bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal slow waves and cerebrovascular diseases
Authors: Inui Koji , Motomura Eishi , Kaige Hiroyuki , Nomura Sen
Published: March 2003

Abstract Sporadic temporal slow waves are considered to be associated with mild cerebrovascular dysfunction. However, electroencephalogram (EEG) changes have not been consistently described by some investigators and correlations inferred on the basis of such data remain inconclusive. In the present study, we examined previously defined temporal slow waves in patients in relation to incidence of cerebrovascular disease. A total of 512 EEG were analyzed during a 1 year period at our laboratory and 74 reference EEG from healthy volunteers were all examined as to the presence of temporal low‐voltage irregular delta wave (TLID), temporal minor slow and sharp activity (TMSSA) or bursts of rhythmical temporal theta (BORTT). The patterns were assessed in relation to clinical histories of patients and controls. There were similarities in clinical correlations for the three EEG changes including associations with mild cerebrovascular diseases and with aging. In addition these temporal EEG findings shared electrographic features and showed left side predominance as well as correlating with each other. Since TLID, TMSSA and BORTT have many clinical and electrographical similarities, we consider that these findings should be grouped into one EEG entity which appears in association with mild cerebrovascular dysfunction.
Associative processing and paranormal belief
Authors: Gianotti Lorena R. R. , Mohr Christine , Pizzagalli Diego , Lehmann Dietrich , Brugger Peter
Published: March 2003

Abstract In the present study we introduce a novel task for the quantitative assessment of both originality and speed of individual associations. This ‘BAG’ (Bridge‐the‐Associative‐Gap) task was used to investigate the relationships between creativity and paranormal belief. Twelve strong ‘believers’ and 12 strong ‘skeptics’ in paranormal phenomena were selected from a large student population (n > 350). Subjects were asked to produce single‐word associations to word pairs. In 40 trials the two stimulus words were semantically indirectly related and in 40 other trials the words were semantically unrelated. Separately for these two stimulus types, response commonalities and association latencies were calculated. The main finding was that for unrelated stimuli, believers produced associations that were more original (had a lower frequency of occurrence in the group as a whole) than those of the skeptics. For the interpretation of the result we propose a model of association behavior that captures both ‘positive’ psychological aspects (i.e., verbal creativity) and ‘negative’ aspects (susceptibility to unfounded inferences), and outline its relevance for psychiatry. This model suggests that believers adopt a looser response criterion than skeptics when confronted with ‘semantic noise’. Such a signal detection view of the presence/absence of judgments for loose semantic relations may help to elucidate the commonalities between creative thinking, paranormal belief and delusional ideation.
Minor physical anomalies in childhood and adolescent onset schizophrenia
Authors: Hata Kazuya , Iida Junzo , Iwasaka Hidemi , Negoro Hidek. I. , Ueda Fumiyo , Kishimoto Toshifumi
Published: March 2003

Abstract A modified version of the Waldrop scale (WS) was used to assess the prevalence of minor physical anomalies in schizophrenic patients (n = 71) and healthy controls (n = 65). The mean total WS score was 3.32 (SD 1.98) for the schizophrenic patients, significantly higher than that for the controls (2.19, SD 1.18). Minor physical anomalies were compared between two schizophrenic groups, divided on the basis of age at onset, early onset schizophrenia (EOS, onset under age 18 years) group and late onset schizophrenia (LOS, onset at or above age 20 years) group. The mean total WS score was 3.92 (SD 1.86) in the EOS group, significantly higher than the 2.59 (SD 1.79) in the LOS group. Minor physical anomalies are an indirect index for early prenatal central nervous system (CNS) maldevelopment; the present study indicated association between minor physical anomalies and EOS, thus a relationship between early prenatal CNS maldevelopment and EOS. These results support the hypothesis that EOS constitutes a subset of schizophrenia in which neurodevelopmental damage is largely involved.
Subversion of antigenic expression in neoplasia: Lessons from immunohistology of teratomas
Authors: Goel Amit , Vasishta R.K. , Joshi Kusum
Published: March 2003

Many examples of inappropriate expression of intermediate filaments and other cell identity markers are known to occur in diagnostic tumor pathology. In the present study, this subversion of antigenic differentiation in tumors has been investigated using teratomas as a model, as these unique tumors not only mimic developing tissues but also show carcinomatous elements. Ten cases of teratoma (eight immature, two mature) were studied immunohistochemically using a panel of 13 commonly used cell identity markers, including intermediate filaments. Examples of antigenic coexpression and transbarrier expression in various morphologically mature and immature tissues were noted to be similar to those seen in various tumors. Carcinomatous elements in teratomas were non‐reactive rather than showing antigenic aberrations. Hence, this study strengthens the proposition that antigenic subversion in neoplasia is related to the process of maturation and differentiation, rather than malignant transformation.
P53 and proliferating cell nuclear antigen (PCNA) expression in non‐tumoral liver diseases
Authors: Akyol Gülen , Dursun Ayse , Poyraz Aylar , Uluoglu Ömer , Ataoglu Ömür , Eda?y Naci , Memis Leyla
Published: March 2003

