bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative power contributions of unit discharges simultaneously recorded in the mesencephalic reticular formation
Authors: Kodama Tohru , Honda Yoshiko , Nakao Mitsuyuki , Sato Seisho , Yamamoto Mitsuaki
Published: March 2003

In order to investigate mutual interactions between neuronal discharges in the mesencepahlic reticular formation, relative power contributions (RPC) were estimated during sleep–wake cycles and serotonin (5HT)‐depleted conditions by the administration of parachlorophenylalanine (PCPA). The RPC for most of the neurons dominated in the lower frequency range below 0.4 Hz during rapid eye movement (REM) sleep and the PCPA‐treated conditions, which were qualitatively reproduced by the neural network model under global disinhibition. The results supported the hypothesis that the peculiar dynamics of neuronal activities during REM sleep, 1/f fluctuations, were generated by neuronal interactions augmented by the release from the global inhibition of 5HT.
Development and application of the ‘Sleep Ukiha’ automated sleep analysis system
Authors: Shirakawa Shinichiro , Uchimura Naohisa , Tanaka Junji , Sakamoto Tetsuro , Satomura Takeshi , Tsutsumi Yasumasa , Kotorii Tsuyoshi , Maeda Hisao , Kuwahara Hiroo
Published: March 2003

Abstrast

We attempted to develop an automated sleep analysis system that uses a personal computer as an aid to the entire sleep research process. Analysis is based on electroencephalogram, chin muscle electromyogram and electrooculography, while other physiological phenomena can be handled arbitrarily. Major characteristics of the system include: (i) simultaneous gathering of physiological phenomena from up to three patients; (ii) high‐speed waveform analysis; (iii) user‐friendly operating environment through the use of a graphical user interface; and (iv) versatile utilization of analytical data in research.
Sleep problems in Japanese industrial workers
Authors: Inoue Yuichi , Hiroe Yu , Nishida Masahiro , Shirakawa Shuichiro
Published: March 2003

In order to investigate the prevalence of a disordered condition due to shift work (DCSW) and the influence of sleep disorders on the performance of working and driving, a preliminary questionnaire was conducted on industrial workers. Among 332 shift workers, 110 (33.1%) were found to suffer from DCSW. Subjects with DCSW were found to be working shorter periods in shift work than were subjects without DCSW. The rate of sleepiness‐related troubles while driving and working were highest in the subjects with probable hypersomnia. This finding encourages the need for early diagnosis and treatment of sleep disorders among industrial workers.
Effects of bright light pre‐exposure on sleep onset process
Authors: Komada Yoko , Tanaka Hideki , Yamamoto Yukari , Shirakawa Shuichiro , Yamazaki Katuo
Published: March 2003

This study investigated the effects on the sleep onset process of enhanced cerebral cortex activity caused by bright light pre‐exposure. Seven healthy young adults were exposed for 40 min before sleep onset, 2500 lx of bright light and 10 lx of dim light. Other factors that affect sleep onset (e.g. circadian phase) were experimentally controlled. Five stages of hypnagogic electroencephalogram (EEG) were scored. The latency of each EEG stage was longer at bright light than at dim light conditions, suggesting that activation of brain activity by bright light pre‐exposure strongly regulates the sleep onset process.
Effect of short duration morning bright light in elderly men: Sleep structure
Authors: Kohsaka Masako , Fukuda Noriko , Kobayashi Riko , Honma Hiroshi , Sakakibara Satoshi , Koyama Emi , Nakano Toshio , Matsubara Hozumi
Published: March 2003

Sleep structure was measured in five healthy elderly men in their homes. The subjects were exposed to bright light (6000 lx) for 30 min in the morning or instructed to sit in front of a desktop lighting device without light. Relative to the control conditions, bright light exposure significantly decreased time in bed and the number of awakenings. Rapid eye movement sleep was significantly fragmented by stage 1 sleep in the control condition compared with the bright light condition. These findings indicate that a short duration of morning bright light changes sleep structure and is effective in maintaining sleep.
Influences of caffeine to nitric oxide production and zonisamide concentration in the brain of seizure‐susceptible EL mice
Authors: Hashiguchi Wataru , Nagatomo Itsugi , Akasaki Yasuaki , Uchida Masahiro , Tominaga Masataka , Takigawa Morikuni
Published: March 2003

Abstract To investigate changes of nitric oxide (NO) productions and zonisamide (ZNS) concentrations in the brain of seizure‐susceptible EL mice given caffeine orally, mice were given caffeine (600 μg/mL) solution ad libitum as a drinking fluid for 1–3 weeks. Nitric oxide production in the brain was determined by measuring levels of nitrite plus nitrate (NOx). The brain NOx levels of mice treated with caffeine for 3 weeks were significantly higher than the control. Seizures in mice treated with caffeine for 2 and 3 weeks were not suppressed by ZNS at a dose of 75 mg/kg. Serum ZNS concentrations of mice with caffeine intake for 1–3 weeks were higher than in untreated mice. Conversely, brain ZNS concentrations of mice with caffeine intake for the same periods were significantly lower than in untreated mice. These results suggested that caffeine influenced brain NO production and ZNS concentrations in the seizure susceptibility of EL mice.
Hypothalamically induced emotional behavior and immunological changes in the cat
Authors: Mori Yoshinobu , Ma Jingyi , Tanaka Sansei , Kojima Kyoji , Mizobe Koji , Kubo Chiharu , Tashiro Nobutada
Published: March 2003

