bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual Huge Intramuscular Granuloma with Calcium Phosphate Crystal Deposition in the Buttock
Authors: Kubo Kiyoko , Manabe Jun , Matsumoto Seiichi , Kawaguchi Tomoyoshi , Kitagawa Tomoyuki
Published: August 2010

An unusual case of a huge granuloma featuring marked calcium phosphate crystal deposition in muscle is presented. A 58‐year‐old male demonstrated a well circumscribed, large, elastic firm mass which had slowly grown over 8 years in the left buttock. Clinical examinations including X‐ray, ultrasonography and computed tomography all suggested a neoplastic growth. Surgical excision revealed three inter‐connected irregular‐shaped masses, measuring up to 11×10×6 cm in size. The histological appearance was of granulomas composed of numerous small crystals surrounded by reactive mononuclear cells embedded in fibrous tissue containing many foreign body type giant cells. Chemical analysis demonstrated the crystals to be made up of calcium phosphate.
Effects of Alkyl Alcohols and Related Chemicals on Rat Liver Structure and Function: III. Physicochemical Properties of Ethanol‐, Propanol‐ and Butanol‐treated Rat Liver Mitochondrial Membranes
Authors: Adachi Kayo , Momota Michihiko , Teranishi Yoshiki , Ueki Reiko , Hagiwara Masatoshi , Wakabayashi Takashi , Popinigis Jerzy
Published: August 2010

The physicochemical properties of mitochondria in liver tissue obtained from rats given 32% ethanol, 32% propanol or 6.9% butanol in drinking water for up to 3 months were investigated using differential scanning calo‐rimetry and fluorescence polarization measurements. The results obtained were as follows: 1) Phospholipids extracted from mitochondria showed increases in the relative amounts of phosphatidylcholine, phosphatidylinositol and phosphatidylserine, and a decrease in the relative amount of phosphatidylethanolamine. An increase in the unsatu‐rated/saturated fatty acid ratio of phospholipids was also observed. 2) Elevation of the thermotropic lipid phase transition temperature with a decrease in the enthalpy value (δH) was revealed by differential scanning calo‐rimetry. 3) The elevation of the lipid phase transition temperature was detected also by fluorescence polarization measurements using 1,6 diphenyl 1, 3, 5 hexatriene (DPH) as a probe. Elevation of mitochondrial membrane fluidity was found in some of the experimental animals, but most showed no changes in comparison with the control. A possible role of membrane fusion in the mechanism of formation of ethanol‐, propanol‐ and butanol induced hepatic megamitochondria is discussed on the basis of these results. Acta Pathol Jpn 42: 549–557, 1992.
Lectin Binding Patterns in Normal Liver, Chronic Active Hepatitis, Liver Cirrhosis, and Hepatocellular Carcinoma An Immunohistochemical and Immunoelectron Microscopic Study
Authors: Murakami Ichiro , Sarker Ashit Baran , Hayashi Kazuhiko , Akagi Tadaatsu
Published: August 2010

We studied the binding patterns of 14 lectins in human normal and cirrhotic liver (LC) tissues and hepatocellular carcinomas (HCC) using the ABC method. Lectins were divided into 4 groups according to their binding patterns in normal tissues: (A) PHA, MPA, LcH, RCA I, and WGA, which bound to hepatocytes and all three types of sinusoidal cells; (B) BPA, GS‐I, PNA, and SBA, which bound to Kupffer cells and endothelia of interlobular arteries and veins and bile duct epithelia in the portal tract, but not to hepatocytes; (C) UEA‐I, which bound only to endothelia of interlobular arteries and veins and bile duct epithelia in the portal tract; (D) LBA, Lotus, LPA, and SJA, which showed no binding. Thus group B lectins may be useful markers of Kupffer cells. Only electron microscopic examination revealed the precise binding sites of lectins in sinusoidal cells and hepatocytes. Hepatocyte cell surface polarities demonstrated by lectin binding in LC and HCC were different from those in the normal liver. The binding pattern of PHA to LC hepatocytes changed from a membranous to both a membranous and a cytoplasmic pattern, and that of LcH to HCC cells changed to dot‐like staining in the cytoplasm. These changes of polarities in LC and HCC might be caused by changes in the distribution of lectin binding carbohydrates or by the altered glycosylation of glycoconjugates. Acta Pathol Jpn 42: 566–572, 1992.
Incidence of Paneth Cells in Minute Tubular Adenomas and Adenocarcinomas of the Large Bowel
Authors: Wada Ryo , Miwa Hiroto , Abe Hiroshi , Santo Ruth Miyuki , Kitamura Shigehiro , Kuwabara Noriyuki , Suda Koichi , Kondo Kenji , Yamada Satoshi , Hamada Tsutomu , Matsukawa Masaaki
Published: August 2010

This study attempted to demonstrate the incidence of Paneth cells within large bowel tubular adenoma and adenocarcinoma according to location and macroscopic appearance using minute tumors (up to 5 mm in size). We have shown that Paneth cells were sometimes seen in the early stage of the development of large bowel epithelial neoplasia. According to the macroscopic appearance (elevated or depressed type), in large bowel epithelial neoplasia, there was a statistical difference between the depressed type (32.5%, 14 of 40 cases) and the elevated type (16.6%, 24 of 145 cases) (Chi square analysis, p < 0.05) in the incidence of Paneth cells. Paneth cells were seen more frequently in adenocarcinoma (45.8%, 11 of 24 cases) than in tubular adenoma (16.8%, 27 of 161 cases), with a significant statistical difference (Chi square analysis, p < 0.01). According to location, in both tubular adenoma and adenocarcinoma, Paneth cells were more frequently observed in the proximal colon (tubular adenoma: p < 0.01, adenocarcinoma: p < 0.05, Chi square analysis). Acta Pathol Jpn 42: 579 584, 1992.
An Autopsy Case of Kawasaki Disease with Reference to Occurrence of Acute Coronary Thrombosis in the Convalescent Stage
Authors: Naganuma Hiroshi , Kyogoku Masahisa , Abe Junichiro , Fukui Kouya , Inoue Shigeo , Yamamoto Katsuya , Kato Seiichi , Nakagawa Hiroshi
Published: August 2010

