bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep architectures of obstructive sleep apnea syndrome in the young child
Authors: Yamadera Wataru , Chiba Shintarou , Itoh Hiroshi , Ozone Motohiro , Takahashi Toshiharu , Sasaki Mitsuo , Ushijima Sadanobu , Moriyama Hiroshi
Published: March 2003

The sleep architectures of obstructive sleep apnea syndrome (OSAS) in the young child (child‐OSAS, n = 17; mean age: 5.9 ± 2.7 years; male : female 14 : 3) were compared with that of OSAS in the adult (n = 19; mean age: 44.7 ± 10.7 years; male : female 18 : 1) and that of primary snoring in the child (n = 5; mean age: 7.0 ± 2.4 years; male : female 5 : 0). Child‐OSAS and OSAS in the adult had the same severity in oxygen desaturation. Child‐OSAS showed lower Apnea–Hypopnea Index compared with OSAS in the adult. Sleep continuity in child‐OSAS was not impaired compared with OSAS in the adult. Sleep fragmentation in child‐OSAS was not so remarkable. The quantity of slow wave sleep in child‐OSAS was similar to that of primary snoring in the child. Both profiles of sleep architectures showed nearly the same pattern.
Facial patterns of obstructive sleep apnea patients using Ricketts’ method
Authors: Kikuchi Makoto , Higurashi Naoki , Miyazaki Soichiro , Itasaka Yoshiaki
Published: March 2003

To analyze the facial patterns of obstructive sleep apnea syndrome (OSAS) patients, we took lateral cephalograms of 31 OSAS patients and 26 non‐OSAS controls and utilized Ricketts’ method. In addition, we measured the hyoid bone position, the length of mandibular plane to H‐point, the length of soft palate, and lower pharynx. The facial patterns of OSAS patients were dolico, the hyoid bone was positioned low, the soft palate was longer and the width of the airway was narrower than that of the non‐OSAS controls.
Cortical activation during retrieval of arithmetical facts and actual calculation: A functional magnetic resonance imaging study
Authors: Kazui Hiroaki , Kitagaki Hajime , Mori Etsuro
Published: March 2003

Abstract By using functional magnetic resonance imaging (fMRI), the neural substrates involved in mental recitation of the single‐digit multiplication table and serial subtraction were studied. The former depends mostly on well‐learned arithmetical facts, while the latter requires arithmetic processing. Activation during each task was compared with that in a number counting control. During the recitation of single‐digit multiplication, the activated regions included the area lying along the left intraparietal sulcus, the premotor and supplementary motor areas, and the posterior portion of the left inferior frontal gyrus. The areas activated during serial subtraction included these areas as well as the bilateral prefrontal and right parietal areas. From the results obtained during retrieval of the multiplication table in this study and previous studies, it was concluded that semantic memory of the multiplication table is stored in the area lying along the intraparietal sulcus and that the frontal areas play an executive role in utilizing the semantic memory of arithmetical facts. It was assumed that the arithmetical facts requiring actual calculation are also stored in the same region. The additional activation during serial subtraction compared with the activation during retrieval of the multiplication table is probably due to the processes of actual calculation. These processes include proper alignment of digits, which may have caused the right parietal activation, and maintaining digits needed for the mental serial subtractions, which may have caused the bilateral prefrontal activation.
Open study of effects of alprazolam on seasonal affective disorder
Authors: Yamadera Hiroshi , Okawa Masako , Takahashi Kiyohisa
Published: March 2003

Abstract Seasonal affective disorder (SAD) differs from depression with melancholic features in atypical symptoms, such as hyperphagia, hypersomnia and weight gain. Moreover, SAD is confined to a certain season of the year. We examined the pharmacological efficacy of alprazolam for treatment of patients with SAD. Six patients with SAD were treated with alprazolam at doses of 1.2 mg/day or 1.2 mg/day first and then 2.4 mg/day for 2 weeks. The improvement was evaluated by the change of total score of the SIGH‐SAD (with both 21 items HAMD and eight items atypical symptoms) and the clinical global impression (CGI). Although only two patients showed a remarkable improvement by SIGH‐SAD, all patients showed a higher than moderate improvement with CGI. Our findings suggest that alprazolam might be efficacious for certain SAD patients.
Sylvian fissure and medial temporal lobe structures in patients with schizophrenia: A magnetic resonance imaging study
Authors: Aso Mitsuo , Suzuki Michio , Kawasaki Yasuhiro , Matsui Mie , Hagino Hirofumi , Kurokawa Kenzo , Seto Hikaru , Kurachi Masayoshi
Published: March 2003

Abstract Volumes of the medial temporal lobe structures (i.e. the amygdala, hippocampus, and parahippocampal gyrus), Sylvian fissure, and inferior horn of the lateral ventricle relative to the cerebral hemisphere were measured in 24 patients with schizophrenia and 23 normal controls using magnetic resonance imaging. The patients had significantly larger Sylvian fissures and inferior horns bilaterally than the controls. In the patients the right Sylvian fissure size showed a significant positive correlation with the duration of illness. Moreover, earlier onset of illness was significantly correlated with decreased volume of the left medial temporal lobe structures. These results replicate previous finding of inferior horn enlargement and suggest the significance of the Sylvian fissure and the medial temporal lobe structures in pathophysiology of schizophrenia.
Borderline personality traits in hysterical neurosis
Authors: Ohshima Tatsuo
Published: March 2003