Abstract Numerous animal studies on the correlation between stress and immunity have been performed but few such studies have been made concerning the relationship between various kinds of stress‐related emotional behavior and immunological changes. Electrical stimulation of the hypothalamus in cats elicits various emotional behaviors such as restlessness, defensive attack, defensive retreat and quiet biting attack. We examined changes in the lymphocyte proliferative responses and plasma cortisol level which accompanied such emotional behavior. A significant increase in plasma cortisol was observed in the restlessness, defensive attack and defensive retreat groups, but not in the quiet biting attack or non‐response (control) groups. A significant increase in the lymphocyte proliferative responses to phytohemagglutinin (PHA) was observed in the restlessness and defensive attack groups but not in the defensive retreat, quiet biting attack or non‐response groups. These results suggest that various kinds of emotional behavior appear to be differentially correlated with the lymphocyte proliferative responses, while also being differentially correlated with the plasma cortisol concentration. Because the changes in lymphocyte responses and plasma cortisol did not always completely correlate with one another, the changes in the lymphocyte responses are not considered to be influenced by plasma cortisol alone.
Relationship between clock drawing test performance and regional cerebral blood flow in Alzheimer's disease: A single photon emission computed tomography study
Authors: Ueda Hideki , Kitabayashi Yurinosuke , Narumoto Jin , Nakamura Kaeko , Kita Hitoshi , Kishikawa Yusuke , Fukui Kenji
Published: March 2003

Abstract The clock drawing test (CDT) is a useful tool for screening cognitive impairment.
Previous neuropsychological studies have revealed that CDT performance requires several
cognitive functions including semantic memory, visuospatial function and executive
function. However, the neural substrates involved remain to be elucidated. The aim
of the present study was to identify the brain regions responsible for CDT performance
in patients with Alzheimer's disease (AD). Twenty‐six patients satisfying
the National Institute of Neurological and Communicative Disease and Stroke‐Alzheimer's
Disease and Related Disorders Association criteria for probable AD underwent the
CDT and the Mini‐Mental State Examination (MMSE), together with a N‐isopropyl‐p‐[123I]
iodoamphetamine (IMP) single photon emission computed tomography measurements of
the resting regional cerebral blood flow (rCBF). The CDT score correlated significantly
with the MMSE score (r = 0.582; P < 0.05). Stepwise multiple regression analysis revealed that the MMSE score and the left posterior temporal rCBF were major predictors of CDT score. These findings suggest that the CDT score may reflect the severity of dementia, and that it has a close relationship with the left posterior temporal function. Our findings provide the first functional neuroimaging evidence for the neural substrates involved in CDT performance.
Monozygotic twin cases of the agenesis of the corpus callosum with schizophrenic disorder
Authors: Motomura Naoyasu , Satani Seiji , Inaba Masaaki
Published: March 2003

Abstract We report the identical monozygotic twin cases of agenesis of the corpus callosum that demonstrated schizophrenic disorder. Patients were 26‐year‐old twin brothers and both cases were diagnosed as having schizophrenia using DSM‐III‐R diagnostic criteria. On magnetic resonance imagings both cases demonstrated the total agenesis of the corpus callosum and the anterior commissure was hypertrophic. We speculated that the developmental disturbance of the corpus callosum might be related to the cause of the psychiatric disorders in the present cases.
Using an air‐pad sensor for the diagnosis of sleep apnea: A trial study
Authors: MIYAZAKI SOICHIRO , KOMATSU NAMIKO , TAKASHIMA MITSURU , TANAKA TOSHIHIKO , ITASAKA YOSHIAKI , YOSHIZAKI KATSUAKI
Published: March 2003

Abstract An air‐pad sensor (APS) was developed to record respiratory effort non‐invasively. The APS is placed under the subjects’ bodies and acoustic signals received by the pad are analysed. Nine patients with obstructive sleep apnea (OSA) and two healthy subjects were examined using an APS and daytime polysomnography, including intraesophageal pressure (Peso), simultaneously. The agreement ratio in terms of the central apnea time between the APS and the Peso was 93.4%, although the ratio between the Peso and an abdominal strain gauge was 40.7%. The agreement ratio in terms of respiratory rate among the Peso, APS, and abdominal strain gauge in patients with OSA was high; but the agreement ratio was low (74.4%) between the Peso and the strain gauge in mixed apnea.
Methylphenidate hydrochloride for excessive daytime sleepiness in a patient with myotonic dystrophy
Authors: MIYAMOTO TOMOYUKI , MIYAMOTO MASAYUKI , SUGA TAKAKO , AIZAWA CHIE , TAKEKAWA HIDEHIRO , HIRATA AND KOICHI
Published: March 2003

Abstract A 28‐year‐old man with a history of myotonic dystrophy (MyD) is described. His progressively worsening excessive daytime sleepiness (EDS) was treated with methylphenidate hydrochloride. Polysomonography (PSG), the multiple sleep latency test (MSLT), middle latency‐evoked response, and auditory event‐related potentials were used to assess the cause of EDS. The PSG detected small numbers of central sleep apneic episodes. Mean sleep latency, which was determined by MSLT, increased from 5 min before treatment to 14 min after treatment. The Pa, P1, and N1 amplitudes at the Cz site increased after treatment, but P3 latency remained unchanged. These observations suggest that EDS and impairment of cognitive and information processing seen in a patient with MyD may be caused by a central nervous system disorder.
Hypocretin‐1 (orexin‐A) concentrations in cerebrospinal fluid are low in patients with Guillain–Barré syndrome
Authors: KANBAYASHI TAKASHI , ISHIGURO HIDEAKI , AIZAWA RIKA , SAITO YASUSHI , OGAWA YURIKO , ABE MASAHITO , HIROTA KOUICHI , NISHINO SEIJI , SHIMIZU TETSUO
Published: March 2003