The tumor suppressor gene p53 is known to be involved in the negative regulation of cell growth. Proliferating cell nuclear antigen (PCNA), which is a nuclear protein and a component of the DNA replication process, is also involved in growth regulation. Both have been studied as progression markers in various tumors including hepatocellular carcinoma. In the present study, the aberrant p53 protein and PCNA expressions in non‐tumoral liver diseases were investigated. Using monoclonal antibodies anti‐p53 (D07‐DAKO) and anti‐PCNA (PC10‐DAKO), 149 samples were stained, including 10 normal and 10 tumoral control liver tissues. p53 Overexpression was detected in 52 specimens (35%) whereas PCNA positivity was found in 96 (64%). There were 21 different pathological entities but most of the positive samples could be grouped into four types of diseases; namely, non‐specific reactive hepatitis, steatohepatitis, chronic hepatitis and cirrhosis. Statistical analyses performed on these groups revealed that p53 positivity was found to be significantly higher in steatohepatitis (P < 0.05), while PCNA positivity did not show any statistical significance. The number of samples showing both p53 and PCNA positivity was 42 but their coexistence was not found to be significant. Certain cytological alterations like nuclear pleomorphism, steatosis and cholestasis, in addition to necroinflammatory activity, were evaluated for their possible impact on p53 and/or PCNA positivity. Necroinflammatory activity in steatohepatitis and steatosis in chronic hepatitis was found to be significant for p53 positivity (P < 0.05). In contrast, nuclear pleomorphism in non‐specific reactive hepatitis was found to be significant for PCNA positivity (P < 0.05).
A case of natural killer/T cell lymphoma of the subcutis resembling subcutaneous panniculitis‐like T cell lymphoma
Authors: Yamashita Yoriko , Tsuzuki Toyonori , Nakayama Atsuo , Fujino Masahiko , Mori Naoyoshi
Published: March 2003

A case of nasal type natural killer (NK)/T cell lymphoma of the subcutis showing clinical and morphological features that resemble subcutaneous panniculitis‐like T cell lymphoma (SPTCL) is presented. A 73‐year‐old man presented with swelling of the left arm and was diagnosed with panniculitis by a dermatologist. It was concluded from a skin biopsy specimen that the patient had non‐Hodgkin’s lymphoma of the large cell, NK/T cell type because the neoplastic cells showed polyclonal CD3 immunoreactivity. Treatment with interferon‐γ was initiated, but the patient died of disseminated intravascular coagulation and multiple organ failure 2 months after the initial symptoms appeared. However, involvement of additional organs by the lymphoma was not apparent clinically. An autopsy was not performed. A routinely stained section of the biopsy skin specimen revealed massive necrosis of the subcutaneous fat, karyorrhexis admixed with reactive histiocytes, and large atypical lymphoid cells. Immunoreactivity for polyclonal CD3 was present in the perinuclear region, but absent in the neoplastic cell membranes. CD56, CD45RO (UCHL‐1), CD43 (MT1), CD45 (leukocyte common antigen), and the cytotoxic molecules perforin, granzyme B and TIA‐1 were positive, but CD20 (L26), CD4, CD8, and βF1 were negative. Epstein‐Barr virus (EBV) mRNA was detected in the nuclei of neoplastic cells by in situ hybridization. Subcutaneous panniculitis‐like T cell lymphoma is reported to be an EBV‐negative, clonal T cell neoplasm. Although this case showed clinical and morphological features that resembled SPTCL, perinuclear polyclonal CD3 staining and membranous CD56 reactivity seen in neoplastic cells were suggestive of NK cells. Furthermore, the neoplastic cells were positive for EBV. This case is considered to be a NK/T cell lymphoma of the subcutis resembling SPTCL. It is believed that it is important to recognize such a tumor because patients may undergo a fulminant clinical course, despite the tumor being localized in the subcutaneous adipose tissue.
Application of tyramide signal amplification system to immunohistochemistry: A potent method to localize antigens that are not detectable by ordinary method
Authors: Toda Yoshinobu , Kono Katsuhiko , Abiru Hitoshi , Kokuryo Kumiko , Endo Mareyuki , Yaegashi Hiroshi , Fukumoto Manabu
Published: March 2003

Tyramide signal amplification–avidin–biotin complex (TSA‐ABC) method is a powerful technique used to detect antigens that are not detectable by ordinary immunohistochemistry. It is worth trying in cases where localization of antigens by the conventional method has failed and antibodies are precious.
Prostatic signet‐ring cell carcinoma: Case report and literature review
Authors: Kuroda Naoto , Yamasaki Ichiro , Nakayama Hirofumi , Tamura Kenji , Yamamoto Yukio , Miyazaki Eriko , Naruse Keishi , Kiyoku Hiroshi , Hiroi Makoto , Enzan Hideaki
Published: March 2003

Signet‐ring cell carcinoma (SRCC) of the prostate is a very rare neoplasm and there have been only 38 cases reported to date. Here the 39th case of prostatic SRCC containing a small amount of neutral mucin, prostatic specific antigen (PSA) and prostatic specific acid phosphatase (PSAP) in the signet‐ring cells is reported. It was also found that some intracytoplasmic lumina were derived from the shallow or deep invagination of luminal membranes of cancer cells that formed the neoplastic glands. Using immunohistochemistry, a combination of monoclonal antibodies against cytokeratins 7 and 20 as well as PSA and PSAP may be useful in differentiating prostatic primary SRCC from metastatic SRCC originating in the gastrointestinal tract.
Molecular cytogenetic identification of cyclin D1 gene amplification in a renal pelvic tumor attributed to phenacetin abuse
Authors: Lee Chyi Chia R. , Wanibuchi Hideki , Yamamoto Shinji , Hirose Masao , Hayashi Yutaro , Fukushima Shoji
Published: March 2003

Despite extensive epidemiologic evidence of phenacetin abuse as a risk factor for renal pelvic carcinomas, genetic alterations in the resultant tumors remain largely unclear. In this report, a phenacetin‐associated renal pelvic carcinoma (histologically a transitional‐cell carcinoma) from an 80‐year‐old female patient was evaluated by molecular cytogenetic methods. Fluorescence in situ hybridization was used to identify chromosome gains or losses for the cyclin D1, p53, Rb and c‐myc genes and the ploidy of their respective chromosomes. Cyclin D1 gene amplification, but normal copy numbers of p53, Rb and c‐myc, and normal ploidy of chromosomes 8, 11, 13 and 17 were observed. Expression of cyclin D1 protein was confirmed by immunohistochemistry. In the absence of p53, Rb or c‐myc abnormalities, the results suggested that cyclin D1 gene amplification and its protein overexpression may be involved in the genesis of renal pelvic carcinomas associated with phenacetin abuse.
Different nuclear/cytoplasmic distributions of RET finger protein in different cell types
Authors: Tezel Gaye , Nagasaka Tetsuro , Iwahashi Naoko , Asai Naoya , Iwashita Toshihide , Sakata Keita , Takahashi Masahide
Published: March 2003

