bluuebunny/crossref_metadata_2025 huggingface dataset:
A 5‐year‐old boy with recurrent mania successfully treated with carbamazepine
Authors: TUZUN UMRAN , ZOROGLU SULEYMAN SALIH , SAVAS HALUK ASUMAN
Published: March 2003

In the present paper the clinical symptomatology and treatment of childhood mania that was first seen in a child at 5 years of age and which re‐emerged at age 7, is reported. The patient presented at the child and adolescent psychiatric outpatient clinic of Istanbul Medical University with the typical symptoms of mania such of hyperactivity, euphoria, irritability, dangerous and risky behavior, decreased sleep, and age‐inappropriate sexual behavior. He was treated with carbamazepine safely and effectively without any major side‐effects. Clinical phenomenology and treatment of the condition are discussed with relevant literature.
Clinical features in two cases with musical obsessions who successfully responded to clomipramine
Authors: Matsui Tokuzo , Matsunaga Hisato , Ohya Kenzo , Iwasaki Yoko , Koshimune Kayo , Miyata Akira , Kiriike Nobuo
Published: March 2003

Abstract Clinical features in two cases with musical obsessions are presented to discuss phenomenological and psychopharmacological differences from those in patients with musical hallucinations. The present patients commonly experienced music as an internally generated cognitive product accompanied by full insight into the senselessness of the symptoms. They also attempted to suppress the musical symptoms or to neutralize them with other thoughts. Thus, despite no covert or systematic compulsive behaviors, the musical symptoms of the present cases are consistent with the phenomenological nature of obsessive–compulsive disorder defined in DSM‐IV. In addition, in contrast to previous case reports of musical hallucinations, the present patients failed to respond to neuroleptics, but showed significant response to an adequate trial of clomipramine. Thus, their symptoms appear to be phenomenologically and biologically distinct from musical hallucinations, especially those characteristic of schizophrenia.
Expression of pepsinogen II with androgen and estrogen receptors in human prostate carcinoma
Authors: Konishi Noboru , Nakaoka Shingo , Matsumoto Kyoichi , Nakamura Mitsutoshi , Kuwashima Shin‐ichi , Hiasa Yoshio , Cho Masaki , Uemura Hirotsugu , Hirao Yoshihiko
Published: March 2003

The expression of pepsinogen II (PG II), an aspartyl proteinase usually involved in the digestion of proteins in the stomach, was immunohistochemically investigated in conjunction with androgen (AR) and estrogen receptor (ER) status in prostate adenocarcinomas. Of a total of 38 samples obtained from radical prostatectomies, 23 tumors (60.5%) were positive for PG II and there was a significant positive correlation to the expression of AR but not to ER. Cells positive for PG II were localized mainly to the peripheral zones of tumorous glands which, in normal prostate, are negative, and in areas also expressing AR. In addition, a significant correlation between AR and ER was detected in the prostate carcinomas examined, which suggests a hormone‐dependent status. On the basis of these results, PG II expression might be closely related to hormonal alterations associated with the development of prostate tumors.
Solid‐pseudopapillary carcinoma of the pancreas
Authors: Shimizu Michio , Matsumoto Takayuki , Hirokawa Mitsuyoshi , Monobe Yasumasa , Iwamoto Sueharu , Tsunoda Tsukasa , Manabe Toshiaki
Published: March 2003

A case of solid‐pseudopapillary carcinoma (SPC) of the pancreas in a 34‐year‐old Japanese woman is presented. An abdominal ultrasonography revealed a mass, which measured 10 cm in diameter, in the body and tail of the pancreas. The tumor was resected and it was originally diagnosed as a non‐functioning islet cell tumor. One year and five months later, the patient was re‐admitted to hospital, and liver metastasis was confirmed by ultrasonography. The patient died 6 days after the second transcatheter arterial embolization (TAE) required for the metastasis. The autopsy showed small foci of liver metastasis. A retrospective examination of the tumor suggested the diagnosis of SPC because of its characteristic solid and pseudopapillary structures, immunohistochemical findings, and liver metastasis. This case suggests that capsular invasion, specifically found at the surgical margin of the peritoneal side, may be an important pathological finding that is suggestive of malignant potential in solid‐pseudopapillary tumor. If there is such a finding in a surgical specimen, an intensive follow up should be advised to the clinician.
Right intraventricular metastasis of squamous cell carcinoma of the uterine cervix: An autopsy case and literature review
Authors: Senzaki Hideto , Uemura Yoshiko , Yamamoto Daigo , Kiyozuka Yasuhiko , Ueda Satoshi , Izumi Haruaki , Tsubura Airo
Published: March 2003

