bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of moderately bright light on subjective evaluations in healthy elderly women
Authors: Kohsaka Masako , Fukuda Noriko , Honma Hiroshi , Kobayashi Riko , Sakakibara Satoshi , Koyama Emi , Nakano Toshio , Matsubara Hozumi
Published: March 2003

Eight healthy elderly women aged 56–72 years (mean age: 67.4 years) participated in this study. They were exposed to moderately bright light (1000 lux) for 1 h in the morning every 6 days in their homes. Moderately bright light improved self evaluations for alertness, mood, motivation, happiness, refreshment, concentration and appetite after the second exposure to the light. Sleep maintenance, anxiety and integrated sleep feeling also improved after the fourth exposure to the light. The phase of rectal temperature rhythm did not change in a moderately bright light condition. These results suggest that bright light influences sleep quality and self evaluations without changing the biological rhythm phase.
Application of the Zung self‐rating depression scale to patients before and after introduction to haemodialysis
Authors: Miura Hideki , Kitagami Tomitsune , Ohta Tatsuro
Published: March 2003

In the present study we applied the Zung self‐rating depression scale (SDS) to 19 renal failure patients who were introduced to haemodialysis in the Nagoya Daini Red Cross Hospital, Nagoya, Japan.

The patients were divided into two groups: the emergent introduction (EI) group, who underwent unanticipated and sudden introduction to haemodialysis, and the ordinary introduction (OI) group, who experienced a more systematic introduction to haemodialysis following recommendation by medical specialists. The patients’ Zung SDS responses were collected twice, just before and 2 weeks after haemodialysis introduction.

The total SDS score of the EI group was significantly higher than that of the OI group, both before and after haemodialysis introduction. The total SDS scores for the EI and OI groups were significantly reduced after haemodialysis introduction. The SDS scores for the EI group were significantly higher in the mood of depression and cognitive symptoms categories, both before and after haemodyalysis introduction. Before introduction, SDS scores of the EI group were significantly higher in the categories of motor and vegetative symptoms. The SDS scores for vegetative symptoms in the EI group significantly decreased after introduction to haemodialysis.

These results suggest that haemodialytic excretion of uremic toxins helps to reduce SDS scores.
Aldehyde dehydrogenase genotypes and male alcohol use disorders: A case‐control study in Khon Kaen, north‐east Thailand
Authors: Nanakorn Somsong , Fukuda Katsuhiro , Nishiyori Atsushi , Shibata Akira , Nakamura Jun
Published: March 2003

A genetic epidemiological case‐control study on aldehyde dehydrogenase 2 (ALDH2) genotype and male probable alcohol use disorders (AUD) was performed in Khon Kaen province, north‐east Thailand. One hundred and twenty‐four of cases (probable AUD) were obtained from male villagers aged 18–65 years using the modified Michigan Alcoholism Screening Test‐Thai version. The same number of controls were selected, being matched with the cases in terms of age (±4 years) within the same village. Marital status, education history and past or present histories of physical illnesses were essentially the same for the cases and the controls. All of the cases and 85.5% of the controls were current drinkers, and the cases tended to drink significantly more often than the controls. Genomic DNA was extracted from fingernails and ALDH2 genotypes were determined by polymerase chain reaction technique and digested by Ksp 632I. The ALDH2 genotypes of the cases and the controls were not significantly different: 90.3% versus 91.1% normal homozygote; 8.1% versus 8.9% heterozygote; and 1.6% versus 0.0% mutant homozygote, respectively. Among the normal homozygote, the daily amount of alcohol intakes of the cases were significantly larger than that of the controls (56.2 ± 40.6 g vs 8.1 ± 14.1 g), the same was found among the ALDH2 deficient (55.9 ± 43.4 vs 2.2 ± 5.8 g). Multivariate analysis based on the conditional logistic regression model showed no significant association of AUD with ALDH2 genotype, marital status, education history, or past history of injury, however, occupation and daily amount of alcohol intake were found to be significantly associated with AUD (OR = 10.72, 95% CI = 1.15 − 99.99, p = 0.037, and OR = 1.12, 95% CI = 1.06 − 1.18, p = 0.000, respectively). Non‐farmers showed 10.7 times larger risk of developing AUD compared to farmers, and the subjects had three times more chance of developing AUD for each increase of 10 g of the daily amount of alcohol intake.
An empirical classification of social anxiety: Performance, interpersonal and offensive
Authors: Iwase Madoka , Nakao Kazuhisa , Takaishi Jyo , Yorifuji Kazuhiro , Ikezawa Koji , Takeda Masatoshi
Published: March 2003

This study empirically identified subtypes of social anxiety using a cluster analytic approach. From 87 out‐patients with social phobia (taijin kyofusho) and 48 controls, social anxiety symptoms, social situations in which symptoms occur, and background information were evaluated. Factor analysis using the ratings of social anxiety symptoms identified four factors: socially inadequate feelings, performance anxiety, offensive fear, and tenacity. Four subtypes emerged from cluster analysis based on the factor scores and they were called performance anxiety type, offensive type, interpersonal anxiety type and mild type. χ2 test and analysis of variance revealed the following: (i) the offensive type had the greatest symptom severity. Any situation could provoke symptoms, and interpersonal tense feelings became much stronger with persons of the same age; (ii) the interpersonal anxiety type was characterized by the fear of social interaction in daily life; and (iii) patients with the offensive type and the interpersonal anxiety type presented more difficulties than did those with the performance anxiety type on developmental and premorbid adjustment.
Effect of melatonin on sleep–wake rhythm: The sleep diary of an autistic male
Authors: Hayashi Etsuko
Published: March 2003