The RET finger protein (RFP), which belongs to the B box zinc finger protein family, has a tripartite motif consisting of a Ring finger, a B box finger and a coiled‐coil domain. The RET finger protein becomes oncogenic when its tripartite motif is fused with the tyrosine kinase domain of the RET protein. This study examined the RFP expression in normal and tumor tissues by immunohistochemistry. RFP was detected in the nuclei of various cells, including peripheral and central neurones, hepatocytes, adrenal chromaffin cells and male germ cells. Among them, RFP was expressed at high levels in male germ cells such as primary spermatocytes and round spermatids, and formed a perinuclear cap structure in primary spermatocytes. On the other hand, high levels of cytoplasmic expression of RFP were observed in some plasma cells as well as solitary plasmacytoma and multiple myeloma. These results suggested that different nuclear/cytoplasmic distributions of RFP might play a role in the regulation of growth or differentiation of different cell types.
Clinicopathological study of pheochromocytoma of the urinary bladder: Immunohistochemical, flow cytometric and ultrastructural findings with review of the literature
Authors: Kato Hiroyuki , Suzuki Masafumi , Mukai Miwako , Aizawa Shigeo
Published: March 2003

Pheochromocytomas usually arise from the adrenal medulla but may also arise from the carotid body, the retroperitoneum, the urinary bladder, and other locations. We report three cases of pheochromocytoma of the urinary bladder with clinicopathological, immunohistochemical, flow cytometric, and ultrastructural findings. Case 1, a 13‐year‐old boy presented with hematuria. He underwent partial cystectomy, 31 years later he presented with a tumor in the thoracic vertebra. Case 2, a 35‐year‐old woman presented with headache, nausea, vomiting, palpitations, and diaphoresis on evacuation. She underwent total cystectomy and regional lymph adenectomy. She survived for 10 years without recurrence or metastasis; however, she died from another disease. Case 3, a 31‐year‐old man presented with dysuria. He underwent total cystectomy and regional lymph adenectomy. The tumor metastasized to the lymph nodes, and the patient died after 4 years. The urinary bladder tumors in these three cases protruded into the lumen and invaded deeper than the middle of the muscle layer. The tumor of the urinary bladder, metastatic lymph nodes, and thoracic vertebra showed alveolar and trabecular patterns, and tumor cells were surrounded by capillaries. The tumor cells were moderate in size with ovoid nuclei and abundant eosinophilic cytoplasm that contained acidophilic granules reactive to Grimelius stain. Vascular invasion was observed in cases 1 and 2. Immunohistochemically, tumor cells showed reactivity for chromogranin, Leu 7, and S‐100 protein. In each of the three cases, the DNA ploidy pattern on flow cytometry was aneuploid. Ultrastructural examination revealed several neurosecretory granules, rough endoplasmic reticulum, and a few mitochondria within the cytoplasm. It is difficult to determine whether pheochromocytoma of the urinary bladder is malignant on the basis of histological, immunohistochemical, and flow cytometric findings. Long‐term follow up is necessary.
Adenocarcinoma of the renal pelvis with vimentin‐positive intracytoplasmic inclusions
Authors: Shintaku Masayuki , Megumi Yuzuru , Maekura Shunji
Published: March 2003

A case of mucus‐producing papillary adenocarcinoma of the renal pelvis associated with multiple renal calculi in a 16‐year‐old male is reported. The majority of the tumor cells contained large, round or cone‐shaped, vimentin‐positive intracytoplasmic inclusions, which exhibited some morphological and immunohistochemical resemblance to inclusions found in malignant rhabdoid tumor of the kidney. An intracytoplasmic accumulation of mucus was also noted in some tumor cells. The patient is free from recurrence and metastasis after a nephrectomy.
Intraplacental choriocarcinoma with fetomaternal transfusion
Authors: Takai Noriyuki , Miyazaki Tami , Yoshimatsu Jun , Moriuchi Akira , Miyakawa Isao
Published: March 2003

Intraplacental choriocarcinoma is very rare, and is usually found only after maternal and fetal metastatic disease is identified. The purpose of this case report is to review the incidence and findings of intraplacental choriocarcinoma. A term placenta was investigated because the newborn was born with severe anemia (Hb 3.0 g/dL). A 2 cm nodule was noted on the surface of the amniotic membrane and grossly resembled an infarction. The tumor was examined microscopically with immunohistochemical staining for the alpha‐ and beta‐human chorionic gonadotropin (α‐hCG, β‐hCG) subunits, human placental lactogen (hPL) and Ki‐67. Microscopically, the tumor consisted of necrotic areas with proliferation of atypical trophoblastic cells and destruction of the villi and capillaries. The cells were positive for the α‐hCG, β‐hCG subunits, hPL and Ki‐67, consistent with intraplacental choriocarcinoma. The mother and newborn were investigated for the presence of metastatic disease. Computed tomography scans and magnetic resonance imaging of the mother and infant were negative for metastatic disease. Choriocarcinoma, limited only to the placenta with no evidence of metastatic disease is very rare. Primary intraplacental choriocarcinoma may frequently be overlooked or missed, and choriocarcinoma may possibly arise in the placenta more often than in retained or persistent trophoblast following pregnancy.
Primary T‐cell non‐Hodgkin’s malignant lymphoma of the appendix
Authors: Kitamura Yukisato , Ohta Tetsuo , Terada Tadashi
Published: March 2003