Abstract The objective of the present study is to demonstrate the traits of the psychopathology of Borderline Personality Disorder (BPD) compared with hysterical neurosis. A total of 48 subjects with BPD and 40 subjects with hysterical neurosis both defined by DSM‐III‐R were assessed by Diagnostic Interview for Borderlines (DIB). Statistical analysis was done by quantification of the second type, a multivariate data analysis. The total scores of DIB were BPD group, 6.13 ± 1.52; hysterical neurosis group, 4.9 ± 2.12 (t = 3.05, P = 0.0016). The correlation ratio (index of to what extent the two groups are discriminated) was 0.2442. Among the four parameters of: (i) affect, (ii) cognition, (iii) impulse–action pattern, (iv), and interpersonal relationships, the partial coefficient correlations of (iii) and (iv) were significantly high (0.342, 0.287, P < 0.01). The question items with high independent coefficients were manipulation (0.4416), intolerance of aloneness (0.3797), demanding nature (0.3768), self‐mutilation (0.3609), visual hallucination (0.3395). Those with low score of independent coefficients were counterdependency (0.0533), identity disturbance (0.1010), depression (0.1551), loneliness (0.1752), hypomanic episode (0.1936). Both of BPD and hysterical neurosis groups were not so fairly well discriminated. However, these results suggested that impulse‐action pattern and disorder of interpersonal relationships were traits of borderline personality disorder. We could admit manipulation, intolerance of aloneness as its symptoms. In addition, counterdependency, identity disturbance were comparatively common to both. There were some borderline personality traits symptomatically in hysterical neurosis.
Study of anticipation in Chinese families with schizophrenia
Authors: Lin Ching‐Hua , Tsai Shih‐Jen , Yu Younger W‐Y. , Yang Kuan‐Hung , Hsu Chiu‐Peng , Hong Chen‐Jee
Published: March 2003

Abstract The anticipation phenomenon is an important aspect in several genetic disorders in which the age at onset (AAO) decreases and the severity of illness increases in successive generations. This phenomenon has been reported in several schizophrenic family studies, and expanded repeat mutations are implicated. In the present study, we investigate the anticipation phenomenon in Chinese schizophrenic families. We compare the AAO between two generations of 38 unilinear schizophrenic families. Intergenerational comparisons show that the AAO was significantly earlier in the offspring generation (mean AAO, 22.2 years) than that in the parental generation (mean AAO, 31.0 years) (P < 0.001). When only including the offspring generation who married, the AAO difference between the two generations was not significant (28.4 years vs 31.0 years, P = 0.151). Our findings suggest that a selection bias in the parental group might greatly impact the study of anticipation in schizophrenia. Other unavoidable biases associated with these analyses are discussed in the text.
High levels of nocturnal activity in children with attention‐deficit hyperactivity disorder: A video analysis
Authors: Konofal Eric , Lecendreux Michel , Bouvard Manuel P. , Mouren‐Simeoni Marie‐Christine
Published: March 2003

Abstract Sleep disturbances can lead to symptoms of attention‐deficit hyperactivity disorder (ADHD) in children. In the present study, we compared the sleep patterns of 30 children with ADHD, with those of 19 controls matched for age (5–10 years) and sex. Sleep patterns were recorded during one night, using polysomnography (PSG) and a video system in the sleep laboratory. Both ADHD children and controls were medication free and showed no clinical signs of sleep and alertness problems. An infrared camera was used to record all types of movement, which were scored and analyzed using specific software (Observer® 3.0; Noldus International, The Netherlands). No significant differences in sleep variables were found between ADHD children and controls. Polysomnography data showed no significant difference between the two groups. Attention‐deficit hyperactivity disorder children moved more often than controls (upper limbs, P < 0.04; lower limbs, P < 0.03; all types, P < 0.003). The duration of movements was significantly longer in ADHD children (upper limbs, P < 0.03; all types, P < 0.02). The results of the video analysis were consistent with previous findings that ADHD children have higher levels of nocturnal activity than controls. This activity concerned mostly upper and lower limb movements. Futher studies are required to determine why noctural activity does not affect sleep continuity in a more significant way and whether it should be treated specifically.
Seasonal changes in sleep and behavioral problems in a pubescent case with autism
Authors: Hayashi Etsuko
Published: March 2003

This study reports on the seasonal changes in sleep problems and behavioral problems in a pubescent case with autism. His care diary, kept for 1 year, showed seasonal changes of sleep and behavioral problems, and that his behavioral problems preceded his sleep problems.
Nineteen‐hour variation of postural sway, alertness and rectal temperature during sleep deprivation
Authors: Nakano Toshio , Araki Kazunori , Michimori Akihiro , Inbe Hiroyuki , Hagiwara Hiroshi , Koyama Emi
Published: March 2003

Nineteen‐hour variation of postural sway, alertness and rectal temperature during sleep deprivation were studied. Alertness decreased gradually at night and remained low until morning. Postural sway in the eyes‐closed condition increased during early morning. In six of the eight subjects the greatest sway was observed during the 3‐h period when rectal temperature was at its minimum. It is suggested that unbearable sleepiness during sleep deprivation will give rise to measurable impairment of postural balance especially during the time zone of temperature nadir.
Effect of clonazepam treatment on antipsychotic drug‐induced Meige syndrome and changes in plasma levels of GABA, HVA, and MHPG during treatment
Authors: Yoshimura Reiji , Kakihara Shingo , Soya Atsushi , Ueda Nobuhisa , Shinkai Koji , Nakamura Jun
Published: March 2003

Abstract We demonstrated the effect of clonazepam (2 mg/day) on Meige syndrome in two schizophrenic patients under continuous treatment with antipsychotic drugs, and changes in the plasma levels of γ‐aminobutyric acid (GABA), homovanillic acid (HVA), and 3‐methoxy‐4‐hydroxyphenylglycol (MHPG) in these cases. The plasma levels of HVA and MHPG during treatment with clonazepam were decreased in the responder, while not changed in the non‐responder to clonazepam. A difference between the responder and the non‐responder was not found in the plasma GABA levels. These results suggest that hyperactivities of the central dopaminergic and noradrenergic neurones are involved in the pathophysiology of Meige syndrome.
Body image, symptoms and insight in chronic schizophrenia
Authors: Koide Reiko , Iizuka Satoshi , Fujihara Kouyou , Morita Nobuaki
Published: March 2003