This study reports on melatonin treatment in autism. A 14‐year‐old autistic male with severe mental retardation was given melatonin at a dose of 6 mg at 9:00 pm (C1) or 11:00 pm (C2). His parents kept a sleep diary. In C1, he often experienced early morning waking and fragmented night sleep but in C2, night sleep was prolonged and sleep–wake rhythm was improved. Suitable medication time, therefore, improved the sleep–wake rhythm.
Integration of a psychoanalytic liaison department at a public hospital
Authors: Neuburger Roberto P.
Published: March 2003

Abstract A general overview of liaison‐psychoanalysis in a general hospital is presented. The team's trajectory is revisited, as generating a presence in the inpatient units: a demand which changes from a purely psychiatric, scarcely operative level to an acknowledgment of subjectivity. Generally, this appears disruptively in medical proceedings. Two case histories are presented: (i) ‘the tenant’ and (ii) ‘the nail‐polishing file’. With regard to the first case history, the transference in its double aspect, with the patient as well as with the unit’s staff, is examined. The analyst's intervention seeks to untangle the impasse, which prevents the physicians from helping the patient. With regard to the second case history, in which the de‐mystification aspects of liaison work are shown, the horror that the so‐called ‘mental illness’ can produce in the medical institution is explored. The aim of narrating this experience is to preserve a psy‐space in the hospital where the overwhelming technological developments menace with its disappearance.
Relationships between age of onset, antisocial history and general psychopathological traits in Japanese alcoholics
Authors: Matsuoka Keiko , Kim Yoshiharu , Toshida Shuta , Ohshima Nobuyori
Published: March 2003

Abstract This study investigated the relationships of age of onset, antisocial history and general psychopathological traits measured by the Minnesota Multiphasic Personality Inventory (MMPI) in Japanese alcoholics (n = 84). A 2 (earlier vs later onset) × 2 (antisocial vs non‐antisocial) multivariate analysis of covariance showed that age of onset had a significant correlation with some subscales of the MMPI such as L (lie), Sc (schizophrenia), and Si (social introversion), whereas history of antisocial behavior had no significant correlation with any MMPI clinical subscales. This result indicated that age of onset was a more significant variable than was antisocial history with regard to the current general psychopathological traits on MMPI in Japanese alcoholics.
Auditory P50 obtained with a repetitive stimulus paradigm shows suppression to high‐intensity tones
Authors: Ninomiya Hideaki , Sato Eigo , Onitsuka Toshiaki , Hayashida Takaharu , Tashiro Nobutada
Published: March 2003

Abstract We manipulated stimulus intensity and number of frequency bands in auditory stimuli in order to investigate the nature of P50 in human auditory evoked potentials. Pure‐tone and mixed‐tone conditions were examined. For each condition, four stimulus intensities were used: 55, 70, 85 and 100 dB sound pressure level (SPL). The P50s were obtained at Cz using a repetitive stimulus paradigm. P50 amplitudes increased as stimulus intensities increased up to 85 dB; with 100 dB stimulation amplitudes decreased. The number of frequency bands in the stimulus did not affect P50 amplitude. Considered in terms of P50 suppression under a conditioning/testing paradigm, the results suggest that the P50 wave reflects activity of the sensory gating mechanism in humans.
Sleep patterns during 30‐m nitrox simulated saturation dives
Authors: Nagashima Hidetoshi , Matsumoto Kazuya , Seo Yoojin , Mohri Motohiko , Naraki Nobuo , Matsuoka Shigeaki
Published: March 2003

The sleep patterns were examined during the simulated 30‐m nitrox saturation dives. The standard polysomnography of 15 divers was recorded for a total of 255 nights, as were patterns of change or consistency in sleep variables. A reduction of total sleep time in accordance with the lengthening of sleep latency and the wake after sleep onset was observed through the latter part of the bottom period to the post‐dive period, but the other sleep variables did not show any changes. These findings suggest that decompression and the psychological stress due to being in the closed environment of a hyperbaric chamber for a long time have effects on divers’ sleep.
Study on withdrawal of hypnotics: Questionnaire on hypnotic use and its withdrawal
Authors: Mukai Masaki , Uchimura Naohisa , Takeuchi Noboru , Kuwahara Hiroo , Hashizume Yuji , Nose Iwao , Satomura Takeshi , Tanaka Jyunji , Maeda Hisao
Published: March 2003

To investigate the situation and problems contingent to hypnotic use and withdrawal, we conducted a questionnaire of outpatients. Only 41% of the patients were satisfied with their sleep and 53% of the patients took hypnotics. As regards the period, 83% of users had used them for more than 1 year and 19% had used them for more than 10 years. Although 90% of patients perceived efficacy of hypnotics, 67% felt more or less anxious about hypnotic use. Sixty‐seven per cent of patients had actually withdrawn from the drugs or decreased dosage before. More than half the patients’ conditions worsened after the withdrawal or reducing dosage.
Sleep–wake rhythm during stay in an intensive care unit: A week’s long‐term recording of skin potentials
Authors: Shiihara Yasufumi , Nogami Toshihide , Chigira Masayoshi , Tanno Yoshihiko , Sakai Yasuziro , Takahashi Sigeru , Kodama Masahisa , Kunimoto Fumio
Published: March 2003

To monitor the sleep–wake cycle of patients during their stay in the intensive care unit (ICU), we tried continuous and long‐term recording of skin potential (SP) levels in patients after surgery. A graph of the week‐long SP showed the sleep–wake pattern to be evident until the fourth day. It disappeared beginning on the fifth day, resulting finally in delirium with a relatively high mean SP level. In another record, the administration of sedative agents to calm the excitement lowered the mean SP level and suppressed SP responses evoked by frequent day and night treatment or nursing care. Continuous monitoring of arousal level by SP will be of help in prevention of ICU syndrome.
Effects of bright light at lunchtime on sleep of patients in a geriatric hospital I
Authors: Kobayashi Riko , Fukuda Noriko , Kohsaka Masako , Sasamoto Yoichi , Sakakibara Satoshi , Koyama Emi , Nakamura Fumihiro , Koyama Tsukasa
Published: March 2003