A case of primary T‐cell lymphoma of the appendix in an 84‐year‐old female was reported. Appendectomy was performed as a result of the clinical diagnosis of acute appendicitis, due to the rebound tenderness of McBurney’s point and thickness of the appendix wall as determined from ultra echo sonograph. Grossly, the surgical resected appendix did not have a dominant inflammatory appearance, therefore a tumor was suspected. Microscopic examination showed diffused proliferation of large and medium size lymphoma cells. Immunohistochemical examination further revealed that the lymphoma cells were positive for T‐cell markers. To ensure this was a T‐cell lymphoma, molecular examination was performed using paraffin‐embedded tissue sections, since T‐cell lymphoma of the appendix is extremely rare. Polymerase chain reaction (PCR) single‐strand conformation polymorphism (SSCP) analysis demonstrated monoclonal T‐cell receptor gene rearrangement. T‐cell‐rich B‐cell lymphoma was excluded. To our knowledge, this is the first reported case of primary T‐cell lymphoma of the appendix. PCR‐SSCP analysis in paraffin‐embedded tissue section was very useful in the diagnosis of lymphoma cell monoclonality.
Overexpression of p53 protein and MDM2 in papillary carcinomas of the thyroid: Correlations with clinicopathologic features
Authors: Horie Satoshi , Maeta Hiroyuki , Endo Kanenori , Ueta Tsuyoshi , Takashima Kazuaki , Terada Tadashi
Published: March 2003

Expression of p53 protein and MDM2 was evaluated in paraffin‐embedded tissue from 78 patients with papillary carcinomas of the thyroid (PCT), in order to elucidate the relationship between them and their correlations with some clinicopathologic features implicated in tumor progression. These proteins were expressed in nuclei of tumor cells, but not in non‐tumor cells. Staining was defined as positive when 10% or more of tumor cells expressed these proteins. The number of cases positive for p53 protein was 21/78 (27%), and that positive for MDM2 was 26/78 (33%). Co‐overexpression of p53 protein and MDM2 was observed in 12/78 cases (15%). A significant positive relationship was found between them (P < 0.01); p53‐positive cases tended to be also positive for MDM2 and vice versa. Statistical analysis revealed that overexpression of p53 protein significantly correlated with large tumor size (P = 0.0271) and the presence of capsular invasion (P = 0.04). There were significant positive correlations between tumor size and intrathyroidal invasion and between tumor size and capsular invasion in PCT, suggesting that p53 protein overexpression is associated only with tumor progression (tumor size). However, we could not find any significant correlations between MDM2 expression and clinicopathologic features. Our findings suggest that overexpression of p53 protein and MDM2 in papillary carcinoma of the thyroid is associated with the progression of the tumors, and that p53 may be a marker of the progression of PCT.
Enhanced expression of basement‐membrane‐type heparan sulfate proteoglycan in tumor fibro‐myxoid stroma of intrahepatic cholangiocarcinoma
Authors: Sabit Hemragul , Tsuneyama Koichi , Shimonishi Tomonori , Harada Kenichi , Cheng Jun , Ida Hiroko , Saku Takashi , Saito Katsuhiko , Nakanuma Yasuni
Published: March 2003

To investigate the molecular mechanism for enhanced fibrous stroma formation in intrahepatic cholangiocarcinoma (ICC), we surveyed the expression pattern of basement‐membrane‐type heparan sulfate proteoglycan (HSPG; also known as perlecan) at the core protein and the mRNA level in ICC as well as in other liver neoplasms and reactive hepatic diseases. Immunohistochemistry of paraffin‐embedded liver sections with hyaluronidase pretreatment showed that HSPG was present in small amounts in normal liver around the bile ducts and the blood vessels within the portal area. There was no evident expression within the hepatic lobules. Intense immunoexpression of HSPG was seen in the tumor‐specific fibro‐myxoid stroma of ICC and metastatic liver cancer originating from the colon. However, tumor‐specific stroma of hepatocellular carcinomas showed little or no expression of HSPG. At the mRNA level, signals for HSPG were found in tumor cells of cholangiocarcinoma and metastatic colonic carcinomas, and in myofibroblasts in the tumor fibro‐myxoid‐specific stroma. From immunoprecipitation and reverse transcription–polymerase chain reaction (RT–PCR) analyses, a cultured human intrahepatic cholangiocarcinoma cell line (CCKS1), was found to express high levels of HSPG core protein and mRNA. These findings suggest that biliary and metastatic colon carcinoma cells as well as stromal myofibroblasts have a potential for HSPG production. In order to investigate the growth, invasion and metastatic ability of ICC, further study of the ‘self‐made’ stromal component of ICC may provide a new approach.
Primary synovial sarcoma of the kidney: Report of a case confirmed by molecular detection of the SYT‐SSX2 fusion transcripts
Authors: Koyama Shune , Morimitsu Yosuke , Morokuma Futoshi , Hashimoto Hiroshi
Published: March 2003