Abstract Historically, schizophrenics' body image problems were regarded as related particularly to delusions and hallucinations. However, during the 1980s, the predominant view of the phenomenology of the disorder broadened to include negative symptoms; deviations in schizophrenics' body image underlie various behaviors or allegations concerning the body and should be refocused. The present study attempted to detect body image deviations in chronic schizophrenia using the Body Image Questionnaire (BIQ), which comprises three hypothetical components (anatomical, functional and other psychological components), and to clarify their related clinical characteristics in symptoms and insight. The BIQ was administered to 93 chronic schizophrenics (diagnosed according to DSM IV; 44 men and 49 women) and 177 normals (78 men and 99 women) adults. The combined data of the three BIQ components in schizophrenic and normal subjects were factor‐analyzed separately, and factor scores obtained were compared between schizophrenic and normal groups. The factor scores that differentiated groups were further compared between schizophrenic subgroups, determined by high or low scores for positive symptoms assessed by Scale for the Assessment of Positive Symptoms, negative symptoms by Scale for the Assessment of Negative Symptoms and insight by the Schedule for Assessing Insight. Significant differences between diagnostic groups were found in five of nine factor scores. Dullness in movement, powerlessness, unusually strong gastrointestinal function, lifelessness and fragility proved to be the deviated body images in chronic schizophrenic patients. Powerlessness and lifelessness proved to be related to positive and negative symptoms, and unusually strong gastrointestinal function and fragility to insight.
Static stabilometry in patients with migraine and tension‐type headache during a headache‐free period
Authors: Ishizaki Kumiko , Mori Nozomi , Takeshima Takao , Fukuhara Yoko , Ijiri Tamami , Kusumi Masayoshi , Yasui Kenichi , Kowa Hisanori , Nakashima Kenji
Published: March 2003

Abstract The vestibulospinal system was evaluated using a stabilometric method in patients
with migraine and episodic tension‐type headache during headache‐free periods. Migraine
patients often complain of dizziness or vertigo during headache attacks and some
exhibit these symptoms between attacks. Computerized static stabilometry is a reliable
and non‐invasive technique to evaluate the equilibrium function in various diseases.
The subjects consisted of 21 patients with migraine, 12 patients with episodic tension‐type
headache and, age‐ and sex‐matched controls. We performed two sets of static stabilometric
measurements with eyes open (EO) and eyes closed (EC) for 30 s. The averages of two
sessions of the following six stabilometric parameters were used for the analysis:
locus length (LNG), environmental area (ENV‐AREA), rectangle area (REC‐AREA), locus
length per second, locus length per environ area (L/E), and root mean square area.
Romberg quotients (EC/EO) of these six parameters were also analyzed. The mean values
of LNG, ENV‐AREA and REC‐AREA in the EC session in the migraine group were significantly
greater than those in the controls (P < 0.05, Mann–Whitney rank sum test). Romberg quotients of all stabilometric parameters except the L/E in the migraine group were significantly greater than in the controls. Patients with episodic tension‐type headache did not show any differences in the stabilometric study from the controls. The present findings suggest that patients with migraine show a significant increase of the body sway during the EC session, which indicates an underlying dysfunction in the vestibulospinal system.
Pain threshold and pain recovery after experimental stimulation in patients with burning mouth syndrome
Authors: Ito Mikiko , Kurita Kenichi , Ito Takako , Arao Munetaka
Published: March 2003

Abstract The aim of the present study was to examine pain threshold and pain recovery in patients with burning mouth syndrome (BMS) and matched no‐pain controls. Twenty female patients diagnosed with BMS without organic gross changes were enrolled in the study. Twenty control subjects were chosen from age‐matched healthy female volunteers. We compared the thermal pain threshold using heat beam dolorimeter on the finger and tongue between patients and controls. Warm (at 50°C for 5 s), cold (at 0°C for 30 s) and mechanical (stimulation by electric tooth brush for 15 s) stimulation was applied to the tongue for both groups. Participants were asked to rate the subjective pain using a visual analogue scale (VAS). Although there was no significant differences between patients and controls in terms of the threshold on the finger, the threshold on the tongue was significantly higher in patients than in controls. We suggest there were peripheral dysfunction at the tongue, and/or central dysfunction in patients with BMS. Among the three types of stimulation, the patients perceived significantly the highest pain from the mechanical stimulation for the first 5 min after the stimulation. Furthermore, when patients with BMS perceived some pain, they continued to complain of the pain longer and more intricately than the controls. This indicates that the pain of the patients is strongly affected not only at a sensory component but also at an affective/motivational component than the controls. However, we should be cautious of simply advancing psychogenic theory in this etiology.
Use of an infrared sensor system to take long‐term bedside measurements of rest–activity patterns in the elderly with dementia
Authors: NAKANO TOSHIO , KOYAMA EMI , NAKAMURA TOSHIYUKI , ITO TAKEO , TAMURA KOJI , YAGINUMA MASAAKI
Published: March 2003

Abstract In order to study long‐term rest–activity patterns of elderly residents in care facilities, an infrared sensor system was developed. This sensor system detects a resident’s presence or absence from their bed and their activity with little inconvenience. Using this system, the rest–activity patterns of two elderly people with dementia was assessed over a period of 3 months. For both subjects, frequent activity peaks and absences from their beds were often observed during the night. Such a sensor system will be useful for evaluating the sleep–wake rhythms of people with sleep disorders.
Perirhinal cortical lesion suppresses the secondary generalization in kainic acid‐induced limbic seizure
Authors: FUKUMOTO SHIN‐ICHIRO , TANAKA SHIGEYA , TOJO HIDESHI , AKAIKE KOICHI , TAKIGAWA MORIKUNI
Published: March 2003