An autopsy case of squamous cell carcinoma of the uterine cervix, which developed cardiac intracavitary metastasis in a 28‐year‐old Filipina, is reported. At autopsy, the right ventricle contained a soft, red–purple, cauliflower‐like mass. Histologically, this mass was made up of sheets of malignant squamous cells similar to the primary uterine foci. The metastases were extensive and associated with multiple organ involvement. Although this case was stage Ib at operation, vascular invasion at the primary site was characteristic, and the intracavitary tumor of the right ventricle developed without myocardial involvement. The carcinoma of the primary site extended along the inferior vena cava and settled as an intracardiac obstructive mass. A literature review (including the present case) disclosed only 14 uterine cervical carcinomas with right intracavitary metastasis. The mean age of these patients was 46 years of age (range, 28–77 years). The clinical stage was Ib in two cases, IIa in one case, IIb in six cases, and IIIb in two cases. The prognosis of these cases was poor; 13 of the patients died at an average of 19.1 months after diagnosis.
Primary amebic meningoencephalitis due to Naegleria fowleri: An autopsy case in Japan
Authors: Sugita Yasuo , Fujii Teruhiko , Hayashi Itsurou , Aoki Takachika , Yokoyama Toshirou , Morimatsu Minoru , Fukuma Toshihide , Takamiya Yoshiaki
Published: March 2003

Free‐living amebas represented by Naegleria fowleri, Acanthamoeba and Balamutia have been known to cause fatal meningoencephalitis since Fowler and Carter (1965) reported the first four human cases. An autopsy case of a 25‐year‐old female with primary amebic meningoencephalitis (PAM) due to Naegleria fowleri is described. Headache, lethargy and coma developed in this patient, and her condition progressed to death 8 days after the onset of clinical symptoms. Cerebral spinal fluid examination confirmed clusters of amebas, which were grown in culture and identified as Naegleria fowleri. At autopsy, lesions were seen in the central nervous system (CNS) and the ethmoid sinus. The CNS had severe, suppurative meningoencephalitis with amebic trophozoites mingled with macrophages. This case is the first report of PAM due to Naegleria fowleri in Japan.
Localization of prostate‐specific antigen‐like immunoreactivity in human salivary gland and salivary gland tumors
Authors: Tazawa Kenichi , Kurihara Yuka , Kamoshida Shingo , Tsukada Kazuhiro , Tsutsumi Yutaka
Published: March 2003

Immunoreactivity of prostate‐specific antigen (PSA), a kallikrein‐like enzyme present in the seminal plasma, was demonstrated by indirect immunoperoxidase staining using a PSA antiserum in the apical cytoplasm along the luminal border of small‐sized duct epithelial cells of the major salivary (parotid and submandibular) gland of both sexes (56/56, 100%). No PSA‐like immunoreactivity was seen in large‐sized duct epithelial cells and acinar cells. Minor salivary gland ducts were negative. When inflammatory and atrophic changes were observed, ductal expression of PSA‐like immunoreactivity was decreased (12/37, 32%) and the site of intracellular localization often became diffusely cytoplasmic. The immunoreactivity was absorbed by human seminal plasma. Immunoreactivities of prostatic acid phosphatase and sex hormone receptors were undetectable in the salivary gland. Twenty‐nine (34%) of 86 salivary gland tumors with ductal differentiation were immunoreactive for PSA mainly in the cytoplasm. A PSA monoclonal antibody ER‐PR8 detected immunoreactivity in the prostate but not in the salivary glands or their tumors. Prostate‐specific antigen‐like immunoreactivity in small‐sized (intercalated) duct epithelial cells of the major salivary gland and their tumors may be due to cross‐reactivity of the antiserum with kallikrein‐like substances.
Renal involvement of thrombotic thrombocytopenic purpura: Special reference to the glomeruloid structures
Authors: Katoh Masahiro , Shigematsu Hidekazu
Published: March 2003