A one‐year, four month‐old boy who had suffered from Kawasaki disease died suddenly during convalescence despite intensive gamma‐globulin treatment. Autopsy revealed a) sausage‐like aneurysms of the left and right coronary arteries and fresh thrombosis in the right coronary aneurysm, b) fresh transmural myocardial necrosis in the whole wall of the left ventricle and the anterior part of the wall of the right ventricle, and c) swelling of the cervical lymph nodes and thymus (60 g). Histologically, fibrocellular thickening of the intima and destruction of the media and internal elastic lamina were conspicuous in the area of the aneurysm, but those of the intima and media in the areas adjacent to the aneurysm were mild. Abrupt narrowing of the lumen at the border between the aneurysm and periphery of the right coronary artery was detected, and this may have been responsible for formation of the thrombus in the right coronary aneurysm. In the systemic arteries, perivascular fibrosis was very noticeable despite less severe injury to the intima and media. These findings suggest that severe inflammation of the periarterial regions was present in the acute phase. The lymph system still showed inflammation, supporting the infectious or toxic nature of Kawasaki disease. Acta Pathol Jpn 42: 604–613, 1992.
Gastric cytoprotection: Morphological perspectives
Authors: Terano Akira , Ota Shinichi , Hiraishi Hideyuki , Mutoh Hiroyuki
Published: August 2010

In 1979, a new mechanism of gastric defense named cytoprotection was followed by numerous reports elucidating this interesting and important phenomenon. During this decade, however, the concept and definition of gastric cytoprotection have been modified from the morphological and ultrastructural viewpoints. This review attempts to describe the concept and mechanisms of cytoprotection as well as its pathophysiological features. Specifically, in vitro studies using isolated cells or monolayer cultured cells as well as molecular investigations of signal transduction system have been documented.
DNA ploidy and stromal bone formation as prognostic indicators of thyroid papillary carcinoma in aged patients: A retrospective study
Authors: Yamashita Hiroto , Noguchi Shiro , Murakami Nobuo , Tsuji Kouichi , Yamaoka Norio , Sakamoto Atsuhiko
Published: August 2010

The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy‐five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non‐survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin‐embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non‐survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P= 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non‐survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non‐survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.
Pulmonary vasculature in idiopathic dilated cardiomyopathy: A morphometric study
Authors: Lijima Tatsuo , Doi Mikio , Kamma Hiroshi , Horiguchi Hisashi , Yazawa Takuya , Ogata Takesaburo
Published: August 2010

The pulmonary vascular alterations of seven patients with idiopathic dilated cardiomyopathy (IDC) were morphometri‐cally examined, and the relation between the vascular alterations and morphological status of the hearts was studied. Most patients with IDC showed not only fibrous thickening of small pulmonary veins but also intimal circumferential fibrosis and medial hypertrophy of small pulmonary muscular arteries to various degrees. The histo‐logical features of the pulmonary vessels were compatible with hypertensive vascular changes observed in patients with mitral stenosis. There was a significant correlation between medial hypertrophy of the pulmonary muscular arteries and right ventricular hypertrophy. The pulmonary vascular changes in IDC were always associated with left atrioventricular dilatation, but were only found in patients with prominent hypertrophy of the left ventricles. Medial hypertrophy of the pulmonary muscular arteries was related more to left ventricular hypertrophy than to left ventricular dilatation. These findings suggest that the pulmonary vascular changes in IDC are caused by venous pulmonary hypertension, which may be developed at the late stage when left ventricular hypertrophy predominates.
An autopsy case of cerebellar degeneration following lithium intoxication with neuroleptic malignant syndrome
Authors: Naramoto Atsuhiko , Koizumi Noriaki , Itoh Nobuo , Shigematsu Hidekazu
Published: August 2010

We report a rare case of cerebellar degeneration that was diagnosed at autopsy in a patient who developed lithium intoxication accompanied by neuroleptic malignant syndrome. This 63 year old female, who suffered from manic depressive psychosis, had received lithium bicarbonate at a daily dose of about 1000 mg for 4 years. She developed a high fever and extrapyramidal symptoms resembling a neuroleptic type of malignant syndrome and died 1 month later. Autopsy revealed an almost complete loss of Purkinje cells with a mild reduction of granule cells in most areas of the cerebellar hemisphere and vermis, except for the tonsil and flocculus, and mild gliosis in the dentate nucleus. In cases of suspected lithium intoxication, one must be alert to the possibility of neuroleptic malignant syndrome and to prevent cerebellar degeneration.
Carcinoma of the gall‐bladder arising in adenomyomatosis
Authors: Kurihara Kenji , Mizuseki Kiyoshi , Ninomiya Tomoyuki , Shoji Ikuo , Kajiwara Shunsuke
Published: August 2010