Abstract It is reported that cerebrospinal fluid (CSF) hypocretin‐1 (orexin‐A) concentrations in patients with narcolepsy are significantly low. Human narcolepsy is also known to be closely associated with a specific human histocompatibility leukocyte antigen (HLA), suggesting that autoimmunity is involved in the pathophysiology of the disease. Thus, it is important to know whether hypocretin changes are found in definite neuroimmunological diseases such as multiple sclerosis and Guillain–Barré syndrome (GBS). The results of the present study indicate that some patients with GBS have lower levels of CSF hypocretin‐1.
Effects of acupuncture to the sacral segment on the bladder activity and electroencephalogram
Authors: TANAKA YOSHIYUKI , KOYAMA YOSHIMASA , JODO EIICHI , KAYAMA YUKIHIKO , KAWAUCHI AKIHIRO , UKIMURA OSAMU , MIKI TSUNEHARU
Published: March 2003

Abstract Using urethane‐anaesthetized rats, the effects of acupunctural stimulation to the sacral segment on the urinary bladder activity and cortical electroencephalogram (EEG) were examined. The acupuncture suppressed urinary bladder activity in 36 of 68 trials. On many occasions (22/36 trials), suppression was accompanied by an increase in EEG amplitude. In such cases, the EEG power increased in all frequency bands after stimulation. The same EEG changes could be induced when the bladder was empty with no contraction. The results suggest that acupuncture stimulation affects both the bladder activity and sleep–arousal system.
Clinical significance of cataplexy and HLADR1501 in narcolepsy
Authors: INOUE YUICHI , HONDA YUTAKA , TAKAHASHI YASURO , NANBA KAZUYOSHI , ISHII AYANO , SAITOU KAORI
Published: March 2003

Clinical symptoms and multiple sleep latency test (MSLT) measures among narcoleptic patients with both cataplexy and HLADR1501 were compared with cataplexy‐free narcoleptic patients with a positive finding of HLADR1501 and cataplexy‐free patients without HLADR1501. Both mean sleep onset latencies and rapid eye movement (REM) latencies on MSLT were shorter in the patients with cataplexy compared with the cataplexy‐free patients. In four cataplexy‐free patients without HLADR1501, nocturnal sleep was remarkably long and their excessive daytime sleepiness did not respond to treatment. The findings suggest that the severity and disease mechanism of narcolepsy might become heterogenous when cataplexy and HLADR1501 are considered.
Effects of aroma on sleep and biological rhythms
Authors: TANAKA JUNJI , UCHIMURA NAOHISA , HASHIZUME YUJI , SHIRAKAWA SHINICHIROU , SATOMURA TAKESHI , OHYAMA TETSU , TAKEUCHI NOBORU , KUWAHARA HIROO , MAEDA HISAO
Published: March 2003

Abstract The polysomnogram (PSG), blood melatonin concentration, rectal temperature, and answers to a self‐evaluation questionnaire about the effects of agarwood (jinkoh in Japanese), which has been reported to have sleep‐promoting effects were examined. The subjects tested were male medical students, who were free of otorhinolaryngological diseases and were non‐smokers. The results of sleep stage and other sleep variables, and those of rectal temperature rhythm and blood melatonin concentrations showed no significant differences between the baseline nights, experimental nights, and recovery nights.
Alteration of circadian periodicity in core body temperatures of patients with acute stroke
Authors: TAKEKAWA HIDEHIRO , MIYAMOTO MASAYUKI , MIYAMOTO TOMOYUKI , YOKOTA NORITSUGU , HIRATA KOICHI
Published: March 2003

Abstract The effect of brain damage on body temperature rhythm was investigated by spectral analysis using the maximum entropy method. The rectal temperatures of 56 patients with acute stroke were recorded for 1–3 days by actigraphy. Many patients with disturbance of consciousness showed infradian rhythm. Ambulatory patients tended to have circadian rhythm, and non‐ ambulatory patients tended to show infradian rhythm. The study’s findings suggest that impaired physical activity and disturbance of consciousness affect body temperature rhythm in patients with acute stroke.
Polysomnographic features of idiopathic central sleep apnea
Authors: WAKAI MASAKAZU , NISHIKAGE HIROFUMI , GOSHIMA KAZUYUKI , YAMAMOTO JUNNOSUKE
Published: March 2003

AbstractTwo patients with idiopathic central sleep apnea (ICSA), which is an uncommon condition, were recently encountered. This study examines the polysomnographic features of ICSA. The characteristic findings of ICSA are summarized as follows: (i) central apneas and hypopneas are progressively less frequent as sleep state deepens from stage 1 to stage 2 to stage 3 + 4 to stage REM (rapid eye movement); (ii) desaturation related to apneas and hypopneas is mild; and (iii) periodic breathing is commonly observed. However, the two patients demonstrated apparently different findings. It is suggested that the mechanisms underlying apnea and hypopnea in ICSA are heterogeneous.
Bizarre delusions and DSM‐IV schizophrenia
Authors: NAKAYA MAKOTO , KUSUMOTO KATSUNORI , OKADA TAKAYUKI , OHMORI KENICHI
Published: March 2003