The effects of lunchtime bright light exposure in patients of a geriatric hospital were investigated. Ten inpatients (six women and four men; mean age ± SD: 81.2 ± 8.8 years) with sleep disturbances were studied for 9 weeks. Nurses performed daily ratings for sleep–wakefulness disturbances. Approximately 8000 lx bright light exposure was performed for 3 weeks in the light therapy room. Before and after exposure, ocular function was evaluated. Clinical ratings of sleep‐wakefulness improved in eight patients. The score of difficulty in falling asleep and drowsiness in the morning declined during the light exposure. The score of drowsiness in the afternoon decreased during the post‐light exposure. Post‐exposure ocular disturbances were not found.
Cause‐specific mortality risk among male alcoholics residing in the Osaka metropolitan area
Authors: Noda Tetsuro , Imamichi Hiroyuki , Tanaka Hideo , Kawata Akira , Hirano Kenji , Ando Tatsuo , Yoneda Hiroshi , Iwata Yasuo , Kinoshita Noriko
Published: March 2003

Abstract We evaluated the mortality risk among 306 male alcoholics living in Osaka, Japan, at the time of initial diagnosis between 1972 and 1983, with regard to the cause of death, length of time from diagnosis, and participation in an alcohol abstinence self‐help group. By the closing date on 1 March 1992, 110 of the 306 alcoholics had died, yielding an observed‐to‐expected (O/E) ratio of 4.5 [95% confidence interval (CI) = 3.7–5.4]. The alcoholics had significantly elevated mortality risks from all malignant neoplasms (O/E = 2.1, 95%CI = 1.2–3.3), esophageal cancer (O/E = 8.4, 95%CI = 1.7–24.5), diseases of the circulatory system (O/E = 4.4, 95%CI = 3.0–6.2), liver cirrhosis (O/E = 15.9, 95%CI = 10.2–23.6), diseases of the genitourinary system (O/E = 6.3, 95%CI = 1.3–18.5), and external death (O/E = 10.3, 95%CI = 6.3–15.8). The mortality risk from all causes still remained significantly high beyond the tenth year following initial diagnosis (O/E = 2.6, 95%CI = 1.0–6.2). The mortality risks from liver cirrhosis and external death (such as suicide) were highest within the first year following diagnosis, and were still high beyond the tenth year. A significantly high mortality risk from diseases of the circulatory system was observed between the first and ninth years, and the mortality risk from all malignant neoplasms was significantly elevated beyond 10 years following diagnosis. Alcoholics who did not join a self‐help group soon after the initial institutional treatment had different cause‐specific and time‐specific mortality risks from those who did join a self‐help group. These findings show the importance of long‐term clinical follow‐up of male alcoholics, taking into consideration the cause‐specific mortality.
Relationship of criminality to endogeneity and anxiety in patients with unipolar depression
Authors: Modestin Jiri , Thiel Christoph , Erni Thomas
Published: March 2003

Abstract The relationship between criminal behavior on the one hand and endogeneity and anxiety on the other hand was investigated in a sample of patients with unipolar depression to help elucidate factors influencing the criminality rate in this population. A lower criminality rate in patients with higher ratings of endogeneity and anxiety was predicted. Clinical records of 179 male and 99 female psychiatric inpatients were retrospectively evaluated using the Newcastle Scale II and Hamilton Anxiety Scale. A full account of conviction records served as a measure of criminal behavior. Forty per cent of male patients and 7% of female patients were criminally registered. A lower criminality rate was indeed found in male and female patients with endogenous type of depression and in male patients with higher anxiety ratings. In a multivariate evaluation, however, sociodemographic variables in terms of age and social class seem to be more important predictors of criminality and all variables we assessed contributed only marginally to the explanation of the criminality variance. Thus, in patients with unipolar depression, sociodemographic factors seem to be of a greater even though still limited importance regarding criminal behavior compared with the clinical variables of endogeneity and anxiety.
Effects of donepezil (Aricept) on the rapid eye movement sleep of normal subjects
Authors: KANBAYASHI TAKASHI , SUGIYAMA TOMONARI , AIZAWA RIKA , SAITO YASUSHI , OGAWA YURIKO , KITAJIMA TSUYOSHI , KANEKO YOSHIHIKO , ABE MASAHITO , SHIMIZU TETSUO
Published: March 2003

Abstract Donepezil (Aricept) is a therapeutic drug for the treatment of Alzheimer’s disease (AD). However, there have been only two reports describing the effects of donepezil on sleep as assessed by nocturnal polysomnography (PSG). With this in mind, the effects of donepezil on the sleep of healthy subjects was evaluated using PSG. The results indicated that the percentage of rapid eye movement sleep to total sleep time was increased significantly by a single dose of 5 mg of donepezil when given to healthy subjects immediately before retiring to bed.
The neurochemistry of waking and sleeping mental activity: The disinhibition‐dopamine hypothesis
Authors: GOTTESMANN CLAUDE
Published: March 2003