We report the case of a 9‐year‐old girl with biopsy‐proven renal thrombotic microangiopathy in thrombotic thrombocytopenic purpura (TTP), with particular reference to the glomeruloid structures. The renal biopsy sample from this TTP patient revealed platelet thrombus deposition, a glomeruloid structure and aneurysm with relative sparing of the glomeruli. The glomeruloid structure displayed a proliferation of mainly capillary‐sized channels lined by Factor VIII‐related, antigen‐positive plump endothelial cells embedded in the edematous connective tissue. These glomeruloid vessels communicated with the aneurysmal segment at the end portion of the arteriolar branch. We believe that the glomeruloid structures in TTP represent not merely organization or recanalization of thrombus but rather active angiogenesis through aneurysmal dilation in the arteriolized vessel, probably initiated by platelet agglutination.
The role of Kupffer cells and regulation of neutrophil migration into the liver by macrophage inflammatory protein‐2 in primary listeriosis in mice
Authors: Ebe Yusuke , Hasegawa Go , Takatsuka Hisakazu , Umezu Hajime , Mitsuyama Masao , Arakawa Masaaki , Mukaida Naofumi , Naito Makoto
Published: March 2003

Depletion of mouse Kupffer cells and splenic macrophages following intravenous administration of liposome‐entrapped clodronate severely reduced host resistance to primary infection with Listeria monocytogenes. Infection of clodronate‐treated mice with a sublethal dose of L. monocytogenes resulted in death of the mice within 3 days. The macrophage depletion resulted in marked increases in bacterial growth in the liver and spleen, but not in other tissues. The proliferation of L. monocytogenes was observed in a large number of hepatocytes that underwent apoptosis. Infiltration of neutrophils in the liver and rapid formation of microabscesses were observed in the control mice after L. monocytogenes infection. However, there was less accumulation of neutrophils in the liver of Kupffer cell‐depleted mice than in the control mice. Expression of macrophage inflammatory protein‐2 (MIP‐2) was enhanced in the livers of both the control and Kupffer cell‐depleted mice after L. monocytogenes infection. MIP‐2 was also induced in a murine hepatocyte cell line following L. monocytogenes infection. The administration of neutralizing anti‐interleukin‐8 receptor homolog antibody severely abrogated neutrophil infiltration into the Listeria‐infected mouse liver. Anti‐MIP‐2 antibody moderately reduced neutrophil infiltration and microabscess formation in the liver. These findings indicate that Kupffer cells protect hepatocytes from L. monocytogenes infection and the resultant apoptosis. Moreover, MIP‐2 and its related molecules produced by the infected hepatocytes regulate neutrophil infiltration and microabscess formation in primary listeriosis.
Analysis of the immunoglobulin heavy chain gene variable region of 101 cases with peripheral B cell neoplasms and B cell chronic lymphocytic leukemia in the Japanese population
Authors: Nakamura Naoya , Kuze Tetsuo , Hashimoto Yuko , Tasaki Kazuhiro , Hojo Hiroshi , Sasaki Yoshikazu , Sato Michiko , Abe Masafumi
Published: March 2003