We describe a case of well differentiated adenocarcinoma of the gall‐bladder that arose from a localized type of adenomyomatosis. Grossly, the cancer was located in the fundus and exhibited a polypoid and well demarcated nodule with multiple small cysts. Histologically, the nodule consisted of glandular structures and stroma containing bundles of smooth muscle cells. The glandular epithelia were varied in appearance, ranging from malignant to benign glands. The adenocarcinoma was limited to the nodule, with normal surface mucosal epithelia and without obvious stromal invasion.
Enhancement of lipid phagocytosis by cloned cells derived from rat malignant fibrous histiocytoma under hyperlipemic conditions
Authors: Yamate Jyoji , Tajima Masanori , Shibuya Katumoto , Saitoh Toshiki
Published: August 2010

The histogenesis of malignant fibrous histiocytoma (MFH) was studied by observing the influence of hyperlipemic (HL) conditions on the behavior of cloned MT‐8 cells with an undifferentiated mesenchymal character and MT‐9 cells with histiocytic and fibroblastic features, both derived from a spontaneous rat MFH. The cells were grown in medium containing 10% normal rat serum (CSM) or 10% HL rat serum (HSM) for 1, 3, 8 and 24 h. The cells grown in HSM showed a time‐dependent, significant increase in numbers of cytoplasmic lipid droplets per cell and cells positive for acid phosphatase (ACP) and non‐specific esterase (NSE) compared with cells grown in CSM. The number of cells positive for two different anti‐rat monocyte/macrophage monoclonal antibodies (ED‐1 and ED‐2) also increased significantly in HSM. This histiocytic nature was confirmed by electron microscopy. Tumors were induced by inoculating MT‐8 and MT‐9 cells into rats on a standard diet and rats on a HL diet. MT‐8 and MT‐9 tumor cells in HL rats phagocytized lipid droplets and showed stronger positive reactions for ACP and NSE compared with tumors in control rats. These results imply that xanthomatous cells in MFH may be a phenotype of MFH cells expressing an enhanced histiocytic nature. MFH cells seem to alter their behavior depending on cultural or microenvironmental conditions.
Pathology of the spleen in primary biliary cirrhosis
Authors: Terayama Noboru , Makimoto Kiyoko P. , Kobayashi Satoshi , Nakanuma Yasuni , Sasaki Motoko , Saito Katsuhiko , Katayanagi Kazuyoshi
Published: August 2010

Pathologic changes of the spleen in primary biliary cirrhosis (PBC) were studied using autopsy cases. By analysis of the data compiled in the Annual Registry of Autopsies of Japan (1977–92), it was found that the splenic weight of 184 cases of PBC (450 ± 224 g) was significantly heavier than that of 41 control autopsy cases of non‐biliary liver cirrhosis from the School of Medicine, Kanazawa University (341 ± 189 g), and also of 210 control cases filed in the Annual Registry of Autopsies of Japan (1982; 334 ± 174 g). Among the cases of PBC, the splenic weight was positively correlated with the liver weight. There was no significant difference in the splenic weight between the cases belonging to histologic stages 1–3 and those of stage 4. Fibrosis extending from the splenic trabecula, proliferation and dilatation of the splenic sinus, and congestion in the red pulp, all being compatible with chronic splenic congestion, were similarly observed in the spleen in PBC as well as in other non‐biliary cirrhotic cases. The present study indicates that the PBC patients present splenomegaly in the non‐cirrhotic histologic stage and splenomegaly persists thereafter. However, the histopathologic changes of the spleen peculiar to PBC were not specified in this autopsy study. Prolonged portal hypertension and other mechanisms, possibly related to immune disarrangement, may be responsible for the prominent splenomegaly in PBC.
Immunohistochemical demonstration of p53 protein in colorectal adenomas and adenocarcinomas. Reliable application of the heat‐induced antigen retrieval method to formalin‐fixed, paraffin‐embedded material
Authors: Hamana Toshiyasu , Kawai Kenji , Serizawa Akihiko , Tsutsumi Yutaka , Watanabe Keiichi
Published: August 2010

Ninety‐nine polypoid neoplasms and eight advanced adenocarcinomas of the colon were studied immunohistochemically for p53 protein expression. For reproducible antigen retrieval, formalin‐fixed, paraffin‐embedded archival sections were heated at 90°C for 120min in 0.01 mol/L phosphate‐buffered saline, pH 7.2, prior to immunostaining. Proliferating cell nuclear antigen served as a positive control marker for effective antigen retrieval. The 99 polyps were categorized into 24 high‐grade adenomas, 60 non‐invasive cancer‐in‐adenomas (CIA), and 15 CIA with stromal invasion. All the polyps contained portions of low‐grade adenoma. Positive nuclear staining of p53 protein was observed in none of the non‐neoplastic mucosa, nine (9%) of 99 low‐grade adenomas, 17 (71%) of 24 high‐grade adenomas, 46 (77%) of 60 non‐invasive CIA, 10 (67%) of 15 invasive CIA, and five (63%) of eight advanced carcinomas. When the antigen retrieval treatment was omitted, the positivity rates were 0, 2, 17, 35, 40, and 63%, respectively. When the antigen‐retrieved staining pattern was classified into (i) ‘sparse’ (< 25% of the nuclei of neoplastic glands labeled), ‘scattered’ (25–75%) and ‘dense’ (> 75%); or (ii) ‘focal’ (the positively labeled glands occupying < 25% of the tumor area), ‘intermediate’ (25–75%) and ‘diffuse’ (> 75%), the sparse and focal patterns predominated in high‐grade adenomas and non‐invasive CIA with low‐grade atypia, while the dense and diffuse patterns predominated in invasive CIA and all the advanced carcinomas revealed the dense and diffuse patterns. Non‐invasive CIA with high‐grade atypia belonged to an intermediate type between the two groups. These findings indicate that accelerated intranuclear accumulation of immunoreactive p53 protein is closely correlated with colorectal tumorigenesis.
Clinicopathological and immunophenotypic studies on 12 cases with B cell chronic lymphocytic leukemia
Authors: Nakamura Naoya , Suzuki Sayuri , Segami Hideo , Nozawa Yoshihiro , Tominaga Kunihiko , Wachi Eiko , Hojo Hiroshi , Abe Masafumi , Sakuma Hideo , Wakasa Haruki
Published: August 2010