Abstract This paper describes a hypothesis related to the neurochemical background of sleep‐waking mental activity which, although associated with subcortical structures, is principally generated in the cerebral cortex. Acetylcholine, which mainly activates cortical neurons, is released at the maximal rate during waking and rapid eye movement (REM) sleep dreaming stage. Its importance in mental functioning is well‐known. However, brainstem‐generated monoamines, which mainly inhibit cortical neurons, are released during waking. Both kinds of influences contribute to the organized mentation of waking. During slow wave sleep, these two types of influence decrease in intensity but maintain a sufficiently high level to allow mental activity involving fairly abstract pseudo‐thoughts, a mode of activity modelled on the diurnal pattern of which it is a poor reply. During REM sleep, the monoaminergic neurons become silent except for the dopaminergic ones. This results in a large disinhibition and the maintained dopamine influence may be involved in the familiar psychotic‐like mental activity of dreaming. Indeed, in this original activation–disinhibition state, the increase of dopamine influence at the prefrontal cortex level could explain the almost total absence of negative symptoms of schizophrenia during dreaming, while an increase in the nucleus accumbens is possibly responsible for hallucinations and delusions, which are regular features of mentation during this sleep stage.
The flunitrazepam abuse prevention program at a general hospital in Taiwan: A descriptive study*
Authors: SHEN WINSTON W. , CHANG CINDY , HSIEH WEN‐CHIEH , YEH CHEN‐JUNG , CHIU FANG‐YI , CHUANG YAO‐CHIN
Published: March 2003

Abstract The Bureau of Controlled Drugs at Ministry of Health, Executive Yuan in Taiwan announced, on 1 April 2000, the schedules of controlled drugs with abuse potential and implemented a policy on 1 October 2000 to control them. Flunitrazepam (FM2), along with other two benzodiazepines (triazolam and brotizolam), is placed on Schedule III. The aim of the present study was to analyze the pattern of flunitrazepam prescriptions across all medical subspecialty departments at Taipei Medical University‐Wan Fang Hospital (TMU‐WFH), Taiwan. We analyzed 1170 prescriptions over 12 month period from 1 July 2000 to 31 May 2001. All prescription data were divided into three 4 month periods: period I was when the flunitrazepam prescription was not controlled, period II represented the time when flunitrazepam was placed on Schedule III and when physicians were required to use a special duplicated prescription form and period III was when the TMU‐WFH started to set a stricter control for the prescription of flunitrazepam. The results indicated that the number of flunitrazepam prescriptions during period III had decreased significantly compared with period I (P ≤ 0.05). Eventually, 45.7% of flunitrazepam‐medicated patients were followed up monthly with a restriction of their flunitrazepam supply to no more than 14 days, 22.9% of patients were followed up fortnightly at clinics with a 14 day supply of flunitrazepam, 15.7% were followed up fortnightly with a 14 day restriction of flunitrazepam plus a non‐flunitrazepan benzodiazepine supplement, 10.7% were referred to clinics within the Department of Psychiatry and 5% were switched from flunitrazepam to other drugs.
Human leukocyte antigen alleles in patients with bipolar disorder in the Korean population
Authors: JUN TAE‐YOUN , PAE CHI‐UN , CHAE JEONG‐HO , PYO CHUL‐WOO , HAN HOON
Published: March 2003

Abstract We performed an association study between human leukocyte antigen (HLA) alleles and bipolar disorder to evaluate the potentiality of HLA as a genetic marker in bipolar disorder. HLA class I and class II allele frequencies were assessed in 87 bipolar patients and were compared with those of 206 normal controls in the Korean population. HLA class I typing was performed using the microlymphocytotoxicity method, whereas class II (DRB1 and DQB1) genotyping was performed with polymerase chain reaction‐sequence specific oligonucleotide probes. When the allele frequency of HLA in bipolar patients was compared with that in normal controls, there were some significant differences. Bipolar patients showed statistically significant increased allele frequencies of HLA‐A29 and B54. Allele frequencies of HLA‐B51 and DRB1*02 were significantly higher in normal controls. However, these results were no longer significant after correcting for the number of alleles. The results of the present study suggest that HLA alleles may not confer susceptibility to bipolar disorder in the Korean population. To clarify the genetic influence of HLA on bipolar disorder, we should conduct a consecutive study with a larger cohort of subjects.
Suicide attempt and self‐mutilation among Turkish high school students in relation with abuse, neglect and dissociation
Authors: Zoroglu Suleyman Salih , Tuzun Umran , Sar Vedat , Tutkun Hamdi , Savaçs Haluk Asuman , Ozturk Mucahit , Alyanak Behiye , Kora Meltem Erocal
Published: March 2003

Abstract A questionnaire consisting of items about abuse, neglect, self‐mutilation and suicide attempt and the Turkish Version of the Dissociative Experiences Scale were given to 862 high school students. The rates of suicide attempt and self‐mutilative behaviors were 10.1% and 21.4%, respectively. Abused or neglected groups (34.3%) had 7.6‐fold higher suicide attempts and 2.7‐fold higher self‐mutilation behaviours. The logistic regression model showed that each type of trauma and dissociation contributed to suicide attempts and self‐mutilation, but dissociation was the most powerful. Suicidal and self‐destructive adolescents should precisely be evaluated for abuse, neglect and dissociation in clinical practice.
CD95 (Fas) ligand expression of Epstein‐Barr virus (EBV)‐infected lymphocytes: A possible mechanism of immune evasion in chronic active EBV infection
Authors: Ohshima Koichi , Suzumiya Junji , Sugihara Midori , Nagafuchi Seiho , Ohga Shouichi , Kikuchi Masahiro
Published: March 2003