Abstract The present study investigated whether schizophrenia patients with and without DSM‐IV bizarre delusions, categorized as bizarre delusions of Schneiderian first rank symptoms (SBD) and as non‐Schneiderian bizarre delusions (non‐SBD), differed on demographic or clinical features, in view of the weight given to bizarre delusions in the diagnosis of schizophrenia. One hundred and twenty‐nine in‐patients with schizophrenia were assessed systematically for both types of bizarre delusions on the five domains of psychopathology of the Positive and Negative Syndrome Scale (PANSS; delusions/hallucinations, thought disorder/disorganization, excitement, negative symptoms and depressive symptoms) and for extrapyramidal side‐effects. Inter‐rater reliabilities for SBD and non‐SBD were assessed and were exceptionally high (kappa value 0.85 and 0.92, respectively). Neither SBD nor non‐SBD were associated with any demographic or non‐PANSS clinical characteristics tested. However, the presence of non‐SBD was significantly associated with more severe psychopathology in all five domains of the PANSS, whereas the presence of SBD was significantly associated with more severe psychopathology in three domains only: delusions/hallucinations, thought disorder/disorganization and depressive symptoms. However, patients with only SBD did not differ from patients with only non‐SBD on any demographic or clinical variables, including five psychopathological domains. These findings suggest that, despite showing more severe symptoms, patients with DSM‐IV bizarre delusions do not constitute a clinically distinguishable subgroup.
Mental health issues of peacekeeping workers
Authors: SHIGEMURA JUN , NOMURA SOICHIRO
Published: March 2003

The end of the Cold War has brought a dramatic change to the international political situation and the role of the United Nations peacekeeping operations (PKO) has drawn increased attention. While many reports on PKO have focused on political or sociologic considerations, the mental health of the peacekeepers themselves has received little attention and psychiatric problems that can have a negative impact on mission success have been largely ignored. Participation in PKO creates a number of stressors and serious psychiatric and/or physical disorders may result. Yet, there is little research on this topic, either domestically or globally, and the methodology for clinical intervention remains in an early stage of development. We have reviewed previous reports to determine how various stressors before, during and after deployment affect the participants. Research in associated fields (e.g. crisis workers and military personnel) are also reviewed and their application to peacekeeping psychiatry is discussed. It must be admitted that the significance of PKO is arguable and each PKO is unique in terms of the nature of its mission and the local situation. Yet, the relationship between the psychiatric status of the personnel and the characteristics of an individual mission has never been studied. At present, no clear consensus regarding a framework for psychiatric intervention exists. Studies that enhance the recognition and significance of peacekeeping psychiatry are likely to improve the efficacy of PKO.
Concordance between self‐ and observer‐ratings on Kasahara's Inventory for the Melancholic Type Personality
Authors: UEKI HIROFUMI , HOLZAPFEL CHRISTIAN , WASHINO KAEI , INOUE MASATO , OGAWA NAOSHI , FURUKAWA TOSHIAKI
Published: March 2003

The concordance between self‐ and observer‐ratings was investigated for items on Kasahara's Inventory for the Melancholic Type Personality (KIMTP). Subjects consisted of 44 patients diagnosed with an ICD‐10 diagnostic criteria for research (DCR) depressive episode (F32) or recurrent depressive disorder (F33) unipolar affective disorder, and 44 observers. Thirty‐one of the 44 patients were diagnosed with endogenous depression. The observers consisted of five parents, eight children, thre siblings, 25 spouses, and three partners. Concordance was tested with Student's paired t‐test and one‐way analysis of variance intraclass correlation coefficient (ANOVA ICC). There was no statistical difference between the mean total self‐rating score and the mean total observer‐rating score in the endogenous depression group, but the mean total self‐rating score was significantly higher than the mean total observer‐rating score in the non‐endogenous depression group. When the self and observer tests in this non‐endogenous depression group were compared on an item‐by‐item basis, most items tended to receive higher scores from the self‐raters than from the observer‐raters. The ICC had good concordance for mean total self‐ and observer‐ratings in the endogenous depression group but not the non‐endogenous depression group. On an item‐by‐item basis, concordance was high between self‐ and observer‐raters for more items in the endogenous depression group than in the non‐endogenous depression group. There were some important differences between self‐ and observer‐ratings for certain items in the non‐endogenous depression group. Patients in this group tended to give higher scores to items representing Typus melancholicus in relation to scores given by observers.
Decreased serum albumin levels in Taiwanese patients with schizophrenia
Authors: HUANG TIAO‐LAI
Published: March 2003

Previous papers have reported lower serum albumin levels in patients with schizophrenia. In the present study, the relationships between serum albumin levels and subtypes of schizophrenia, physical violence and suicide attempts were investigated. A review of medical charts over a 1‐year period was carried out in a population of 213 Taiwanese psychiatric inpatients that included 106 patients with schizophrenia. The collected data included age, bodyweight, height, serum albumin levels and routine blood biochemistry examinations. These data were compared with data from a healthy control group (n = 32) composed of staff members using analysis of covariance after age adjustment. The statistical results showed significantly lower serum albumin levels in patients with schizophrenia in the acute phase than in the control group. However, no significant differences in serum albumin levels were found between paranoid and non‐paranoid schizophrenic patients, between patients who had or had not exhibited physical violence, or between patients who had or had not made a suicide attempt.
Electrophysiological correlates of personality dimensions measured by Temperament and Character Inventory
Authors: KIM MYUNG‐SUN , CHO SANG‐SOO , KANG KYUNG‐WHUN , HWANG JOO‐LEE , KWON JUN SOO
Published: March 2003

The present exploratory study was attempted to investigate the relationship between components of event‐related potential (ERP) and Cloninger's personality dimensions. The ERP was measured using the auditory oddball paradigm, and personality was evaluated by Temperament and Character Inventory (TCI) in 25 healthy subjects. The results showed that P300 amplitude at Fz was significantly associated with reward dependence, and that P300 latency was positively correlated with persistence, and negatively correlated with novelty seeking. No correlations were found between N100, P200 and personality dimensions. These results indicate that personality dimension is related to information‐processing in the brain. The neurobiological and psychological aspects of personality, which may relate to the P300 were considered.
Combined small and transitional cell carcinoma of the urinary bladder with CA19‐9 production
Authors: Kuroda Naoto , Hayashi Yoshitake , Nishida Yoshifumi , Itoh Hiroshi
Published: March 2003