We have analyzed the immunoglobulin heavy chain (VH) gene variable regions (CDR2 and FW3) of 101 Japanese cases with peripheral B cell neoplasms. When all except one case with a deletion were graphed by frequency of replacement mutation, the 100 cases could be separated into two groups: 24 cases with zero, one and two mutations (germline or low frequency of somatic mutation); and 76 cases with three or more mutations (medium to high frequency of somatic mutation). While most mantle cell lymphoma cases (11/13) showed germline or low frequency of somatic mutation, all cases of mucosa‐associated lymphoid tissue (MALT) lymphoma (11/11), follicular lymphoma (three of three cases), plasma cell myeloma (seven of seven cases) and most cases of diffuse large B cell lymphoma (DLBCL; 42/47) belonged to the latter group. These 76 cases, therefore, may be considered to show somatic hypermutation. More than half of chronic lymphocytic leukemia/small lymphocytic lymphoma cases (CLL/SLL; eight of 13) showed a hypermutated VH gene and the ratio of replacement mutation : silent mutation in CDR2 of CLL/SLL was considerably higher compared with DLBCL and MALT lymphoma, showing somatic hypermutation. When comparing VH gene type of B cell‐CLL (B‐CLL) among our series and those in the literature, more cases of CD5+ B‐CLL in the Western literature have the VH5 and VH6 family types, while more cases in Japan are reported to have VH4 family. The occurrence of VH families in B‐CLL between Japanese and Western people seems to be comparable.
Melanotic peritoneal sarcomatosis originating from clear cell sarcoma
Authors: Ohba Yusuke , Suzuki Hiroaki , Hiraga Hiroaki , Ito Tomoo , Sawa Hirofumi , Nagai Makoto , Satoh Shin‐ichi , Iwaki Hiroyuki , Nagashima Kazuo
Published: March 2003

Peritoneal sarcomatosis was found in a 53‐year‐old male who had a history of resection of clear cell sarcoma (CCS) of the right wrist 7 years previously. Both the previous wrist tumor and the peritoneal disseminants consisted of small, spindle‐shaped cells occasionally containing melanophages. Histologic features, histochemical demonstration of argentaffin granules, immunohistochemical reaction with HMB 45, and the demonstration of a chimeric transcript of EWS‐ATF‐1 established the diagnosis of CCS in the peritoneal tumors. As far as we are aware, this is the first case of a peritoneal sarcomatosis associated with CCS.
Chronic sclerosing sialadenitis of the submandibular gland associated with idiopathic retroperitoneal fibrosis
Authors: Sekine Shigeki , Nagata Michio , Watanabe Teruo
Published: March 2003

We report a case of a 57‐year‐old man who developed a fibrosclerosing lesion in the submandibular gland and idiopathic retroperitoneal fibrosis (IRF) involving the unilateral periureteral region within a year. Both lesions were resected surgically because of the suspicion of neoplasm. Pathologic examination revealed similar histologic and immunohistochemical features for both lesions, namely, fibrosclerosis with prominent hyalinizing collagen bundles and proliferation of myofibroblastic cells, and a non‐neoplastic reactive nature. There was infiltration by lymphocytes with prominent lymph follicles, plasma cells and macrophages. The histologic and immunohistochemical findings suggest that the two lesions were of a similar pathogenesis, which was possibly mediated by macrophages. We think that the present case may be an unusual form of multifocal fibrosclerosis. Although sialolithiasis is thought to be a major pathogenic factor for chronic sclerosing sialadenitis of the submandibular gland, the present case suggests that certain cases might have an etiology similar to IRF.
Solitary fibrous tumor of the spinal nerve rootlet: Case report and literature survey
Authors: Kataoka Hiroaki , Akiyama Yutaka , Kubo Shinichiro , Itoh Hiroshi , Hamasuna Ryouichi , Tajima Naoya , Koono Masashi
Published: March 2003