To elucidate the role of the perirhinal cortex (PRC) in experimental epilepsy, the effects of the lesion of the PRC on kainic acid (KA)‐induced limbic seizure were investigated. The PRC lesion was made by means of ibotenic acid (IBO) microinjection. The electroencephalogram in the PRC‐lesioned rats demonstrated suppression of the propagation of epileptic discharges from the limbic structures to the sensorimotor cortex. Behaviorally, motor manifestations such as mastication, facial twitching and forelimb clonus were attenuated. These results indicate that the PRC seems to be a potent relay station of the secondary generalization from the limbic structures to the sensorimotor cortex.
Mental health conditions among atomic bomb survivors in Nagasaki
Authors: HONDA SUMIHISA , SHIBATA YOSHISADA , MINE MARIKO , IMAMURA YOSHIHIRO , TAGAWA MASUKO , NAKANE YOSHIBUMI , TOMONAGA MASAO
Published: March 2003

To elucidate the effects of the bombing on the atomic bomb survivors’ mental health, a mental health survey was conducted using a 12‐item version of the General Health Questionnaire (GHQ‐12) and a mail survey on atomic bomb exposure conditions and lifestyle using a self‐administered questionnaire. A total of 3526 atomic bomb survivors in Nagasaki responded and a high GHQ‐12 score, as defined when the responses to four or more items were positive, was observed in 296 (8.4%) subjects. It was indicated that the risk of a high GHQ‐12 score will decrease 0.98‐fold with every 1‐year increase in age, and will increase 1.45‐fold and 1.70‐fold in those who lost family members due to the bombing and those who had acute symptoms, respectively, compared with those who did not. It was indicated that the atomic bomb exposure has affected survivors’ mental health and that the care of their mental health is important.
Dipeptidyl peptidase IV (DPP IV/CD26) staining predicts distant metastasis of ‘benign’ thyroid tumor
Authors: Hirai Keisuke , Kotani Tomio , Aratake Yatsuki , Ohtaki Sachiya , Kuma Kanji
Published: March 2003

Because follicular thyroid carcinoma is extremely difficult to diagnose, several cases were encountered which have been rediagnosed as carcinoma due to distant metastasis. In the search for a method of correctly diagnosing ‘benign’ thyroid tumor, dipeptidyl peptidase (DPP) IV immunostaining was applied to 10 cases whose diagnoses had been corrected to follicular thyroid carcinoma because of distant metastases. The positive rate of immunostaining using paraffin sections in the rediagnosed follicular thyroid carcinoma group (7/10) was much higher than that of the control group (1/29), which consisted of 15 cases of follicular thyroid adenoma and 14 cases of nodular hyperplasia. These results suggested that pre‐ or postoperative DPP IV staining is useful for predicting distant metastasis of ‘benign’ thyroid tumor.
Expression of sialyl‐Tn, Tn and T antigens in primary liver cancer
Authors: Sasaki Motoko , Yamato Taro , Nakanuma Yasuni
Published: March 2003

Sialyl‐Tn, Tn and T antigens are caused by aberrant or incomplete glycosylation of apomucins and are related to the aggressiveness of malignant neoplasms. Using 41 liver samples from patients with cholangiocarcinoma (including four with cirrhosis), 21 with combined hepatocellular– cholangiocellular carcinoma and 17 with hepatocellular carcinoma, the expression of sialyl‐Tn, Tn and T antigens were characterized immunohistochemically and the correlation with apomucin profiles was evaluated. The prevalence of sialyl‐Tn, Tn and T antigens expression was 89, 95 and 51% in cholangiocarcinoma without cirrhosis; 25, 75, and 0% in cholangiocarcinoma with cirrho‐ sis; 29, 90, and 48% in combined hepatocellular– cholangiocellular carcinoma; and 0, 12 and 6% in hepatocellular carcinoma, respectively. Sialyl‐Tn antigen was frequently expressed in cholangiocarcinoma without cirrhosis compared with cholangiocarcinoma with cirrhosis and combined hepatocellular–cholangiocellular carcinoma (P< 0.01). Although sialyl‐Tn expression was associated with MUC1, MUC6 and MUC7 expression, the expression sites among them were not identical in the individual cases. These data suggest that the different expressions of sialyl‐Tn antigen among cholangiocarcinoma without cirrhosis, cholangiocarcinoma with cirrhosis and combined hepatocellular–cholangiocellular carcinoma may reflect the biological features inherent to these tumors, such as the ability of invasion.
Esophageal undifferentiated carcinoma displaying marked chondroid differentiation at metastatic foci
Authors: Yokoo Hideaki , Arai Hanako , Isoda Koji , Nakazato Yoichi , Nakayama Yuko , Suzuki Yoshihiko , Hatakeyama Setsuko
Published: March 2003

A report of an unusual esophageal tumor in an 81‐year‐old man is presented. The primary tumor was diagnosed as undifferentiated carcinoma at biopsy and had disappeared after irradiation treatment. However, multiple metastases were noted in the brain, lungs, kidneys, adrenals and spleen at autopsy. Histologically, metastases showed marked cartilaginous metaplasia as demonstrated by light microscopy, histochemical and immunohistochemical studies, although the initial biopsy sample did not possess chondroid matrix. Furthermore, an apparent transition could be traced from carcinomatous to chondroid cells, suggesting that the chondroid cells were derived from carcinoma cells. The carcinomatous area partially showed both squamous and glandular differentiation, although they were poorly differentiated. A retrospective immunohistochemical study that used a panel of antibodies suggested a phenotypic relevance between primary and metastatic tumors.
Heterotopic sebaceous glands in the esophagus: Histopathological and immunohistochemical study of a resected esophagus
Authors: Nakanishi Yukihiro , Ochiai Atsushi , Shimoda Tadakazu , Yamaguchi Hajime , Tachimori Yuji , Kato Hoichi , Watanabe Hiroshi , Hirohashi Setsuo
Published: March 2003