To clarify the histogenesis of B cell chronic lymphocytic leukemia (BCLL), clinicopathological and immunophenotypic studies were performed using a large panel of monoclonal antibodies on 12 cases with BCLL including three caes with prolymphocytic/chronic lymphocytic leukemia (CLL/PL). Immunophenotypically, CD19 and CD20 were positive for all cases of this series and CD5, CD21, CD22, CD23, CD25, CD38, Leu‐8, KB‐61, and bcl‐2 protein were expressed in variable proportion from case to case. CD10, however, did not react. No alkaline phosphatase (ALP) positive cases were found. The phenotype of BCLL was similar to that of B cells of the mantle zone (MZ) of secondary follicle in the lymph node. It is therefore postulated that the neoplastic cells of BCLL in these cases might be derived from B cells of the MZ. Moreover, the cells possibly originated from the lymphocytes located in the inner layer of the MZ, since ALP+ B cells are usually observed in the outer layer of the MZ. The pseudofollicular (PF) pattern was observed in four biopsied lymph nodes among five cases tested, but no such a pattern in an aspiration clot of bone marrow. These four cases consisted of three cases with CLL and a case with CLL/PL. The immunohistochemical study showed that there were many proliferating cells showing Ki‐67+ in the PF area of the lymph nodes. In these cases, leukemic cells might have developed from the PF area of the lymph node.
Giant symptomatic myelolipoma of the adrenal gland
Authors: Hirakawa Eiichiro , Haba Reiji , Miki Hiroshi , Kobayashi Shoji , Ishikawa Masashi , Mori Seiji , Ohmori Masaki , Sugimoto Mikio
Published: August 2010

A case of giant symptomatic myelolipoma is described in which clinical differentiation was difficult. It was considered to be an extremely rare case of glant myelolipoma arising in the adrenal gland. Histologically the present case contained more lipornatous elements than others reported to date. This is a case of giant adrenal myelolipoma with a few foci of myeloid elements and it is suggested that this case has a true neoplastic nature rather than a hyperplastic or metaplastic one.
Enteroviraf RNA in endomyocardial biopsy tissues of myocarditis and dilated cardiomyopathy
Authors: Satoh Mamoru , Tamura Gen , Segawa Ikuo
Published: August 2010

Enteroviruses are potential etiologic agents of myocarditis and dilated cardiomyopathy (DCM). A recently developed molecular approach has offered evidence of viral infection by detecting the virus genome. The nested reverse transcrip‐tase polymerase chain reaction (nRT‐PCR) was used to detect enteroviral RNA in endomyocardial biopsy tissues of myocarditis and DCM. The authors examined 44 tissues obtained from 36 patients with myocarditis, as well as from 10 patients with non‐infectious cardiac diseases as controls.

Enteroviral RNA was detected in 12 of 36 patients with myocarditis. The second endomyocardial biopsy was carried out in five of the patients, in whom enteroviral RNA was detected at the first biopsy, at intervals from 3 weeks to 8 years after the first biopsy, and enteroviral RNA was found in four and had disappeared in one. In one of the four positive patients at the second biopsy, a third biopsy was carried out 5 months later (6 months after the first), and the RNA was detected. Active myocarditis became clinically and microscopically mild at the second and third biopsies. In one patient who developed DCM, enteroviral RNA was also detected at a second biopsy performed 8 years after the first. Enteroviral infection is a probable cause of myocarditis and enterovirus‐infected myocarditis may progress to DCM.
Infarction of breast fibroadenoma in a postmenopausal woman
Authors: Ichihara Shu , Matsuyama Takako , Kubo Kanji , Tamura Zyun , Aoyama Hideaki
Published: August 2010

Infarction of a breast fibroadenorna usually occurs in young females during pregnancy or lactation. This report describes a rare case of the total infarction of a fibroadenoma in a 58 year old postmenopausal woman. The chief complaint was a rapidly enlarged, slightly painful lump. Medullary carcinoma was suspected on palpation and mammography. Microscopically, the tumor was composed of a coarsely lobulated necrotic mass invaginated into an epithelial lined cyst. This was interpreted as an infarcted intracanalicular flbroadenoma, although the possibility of an infarcted phyllodes tumor cannot be entirely excluded. The significance of this rare event is the possible confusion with carcinoma. Extensive search for viable tissue is essential for the confirmation of the diagnosis.
A case of pseudolymphoma of the liver
Authors: Katayanagi Kazuyoshi , Terada Tadashi , Nakanuma Yasuni , Ueno Toshio
Published: August 2010