The Epstein‐Barr virus (EBV) induces infectious mononucleosis (IM) and can be associated with chronic active EBV infection (CAEBV). Cytotoxic T lymphocytes (CTL) play an important role in excluding EBV‐infected cells. Two cytotoxic mechanisms of CTL have been demonstrated: one perforin/granzyme‐based and the other Fas (CD95)/Fas ligand (FasL)‐based. To clarify these two pathways in CAEBV, we analyzed six patients with CAEBV and four patients with IM using immunohistochemical staining of the lymph nodes. In both CAEBV and IM, CD8+ T‐cells increased in number, but CD56+ natural killer cells were rare. In four of six cases with CAEBV, approximately half the lymphocytes were positive for T cell‐restricted intracellular antigens (TIA‐1), which were recognized by the cytolytic granules of CTL. In IM, the number of TIA‐1 positive cells was smaller than that in CAEBV. Fas‐positive lymphocytes were frequently encountered in both CAEBV and IM. However, FasL‐positive lymphocytes increased in three of six patients with CAEBV, but not in patients with IM. Except for one case with CAEBV, the number of perforin‐ and/or granzyme‐positive cells was small in number in both CAEBV and IM cases. In double‐staining FasL and EBV in situ hybridization, FasL‐positive EBV‐infected lymphocytes were detected in CAEBV but not in IM. In CAEBV, the Fas/FasL pathway and not perforin pathways appears to play an important role in the pathogenesis. The data suggest that EBV‐infected lymphocytes may evade immune attack through the expression of FasL.
Usefulness of proliferative activity, DNA ploidy pattern and p53 products as diagnostic adjuncts in colorectal adenomas and intramucosal carcinomas
Authors: Sugai Tamotsu , Nakamura Shin‐ichi , Habano Wataru , Uesugi Noriyuki , Sato Hajime , Yoshida Toru , Orii Seishi
Published: March 2003

Although numerous studies have assessed the biologic parameters of tumors, measurement of these parameters has had, to date, little impact on histologic diagnosis. Furthermore, analysis of a single parameter is insufficient to evaluate tumor malignant potential. In the present study, cell proliferation, DNA ploidy and p53 product were analyzed to objectify the tumor malignant potential in colorectal adenomas and intramucosal carcinomas. Sixty‐one adenomas and 49 intramucosal carcinomas were studied using immunohistochemical analysis of Ki‐67 and p53, silver‐staining nucleolar organizer region (AgNOR) stain and DNA ploidy in fresh samples. Intramucosal carcinoma exhibited a greater Ki‐67‐positive rate and AgNOR count than the adenomas, although these parameters varied widely among samples. The incidence of aneuploidy and p53 over‐expression in colorectal intramucosal carcinomas was significantly higher than in colorectal adenomas. These results indicate that DNA aneuploidy and p53 accumulation are the most reliable parameters for distinguishing benign and malignant lesions.
Paraneoplastic vasculitis associated with esophageal carcinoma
Authors: Mita Toshihiro , Nakanishi Yukihiro , Ochiai Atsushi , Shimoda Tadakazu , Kato Hoichi , Yamaguchi Hajime , Toda Gotaro
Published: March 2003

We report a case of esophageal carcinoma associated with paraneoplastic vasculitis. A 69‐year‐old man suffered from low‐grade fever and numbness of the lower limbs for 3 months before esophageal and gastric carcinomas were detected. Concurrent infection or collagen disease was ruled out following clinical and laboratory examinations. In April 1996, the gastric carcinoma was completely removed by endoscopic mucosal resection, but the symptoms remained. Three weeks later esophagectomy was performed for esophageal carcinoma after which time the fever and numbness disappeared. The esophageal carcinoma was a well‐differentiated squamous cell carcinoma invading into the submucosal layer. Twenty‐two lymph node metastases were found in 68 resected lymph nodes. Latent thyroid cancer was found. Histologically, vasculitis was detected in the esophagus, stomach and serratus anterior muscle. The distribution and degree of vasculitis were most pronounced in the esophagus. The concurrent onset and spontaneous resolution of fever and numbness after the removal of the esophageal carcinoma suggested a paraneoplastic origin. The majority of patients with malignant neoplasm‐associated vasculitis had hematologic neoplasms. Cases of esophageal carcinoma associated with paraneoplastic vasculitis are extremely rare.
Epithelioid srcoma of the penis: A case report and review of the literature
Authors: Rossi Giulio , Ferrari Giovanni , Longo Lucia , Trentini GianPaolo
Published: March 2003

A rare case of epithelioid sarcoma (ES) of the penis is presented. The patient, a 35‐year‐old man, was initially treated as having Peyronie’s disease, but the subsequent appearance of a subcutaneous nodule displayed a ‘distal‐type’ ES. At immunohistochemical phenotypification, the tumor was positive for vimentin, cytokeratins and epithelial membrane antigen (EMA), as well as for some other multidirectional antibodies, including a membranous reaction for CD99. The review of 11 similar cases so far reported in the literature led to the conclusion that the clinicopathological characteristics of penile ES are basically the same as those of tumors in more classical locations: the age at diagnosis ranged from 23 to 43 years, the interval between first manifestations and diagnosis averaged 37 months (delayed diagnosis being common because of the slow growth rate and the harmless appearance of the lesion), the typical sign was a superficial nodule or mass, usually accompanied (better preceded) by urethral stenosis, dysuria and erectile disturbances. Total or partial penectomy was the treatment of choice in most patients, but lack of adequate follow up did not permit any definitive conclusion to be reached regarding its efficacy.
Malignant intramuscular forearm tumor with overwhelming squamous element
Authors: Orui Hiroshi , Yamakawa Mitsunori , Ishikawa Akira , Tsuchiya Takashi , Ogino Toshihiko
Published: March 2003