It is well known that extrapulmonary small cell carcinoma, which exhibits morphological features similar to those observed in the lung, occurs in various organs. Clinically, most cases manifest aggressive biological behavior. A case of small cell carcinoma of the urinary bladder producing a high level of serum carbohydrate antigen (CA) 19‐9, in which expression was confirmed in cancer cells of small as well as transitional cell carcinoma in the same tumor mass by immunostaining is reported. This paper documents combined small and transitional cell carcinoma of the urinary bladder with CA19‐9 production, although it has already been reported that adenocarcinoma or transitional cell carcinoma in various organs frequently expresses CA19‐9. Observations suggest that the histogenesis of some cases of combined small and transitional cell carcinoma in the urinary bladder may be the same, as both can produce CA19‐9.
Ossifying fibromyxoid tumor of soft parts: Clinicopathologic, immunohistochemical and ultrastructural study of four cases
Authors: Matsumoto Koshi , Yamamoto Taiichi , Min Wen , Yamada Nobutaka , Asano Goro , Moriyama Masaki , Matsumoto Toshiharu
Published: March 2003

Four cases of uncommon soft tissue tumors were investigated histopathologically. All of them consisted of fibrous and myxoid components, and mature bone showed shell‐like characteristics. Histological features revealed these tumors were well circumscribed by a thick collagenous fibrous capsule and composed of uniform‐sized fusiform cells with eosinophilic cytoplasm and a round or oval nucleus in the myxoid matrix. An incomplete shell of mature bone with lamellar structure was also observed at the periphery. Immunohistochemical and ultrastructural studies were performed. The major component of the proliferating cells in the tumors had positive staining for vimentin, S‐100 protein, neuron‐specific enolase and synaptophysin. The myxoid matrix was stained by alcian blue and was digested completely by pretreatment with hyaluronidase. Electron microscopy showed the cytoplasm contained dense‐core granules measuring 100–200 nm and abundant filaments of an intermediate size. It is suggested that these uncommon tumors might be diagnosed as the ‘ossifying fibromyxoid tumor of soft parts’ previously described by Enzinger et al., which were derived from peripheral nerve sheath tumors such as neurofibroma and myxoid neurofibroma.
Loss of chromosome 10 in glioblastoma: Relation to proliferation and angiogenesis
Authors: Horiguchi Hidehisa , Hirose Takanori , Sano Toshiaki , Nagahiro Shinji
Published: March 2003

Loss of chromosome 10 was assessed in 17 specimens of glioblastoma (GBM) by fluorescence in situ hybridization (FISH) technique using the centromere probe for chromosome 10. Cytospinned smear specimens were prepared from paraffin‐embedded specimens. The percentage of nuclei containing a single fluorescent signal ranged from 19.2 to 88.0% (mean, 49.3%). Thirteen tumors (76.5%) were designated as monosomy 10 because the proportion of single‐signal nuclei exceeded the cut‐off value (31.5%: mean of five control materials +3 standard deviations). The results confirmed the importance of the loss of chromosome 10 for the development of GBM, although no significant correlation was demonstrated between the loss of chromosome 10 and survival. In addition, proliferation potential and angiogenesis of GBM were immunohistochemically analyzed using antibodies against Ki‐67 antigen (MIB‐1), factor VIII‐related antigen (FVIII R/Ag) and vascular endothelial growth factor (VEGF), respectively. The labeling indices of MIB‐1 (1.5–57.8%) and the number of blood vessels immunoreactive for FVIII R/Ag (18–279/10 high‐power fields) were not significantly related to the loss of chromosome 10. Vascular endothelial growth factor immunoreactivity in areas microvessels were counted was seen in 12 cases. However, neither the loss of chromosome 10 nor number of vessels was not correlated with VEGF expression. Other genetic abnormalities as well as loss of chromosome 10 may be involved in the cell proliferation and angiogenesis of GBM.
The histological spectrum of subperiosteal fibrocartilaginous pseudotumor of long bone (focal fibrocartilaginous dysplasia)
Authors: Kim Chong Jai , Choi In Ho , Cho Tae Joon , Chung Chin Youb , Chi Je G.
Published: March 2003

Clinicopathological features in six cases of focal fibrocartilaginous dysplasia (FFCD) which involved either the tibia (n = 4) or the femur (n = 2) were reviewed. All cases presented clinical and radiological characteristic features, and histopathological findings were analyzed in five of the six cases. The subject group comprised three boys and three girls, ages ranged from 12 to 18 months. Histologically, the individual lesions showed regional variation in cellularity, amount of fibrous and cartilaginous components. Paucicellular areas were mainly composed of dense fibrous tissue while more cellular areas contained foci of fibrocartilaginous element. The chondrocytes and stellate cells around cartilaginous area were positive for S‐100 protein. One case contained both hyaline and fibrocartilage, and architecturally mimicked normal tendinous insertion. One case, which involved proximal tibia, was purely composed of fibrous tissue without fibrocartilage. All cases formed undulating and irregular borders against underlying cortical bone. Histopathologically variable spectrum suggests a strong possibility of undergoing transition from initial cellular and cartilagnous to late paucicellular, fibrous phase. Although any evidence that can explain basic pathogenesis or prognostic histological parameter is lacking, we believe that the term FFCD is not relevant because the presence of fibrocartilage is not an essential feature, and it can cause confusion with other pathological processes. We propose the term ‘subperiosteal fibrocartilaginous pseudotumor of long bone’ for this unique clinicopathological entity with which heterologous cartilaginous element can be associated.
Pulmonary fibrosis and lung carcinoma: A comparative study of metaplastic epithelia in honeycombed areas of usual interstitial pneumonia with or without lung carcinoma
Authors: Hironaka Mitsugu , Fukayama Masashi
Published: March 2003