A case of pseudolymphoma (reactive lymphoid hyperplasia) of the liver in a 66 year old female is presented. A tumor‐like lesion was incidentally discovered in the liver during clinical follow up of diabetes mellitus. The hepatic lesion was resected because malignant lymphoma was suspected after a needle biopsy. Grossly, the lesion was well‐deflned and measured 1.0 × 1.5 × 1.0 cm. Microscoplcally, the lesion consisted of hyperplastic lymphoid follicles with distinctive germinal centers and interfollicular areas consisting of mature lymphocytes and plasma cells. An immunohistologlcal study revealed that the lymphoid cells of the lesion were polyclonal in immunophenotypes. These histological and immunohistochemical findings strongly suggested a pseudolymphoma and not hepatic inflammatory pseudotumor. Thls case was diagnosed as pseudolymphoma of liver. Only a few cases of hepatic pseudolymphoma have so far been reported In the English literature.
Malignant lymphoma of the esophagus associated with macroglobulinemia: Report of a case
Authors: Kurihara Kenji , Fukui Akira , Kumano Seishi
Published: August 2010

A case of non‐Hodgkin's lymphoma of the esophagus in a 74 year old man is presented. Grossly, the surgically removed esophagus had a fuslform submucosal mass covered with smooth surfaced mucosa. Microscopic examination revealed that the mass consisted of a dense infiltrate of small to medium‐sized lymphoid cells with plasmacytoid differentiation, leading to a diagnosis of diffuse small cell lymphoma with lymphoplasmacytic subtype. Laboratory data as well as immunohistochemical studies proved that the lymphoma produced monoclonal immunoglobulin M, giving rise to macroglobulinemia.
Ossifying subcutaneous tumor with myofibroblastic differentiation
Authors: Fukunaga Masaharu , Ushigome Shinichiro , Ishikawa Eisei
Published: August 2010

Immunohistochemical, ultrastructural, and flow cytometric studies were performed on an ossifying soft‐tissue tumor, presumed to be a variant of ossifying fibromyxoid tumor of soft parts, which was located in the subcutis of the left buttock of a 76 year old Japanese woman. Histologically, this was a benign‐looking spindle, oval, or round cell lesion, having a fibrous capsule with a discontinuous rim of bone as seen in typical cases. However, this lesion was also characterized by a high degree of cellular proliferation in storiform and whorl arrangements, extensive ossification, osteoid and metaplastic bone formation and absence of myxoid features. In an immunohistochemical study using formalin‐fixed, paraffinembedded sections, many tumor cells expressed vimentin, S‐100 protein, Leu‐7, neuron specific enolase, and desmin. Ultrastructuraliy, this neoplasm consisted of fibroblast‐like cells and myofibroblast‐like cells. This tumor had an aneuploid DNA content. No recurrence has been observed for 16 months. These results suggest that the neoplastic cells may show the phenotypic expressions of myofibroblast and also osteogenic differentiation.
Pathology of pulmonary hypertension: A human and experimental study
Authors: Hosoda Yasuhiro
Published: August 2010

To clarify the histopathological characteristics of pulmonary hypertension (PH) in Japan, and to clarify the role of serotonin and endclthelin in monocrotaline induced PH, human histopathologiical studies and experimental studies were carried out. An epidemiological study based on the Annual of the Pathological Autopsy Cases in Japan, and a morphological study on autopsy cases of congenital heart disease and idiopathic PH were performed. Plasma levels of serotonin and endothelin, vascular responsiveness to serotonin, and the effects of a selective serotonin antagonist, DV‐7028, were investigated after monocrotaline injection. Plexogenic pulmonary arteriopathy was prevalent, and recurrent pulmonary thromboembolism and pulmonary veno‐occlusive disease extremely rare among primary pulmonary hypertension in Japan. In secondary PH, systemic lupus erythematosus and mixed connective tissue disease were frequent and showedl particularly severe intimal and medial thickening. After an injection of monocrotaline, plasma serotonin and endotheliii levels were raised, and pulmonary arteries showed hyperreactivity to serotonin. DV‐7028 (5‐HT2 receptor antagonist) attenuated the rise in pulmonary artery pressure and the various effects of monocrotaline. There may be some genetic difference between PH in Japan and other countries. Roles far serotonin and endothelin in the initiation and progression of monocrotaline induced PH are suggested.
Correlation of E‐and P‐cadherin expression with differentiation grade and mode of invasion in gingival carcinoma
Authors: Sakaki Toshio , Wato Masahiro , Kaji Ryuichi , Mushimoto Kozo , Shirasu Rikiya , Tanaka Akio
Published: August 2010

The expression pattern of two Ca2+‐dependent cell‐cell adhesion molecules, E‐and P‐cadherin (CD), in 25 primary gingival squamous cell carcinomas (SCC) was examined immunohistochemically. The occurrence of reduced‐type expression of both E‐and P‐CD increased significantly with the grade of carcinoma differentiation, culminating in a complete loss of P‐CD in poorly differentiated SCC. The occurrence of reduced‐type P‐CD expression also increased significantly with the mode of invasion, as was the case with E‐CD. Furthermore, no P‐CD molecules were detected in one of the six SCC having a diffuse, cord‐like invasion and in three of the six having a diffuse type of invasion. These findings suggest that the down‐regulation of these cell adhesion molecules closely correlates with the differentiation grade and mode of invasion of gingival SCC.
Evaluation of malignant grade of salivary gland tumors: Studies by cytofluorometric nuclear DNA analysis, histochemistry for nucleolar organizer regions and immunohistochemistry for p53
Authors: Ishii Kaoru , Nakajirna Takashi
Published: August 2010