A resected esophagus with numerous heterotopic sebaceous glands was examined in an attempt to determine whether esophageal heterotopic sebaceous glands are the result of a metaplastic process or a congenital anomaly. The present case concerns a 79‐year‐old Japanese man with numerous esophageal heterotopic sebaceous glands accompanied by superficial esophageal cancer. The resected esophagus possessed numerous heterotopic sebaceous glands, which could be seen clearly as slightly elevated, yellowish lesions. Histological examination of these glands, all of which were located in the lamina propria, revealed lobules of cells that showed characteristic sebaceous differentiation. Bulbous nests of proliferating basal cells showing sebaceous differentiation were occasionally observed in the esophageal epithelium. Of the antibodies against six different keratins used, only anti‐keratin 14 labeled both the heterotopic sebaceous glands and the bulbous nests. Acquired metaplastic change of the esophageal epithelium is probably the pathogenetic mechanism involved in these unusual lesions.
Primary low‐grade gastric mucosa‐associated lymphoid tissue (MALT) lymphoma with polypoid appearance. Polypoid gastric MALT lymphoma: A clinicopathologic study of eight cases
Authors: Yokoi Takio , Nakamura Tsuneya , Kasugai Kunio , Yatabe Yasushi , Fujita Masahiro , Kuroda Makoto , Akaza Kayoko , Nomura Chisa , Hamajima Eiji , Suchi Taizan , Seto Masao , Hara Kazuo , Nakamura Shigeo
Published: March 2003

In the current study, we report eight cases with primary low‐grade gastric mucosa‐associated lymphoid tissue (MALT) lymphoma endoscopically characterized by polypoid lesions in order to highlight their clinicopathologic significance.

Four patients were male, their ages ranging from 40 to 78 years old. The resected specimens revealed a histology of low‐grade MALT lymphoma characterized by dense lymphocytic infiltration predominantly in the submucosa and a relatively monotonous proliferation of centrocyte‐like cells with reactive follicles and infrequent lymphoepithelial lesions. The tumor cells were of CD5−, CD10−, CD20+, BCL2+ and cycline D1− phenotype, and showed a monoclonal rearrangement of immunoglobulin heavy chain genes in the five of six cases examined. Interestingly, Helicobacter pylori (H. pylori) was detected in three (37.5%) of the eight patients, which was significantly lower than previous reports. Two of the H. pylori‐positive cases initially underwent H. pylori eradication, but showed no change in their lymphomas after the cure of H. pylori infection. The clinicopathologic findings of the present cases appeared to closely resemble those of colorectal MALT lymphoma with a polypoid appearance and few association of H. pylori infection in their pathogenesis. These gastric polypoid cases may merit separate consideration because of the therapeutic problems they pose.
Expression of sonic hedgehog signal transducers, patched and smoothened, in human basal cell carcinoma
Authors: Tojo Michiko , Mori Tetsuji , Kiyosawa Hidenori , Honma Yutaka , Tanno Yoshihiro , Kanazawa Ken‐ya , Yokoya Sachihiko , Kaneko Fumio , Wanaka Akio
Published: March 2003

In basal cell nevus syndrome (BCNS) patients, mutations of a gene, patched (ptc), which encodes a putative signal transducer of sonic hedgehog protein (SHH), were found and are thought to be one of the major causes of BCNS. The SHH signaling pathway is an important developmental pathway, and ptc protein (PTC) is a suppressive component serving as a receptor for the secreted SHH. Another transmembrane protein, smoothened (SMO), forms a complex with PTC and regulates this signaling pathway. Recent transgenic studies have strengthened the importance of the SHH signaling system in the etiology of basal cell carcinoma (BCC). In this study, we examined the expression patterns of mRNA for ptc and smo in two different BCC subtypes and normal skin. We found that the expressions of ptc and smo mRNA were enhanced in the tumor nests of the nodular BCC, especially at the advancing portions, but were under the detectable level in the superficial BCC cases examined, indicating that ptc and smo mRNA expressions might be associated with BCC tumor progression and divide the BCC histologic types into two subtypes, superficial and nodular types. In addition, no obvious signals for ptc and smo mRNA were detected in the normal human epidermis, appendages, or seborrheic keratosis, indicating that the abnormal proliferation of follicular epithelial cells caused by ptc, smo and/or other genetic changes, which also cause ptc and smo overexpressions, might result in BCC tumor formation.
Functional aspects of megamitochondria isolated from hydrazine‐ and ethanol‐treated rat livers
Authors: Wakabayashi Takashi , Teranishi Masa‐aki , Karbowski Mariusz , Nishizawa Yuji , Usukura Jiro , Kurono Chieko , Soji Tsuyoshi
Published: March 2003