Solitary fibrous tumor (SFT) is a rare tumor that arises most commonly in the pleura. Recent evidence indicated that it is a tumor that originates from mesenchymal, probably fibroblastic, cells and is not restricted to the pleura. This report presents a case of primary SFT occurring as a dumbbell‐shaped tumor of the cervical spine (C4/5) in a 46‐year‐old Japanese female, probably originating from the spinal rootlet. The tumor was predominantly extradural, loosely attached to the dura mater, with a small intradural extramedullary part attached to the C5 anterior and posterior rootlets. Histologically, the tumor was predominantly composed of a haphazard proliferation of spindle cells separated by abundant collagen. Immunohistochemically, the cells were strongly positive for CD34, bcl‐2 and vimentin, but were negative for S‐100 protein, neuron specific enolase, cytokeratin and epithelial membrane antigen. The present case and review of the literature strongly suggest that SFT is an entity that should be considered in the differential diagnosis of tumors of the cerebrospinal region.
Phaseolus vulgaris leukoagglutinating lectin‐binding reactivity in human diffuse large B‐cell lymphoma and its relevance to the patient’s clinical outcome: Lectin histochemistry and lectin blot analysis
Authors: Suzuki Osamu , Nozawa Yoshihiro , Kawaguchi Takanori , Abe Masafumi
Published: March 2003

Many reports have suggested a strong correlation between certain lectin‐binding patterns and biological behavior in various tumors. To clarify a relationship between lectin‐binding reactivity and survival of patients with diffuse large B‐cell lymphoma (B‐DLCL), 57 cases with B‐DLCL were analyzed by lectin histochemistry and lectin blot method with or without treatment of neuraminidase or acidic hydrolytic conditions. B‐DLCL cases were grouped into three types based on the data on lectin‐binding reactivity under neuraminidase‐treated or untreated conditions: (i) Group A (non‐reactive type); (ii) Group B (sialylated type); and (iii) Group C (non‐sialylated type). Among various lectins, Phaseolus vulgaris‐L (L‐PHA) binding reactivity showed that the survival of patients with Group A + B or Group B was significantly shorter than that of patients with Group C. Lectin blot analysis revealed failure of L‐PHA‐binding to 32 kd and 29 kd glycoproteins, which may be attributable to the masking of L‐PHA‐binding sites by sialylation or the lack of L‐PHA‐binding sites, leading to the short survival of patients with B‐DLCL. L‐PHA‐binding reactivity may be a useful marker for the evaluation of survival of patients with B‐DLCL.
Time‐specific occurrence of alopecia in neonatal C57BL mice treated with N‐methyl‐N‐nitrosourea and the therapeutic efficacy of tacrolimus hydrate
Authors: Yoshizawa Katsuhiko , Nambu Hiroyuki , Yamamoto Daigo , Yang Jihong , Kiyozuka Yasuhiko , Shikata Nobuaki , Tsubura Airo
Published: March 2003

Alopecia was induced in male and female neonatal C57BL mice by a single intraperitoneal injection of 60 mg/kg N‐methyl‐N‐nitrosourea (MNU). MNU administration was most effective in the 8‐day‐old mice and less effective in the 5‐day‐old mice (at active and early anagen stages of the first hair cycle, respectively). No alopecia was seen in the day 14 MNU‐treated animals (at telogen stage of the first hair cycle). MNU effectively induced hair follicular cell apoptosis at the anagen stage by up‐regulation of Bax protein without down‐modulation of Bcl‐2 protein. In day 8 MNU‐treated mice, the immunosuppressive agent 0.01% tacrolimus hydrate (FK506), when topically applied for 5 days from 1 day after MNU treatment (before the occurrence of alopecia), decreased the severity of alopecia. However, it did not stimulate hair growth when applied for 5 days from 20 days of age (after occurrence of alopecia).
Acute inorganic mercury vapor inhalation poisoning
Authors: Asano Sigeyuki , Eto Komyo , Kurisaki Emiko , Gunji Hirofumi , Hiraiwa Koichi , Sato Masao , Sato Hiroshi , Hasuike Miki , Hagiwara Noboru , Wakasa Haruki
Published: March 2003