Squamous cell carcinoma (SCC) arising in the skeletal muscle is rare. A case of a 19‐year‐old female patient with an intramuscular forearm tumor showing a histopathologically overwhelming squamous element is presented. Microscopic examination revealed the classical features of SCC, including horn pearls, individual cell keratinization and intercellular bridge. A malignant spindle cell component was not detected. Neither evidence of another primary site nor skin lesion over the tumor was found and no metastatic lesion was detected in the 5 years since the appearance of the mass.
Correlation between morphological heterogeneity and genetic alteration within one tumor in adenocarcinomas of the lung
Authors: Yamasaki Masahiro , Takeshima Yukio , Fujii Satoshi , Matsuura Masahiro , Tagawa Kohei , Inai Kouki
Published: March 2003

In some human cancers, multistep carcinogenesis has been advocated on the basis of morphological and genetic analysis. In adenocarcinoma of the lung, a carcinogenetic process from atypical adenomatous hyperplasia (AAH) to bronchiolo‐alveolar carcinoma (BAC) and/or more malignant adenocarcinoma has been recently suggested. In the present study, we selected 13 lung tumors which had AAH‐like or BAC‐like areas at the periphery, and poorly differentiated areas at other sites, and examined their loss of heterozygosity (LOH) on chromosome 3p, 9p and 17p and point mutation of the p53 gene. A heterogeneous pattern of LOH and/or point mutation of the p53 gene was detected in five of 13 cases, and genetic alterations were frequent in the areas of poorer differentiation. These findings suggest that some adenocarcinomas of the lung occur through multistep carcinogenesis.
Intramuscular spindle cell lipoma: Case report and review of the literature
Authors: Horiuchi Keisuke , Yabe Hiroo , Nishimoto Kazumasa , Nakamura Noriko , Toyama Yoshiaki
Published: March 2003

Spindle cell lipoma (SCL) is a relatively rare adipocytic neoplasm and is histologically characterized by a mixture of uniform spindle cells and mature fat cells. It occurs predominantly in male patients aged 45–65 years, and in most cases it arises in the subcutaneous tissue of the neck or shoulder. Although the neoplasm sometimes affects unusual sites, only three cases have been reported in which the lesion was intramuscular. Here we present a case of SCL arising in skeletal muscle; to our knowledge, the first report in 10 years. The tumor occurred in the neck of a 50‐year‐old male patient. Magnetic resonance imaging (MRI) revealed a lipomatous tumor within the right trapezius muscle. The tumor was localized beneath the fascia and was excised completely at surgery. Histologically, the tumor was typical of a spindle cell lipoma with no evidence of malignancy. An immunohistochemical study revealed all spindle cells were strongly positive for CD34. Differential diagnosis is discussed with a review of the literature.
Endometrioid adenocarcinoma arising from adenomyosis: Report and immunohistochemical analysis of an unusual case
Authors: Sasaki Toshiki , Sugiyama Tatsuo , Nanjo Hiroshi , Hoshi Naoto , Murakami Masayo , Sugita Akihiro , Takahashi Masato , Kawamura Koichi , Ono Iwao , Masuda Hirotake
Published: March 2003

A case of endometrioid adenocarcinoma arising from adenomyosis is reported. The patient was a 53‐year‐old woman who complained of vulvar itching. Smear cytology of the endometrium revealed adenocarcinoma. Magnetic resonance imaging of the pelvis revealed a lesion with a slightly high intensity in the uterine fundus on a T2‐weighted image. Semiradical total hysterectomy and bilateral adnexectomy were performed, followed by chemotherapy. Histologically, the lesion in the uterine fundus was composed mostly of adenocarcinoma with stromal invasion. There were many adenomyotic foci in and around the carcinoma, including some showing transition to adenocarcinoma. There was no malignant finding in the normally situated endometrium. The carcinoma invaded in the myometrium, involving the uterine serosa, but no dissemination to the peritoneal cavity was found. The carcinoma was, therefore, considered to be endometrioid adenocarcinoma arising from adenomyosis. Immunohistochemistry showed expression of p53 oncoprotein and Ki‐67 antigen in the carcinoma cells. The value of immunohistochemistry in predicting prognosis is discussed.
Primary intrapelvic seminoma in Klinefelter's syndrome
Authors: Kurabayashi Atsushi , Furihata Mutsuo , Matsumoto Manabu , Sonobe Hiroshi , Ohtsuki Yuji , Aki Masashi , Kuwahara Morimasa
Published: March 2003

Seminoma arising in patients with Klinefelter's syndrome is extremely rare; to our knowledge, only three cases have been reported in the English language literature. We report a case of intrapelvic seminoma in a 39‐year‐old man with Klinefelter's syndrome. Gross examination revealed that the tumor was a solid and irregular mass measuring 90 mm in diameter. The cut surfaces of this ill‐defined tumor were yellow–white with necrotic foci. Histologically, the tumor cells were separated into lobules by branching, fibrous septa containing lymphocytes. In some parts of the tumor, a cord‐like arrangement of tumor cells was present. Immunohistochemically, the tumor cells were strongly and diffusely positive for antiplacental alkaline phosphatase antibody along their cytoplasmic membranes, but negative for both chorionic gonadotrophin and α‐fetoprotein. Based on these findings, we diagnosed this tumor as a seminoma. The testes when examined were found to be atrophic bilaterally, but with no tumor lesions. Chromosomal analysis yielded a 47XXY karyotype, compatible with Klinefelter's syndrome. These findings indicate a case of primary intrapelvic seminoma in Klinefelter's syndrome. The patient underwent intensive radiation therapy postoperatively, and he demonstrated no evidence of recurrence or metastasis during the 13‐month period following surgery.
Adenosarcoma of the uterine corpus associated with ovarian thecoma
Authors: Nomura Kouichi , Aizawa Shigeo , Ushigome Shinichiro
Published: March 2003