It is essential to analyze functions of megamitochondria (MG) to elucidate the mechanism of the formation of MG induced under various pathological conditions. The MG fraction obtained by a routine isolation procedure for normal mitochondria always consists of a mixed population of mitochondria enlarged to various degrees and also normal‐sized ones. The purpose of the present study is to answer the question of whether or not data obtained from the MG fraction consisting of such a heterogeneous population of mitochondria with respect to their sizes really reflect functions of MG. In the present study mitochondria were obtained from the livers of rats treated with a 1% hydrazine diet for 8 days and those given 32% ethanol in drinking water for up to 2 months using various isolation procedures. Results obtained are summarized as follows: (i) mitochondria enlarged to various degrees and normal‐sized ones are sometimes connected with each other by a narrow stalk in the hepatocyte of hydrazine‐treated animals, and such connections are maintained to some extent when mitochondria are isolated; and (ii) mitochondria obtained from experimental animals by a routine isolation procedure for mitochondria ((700–7000)gR2′′′) and those obtained by alternative isolation procedure yielding the heavy ((500–2000)gR2′′′) and light ((2000–7000)gR2′′′) fractions show some functional similarities: decreases in the content of cytochrome a+a3; decreases in oxygen consumptions and phosphorylating abilities; decreases in monoamine oxidase and cytochrome c oxidase activities; lowered membrane potential of mitochondria; decreases in the rate of the generation of reactive oxygen species. These results may suggest that mitochondria enlarged to various degrees and normal‐sized ones are functionally similar to each other and that the MG fraction obtained by a routine isolation procedure for normal mitochondria can be applied to the study of the function of MG.
Abnormal pigmentation of schwannoma attributed to excess production of neuromelanin‐like pigment
Authors: Fukuda Takeaki , Igarashi Toshihiko , Hiraki Hiroyuki , Yamaki Toshifumi , Baba Kyoko , Suzuki Toshimitsu
Published: March 2003

Five cases of non‐melanotic pigmented schwannoma with excess accumulation of neuromelanin are presented. The tumors were composed basically of spindle or fusiform tumor cells, compatible with those of classical schwannoma, together with varying numbers of tumor cells containing various amounts of light brown or grayish pigment. Fontana‐Masson stain demonstrated argentaffin granules in some tumor cells of each tumor and bleaching with potassium permanganate abolished argentaffin reaction. Ultrastructural examination demonstrated the granules contained fine particles with heterogeneous density, occasionally together with coarse granular materials or amorphous high‐density areas, indicating lysosome or autophagosome. Neither typical melanosomes nor neurosecretory granules were detected. In immunohistochemistry, neurogenic markers as well as CD68 were expressed in most tumor cells in each case and various numbers of tumor cells were positive for Leu7 and CD34. Lysozyme was also frequently positive in tumor cells, especially in granular cells. HMB45 was not expressed in any of the cases. These findings indicate that these cases are schwannomas with abnormal accumulation of neuromelanin‐like pigment.
Overexpression of keratinocyte growth factor in cancer cells and enterochromaffin cells in human colorectal cancer
Authors: Watanabe Masanori , Ishiwata Toshiyuki , Nishigai Keiko , Moriyama Yukichi , Asano Goro
Published: March 2003

Keratinocyte growth factor (KGF) is a mitogenic polypeptide that is mainly synthesized by mesenchymal cells. Its actions are dependent on its binding to a specific cell‐surface KGF receptor (KGFR), which is localized in epithelial cells. In the present study, the expression level of KGF and KGFR messenger RNA (mRNA), and the localization of these mRNA and proteins in tumor specimens obtained from 12 human colorectal cancer cases were estimated. Competitive reverse transcriptase–polymerase chain reaction (RT‐PCR) revealed the expression of KGF and KGFR mRNA in both colorectal cancer and normal colorectal tissues. In specimens from 10 of the 12 cancer cases, the KGF mRNA level was higher in the specimens obtained from the cancerous portions than in those obtained from non‐cancerous tissues of the same cases. KGFR mRNA was higher in cancerous tissues in eight of 12 cases. To localize the KGF protein in normal and cancerous human colorectal tissues, immunohistochemistry was employed. In normal colorectal tissue, faint KGF immunoreactivity was present in a few fibroblasts. In contrast, strong KGF immunoreactivity was present in many of the neuroendocrine cells present in close proximity to cancer cells, and moderate immunoreactivity was recognized in the cancer cells themselves and adjacent fibroblasts. KGF‐positive neuroendocrine cells also showed serotonin immunoreactivity, indicating that they were enterochromaffin cells. By in situ hybridization, both KGF and KGFR mRNA were co‐overexpressed in these colorectal cancer cells, and KGF mRNA was recognized in neuroendocrine cells lying in close proximity to the cancer cells. These findings indicate the possibility that KGF acts in both a paracrine and autocrine manner to induce colorectal cancer cell growth in vivo.
Isoproterenol‐induced myocardial injury resulting in altered S100A4 and S100A11 protein expression in the rat
Authors: Inamoto Shinya , Murao Shinichi , Yokoyama Mitsuhiro , Kitazawa Sohei , Maeda Sakan
Published: March 2003

S‐100 proteins (S100) are characterized by calcium‐binding ability with two structural EF hands. Several S100 are expressed in cardiomyocytes and thought to play a crucial role in calcium signaling. To examine whether the expression of S100 is a response to detectable myocardial damage or regeneration, we investigated, immunohistochemically, the expression of S100A4 and S100A11 in the isoproterenol (ISP)‐treated rat heart. Definite expression of S100A4 and S100A11 was demonstrated in normal cardiomyocytes, and their staining patterns were enhanced in the ISP‐treated rat heart, suggesting the possible involvement of S1–A4 and S100A11 in ISP‐induced myocardial damage.
Dedifferentiated liposarcoma with chondroblastic osteosarcomatous dedifferentiation
Authors: Yamamoto Tetsuji , Matsushita Takehiko , Marui Takashi , Mizuno Kosaku , Minami Rieko , Hayashi Yoshitake , Hanioka Keisuke
Published: March 2003

