory neuroblastoma with epithelial and endocrine differentiation transformed into ganglioneuroma after chemoradiotherapy
Authors: Miura Katsutoshi , Mineta Hiroyuki , Yokota Naoki , Tsutsui Yoshihiro
Published: March 2003

We report a 56‐year‐old man in whom an olfactory neuroblastoma with epithelial and endocrine differentiation transformed into a mature ganglioneuroma after chemoradiotherapy. The tumor arising from the sphenoidal and maxillary sinuses showed rapid growth into the frontal lobe and metastasis to the cervical lymph nodes. The patient showed signs of a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A radical craniofacial resection of the primary tumor was performed after 16 Gy of local irradiation and systemic chemotherapy. Three months after the operation, the patient died of mediastinal metastasis. The biopsy before chemoradiotherapy showed a neuroblastoma with Homer–Wright rosettes, fibrillary matrix, Flexner–Wintersteiner rosettes and antidiuretic hormone production. After chemoradiotherapy, the histology changed to that of a ganglioneuroma consisting of large ganglion cells and Schwann cells without immature neuroblastoma components. Although transformation to ganglioneuroma in an adrenal neuroblastoma is common, an olfactory neuroblastoma showing ganglioneuronal maturation after chemoradiotherapy has not been reported. The pluripotent progenitor cells of the olfactory neurons may be the origin and their existence explains why various neoplasms with neuronal and epithelial differentiation arise from the olfactory mucosa.
Double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver
Authors: Zhang Zean , Nonaka Hiroko , Nagayama Tadashi , Hatori Tsutomu , Ihara Fumie , Zhang Liang , Akima Michio , Shiba Tadaaki
Published: March 2003

A very rare case of a double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver in a 65‐year‐old‐man is discussed. The patient was hospitalized with epigastralgia in May 1997. Abdominal computed axial tomography revealed a tumor located in the left lobe of the liver and a left hepatic lobectomy was performed. The tumor recurred several months after surgery and the patient died on 4 June 1999. At autopsy, both a major tumor mass with extensive involvement, located in the surgical margin, and a small mass located in S7 were discovered. Microscopically, the major tumor was diagnosed as adenosquamous carcinoma and the small one in S7 as hepatocellular carcinoma. To our knowledge, this is the first case of a double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver. The pathological findings support the hypothesis that this tumor developed as a squamous transformation of adenocarcinoma.
Aberrant expression of pRb, p16, p14ARF, MDM2, p21 and p53 in stage I adenocarcinomas of the lung
Authors: Xue Qi , Sano Takaaki , Kashiwabara Kenji , Saito Masako , Oyama Tetsunari , Nakajima Takashi
Published: March 2003

Cancers are always associated with cell cycle abnormalities. To clarify the cell cycle abnormalities present in lung adenocarcinomas, various cell cycle regulatory proteins of both the pRb and p53 pathways were studied immunohistochemically in 50 cases of stage I adenocarcinoma of the lung. In regard to the pRb pathway, most adenocarcinomas showed frequent expression of both p16 and pRb proteins, and aberrant expression in the pRb pathway was observed in about one‐quarter of stage I adenocarcinomas. In regard to the p53 pathway, the frequency of immunohistochemical positivity was 8% for p14ARF, 64% for MDM2, 20% for p53 and 24% for p21. In this pathway, the immunohistochemical profile of p14ARF‐negative/MDM2‐positive/p53‐negative is characteristic of stage I adenocarcinoma of the lung. An inverse relationship was found between MDM2 and p53 protein and was associated with the differentiation status of stage I adenocarcinoma of the lung. Our results suggest that the disruption of the pRb and p53 pathways is frequently observed in the early stages of lung adenocarcinoma and might play an important role in the growth and differentiation of adenocarcinoma of the lung.
Primary osteosarcoma of the uterine corpus: Case report and review of the literature
Authors: Su Mu , Tokairin Takuo , Nishikawa Yuji , Yoshioka Tomomi , Takahashi Osamu , Watanabe Hitoshi , Doi Yuko , Omori Yasufumi , Yoshioka Toshiaki , Sageshima Masato , Tanaka Toshinobu , Enomoto Katsuhiko
Published: March 2003

A rare case of rapidly growing osteosarcoma that developed in the uterine corpus of a 62‐year‐old woman is presented. The tumor occupied almost the entire pelvic cavity and extended into the abdominal cavity, with marked involvement of the intestines. Histopathologically, the tumor was composed of an osteoblastic component, accompanied by conspicuous bone formation, and a fibroblastic component. The tumor cells were positive for vimentin and osteocalcin, as well as desmin, α‐smooth muscle actin and muscle‐specific actin, but negative for h‐caldesmon. The results indicated myofibroblastic differentiation in a part of the tumor. A review of 14 reported cases and our case of uterine osteosarcoma revealed that this tumor has a biologically aggressive nature, although its histopathological and immunohistochemical features are similar to those of osteosarcomas in soft tissue and bone. As the prognosis of patients with this tumor is poor, it is of importance to differentiate this tumor from other types of tumors arising from the uterine corpus.
Antisense oligodeoxynucleotides against thrombomodulin suppress the cell growth of lung adenocarcinoma cell line A549
Authors: Fujiwara Masakazu , Jin Enjing , Ghazizadeh Mohammad , Kawanami Oichi
Published: March 2003

Thrombomodulin (TM), an anticoagulant factor on endothelial cells, is known to be expressed in non‐endothelial cells as well. In neoplastic cells of lung adenocarcinomas, TM is expressed but its correlation with growth potential has not been studied. As TM expression has a negative correlation with cell proliferation in lung squamous cell carcinomas, we examined its growth effect on lung adenocarcinoma cells of the A549 cell line by inhibiting TM expression with antisense oligodeoxynucleotides (ODN). In the antisense ODN transfected cells, the expression of TM mRNA was decreased to 49% at 12 h and 47% at 24 h, which was in accordance with TM expression at the protein level. By IdU (5‐iodo‐2′‐deoxyuridine) incorporation assay, the growth of A549 cells was found to have decreased to 36% of the control level at 24 h post‐transfection. The suppression of cell growth was maintained in a concentration‐dependent manner for 48 h after transfection, when the expression of TM started to rebound. In the transfected cells, the G1 phase cell count was reduced to 60.7%, compared with 68.2% in the control transfectants. These results suggest that TM expression may play a suppressive role in the proliferation activity of A549 lung adenocarcinoma cells.