We describe a case of adenosarcoma of the uterine corpus associated with ovarian thecoma in a 67‐year‐old woman. The patient underwent surgery under a diagnosis of ovarian carcinoma. The 110 × 70 mm‐sized ovarian tumor was diagnosed as thecoma. The polypoid tumor of the uterine corpus which measured 30 × 15 mm was diagnosed as adenosarcoma. Cells of both epithelial and stromal elements of the adenosarcoma expressed estrogen receptors (determined by immunohistochemistry). These findings support the view that estrogen stimulation, including that by a pre‐existing ovarian thecoma, may play a role in the development of mesenchymal and mixed epithelial / mesenchymal uterine tumors, including adenosarcoma.
Nuchal fibrocartilaginous pseudotumor: Immunohistochemical and ultrastructural study of two cases
Authors: Zamecnik Michal , Michal Michal
Published: March 2003

Two cases of nuchal fibrocartilaginous pseudotumor are reported. The lesions occurred in a 50‐year‐old woman and a 41‐year‐old man. From the clinical point of view, the absence of history of trauma in one case represents an unusual observation. Histologically, both lesions were similar to the 10 cases which have been previously described. They consisted of poorly defined, moderately cellular fibrocartilage nodules, and they lacked nuclear atypia and mitotic activity. Immunohistochemically, the lesions showed diffuse expression of vimentin and CD34. Mild expression of S‐100 was limited to some chondroid cells. Desmin, α‐smooth muscle actin, and CD99 (MIC2 gene product) were not expressed. Ultrastructurally, cells with features of fibroblasts and chondroblasts without any signs of myofibroblastic or myochondroblastic differentiation were found.
Autopsy case of lymphoplasmacytic lymphoma with a large submucosal tumor in the stomach
Authors: Okada Yoshikatsu , Mori Hiroshi , Maeda Tamaki , Ito Yasuhiro , Hasegawa Minoru , Kageyama Takashi
Published: March 2003

An autopsy case of lymphoplasmacytic lymphoma with a large submucosal tumor in the stomach is presented. The patient was a 77‐year‐old woman with gastric lymphoma associated with Waldenström’s macroglobulinemia of IgM‐λ type. Diagnosis was initially mucosa‐associated lymphoid tissue (MALT) lymphoma of the stomach, because gastric biopsy specimens showed epitheliotropic proliferation (lymphoepithelial lesion) of the lymphoma cells. Post‐mortem examination revealed a large gastric lymphoma with metastatic foci in the esophagus, larynx, trachea, lungs, spleen and lymph nodes. The bone marrow was also involved. Lymphoma cells consisted of small lymphocytoid cells occasionally admixed with blast‐like large cells and a large number of plasmacytoid or plasma cells. Centrocyte‐like cells were not found. Lymphoepithelial lesions were not conspicuous in autopsy specimens. Immunohistochemically, lymphoma cells reacted with CD20, CD45, CD79a, anti‐IgM, anti‐λ protein and anti‐BCL‐2, but not with CD5, CD10, CD23 or CD38. Based on these findings, the revised diagnosis of the present case was lymphoplasmacytic lymphoma, and it highlighted the differential diagnostic problem from marginal zone B‐cell lymphoma of MALT type.
Mycobacterium tuberculosis infection within Warthin’s tumor: Report of two cases
Authors: Watanabe Masatoshi , Nakayama Tsuyoshi , Koduka Yuji , Katoh Hiroya , Hirokawa Yoshifumi , Inoue Rie , Imai Hiroshi , Nakano Hiroshi , Shiraishi Taizo
Published: March 2003

We report two patients with Warthin’s tumor who were also infected with Mycobacterium tuberculosis. Case 1 was a 75‐year‐old woman with Warthin’s tumor and multiple small epithelioid granulomas with caseous necrosis involving the submandibular gland. This patient died of tuberculous meningitis 4 months after biopsy. Case 2 was a 78‐year‐old man with a 10‐year history of a parotid mass which had enlarged rapidly over 2 months. Surgical excision revealed Warthin’s tumor and epithelioid granulomas involving the left parotid gland. DNA extracted from paraffin sections was amplified by nested polymerase chain reaction (PCR) with primer sets for the mycobacterial 65‐KDa antigen gene. Restriction enzyme digestion of the PCR products could differentiate Mycobacterium tuberculosis from other mycobacteria in both cases. Although the histogenesis of lymphoid components of Warthin’s tumor is controversial, the frequent prevalence of inflammation or necrosis and our present findings suggest these components have a similar behavior to regional lymph nodes.
Apocrine adenocarcinoma of the eyelid with aggressive biological behavior: Report of a case
Authors: Shintaku Masayuki , Tsuta Kohji , Yoshida Hidehiko , Tsubura Airo , Nakashima Yasuaki , Noda Kazuo
Published: March 2003

A case of apocrine adenocarcinoma of the eyelid that showed unusually aggressive biological behavior is reported. The patient was a 57‐year‐old man who complained of discomfort and excessive lacrimation of the left eye. A subcutaneous tumor measuring 2.5 cm was found at the medial canthus of the upper eyelid, and a plica‐like subconjunctival spread was noted in the lacrimal caruncle. Invasion into the extraocular muscles and metastasis to the cervical lymph nodes and bone were already present at the time of initial presentation. Histopathologically, the tumor showed features of poorly differentiated adenocarcinoma, and polygonal tumor cells had large, hyperchromatic nuclei with prominent nucleoli and abundant eosinophilic cytoplasm. The formation of ductal structures was found occasionally. The differentiation of the tumor cells towards the apocrine gland was corroborated by immunohistochemistry using monoclonal antibodies GCDFP‐15 and B72.3. The histogenesis and pathological differential diagnosis are discussed briefly, and the tumor was considered to have originated in the Moll’s gland in the eyelid. This case emphasizes that apocrine adenocarcinomas of the ocular region have the potential for aggressive biological behavior, including distant metastasis.
Size‐dependent expression of cyclooxygenase‐2 in sporadic colorectal adenomas relative to adenomas in patients with familial adenomatous polyposis
Authors: Azumaya Masaki , Kobayashi Masaaki , Ajioka Yoichi , Honma Terasu , Suzuki Yutaka , Takeuchi Manabu , Narisawa Rintarou , Asakura Hitoshi
Published: March 2003