We describe a rare case of dedifferentiated liposarcoma with features resembling chondroblastic osteosarcoma in the dedifferentiated component. The tumor was removed from the left thigh in a 78‐year‐old male. It consisted of a well‐differentiated liposarcoma and an anaplastic component that contained numerous osteoid and cartilaginous tissues surrounded by high‐grade spindle cell sarcoma. To our knowledge, only two cases similar to the divergent chondroblastic osteosarcomatous dedifferentiation of this disease have been reported in the literature.
Apoptosis and apoptotic‐related factors in mucoepidermoid carcinoma of the oral minor salivary glands
Authors: Yin Hong‐Fang , Okada Norihiko , Takagi Minoru
Published: March 2003

The oncoproteins Bcl‐2 and Bax, the tumor suppressor gene product p53, TUNEL (TdT [terminal deoxynucleotidyl transferase] dUTP nick end‐labeling) and the cell‐cycle antigen Ki‐67 were studied in 71 cases of mucoepidermoid carcinoma originating in the oral minor salivary glands. Grade I tumors had higher expression of Bcl‐2 than Grade II and III tumors (χ2 test, 0.01 < P < 0.025) and the Bcl‐2‐positive group had a higher survival rate than the Bcl‐2‐negative group (generalized Wilcoxon, P = 0.00051). Patients with strong TUNEL positivity had a higher survival rate than those with either weak positivity or negativity (generalized Wilcoxon, P = 0.047). The expression of p53 and TUNEL had a positive correlation (P = 0.0315). Grade II and III tumors had a higher frequency of positive Ki‐67 expression than Grade I tumors (χ2 test, 0.01 < P < 0.025) and patients with Ki‐67‐negative tumors had better survival than patients with Ki‐67‐positive tumors (generalized Wilcoxon, P = 0.000099). This study showed that Bcl‐2 proteins, p53 protein, TUNEL and Ki‐67 are potentially useful prognostic markers for survival in patients with mucoepidermoid carcinoma of the oral minor salivary glands.
Mucinous carcinoma of the breast with neuroendocrine differentiation
Authors: Nakagawa Hiroyuki , Shikata Nobuaki , Senzaki Hideto , Uemura Yoshiko , Inoue Tomoo , Kashu Shin , Tsubura Airo
Published: March 2003

A case of mucinous carcinoma of the breast with neuroendocrine differentiation in an 89‐year‐old woman is presented. The patient presented with a rapidly growing right breast mass, which she had had for 2–3 years. The tumor, 15 × 8 × 5 cm, was located mainly in the upper outer quadrant. Light microscopy revealed a pure mucinous carcinoma of type B. Neuroendocrine differentiation was demonstrated by Grimelius stain and chromogranin A, as well as the presence of neurosecretory granules. The breast cancer cells were of luminal origin and had dedifferentiated to attain neuroendocrine properties.
Leiomyosarcoma of the pulmonary vein
Authors: Okuno Tomoko , Matsuda Katsuhiko , Ueyama Koji , Oota Noritaka , Terada Yasuji , Hohjoh Yoshihisa , Sakurai Takaki , Nakayama Tomoyoshi , Kitaichi Masanori , Yamabe Hirohiko
Published: March 2003

A case of a 74‐year‐old man with leiomyosarcoma of the pulmonary vein is reported. The patient felt transient chest oppression while playing golf 1 week before he visited a clinic with a common cold. He underwent an ultrasonographic examination of the heart, which showed a mass lesion in the left atrium. The preoperative clinical diagnosis was myxoma of the left atrium. Cardiac surgery revealed the mass to be a leiomyosarcoma, probably extending from the left inferior pulmonary vein. The patient underwent a left lower lobectomy of the lung, and the tumor was confirmed to have originated from the wall of the left inferior pulmonary vein. Although the patient had a metastatic lesion in the right axillary lymph node 11 months later, which was excised, he remained free of disease 14 months after the initial operation. Histologically, the tumors were composed of pleomorphic cells with bizarre nuclei and spindle cells with blunt‐ended nuclei with 1–4 mitotic figures in 10 high power fields. Immunohistologically, the tumor cells were positive for α‐smooth muscle actin and desmin. We reviewed 17 cases of leiomyosarcoma of the pulmonary vein (six males and 11 females with a mean age of 50 years in each group). The present case was the oldest in age and to our knowledge was the first reported case with metastasis in a distant lymph node.
Pulmonary adenocarcinoma with heterotopic bone formation
Authors: Hara Hidenori , Iwabuchi Keiichi , Shinada Jun , Yoshimura Hirokuni , Kameya Toru
Published: March 2003

Adenocarcinoma of the lung is a common malignancy. Frequently, this tumor can cause calcification within a primary tumor. However, an extremely rare occurrence in lung carcinomas is ossification within a primary tumor, and to our knowledge only three cases have been reported. We report a case of pulmonary adenocarcinoma with ossification, and discuss the pathogenesis of intratumoral ossification with a review of the literature.
Chromophobe renal cell carcinoma: Clinical, pathological and molecular biological aspects
Authors: Nagashima Yoji
Published: March 2003

Chromophobe renal cell carcinoma (RCC), a newly established subtype of renal neoplasm, is composed of tumor cells with characteristically cloudy, weakly eosinophilic and reticular cytoplasm. The tumor should be distinguished from the common clear cell RCC, because of the unique clinicopathological and molecular biological features. The tumor does not show gender bias. Patient ages are similar to those of clear cell RCC, but might occur in the 20‐ to 40‐year‐old age group. Grossly, the tumor tends to be beige in color, which is different from the yellowish color of common RCC. Electron microscopy and immunohistochemistry indicate the intercalated cell of the collecting duct as the cellular origin. Cytogenetic study shows non‐random multiple chromosome loss, with mitochondrial DNA rearrangement. Alteration of the von Hippel–Lindau (VHL) gene, a cancer suppressor gene relating with clear cell RCC, has not yet been observed. In order to adopt the most appropriate treatment, including gene therapy, recognition and correct pathological diagnosis of chromophobe RCC are extremely important.
Histopathological characterization of aortic intimal sarcoma with multiple tumor emboli
Authors: Nishida Naoki , Yutani Chikao , Ishibashi‐Ueda Hatsue , Tsukamoto Yoshitane , Ikeda Yoshihiko , Nakamura Yoichi
Published: March 2003