We describe an unusual case of primary synovial sarcoma of the kidney. A 47‐year‐old woman had a tumor massively replacing the right kidney. There were no primary extrarenal neoplastic lesions. Microscopically, the tumor was composed of a cellular proliferation of relatively uniform spindle‐shaped cells having atypical spindle or oval nuclei arranged in fascicles with tumor necrosis, without epithelial areas. Immunohistochemically, a small number of the tumor cells were positive for epithelial markers such as cytokeratin and epithelial membrane antigen. The SYT‐SSX2 fusion transcripts were detected by a reverse transcription–polymerase chain reaction (RT–PCR) using RNA extracted from formalin‐fixed, paraffin‐embedded tissue. ETV6‐NTRK3 fusion gene transcripts that result from t(12; 15)(p13;q25), which is characteristic of cellular congenital mesoblastic nephroma, were not demonstrated. To our knowledge, this is the ninth case of primary renal synovial sarcoma. This case report indicates that synovial sarcoma should be taken into account for the differential diagnosis of renal spindle cell tumors and the molecular assay detecting the SYT‐SSX fusion transcripts is useful for the final diagnosis of synovial sarcoma arising in an unusual location.
Gastrointestinal stromal tumors and KIT‐positive mesenchymal cells in the omentum
Authors: Sakurai Shinji , Hishima Tunekazu , Takazawa Yutaka , Sano Takaaki , Nakajima Takashi , Saito Ken , Morinaga Shojiroh , Fukayama Masashi
Published: March 2003

Gastrointestinal stromal tumor (GIST) is currently considered to be derived from the interstitial cells of Cajal (ICC). To test the hypothesis that omental mesenchymal tumor is also a type of GIST, we evaluated the expression of specific molecules in GIST, and c‐kit gene mutation in omental mesenchymal tumors, and we identified a possible counterpart of ICC in the omentum. Immunohistochemically, all of the omental mesenchymal tumors (n = 5) were positive for both KIT and CD34, and three of the five tumors were also positive for an embryonic form of smooth‐muscle myosin heavy chain (SMemb). Polymerase chain reaction–single‐strand conformational polymorphism analysis (PCR–SSCP) and direct sequencing revealed mutations in c‐kit gene exon 11 in all five tumors. As for the ICC counterparts in the omentum, there were some KIT‐positive mesenchymal cells resembling ICC at the surface of the omentum. Double fluorescence immunostaining, using anti‐KIT polyclonal antibodies and monoclonal antibodies against other molecules, demonstrated that KIT‐, CD34‐ and SMemb‐positive cells were present just beneath the mesothelial cells of the omentum. These results show that omental mesenchymal tumor corresponds to GIST of the omentum, and that KIT‐positive bipolar mesenchymal cells may be a counterpart of ICC in the gastrointestinal tract. Identification of a new type of KIT‐positive mesenchymal cell in the omentum may lead to the discovery of a new physiological role for this organ.
Gastric carcinoma with psammomatous calcification after Billroth II reconstruction: Case report and literature review
Authors: Kawahara Kunimitsu , Niguma Takefumi , Yoshino Tadashi , Omonishi Kunihiro , Hatakeyama Setsuko , Nakamura Shin‐ichi , Hirota Seiichi , Motoi Makoto
Published: March 2003

A case of gastric carcinoma with psammomatous calcification arising in the remnant stomach after Billroth II reconstruction is reported. Borrmann type 1 gastric carcinoma was detected in the remnant stomach of an 82‐year‐old woman, who had a past history of distal partial gastrectomy for a perforated gastric ulcer, with Billroth II reconstruction at 40 years of age. Histologically, the tumor was a tubular adenocarcinoma that invaded the muscularis propria. Numerous psammoma bodies were found in the lumens of the tumor glands. Dystrophic calcification of gastric cancer is rare and psammomatous calcification of gastric cancer has only been reported in five cases previously. To our knowledge, this is the first case of gastric carcinoma with psammomatous calcification arising in the remnant stomach. We also review previously published reports regarding gastric carcinoma with psammomatous calcification.
Angiogenesis and phenotypic alteration of alveolar capillary endothelium in areas of neoplastic cell spread in primary lung adenocarcinoma
Authors: Jin Enjing , Ghazizadeh Mohammad , Fujiwara Masakazu , Nagashima Mikio , Shimizu Hajime , Ohaki Yoshiharu , Arai Satoru , Gomibuchi Makoto , Takemura Tamiko , Kawanami Oichi
Published: March 2003

Normal alveolar capillary endothelium is quiescent in nature and displays anticoagulant thrombomodulin (TM) on its surface. The cytoplasms of these endothelial cells are ultrastructurally non‐fenestrated type, and they barely express von Willebrand factor (vWf). Alveolar fibrosis is accompanied by a capillary endothelium reactive for vWf, and a loss of TM expression. In primary lung adenocarcinoma, neovascularization occurs in association with alveolar fibrosis. In order to study basic factors related to angiogenesis and phenotypic changes of the capillaries located in tumor‐bearing alveolar walls, we examined 37 primary lung adenocarcinomas with electron microscopy and confocal laser scanning microscopy with antibodies for TM, vWf, vascular endothelial growth factor (VEGF), and its receptors (KDR and Flt‐1), and proliferating markers (Ki‐67/proliferating cell nuclear antigen). Tissues microdissected specifically from alveolar walls were used for reverse transcription–polymerase chain reaction (RT–PCR) to assess expressions of mRNA isoforms of VEGF and its receptors. New capillary branching was found by ultrastructural study in the alveolar walls in 12% of the patients. Nuclei of the capillary endothelial cells were reactive for proliferating cell markers. Endothelial fenestrae were developed in 65% of the patients, TM reactivity was lost in the alveolar capillaries, and their cell cytoplasms obtained a reactivity for vWf through a transitional mosaic‐like distribution pattern of both antigens. Besides cytoplasmic VEGF expression in neoplastic cells, tumor‐bearing alveolar walls showed significant expression of mRNA of VEGF165 and KDR. These findings imply that angiogenesis and phenotypic changes of the alveolar capillaries are closely related to a higher expression of tumor‐associated VEGF165 and of KDR in the alveolar walls in primary lung adenocarcinoma.
Malignant glomus tumor in the branchial muscle of a 16‐year‐old girl
Authors: Matsumoto Kazuhito , Kakizaki Hiroshi , Yagihashi Norito , Yagihashi Soroku
Published: March 2003