Several studies have indicated that administration of non‐steroidal anti‐inflammatory drugs (NSAID) to patients with familial adenomatous polyposis (FAP) results in a regression of colorectal adenomas through inhibition of cyclooxygenase‐2 (COX‐2). It is thought that sporadic colorectal adenomas might also be useful targets for the chemoprevention of colorectal cancer, but a marked effect of NSAID on the regression of sporadic adenomas has not been observed. We investigated the immunohistochemical expression of COX‐2 in sporadic tubular adenomas (n = 100) from 63 patients and in tubular adenomas (n = 121) from 12 patients with FAP, in order to determine if chemoprevention might be more successful in sporadic adenomas once they have reached a certain size. COX‐2 scores were significantly lower (P < 0.0001) in small (< 5 mm in diameter) adenomas than in large (≥ 5 mm) adenomas. This was observed in both sporadic cases and in cases involving patients with FAP. With regard to small (< 5 mm) adenomas, significantly higher (P = 0.02) COX‐2 scores were obtained in adenomas resulting from FAP than sporadic adenomas. The variation in COX‐2 expression observed among sporadic adenomas of different sizes should be taken into account when making decisions regarding attempts at chemoprevention using NSAID. Sporadic adenomas 5 mm or larger with upregulated COX‐2 expression are potentially useful targets for the antiproliferative effects of NSAID.
Collagenous fibroma (desmoplastic fibroblastoma) of the finger in a child
Authors: Nishio Jun , Iwasaki Hiroshi , Nishijima Takeo , Kikuchi Masahiro
Published: March 2003

Collagenous fibroma (desmoplastic fibroblastoma) is a distinctive benign fibrous soft tissue tumor that typically occurs in the subcutaneous tissue or skeletal muscle in adults. We describe a case of collagenous fibroma in a 7‐year‐old boy who presented with a 1‐cm solitary, firm nodule on the volar aspect of the metacarpophalangeal joint of the left little finger. Microscopically, the tumor was composed of spindle‐ and stellate‐shaped cells embedded in a hypovascular, densely collagenous stroma. No mitotic figures, calcifications or necrosis were identified. Immunohistochemically, tumor cells were diffusely positive for vimentin, but negative for smooth muscle actin, muscle‐specific actin, desmin, cytokeratin, S‐100 protein or CD34. To our knowledge, this is the second reported case of collagenous fibroma in children. Our case report indicates that the clinicopathological features of collagenous fibroma in childhood are similar to those in adults.
Microcystic variant of localized malignant mesothelioma accompanying an adenomatoid tumor‐like lesion
Authors: Umezu Hajime , Kuwata Kazuhisa , Ebe Yusuke , Yamamoto Takashi , Naito Makoto , Yamato Yasushi , Ishiyama Takaaki , Tsuchida Masanori , Okuizumi Mina , Ishikawa Hiroshi , Koizumi Naoya
Published: March 2003

The case of a 70‐year‐old man with a hitherto undescribed pleural mesothelioma is reported. The tumor was localized in the left lung apex and had invaded the parietal pleura. Histologically, the tumor was characterized by a proliferation of epithelioid cells and the formation of microcysts. The tumor cells were positive for calretinin and vimentin, and possessed abundant microvilli, indicating a mesothelial cell origin for the tumor. A high Ki‐67 index and mitotic index, and the recurrence of the tumor after surgery, indicated malignancy. Based on the evidence, we propose that the tumor is a microcystic variant of a localized malignant mesothelioma.
Expression of lumican in human colorectal cancer cells
Authors: Lu Yue Ping , Ishiwata Toshiyuki , Kawahara Kiyoko , Watanabe Masanori , Naito Zenya , Moriyama Yukichi , Sugisaki Yuichi , Asano Goro
Published: March 2003

Lumican is a member of a small leucine‐rich proteoglycan family and its overexpression in human breast cancer tissues is reported to influence the growth of cancer cells. In the present study, we aimed to clarify the expression of lumican mRNA and its protein in human colorectal cancer cell lines and their localization in normal and cancerous colorectal tissues. Reverse transcription–polymerase chain reaction and western blot analysis revealed lumican mRNA and its protein expression in COLO 205, DLD‐1, HCT‐15, SW 480 and WiDr colorectal cancer cell lines. The lumican in colorectal cancer cells had non‐sulfated or poorly sulfated polylactosamine side chains. Based on its immunoreactivity, the lumican protein was found to be localized in fibroblasts and stromal tissues of normal colorectal tissues, but not in colorectal epithelial cells. In colorectal cancer tissues, the lumican was strongly localized in cancer cells in eight of 12 cancer cases. The lumican protein was also localized in epithelial cells with mild reactive dysplasia and fibroblasts adjacent to cancer cells. Lumican mRNA was expressed in cancer cells and adjacent fibroblasts, and epithelial cells. These findings may indicate that the lumican protein synthesized by cancer cells, fibroblasts and epithelial cells with mild reactive dysplasia found adjacent to cancer cells may affect the growth of human colorectal cancer cells.