A case of aortic intimal sarcoma with multiple tumor emboli and distal metastasis is reported. All metastasis (adrenal, spleen) were via the arteries. This case also had independent lung cancer. Macroscopically, the aortic tumor did not form a bulged mass, but had linear ulceration with abundant mural thrombi. Poorly cohesive large atypical cells were seen in the intima of the abdominal aorta without invasion into the media. Tumor cells were disseminated into the mural thrombi on the aorta and embolized its branches. In the metastatic tumor or tumor emboli of the distal artery, there were not only large atypical cells, but also the foci of spindle‐shaped cells or epithelioid differentiation. Tumor cells in the aorta were immunohistochemically positive for only vimentin. Muscle‐specific actin was positive focally for spindle‐shaped cells of tumor emboli and metastatic tumors. Furthermore, cytokeratin‐positive cells were scatteredly seen. All tumor cells were negative for factor VIII and did not have a histologic or phenotypic analogy with lung cancer. The primary intimal sarcoma in the present case was of undifferentiated non‐endothelial intimal stromal cell origin, and may have had multipotential for differentiation. Investigation of the metastatic site was useful for recognizing the features of this tumor.
Abnormal distribution of collagen type IV in extrahepatic bile duct carcinoma
Authors: Chen Yongxin , Sasatomi Eizaburo , Satoh Toshimi , Miyazaki Kohji , Tokunaga Osamu
Published: March 2003

The present study investigated the pathogenesis of desmoplastic stroma formation, which is characteristic of most bile duct carcinomas and other scirrhous carcinomas. Using immunohistochemical analysis, the expression of collagen types I and IV, laminin and TGF‐β1 was examined in human extrahepatic bile duct carcinoma and compared with gastric and colon carcinoma. In addition to delineating the basement membranes of carcinoma nests and blood vessels, collagen type IV was present along the thick bundles of collagenous fibers in the stroma of extrahepatic bile duct carcinoma and scirrhous gastric carcinoma. The immunoreactivity of collagen type IV was strong in the adjacent or surrounding interstitium of tumor cell nests, but was absent or weak in older, more central portions of the tumor that contained sclerotic collagen. In situ hybridization demonstrated active expression of collagen α1(IV) mRNA in extrahepatic bile duct carcinoma and scirrhous gastric carcinoma cells. These results suggest that, although collagen type IV is typically a component of the basement membrane, it is expressed in the interstitial stroma of extrahepatic bile duct carcinoma and scirrhous gastric carcinoma where it may play a role in desmoplastic stroma formation.
Ovarian fibrosarcoma producing multiple cytokines
Authors: Fukuda Takeaki , Yamaguchi Tomiko , Yamaki Toshifumi , Suzuki Toshimitsu
Published: March 2003

A case of ovarian fibrosarcoma producing multiple cytokines is presented. The tumor occurred in the left ovary of a Japanese woman with epigastralgia, remittent fever, leukocytosis and slight thrombocytosis with moderate increase of mast cells in bone marrow, but lack of hormonal abnormality. The resected tumor of the ovary was well encapsulated and it was composed of spindle‐shaped tumor cells and scattered tubules with marked mast cell infiltration. The tumor recurred in the pelvic cavity 14 months later, accompanied by similar signs and symptoms as occurred with the primary tumor. Serum levels of interleukin (IL)‐6 and tumor necrosis factor (TNF)‐α were elevated. The recurrent tumor showed similar histological findings to those of the primary tumor, except for lack of tubules. Tumor cells revealed a focally positive immunoreaction for vimentin, IL‐6 and TNF‐α and α‐inhibin. Reverse transcription–polymerase chain reaction using total RNA obtained from the recurrent tumor demonstrated mRNA expression of IL‐6, IL‐10, TNF‐α and stem cell factor. This is a rare case of ovarian fibrosarcoma producing multiple cytokines, resulting in atypical clinical findings.
Hepatoid adenocarcinoma in Barrett’s esophagus associated with achalasia: First case report
Authors: Tanigawa Hitoshi , Kida Yoshiki , Kuwao Sadayoshi , Uesugi Hidenaga , Ojima Tatsuya , Kobayashi Nobuyuki , Saigenji Katsunori , Okayasu Isao
Published: March 2003

We report an unusual hepatoid adenocarcinoma in Barrett’s esophagus with achalasia, which developed in a 44‐year‐old Japanese woman. The patient received an esophago‐gastrectomy after diagnosis of the tumor and achalasia at the lower esophagus, 4 months before her death due to multiple metastatic tumors of the liver. The main granular tumor removed surgically was a hepatoid adenocarcinoma, mainly composed of clear cancer cells (α‐1 antitrypsin, albumin and α‐fetoprotein positive), with elements of choriocarcinoma and tubular adenocarcinoma. Non‐neoplastic specialized columnar epithelium was present extensively near the oral side of the tumor edge in the esophagus, indicating Barrett’s esophagus. This unusual tumor was therefore considered to have originated in Barrett’s esophagus. The gastroesophageal reflux was presumed to have occurred for a long period, as there was a well‐preserved fundic gland in the stomach and a history of frequent vomiting from the patient’s youth, accounting for the appearance of achalasia.