Investigations were carried out in 109 surgically resected salivary gland tumors, 46 adenomas and 63 carcinomas for nuclear DNA content by cytofluorometry, nucleolar organizer regions (AgNOR) by histochemistry and nuclear p53 accumulation by immunohistochemistry. The mean nuclear DNA content and the incidence of aneuploidy as well as the mean number of the AgNOR in carcinomas were significantly higher than those in adenomas. In the DNA histogram pattern, the aneuploidy frequently appeared in high grade carcinoma groups (adenocarcinoma, salivary duct carcinoma, carcinoma in pleomorphic adenoma and oncocytic carcinoma). Immunohistochemical nuclear p53 accumulation was observed in 15 tumors, of which ten showed DNA aneuploidy. In high grade carcinomas, DNA aneuploidy was closely related to p53 immunoreactivity. This study revealed that combined cytofluorometric nuclear DNA analysis, histochemical AgNOR count and immunoreactivity for p53 might be quite useful for evaluating the malignant grade of salivary gland tumors.
CA125‐producing adenocarcinoma of the seminal vesicle
Authors: Ohmori Takaaki , Okada Kazuyo , Tabei Ryo , Sugiura Keisuke , Nabeshima Shinji , Ohoka Hiroji , Okamoto Masaki
Published: August 2010

A case of primary seminal vesicle carcinoma is reported. The tumor was a CA125‐producing adenocarcinoma consisting of fine papillary‐tubular, intricate branching or anastomosing glandular structures and was composed of small cuboidal, but occasionally hobnailed, cells with mostly clear, but occasionally granular, cytoplasm. Some tumor cells showed evidence of secretion of seromucinous materials into the interpapillary and cystic space. lmmunohistochemically, almost half of the tumor cells expressed a positive reaction with anti‐CAl25, a common serological marker for ovarian epithelial carcinomas; however, no tumor cells expressed any other serological tumor markers such as carcinoem‐bryonic antigen, α‐fetoprotein, human chorionic gonadotropin, prostatic specific acid phosphatase, or prostatic specific antigen. The patient showed a high level of serological CA125, which fluctuated parallel with the growth, removal and recurrence of the tumor. The morphological and immunohistochemical findings suggested a close relationship between the present tumor and clear cell carcinoma of the ovary, which is thought to be of a Müllerian‐Wolfian duct origin.
Lipomatous pleomorphic adenoma of the ceruminous gland
Authors: Kuwabara Hiroko , Haginomori Shin‐Ichi , Takamaki Atsuko , Ito Kanako , Takenaka Hiroshi , Kurisu Yoshitaka , Tsuji Motomu , Mori Hiroshi
Published: August 2010

A case of lipomatous pleomorphic adenoma in the ceruminous gland is reported. A 69‐year‐old Japanese woman presented with a mass in the posterior wall of the cartilaginous external auditory canal. Light microscopic examination revealed a well‐circumscribed tumor composed of tubular structures with apocrine secretion and ceroid deposition, extensive mature adipocytes, and spindle‐shaped myoepithelial cells in the myxoid and fibrous stroma. This case demonstrates the peculiar location of a lipomatous pleomorphic adenoma in the external auditory canal.
Clinicopathological study of invasive ductal carcinoma with large central acellular zone: Special reference to magnetic resonance imaging findings
Authors: Yamaguchi Rin , Furusawa Hidemi , Nakahara Hiroshi , Inomata Masuko , Namba Kiyoshi , Tanaka Maki , Ohkuma Kazuaki , Tayama Kohsuke , Fujii Teruhiko , Yano Hirohisa , Kage Masayoshi , Kojiro Masamichi
Published: August 2010

Invasive ductal carcinoma (IDC) with central acellular zone is sometimes encountered, but its clinicopathological features have not yet been fully investigated. The clinicopathological features of 10 resected cases of IDC with a large central acellular zone were investigated. The tumor size ranged from 6 to 28 mm with a mean of 14.3 ± 6.9 mm. Contrast‐enhanced magnetic resonance imaging (MRI) showed a ring‐like appearance in the tumor. Sagittal fat‐suppressed T2‐weighted MRI had very high to intermediate signal intensity in a central area. Histologically, cancer tissue was located in the periphery of the tumor with a ring‐like pattern and a large central area was occupied by acellular amorphous tissue that was strongly stained by alcian blue. Lymph vessel permeation was seen in eight cases. Among the tumors with focal enhancement in the central areas >1 cm in diameter on contrast MRI, marked increase of microvessel was observed in the enhanced spot. The mean of p53 and Ki‐67 labeling indices was 56.2% and 36.3%, respectively. IDC with a large central acellular zone presenting with characteristic MRI should be noted as a new morphological entity.
Osteopontin expression in the liver with severe perisinusoidal fibrosis: Autopsy case of Down syndrome with transient myeloproliferative disorder
Authors: Tokairin Takuo , Nishikawa Yuji , Watanabe Hitoshi , Doi Yuko , Omori Yasufumi , Yoshioka Toshiaki , Yamamoto Youhei , Yoshida Masayuki , Nishimura Takuya , Li Qinchang , Arai Hirokazu , Ishida Akira , Takada Goro , Enomoto Katsuhiko
Published: August 2010