Malignant glomus tumor is an extremely rare neoplasm and its histological features are not well characterized. We report a 16‐year‐old female patient with a malignant glomus tumor. The patient was admitted to our hospital presenting with a mass in the right upper arm that she had noticed for the previous 6 months. Computed tomography and magnetic resonance imaging revealed an expanded mass involving the surrounding tissues. At surgery, an ill‐defined and expanded mass was found, 5 × 4 × 3 cm in size, in the right branchial muscle. The tumor was extirpated, along with neighboring muscle tissues. Histologically, tumor cells were round to short‐spindle shaped, forming solid sheets admixed with vessels of varying size. Their nuclei were uniformly oval to round, and their cytoplasms were slightly eosinophilic. The growth pattern of the tumor cells resembled that of glomus tumor, but mitotic figures were frequent (as high as 10 per 10 high‐power fields). Immunohistochemically, the tumor cells were positive for vimentin and muscle actin, but negative for desmin. There were no areas typical of benign glomus tumor or sarcomatous change. These findings led us to a diagnosis of primary malignant glomus tumor arising de novo. There has been no recurrence or metastasis for 21 months after wide excision.
Presence of natural killer‐cell clones with variable proliferative capacity in chronic active Epstein–Barr virus infection
Authors: Nagata Hiroshi , Numata Tsutomu , Konno Akiyoshi , Mikata Ittaku , Kurasawa Kazuhiro , Hara Satoru , Nishimura Miki , Yamamoto Kohtaro , Shimizu Norio
Published: March 2003

Chronic active Epstein–Barr virus infection (CAEBV) is a syndrome that takes diverse clinical courses and is often associated with lymphoproliferative disorders of T / natural killer (NK)‐cell lineage. We describe a patient with CAEBV associated with persistent pharyngeal ulcer, and with subsequent nasal T/NK‐cell lymphoma in her neck lymph nodes and nasopharynx. Immunophenotyping of lymphoid cells showed that the lineage of Epstein–Barr virus (EBV)‐positive cells in the patient was of NK‐cell origin. By means of high‐dose recombinant interleukin‐2, we established an EBV‐positive cell line of NK‐cell lineage from her peripheral blood. Southern blot analysis for the number of terminal repeat sequences of EBV detected three NK‐cell clones in the patient’s lymph node. One of these clones was identical to the established cell line but was not observed in the pharyngeal ulcer, while the other two clones were present in the pharyngeal ulcer. These results suggest that the patient had expansion of the three NK‐cell clones, one of which had proliferative capacity in vitro and was involved in the formation of the lymphoma. Moreover, the results suggest that the proliferative capacity of EBV‐positive cells can be variable even in a single patient, and this variability may explain the clinical diversity in CAEBV.
Papillary carcinoma of the thyroid gland forming a myofibroblastic nodular tumor: Report of two cases and review of the literature
Authors: Naganuma Hiroshi , Iwama Noriyuki , Nakamura Yasuyuki , Ohtani Noriko , Ohtani Haruo , Takaya Kiyoshi , Sakai Nobumitsu
Published: March 2003

We encountered two unique cases of papillary carcinoma of the thyroid gland forming fibroma‐like nodular tumors. The two cases showed well‐defined nodules composed largely of fibromatosis‐like stroma with small foci of papillary carcinoma. This type of tumor is relatively rare and has been reported with the name of ‘papillary carcinoma of the thyroid with fibromatosis‐like stroma or nodular fasciitis‐like stroma’. The stromal cells have had myofibroblastic features in all reported cases, including the present cases. The pathogenesis of this tumor is still unknown. We must be careful to differentiate this type of thyroid tumor from fibrosarcomatous anaplastic carcinoma, particularly in the intraoperative consultation. We speculate that this unique tumor is an autonomous proliferation of stromal cells, based on the immunohistochemical analyses of early stromal changes in usual‐type papillary carcinoma of the thyroid. The present names of this disease may not represent the proper features of this tumor because all the reported cases formed fibroma‐like nodules. We propose the name ‘papillary carcinoma forming myofibroblastic nodular tumors’.
Evaluation of interobserver agreement in scoring immunohistochemical results of HER‐2/neu (c‐erbB‐2) expression detected by HercepTest, Nichirei polyclonal antibody, CB11 and TAB250 in breast carcinoma
Authors: Tsuda Hitoshi , Sasano Hironobu , Akiyama Futoshi , Kurosumi Masafumi , Hasegawa Tadashi , Osamura R. Yoshiyuki , Sakamoto Goi
Published: March 2003

To examine interobserver reproducibility in the judgments of HER‐2/neu (c‐erbB‐2) oncoprotein expression, HER‐2/neu expression was scored immunohistochemically. A total of 106 breast carcinomas were independently scored by five or six pathologists, using four commercially available anti­bodies (HercepTest, Nichirei polyclonal antibody, CB11 and TAB250). Two systems were used for the evaluation. In the Dako system, the intensity of membrane staining was primarily evaluated whereas in the Tohoku system, the area of the membrane‐staining‐positive cells was primarily evaluated. All four antibodies gave excellent concordance rates among the pathologists’ judgments of the scores. Using the HercepTest and Nichirei polyclonal antibody, dividing the cases into two groups designated score 3+ and score 0/1+/2+ achieved a higher percentage of concordant cases than division into groups designated score 2+/3+ and score 0/1+. Using the HercepTest, the Dako system tended to achieve higher concordance than the Tohoku system. Conversely, CB11 and TAB250 showed similar concordance rates under both the Dako and the Tohoku systems, regardless of how the cases were divided. High interobserver agreement levels were achieved only when HER‐2/neu overexpression was defined as a score of 3+, using any of the antibodies; these were similar between the Dako system and the Tohoku system. Positivity by TAB250 was lower than that by CB11. Using the HercepTest and Nichirei polyclonal antibody, cases with a score of 3+ almost always achieved complete interobserver agreement and showed HER‐2/neu gene amplification. Conversely, cases with a score of 2+ achieved a low percentage of interobserver agreement and showed no gene amplification. Because judgment of a case as score 2+ was not very reproducible, and a score of 3+ was of biological significance and had high interobserver reproducibility, we suggest that only a score of 3+ be considered as overexpression. When cases of score 2+ are entered into a protocol, evaluation should be given by multiple observers and/or by using other tests such as fluorescence in situ hybridization.
Multinodular hydropic leiomyoma of the uterus with perinodular hydropic degeneration and extrauterine extension
Authors: Ceyhan Koray , Şimşir Coşkun , Dölen i̇smail , Çalýşkan Eray , Umudum Haldun
Published: March 2003