Usual interstitial pneumonia (UIP), or idiopathic pulmonary fibrosis, has been considered to be associated with a high risk for lung carcinoma. To investigate this well‐known but still equivocal relationship, we reviewed the clinical features of UIP autopsy cases with or without lung carcinoma (n = 32 and 38, respectively), and compared the morphology and cell kinetics of metaplastic epithelia in the honeycombed areas (n = 11, each group). Thirty‐two of 70 UIP autopsy cases showed lung carcinomas. Clinically, UIP with lung carcinoma showed a male predominance (P = 0.001), a higher rate of smoking history (P = 0.001) and a later onset of UIP (P = 0.02), compared with UIP without lung carcinoma. Most of the carcinomas were peripheral in origin (90%), and 65% were topographically associated with honeycombed areas or the border between honeycombing and non‐fibrotic areas. Quantitative assessment of the metaplastic epithelia in the honeycombed areas revealed that squamous metaplasia, but not cuboidal cell metaplasia or bronchial cell metaplasia, occurred more frequently in UIP with lung carcinoma than in UIP without lung carcinoma (P = 0.02). There were no significant differences between the two groups with regard to the labeling indexes of Ki‐67 and p53 in the metaplastic epithelia, including squamous metaplasia. The degree of atypical squamous metaplasia was not different between the two groups. The quantitative predominance of squamous metaplasia in the honeycombed areas may not be a precursor for lung carcinoma, but might reflect a constitutional susceptibility of UIP patients to develop a lung carcinoma.
Optically clear nuclei in papillary carcinoma of the thyroid: Demonstration of one of the fixation artifacts and its practical usefulness
Authors: Naganuma Hiroshi , Murayama Harunobu , Ohtani Noriko , Takaya Kiyoshi , Mori Yoko , Sakai Nobumitsu , Kakudo Kenichi
Published: March 2003

To examine whether or not optically clear nuclei are one of the fixation artifacts in papillary carcinoma of the thyroid. Experiments using an optimal immersion fixation method by making thin‐sliced specimens, 5 × 2 × 2 mm in size were adopted. Fixatives tested were 10% formalin, 10% buffered formalin, mixture of alcohol and formalin (4 : 1), 95% alcohol, 4% phosphate‐buffered paraformaldehyde, Carnoy’s fixative, Bouin’s fixative and various concentrations of formalin. Tested thyroid lesions in total were: cases with papillary carcinoma (38); follicular carcinoma (one); follicular adenoma (15); adenomatous goiter (11); Hashimoto’s thyroiditis (two); Grave’s disease (five); and normal thyroid tissue around tumor (five). Routinely processed papillary carcinoma showed a high occurrence (64.6%) of the optically clear nuclei contrasted by a low occurrence (almost 0%) in other lesions. However, this rate in papillary carcinoma decreased (< 35.3%) in all experimental groups irrespective of the choice of fixatives. Frequent occurrence (61.9–66.6%) of the optically clear nuclei was reproduced in papillary carcinoma fixed in a higher concentration of formalin (40–60%) in the experimental groups. These results demonstrated that the optically clear nuclei are one of the fixation artifacts, although still useful as a diagnostic criterion.
Activation of the TCL1 protein in B cell lymphomas
Authors: Nakayama Ichiro , Murao Shinichi , Kitazawa Sohei , Azumi Atsushi , Yamamoto Misao , Maeda Sakan
Published: March 2003

The TCL1 gene, localized near the break point of chromosome 14q32.1 often involved in T cell leukemias, is also expressed in normal precursor T and B cells, and B cell lymphoma cell lines. We investigated the expression of the TCL1 protein in various types of B cell lymphomas according to the Revised European–American Classification of Lymphoid neoplasms. Paraffin‐embedded tissue sections of lymphoma specimens were subjected to TCL1 immunohistochemistry, and positivity was scored on a three‐tiered scale: – (< 25% cells), + (25–50% cells), and ++ (> 50% cells). The TCL1 protein was expressed in low‐grade B cell lymphomas including mucosa‐associated lymphoid tissue type in ocular adnexa (18/20, 90%). It was also expressed in follicular, lymphoplasmacytic, and mantle cell lymphoma, but not in high‐grade diffuse large B cell lymphoma (2/11, 18%). These data suggest that the expression of the TCL1 gene characterizes low‐grade B cell lymphomas, and may be involved in certain processes of lymphomatogenesis.
Adrenal rest tumor of the liver: A case report with immunohistochemical investigation of steroidogenesis
Authors: Arai Kazumori , Muro Hiroyuki , Suzuki Makoto , Oba Noriyuki , Ito Kazuki , Sasano Hironobu
Published: March 2003

A case of adrenal rest tumor arising in the liver of a 62‐year‐old male with chronic hepatitis type C is reported. The tumor was clinically non‐functioning and required distinction from hepatocellular carcinoma. The yellowish–brown tumor measured 25 × 18 × 15 mm and was located in the subcapsular portion of the right hepatic lobe. Histologically, the tumor presented features similar to those of the adrenal cortex and was predominantly composed of pale cells. Electron micrograph revealed lipid droplets and mitochondria with tubulo–vesicular cristae, consistent with the characteristics of steroid‐producing cells. Immunohistochemically, the tumor expressed the adrenal 4 binding protein and a number of enzymes involved in the synthesis of adrenocortical steroids. At surgery, the right adrenal gland was present independently from the liver. This hepatic tumor was considered to be an adrenal rest tumor with steroidogenic capability.
Spontaneously regressed Kaposi’s sarcoma and human herpesvirus 8 infection in a human immunodeficiency virus‐negative patient
Authors: Kondo Yasuko , Izumi Tatsuya , Yanagawa Tatsuo , Kanda Hiroaki , Katano Harutaka , Sata Tetsutaro
Published: March 2003