Down syndrome with transient myeloproliferative disorder (TMD) is often associated with perinatal liver fibrosis. The authors recently encountered an autopsy case of this disease with a characteristic severe perisinusoidal liver fibrosis. Osteopontin (OPN) is a molecule that plays an important role in diverse fibro‐inflammatory diseases. The purpose of the present report was to examine the involvement of OPN in development of the Down syndrome‐associated liver fibrosis. Histology indicated severe perisinusoidal fibrosis and ductular arrangements of hepatocytes in the liver. Appearance of atypical megakaryocytes in the liver, a feature of TMD associated with Down syndrome, was not evident. On immunohistochemistry expression of OPN was observed in hepatocytes often having ductular arrangements and infiltrating macrophages. In contrast, a small number of transforming growth factor‐β1 (TGF‐β1)‐positive mononuclear cells were present in the liver. Numerous activated hepatic stellate cells (HSC) expressing α‐smooth muscle actin (α‐SMA) were seen in the perisinusoidal area. A recent report indicated that OPN could directly activate the HSC. Thus, it is suggested that OPN produced by hepatocytes and macrophages induces activation of the HSC, and leads to the development of perisinusoidal liver fibrosis.
Lymphoepithelioma‐like cholangiocarcinoma not associated with EBV
Authors: Adachi Shiro , Morimoto Osakuni , Kobayashi Tetsuro
Published: August 2010

Reported herein is an unusual case of intrahepatic cholangiocarcinoma with lymphoepithelioma‐like appearance in a 64‐year‐old man who was found to have an intrahepatic mass without cirrhosis. The tumor had two distinct histological patterns with dense lymphoplasmacytic infiltrate. The first was similar to nasopharyngeal undifferentiated carcinoma; the second pattern was a well‐differentiated adenocarcinoma. Transition between the two components was observed in the same duct. Immunohistochemistry indicated that the tumor was immunoreactive with AE1/AE3 and cytokeratin (CK) 7, but negative for CEA and CK20. Stromal inflammatory infiltrate primarily consisted of plasma cells and lymphocytes. Immunohistochemical examination and in situ hybridization for EBV showed no integration of the virus in the tumor cells. Intrahepatic lymphoepithelioma‐like carcinoma is rare, and most are associated with EBV. Only three cases were not associated with EBV. The authors would like to add one more example of the tumors not associated with EBV.
Clinicopathological features of CpG island methylator phenotype‐positive colorectal cancer and its adverse prognosis in relation to KRAS/BRAF mutation
Authors: Lee Sun , Cho Nam‐Yun , Choi Minhee , Yoo Eun J. , Kim Jung‐Ho , Kang Gyeong H.
Published: August 2010

CpG island methylator phenotype (CIMP) is a recently described subset of colorectal cancers (CRC) with widespread methylation of multiple promoter CpG islands. But the prognostic implication of CIMP in CRC has not been clarified. Thus, the aim of the present study was to differentiate the unique characteristics of CIMP from those of microsatellite instability (MSI)‐high CRC, especially with regard to prognosis. CIMP, MSI, and mutations of KRAS codons 12 and 13 and of BRAF codon 600 were evaluated in 134 sporadic CRC. Patient survival and other clinicopathological variables were correlated with CIMP or genetic changes. High CIMP, high MSI, and mutations in KRAS or BRAF were detected in 31.3%, 14.2%, 33.6%, and 4.5% of overall CRC, respectively. High CIMP was closely associated with MSI and BRAF mutation but not with KRAS mutation. CIMP‐high, microsatellite‐stable (MSS) CRC were significantly associated with proximal location and nodal metastasis and had close but non‐significant associations with liver metastasis. A worse clinical outcome was found for CIMP‐high, MSS CRC with KRAS/BRAF mutation but not for those lacking KRAS/BRAF mutation. The findings support the contention that CIMP‐high CRC have distinct clinicopathological and epidemiological features and suggest that the alleged poor clinical outcome of CIMP‐high CRC patients is closely associated with the presence of KRAS/BRAF mutation.
Evaluation using a combination of lymphatic invasion on D2‐40 immunostain and depth of dermal invasion is a strong predictor for nodal metastasis in extramammary Paget's disease
Authors: Yamada Yuki , Matsumoto Toshiharu , Arakawa Atsushi , Ikeda Shigaku , Fujime Makoto , Komuro Yuzo , Takeda Satoru
Published: August 2010

In extramammary Paget's disease (EPD), lymph node metastasis occasionally occurs and nodal metastasis influences prognosis. Therefore, in the present study a predictor of nodal metastasis in EPD was examined. Surgical specimens from 54 cases of EPD in the external genitalia were examined on D2‐40 immunostain. In 23 cases, dissection of the inguinal lymph nodes was performed. Dermal invasion occurred in 24 patients (44.4%). Nodal metastasis was found in seven patients who had dermal invasion >1 mm. In non‐metastatic patients, three had dermal invasion <0.5 mm in depth. Lymphatic invasion was well detected on D2‐40 immunostain, and invasion was found in five patients. All four patients with lymphatic invasion, in whom lymph node dissection was performed, had nodal metastasis. However, three patients with dermal invasion, who did not have lymphatic invasion, did have nodal metastasis, and the depth of invasion was >1 mm. Dermal invasion (P < 0.001) and lymphatic invasion according to D2‐40 immunostain (P = 0.001) had a positive correlation with nodal metastasis. In conclusion, evaluation using a combination of lymphatic invasion according to D2‐40 immunostain and depth of dermal invasion is a strong predictor of nodal metastasis in EPD.
Geissleria gereckei sp. nov. (Bacillariophyta) from leaf‐litter covered stones of very shaded carbonate mountain springs with extremely low discharge
Authors: Cantonati Marco , Lange‐Bertalot Horst
Published: August 2010

A new benthic freshwater diatom, Geissleria gereckei sp. nov., was identified from light and scanning electron micrographs. The most characteristic morphological features are the valve outline (elliptical, but with lateral margins that can range from slightly convex to slightly concave and also straight, and protracted, almost capitate ends), the size and length/width ratio, and the pattern of the striae around the central area. The new species was found to be epilithic, and characteristic of leaf‐litter covered stones of very shaded carbonate mountain springs of the Italian Alps with extremely‐low discharge (likely to be affected by seasonal desiccation). Very‐low‐discharge springs host a highly specialized diatom microflora, and are likely to increase in number in the near future due to the reduction of water, which is predicted to be caused by climate change in many regions.
Evaluation of growth and neurodevelopment in children with congenital heart disease
Authors: Polat Selda , Okuyaz Cetin , Hallıoğlu Olgu , Mert Ertan , Makharoblidze Khatuna
Published: August 2010

Background:  Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status.