Multinodular hydropic leiomyoma (MHL) of the uterus is one of the rarest variants of uterine leiomyomas and can create some diagnostic problems. Only five cases have been reported previously. We describe an MHL with perinodular hydropic degeneration in a 48‐year‐old woman. Gross examination revealed a large and predominantly intramural, edematous multinodular uterine tumor and extrauterine, small grape‐like nodules overlying the lateral surface of the uterine serosa. Histologically, the tumor was composed of extra‐intrauterine benign, small smooth muscle nodules with perinodular hydropic degeneration, prominent intramural dissecting growth pattern, and satellite nodules closely resembling vascular invasion. Immunohistochemically, these cells stained for desmin, smooth muscle actin and vimentin. The patient had no evidence of disease for 18 months after hysterectomy. Multinodular hydropic leiomyoma is a clinically benign tumor and should not be confused with intravenous leiomyomatosis and some other unusual leiomyoma variants.
Immunohistochemical localization of endothelial cell markers in solitary fibrous tumor
Authors: Sawada Namie , Ishiwata Toshiyuki , Naito Zenya , Maeda Shotaro , Sugisaki Yuichi , Asano Goro
Published: March 2003

Solitary fibrous tumor (SFT) is an uncommon tumor first reported in the pleura, but recently described in other tissues. CD34, which is expressed in hematopoietic stem cells, endothelial progenitor cells and vascular endothelial cells, is observed in most SFT and some investigators believe that its expression is a definitive marker of this tumor. In the present study, the expression of vascular endothelial cell markers, such as vascular endothelial growth factor receptor (VEGFR)‐1 (flt‐1), VEGFR‐2 (flk‐1/KDR), Tie‐2 and c‐Met, was examined in SFT to clarify the relationship between SFT and endothelial cells. By immunohistochemical staining of tumor cells from 26 patients, VEGFR‐1 was detected in 24 (92%), VEGFR‐2 in five (19%), Tie‐2 in 14 (54%), and c‐Met, a specific receptor of hepatocyte growth factor (HGF) in 23 patients (88%). Furthermore, VEGFR‐3 (flt‐4) immunoreactivity was detected in eight of 26 patients (31%). In contrast, VEGF, VEGF‐C and HGF, which are ligands for the receptors, were not localized in the SFT cells. These findings indicate that most SFT may closely relate to vascular or lymphatic endothelial cells and the endothelial growth factors may contribute to the growth of SFT in a paracrine manner.
Phycoerythrin‐containing Microcystis isolated from P.R. China and Thailand
Authors: Otsuka Shigeto , Suda Shoichiro , Li Renhui , Watanabe Masayuki , Oyaizu Hiroshi , Hiroki Mikiya , Mahakhant Aparat , Liu Yongding , Matsumoto Satoshi , Watanabe Makoto M.
Published: March 2003

Four strains of the unicellular, colonial cyanobacteria, Microcystis were isolated from P.R. China and Thailand, and showed greyish‐brown to dark brown color of cell mass. Their cells were almost spherical, 3.8–5.5 μm in diameter and had gas vesicles. Their colony forms have some differences among the strains but still have common characteristics including being irregular, reticulate, elongated and lobated. These characteristics are remarkably similar to Microcystis aeruginosa (Kutz.) Kutz. In addition, three of the strains also have the characteristics of Microcystis ichthyoblabe Kutz at times, and another sometimes shows characteristics similar to Microcystis novacekii (Kom.) Comp. The absorption spectra of both intact cells and extracted phy‐cobiliproteins showed an absorption peak at 560–570 nm in wavelength, which is the absorption range of phycoerythrin. Since no species of Microcystis has ever been reported to have phycoerythrin, the existence of phycoerythrin separates these four strains from the known species of Microcystis, and might enable them to be classified as a new species. Phycoerythrin might give these organisms the advantage to live underwater where the light is predominantly green in color.
Morphological, biochemical and physiological characteristics of Lyngbya hieronymusii var. hieronymusii (Oscillatoriales, Cyanobacteria)
Authors: Suda Shoichiro , Liu Yongding , He Jiawan , Hu Zhengyu , Hiroki Mikiya , Watanabe Makoto M.
Published: March 2003