Kaposi’s sarcoma occurring in a 78‐year‐old woman, with the absence of the human immunodeficiency virus infection, was correctly diagnosed by immunohistochemistry using anti‐human herpesvirus 8 (HHV8) antibody (PA1‐73N) for the first time. The patient suffered from chronic respiratory failure and was treated with a low dose of steroids for 2.5 years. After her medication dosage was increased for the exacerbation of the respiratory failure, multiple skin tumors in her feet and legs suddenly developed. Histopathologically, skin tumors were suspected as Kaposi’s sarcoma at the first biopsy and reactive angiomatosis at the second biopsy. Polymerase chain reaction and immunohistochemistry, however, revealed the presence of HHV8 DNA fragment and positive staining in the majority of spindle cells in the skin tumors. Serological examination confirmed the positivity of anti‐HHV8 antibodies. HHV8 infection and steroid‐induced immunosuppression, as well as environmental factors played a role in the development of Kaposi’s sarcoma in this patient, because she was born in Okinawa, which is a well‐known endemic area of Kaposi’s sarcoma in Japan. As her general condition improved, the skin lesions regressed without any specific treatment, and disappeared completely 8 months later, in which regression may be associated with evidence of numerous CD8 cell infiltration in the second biopsy tissues. No recurrence was observed during the following 6 month follow up.
Giant adrenal myelolipoma: Case report and review of the literature
Authors: Yildiz Levent , Akpolat Ilkser , Erzurumlu Kenan , Aydin Oguz , Kandemir Bedri
Published: March 2003

Myelolipoma is a tumor‐like growth composed of mature fat tissue and bone marrow elements. It occurs in the adrenal gland or as an isolated soft tissue mass. It may be associated with endocrine disorders such as hermaphroditism, Cushing’s disease, Addison’s disease and obesity of unknown cause. These lesions rarely measure more than 5 cm in diameter, although giant tumors have been reported in the literature. The fifth largest surgically resected adrenal myelolipoma in the literature is reported and its clinical associations and, macroscopic and microscopic features are discussed.
Ovarian yolk sac tumor with virilization during pregnancy: Immunohistochemical demonstration of Leydig cells as functioning stroma
Authors: Arima Nobuyuki , Tanimoto Akihide , Hayashi Ryunosuke , Hamada Tetsuo , Sasaguri Yasuyuki
Published: March 2003

A case is reported of yolk sac tumor occurring in the left ovary and complicated by pregnancy. The 22‐year‐old patient presented at 28 weeks gestation with virilization and elevated serum levels of testosterone and alpha‐fetoprotein. The tumor showed the typical features of yolk sac tumor with a mixture of islands of Leydig cells. The accumulations of Leydig cells were well demarcated from the cellular components of the yolk sac tumor and were distributed throughout the tumor, although with predominant localization at the periphery. By immunohistochemistry the Leydig cells were intensely positive for vimentin and negative for cytokeratins, allowing clear distinction from the cell components of the yolk sac tumor, which were positive for cytokeratins and negative for vimentin. Testosterone was also identified in the cytoplasm of the Leydig cells. After tumor resection the testosterone and alpha‐fetoprotein levels declined simultaneously; this, together with the immunohistochemical demonstration of testosterone, indicates that the Leydig cells were responsible for the endocrine manifestations. Furthermore, antibodies against inhibin alpha‐subunit and calretinin could be used to detect the Leydig cells. The present case, a combination of yolk sac tumor and Leydig cells acting as a functioning stroma and causing virilization during pregnancy, is very rare.
Clinicopathological characteristics of atypical cystic duct (ACD) of the breast: Assessment of ACD as a precancerous lesion
Authors: Kusama Ritsu , Fujimori Minoru , Matsuyama Ikuo , Fu Li , Ishii Keiko , Hama Yoshihisa , Asanuma Kazuhiko , Shingu Kiyoshi , Kobayashi Shinya , Tsuchiya Shin‐ichi
Published: March 2003

To clarify the clinicopathological features of an atypical cystic duct (ACD) as defined by Tsuchiya’s criteria as a precancerous lesion of the breast, we used 200 whole mammary gland serial sections of breast cancer. Forty‐four (22%) of the 200 breast cancer patients had ACD breast lesions. The frequency of patients with ACD increased in premenopausal women (P= 0.001). There was no correlation between the ACD‐present group and the ACD‐absent group for immunohistochemical status of the estrogen receptor (ER), progesterone receptor (PgR), p53, or c‐erbB2; Ki‐67 labeling index of cancer tissues; size of tumor, or lymph node metastases. A number of ACD lesions displayed continuity to cancer lesions. In 500 serial sections of a paraffin‐embedded tissue of a ACD case at 3 μm intervals, an apparent transition from ACD into ductal carcinoma in situ was observed. Immunohistochemical analysis using α‐smooth muscle actin showed that myoepithelial cells of ACD stained strongly, and their nuclei and cytoplasm were thinning. In 16 of the 44 (36%) ACD‐present patients, carcinoma cells stained positive for p53. Within those 16 cases, 12 cases (75%) were positive for p53 in ACD lesions. There was a significant correlation between the expression of p53 protein in malignant cells and ACD (P= 0.001). All 44 ACD lesions had no staining of c‐erbB2, regardless of staining in malignant lesions. The mean Ki‐67 labeling index of ACD lesions was low (0.3%), suggesting that ACD had a low proliferative rate. We suggest that ACD is the precancerous breast lesion because of a histologic continuum between ACD and malignancy, and because of p53 protein expression in ACD.
Sinonasal teratocarcinosarcoma
Authors: Endo Hideko , Hirose Takanori , Kuwamura Kei‐ichi , Sano Toshiaki
Published: March 2003