Methods:  Patients with congenital heart disease (n= 76) and healthy children (n= 51) aged 1–72 months applied to Mersin University Hospital, Mersin, Turkey were included. Patients with heart failure and those requiring intervention or surgery were classified as hemodynamically impaired (HI group, n= 30), and the others, hemodynamically normal (HN group, n= 46). Growth parameters including weight, height, body mass index (BMI), mid‐arm circumference (MAC), and triceps skin fold thickness (TSF) were measured and standard deviations (SD) were determined. Functional development was assessed by Denver Developmental Screening Test‐II (DDST II).

Results:  MAC and BMI values of the group with impaired hemodynamic status were significantly lower than the hemodynamically normal and control groups (MAC P < 0.05 and BMI P < 0.01). In the DDST II, the group with hemodynamic abnormality had more failures in gross motor and fine motor skills than HN group and controls (gross motor P= 0.011, P < 0.001 and fine motor P= 0.028, P= 0.001, respectively) and more failures in language development than the control group (P= 0.001).

Conclusion:  The results showed the importance of hemodynamic status in growth and neurodevelopment of children with congenital heart disease. Besides routine growth parameters, more detailed examinations such as BMI, MAC, TSF, and developmental screening tests appear useful in identifying children with cardiac disease who are under risk for delayed growth and development.
Intramuscular midazolam rapidly terminates seizures in children and adults
Authors: McDONAGH THOMAS J , JELINEK GEORGE A , GALVIN G MICHAEL
Published: August 2010

Objective: To study the efficacy of intramuscular midazolam in treating seizures.

Design: On arrival, patients with seizures were treated with intramuscular midazolam, a stopwatch was started, and an intravenous line inserted. If the seizure had not stopped within six minutes, standard intravenous anticonvulsants were given. The time to cessation of the seizure was recorded.

Setting: Department of Emergency Medicine, Fremantle Hospital, a busy emergency department (50,000 annual attendances, 18% children) in a general community teaching hospital.

Main outcome measure: Time to cessation of fitting.

Results: Thirty eight patients aged from 15 months to 89 years, were treated with intramuscular midazolam at an average dose of 0.12mg/kg (range 0.07–0.21mg/kg). The seizures terminated in all but two cases in an average time of 1minute 53 seconds overall (range 15 seconds to 6 minutes 7 seconds). In a subgroup of 15 patients with prolonged seizures of 36 minutes duration on average, the seizures ceased in a mean time of 2 minutes 41 seconds, with one failure. The latter time is likely to represent the true response time of seizures to intramuscular midazolam as some of the short‐lived seizures may have ceased spontaneously. All seven children treated with intramuscular midazolam ceased fitting. There were no adverse side effects in any patient.

Conclusion: Midazolam given by intramuscular injection was shown to be rapidly effective for the control of generalised convulsive seizures, focal seizures and status epilepticus in adults and in children.

This new therapy has exciting applications in the treatment of seizures in children and in the pre‐hospital setting.
Adrenaline activity is not significantly altered by high ambient temperatures.
Authors: Rudland Simon , Annus Tebor
Published: August 2010

Drugs used in prehospital care are exposed to extremes of temperature, which exceed the manufacturerer's recommended storage conditions, and may result in degradation of the formulation. Adrenaline, which can be degraded by high temperatures, is a key agent for the effective management of cardiac arrest and acute anaphylaxis in the prehospital setting. We demonstrate that the activity of adrenaline vials carried in St John's ambulances in the Perth metropolitan area during summer months when ambient temperatures can reach 40°C was not significantly altered.
ANGIOGENESIS IN SUPERFICIAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA: MAGNIFYING ENDOSCOPIC OBSERVATION AND MOLECULAR ANALYSIS
Authors: Kumagai Youichi , Toi Masakazu , Kawada Kenro , Kawano Tatsuyuki
Published: August 2010

Observations of esophageal squamous cell carcinoma using magnifying endoscopy have now been carried out extensively and, as a result, it has become clear that the morphology of the microvessels evident at the tumor surface reflects the depth of tumor invasion. In M1 and M2 cancer, the surface microvasculature reveals dilation and elongation of the intrapapillary capillary loops (IPCL). However, at this stage, some immature capillaries resembling IPCL also arise inside the tumor and, therefore, the view of the microvasculature should be described as one showing ‘intermixing of modified IPCL and IPCL‐like immature capillaries (IPCL‐like abnormal capillary)’. As cancer invades into the muscularis mucosa (M3 or deeper), an obviously dilated and irregularly branched tumor‐specific vasculature, more accurately described as ‘neovasculature’, can be observed. From our magnifying endoscopy observations and studies of the molecular profile of early esophageal cancer, we conclude that two major angiogenic steps exist in precancerous and M3 lesions in the early phase of cancer progression. In addition, it is now possible to study cell morphology using an endocytoscope with a much higher magnification (×400–×1000) than magnifying endoscopes currently on the market. The histology revealed in this way may reduce the need for conventional biopsy histology in the future.