An axenic clonal strain, CN4–3, of Lyngbya was obtained from a water sample collected from Lake Dalai, Inner Mongolia, P.R. China. The filaments were solitary, usually straight, sometimes a little bent and twisted. They sometimes made loose bundles. A filament was composed of a clear and film sheath and the trichome had no polarity and false branching. The sheath was approximately 0.5 μm in thickness and had no coloration in standard culture conditions, but the sheath was observed to be yellow in some filaments in seawater medium. The trichome had no constriction at the cross‐walls. Many small gas vacuoles were scattered in the cell. The end cells of the trichomes were broadly rounded and sometimes had calyptra. The presence or absence of granulation at the cross‐walls and calyptra was thought to be variable due to the range of environmental conditions or developmental stages of individual filaments. Trichomes were brownish‐green to olive‐green. Cell dimensions were 12.6–14.0 μm wide and 1.7–2.6 μm long. These characteristics are similar to those of Lyngbya hieronymusii Lemmermann var. hieronymusii. DNA base composition was 49.14 ± 0.34 mol% GC. Fatty acids were composed of four major components, 14:0, 16:0, 18:2 and 18:3α and six minor components, 16:1*, 16:1cis, 16:2, 16:3, 18:0 and 18:1 showing characteristics of group 2 (Kenyon et al. 1972; Murata et al. 1992). More than 20% of fatty acids were 14:0. This kind of fatty acid composition has never been reported in the other filamentous cyanobacteria of group 2. In vivo and phycobilin pigment absorption spectra showed that the strain contained phycoerythrin. Growth at different temperatures showed that the strain could grow from 10 to 40°C with the optimum growth at 20 and 30°C. Growth at different salinities showed that the strain could grow from standard (CT) medium to half strength (1.78%) of seawater medium. Even in the seawater medium (3.58%), the strain survived during experiments. These results suggest that L. hieronymusii var. hieronymusii has a peculiar taxonomic position within the filamentous cyanobacteria belonging to group 2 and inhabits various habitats.
Asthma and chronic obstructive airway diseases are associated with osteoporosis and fractures: A literature review
Authors: Smith Brian , Phillips Patrick , Heller Richard
Published: March 2003

The objective was to assess the association between asthma and/or chronic obstructive airway diseases (COAD), and osteoporosis, and appraise treatments of osteoporosis in these patients. MEDLINE and Excerpta Medica were searched for original research with control groups which tested the above association. One cohort and nine cross‐section studies of bone density in patients with asthma and/or COAD were retrieved. These demonstrated clinically important bone density reductions of up to 29% in subjects, dependent upon daily oral corticosteroids, by a variety of measurement techniques, at various bone sites. Bone density reduction has also been less consistently reported in the absence of oral corticosteroids, suggesting that other factors including high‐dose inhaled corticosteroids may have a role. Fracture studies. Three studies in oral corticosteroid‐dependent asthmatics demonstrated a vertebral fracture prevalence up to 56%, and annual vertebral fracture incidence of up to 42%. The strength of the available evidence is limited, but suggests that patients with asthma and/or COAD are at increased risk of osteoporosis. The evidence of the association between osteoporosis and inhaled corticosteroids is much more limited than for oral corticosteroids. Bisphosphonates are promising agents to maintain and/or promote bone mass in this patient group.
Comparison of preference and ease‐of‐use of breath‐actuated inhalation devices in children
Authors: Ng Daniel Kk , Lee Vincent , Ho Jackson Cs
Published: March 2003

This study was conducted to evaluate children’s and nurses’ preference among the three breath‐actuated devices, TurbuhalerTM (Astra), AutohalerTM (3M) and AccuhalerTM (Glaxo‐Wellcome). This was an open study conducted in the paediatric in‐patient department of Kwong Wah Hospital, Hong Kong. Subjects over 6 years of age who had not previously used any inhalation devices were recruited. The three devices were in random order. The preferences of subjects and nurses were ranked in a three‐point scale. The children had a statistically significant preference for AccuhalerTM, while the nurses preferred to teach both AccuhalerTM and AutohalerTM but not the TurbuhalerTM.
Heat shock response decreases endotoxin‐induced acute lung injury in rats
Authors: Koh Younsuck , Lim Chae‐Man , Kim Mi Jung , Shim Tae Sun , Lee Sang Do , Kim Woo Sung , Kim Dong‐Soon , Kim Won Dong
Published: March 2003

Objective:

Transient whole‐body hyperthermia was reported to reduce lung damage in a rat with intra‐abdominal sepsis produced by caecal perforation.

Methodology: In order to determine the effect of heat shock response on acute lung injury induced by endotoxin, which plays a central role in the pathogenesis of sepsis, we instilled either saline or lipopolysaccharide (LPS) intravenously with and without heat pretreatment in rats. The heated rats had their rectal temperature raised to more than 40°C for 13 min 18 h before intravenous administration of saline or LPS.

Results: We found that the lung leak was significantly increased among the rats given LPS intravenously with (median, 0.17; range, 0.15–0.22; n = 10) and without heat pretreatment (0.23; 0.17–0.30; n = 10) compared with those of saline‐treated rats (0.13; 0.10–0.14; n = 10) (P < 0.05 in each). However, rats given LPS after heat pretreatment had significantly decreased lung leak index compared with those of LPS‐treated rats without heat pretreatment (P < 0.05). Rats administered LPS intravenously showed increased myeloperoxidase activity without heat pretreatment (19.01; 9.34–28.00 U/g; n = 10) compared with that of saline‐treated rats (7.09; 4.49–10.56 U/g; n = 5) (P < 0.05) (
Fig. 2). Myeloperoxidase activity of the rats treated with LPS with heat pretreatment (5.57; 2.87–8.96 U/g; n = 10) was significantly decreased to the level of normal control compared with that of LPS‐treated rats without heat pretreatment (P < 0.05). The levels of heat shock proteins (HSP72) in lung tissue, which were examined by western blot analysis, were increased over baseline levels at 23 h after hyperthermic stress.

Heat pretreatment decreased lung myeloperoxidase (MPO) activity in rats administered lipopolysaccharide (LPS; 3 mg/kg) intravenously. The number of determinations is shown in parentheses. *P < 0.001 compared with saline‐treated rats. **P > 0.05 compared with saline‐treated rats. Boxplot: Box = 25–75 percentile; bold line, median value; whiskers indicate the minimum and maximum values.

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Conclusions: These observations show that brief heat shock response is associated with the induction of HSP72 protein synthesis and attenuated neutrophil recruitment and acute lung leak is induced by endotoxin in rats.