Sinonasal teratocarcinosarcoma (SNTCS) is a rare, teratoma‐like lesion of the nasal cavity and paranasal sinus. To the best of our knowledge, SNTCS is highly malignant. We report a case of SNTCS arising in the nasal cavity of a 71‐year‐old male who complained of nasal obstruction and epistaxis. In spite of intensive treatment, the tumor recurred three times and the patient died from a local extension into the anterior cranial fossa 7 years after initial onset. The resected tumors consisted of variegated components, such as epithelial elements, including cystic, ductal and glandular structures occasionally associated with squamous differentiation, neuroectodermal ones exhibiting neural rosette formation, and mesenchymal ones with prominent rhabdomyoblastic differentiation. Immunohistochemical and ultrastructural studies clearly demonstrated characteristic cellular differentiation of each component. These three principal elements were often topographically related and showed morphological transition with each other. These findings suggest the derivation of divergent components from common progenitor cells. Although the cellular atypia of the primary lesion was inconspicuous, the recurrent tumors became anaplastic and mitotically active. Histologic anaplasia may be somewhat related with aggressiveness of recurrent lesions. Appropriate sampling of specimens, and awareness of this rare teratoid tumor are important to make the correct diagnosis.
Adult‐onset herpes simplex virus hepatitis with diffuse myofibroblastic transformation of hepatic stellate cells (Ito cells) in non‐necrotic areas
Authors: Toi Makoto , Kuroda Naoto , Tao Lihua , Jin Yulan , Guo Limei , Miyazaki Eriko , Hayashi Yoshihiro , Hiroi Makoto , Komatsu Naoki , Nakata Hideshi , Ogata Kimiko , Enzan Hideaki
Published: March 2003

The myofibroblastic transformation of hepatic stellate cells (HSC; also known as Ito cells) usually occurs following necrosis of adjacent liver cells. No report has previously found that such a transformation occurs in herpes simplex virus (HSV) hepatitis. We present an autopsy case of HSV hepatitis with myofibroblastic transformation of HSC that is different from the usual transformation of HSC. The patient was a 66‐year‐old woman who had received various therapies for cutaneous T‐cell lymphoma. An autopsy revealed submassive hepatic necrosis with hemorrhage due to HSV hepatitis. HSV infection was confirmed by DNA in situ hybridization in liver tissue. Immunohistochemical staining for α‐smooth muscle actin (ASMA) showed a strong positive reaction in almost all of the HSC in non‐necrotic areas. However, in necrotic areas, the HSC were completely negative for ASMA. These findings indicate that not only liver cells but also HSC can become necrotic in HSV hepatitis. In contrast, in non‐necrotic areas, almost all of the HSC showed active transformation to myofibroblasts.
Microsatellite instability of papillary subtype of human gastric adenocarcinoma and hMLH1 promoter hypermethylation in the surrounding mucosa
Authors: Guo Rong‐Jun , Arai Hajime , Kitayama Yasuhiko , Igarashi Hisaki , Hemmi Hiromichi , Arai Tomio , Hanai Hiroyuki , Sugimura Haruhiko
Published: March 2003

Gastric cancer has striking heterogeneity in histological pattern, cellular phenotype, genotype, biomarkers, and biological behavior. We focused on the specific morphological papillary phenotype of gastric adenocarcinoma and attempted to identify its distinct molecular characteristics. In our comparative study, early stage papillary (papillary‐dominant) gastric cancer showed a significantly higher and more widespread high‐frequency microsatellite instability (MSI‐H) than other morphological types. Analysis of mutations in a panel of five putative microsatellite instability (MSI)‐associated genes in the MSI‐H cases revealed that papillary or papillary‐dominant cancer displays a unique profile of mutations compared to profiles previously reported in gastric cancer. Immunohistochemical staining and methylation analysis revealed that silencing of hMLH1 by methylation in its promoter region was responsible for the failure of mismatch repair in papillary‐type gastric cancer, whereas aberrant promoter methylation of hMLH1 was not found in any cases without the unique mutator phenotype. Promoter hypermethylation of the hMLH1 genes was found to a lesser degree in the adjacent non‐tumor mucosa in four of the 10 cases with tumor having the mutator phenotype. Microsatellite instability itself could not be detected in the adjacent non‐tumor mucosa. Inactivation of hMLH1 expression by promoter hypermethylation may be an early event in carcinogenesis of this type of gastric cancer, preceding the development of the clear MSI phenotype of papillary carcinoma.
Absence of BAT‐26 instability in gastric intestinal metaplasia
Authors: Jin Zhe , Tamura Gen , Satoh Michiko , Meguro Toru , Miura Takayuki , Hayashi Masahiro , Osakabe Mitsumasa , Ohmura Kiyonari , Ogata Shin‐ya , Endoh Yasushi , Motoyama Teiichi
Published: March 2003

BAT‐26 instability, a sensitive marker for the high‐frequency microsatellite instability (MSI‐H) phenotype, was analyzed in samples of gastric cancer and in adjacent intestinal metaplastic mucosae. Although all MSI‐H gastric cancer samples showed BAT‐26 instability, as assessed using 12 dinucleotide microsatellite markers, BAT‐26 instability was not found in the adjacent intestinal metaplastic mucosa in any of the samples.