Mercury contamination is a serious environmental problem worldwide. Two primary sources of contamination are dumping of large quantities of inorganic mercury and exposure in the mining industry. Although the actual fatal level of mercury vapor is not known, exposure to more than 1–2 mg/m3 of elemental mercury vapor (Hg0) for a few hours causes acute chemical bronchiolitis and pneumonitis. Two hours after exposure, lung injury appears as hyaline membrane formation, and finally, extensive pulmonary fibrosis occurs. Clinical findings correlate with the duration of exposure, the concentration of mercury, and the survival time after exposure. There is no correlation between pathological findings and the concentration of mercury in the tissues. Necrosis of proximal convoluted tubules may be attributed to the disruption of the enzyme systems of Hg2+‐sulfhydryl compounds. Metallothionein protein (MT), induced by the accumulation of Hg2+ in the kidneys, may play an important role in detoxication after it forms a non‐toxic Hg2+‐MT compound. Despite the deposition of mercury in the brain, compared with organic mercury, inorganic mercury did not seem to damage the neurons. Drugs such as chelating agents and corticosteroids appear to effectively decrease the inflammation and delay pulmonary fibrosis.
Malignant adenomyoepithelioma of the breast: A non‐tubular and matrix‐producing variant
Authors: Sugano Isamu , Nagao Toshitaka , Tajima Yasuo , Ishida Yasuo , Nagao Koichi , Ooeda Yoshio , Takahashi Toshimi
Published: March 2003

Two women, aged 82 and 58 years old, cases 1 and 2, respectively, with the non‐tubular and matrix‐producing variant of malignant adenomyoepithelioma (MAM) of the breast are described. The tumors were 20 and 35 mm in diameter, respectively, and had cut surfaces with a tan–white‐colored appearance and vague lobulation. Although both tumors showed marked central necrosis and a high level of mitoses, the tumor cells had relatively monomorphous nuclei and exhibited only mild atypia. The invasive component was predominantly trabecular and lobular, and the intraductal component demonstrated a focal‐comedo pattern. The cytoplasm of the tumor cells was rather scanty, vacuolar or pale with ill‐defined borders. The tumor in case 2 contained intermingled spindle‐shaped cells. The stroma of both tumors resembled that of pleomorphic adenoma, containing a myxoid and chondroid matrix and, in case 2, cartilage and mature bone. Immunohistochemical and ultrastructural analyses of both tumors revealed dual cytological differentiation, predominantly of myoepithelial cells with secretory epithelial cells intermingled haphazardly. Although these tumors resembled metaplastic carcinomas, particularly matrix‐producing carcinomas, they showed marked myoepithelial differentiation without overt tubular differentiation, a pattern quite different from matrix‐producing carcinomas and from the adenomyoepitheliomas reported so far. MAM of the breast, non‐tubular and matrix‐producing variant, resembles epithelioid myoepithelial carcinoma of the salivary gland and has not been reported previously in the English literature.
Spontaneous occurrence of chronic non‐suppurative destructive cholangitis and antimitochondrial autoantibodies in MRL/lpr mice: Possible animal model for primary biliary cirrhosis
Authors: Tsuneyama Koichi , Nose Masato , Nisihara Miyuki , Katayanagi Kazuyoshi , Harada Kenichi , Nakanuma Yasuni
Published: March 2003

MRL/MP mice bearing the lymphoproliferative gene lpr (known as MRL/MP‐lpr/lpr or MRL/Ipr mice) are known to spontaneously develop severe autoimmune diseases such as glomerulonephritis, arteritis and arthritis at an early stage of their life. They have also been reported to develop severe sialadenitis, suggesting that this mouse could be a model for Sjögren’s syndrome. Primary biliary cirrhosis, an autoimmune disease characterized by chronic non‐suppurative destructive cholangitis and the occurrence of antimitochondrial antibodies, is frequently associated with Sjögren’s syndrome. In this study, we examined whether cholangitis and/or antimitochondrial antibodies occur in this mouse model, using more than 100 young and old MRL/Ipr mice. We frequently found portal inflammation associated with cholangitis of small intrahepatic bile ducts, especially in older mice. There was also infiltration of inflammatory cells (monocytes) as well as CD4‐positive T cells. Epithelioid granuloma and bile‐duct loss were also occasionally found. These histological features resemble primary biliary cirrhosis. In addition, antimitochondrial antibodies were shown by immunocytochemistry to be present in the sera of MRL/Ipr mice. There is currently no established animal model for primary biliary cirrhosis. Therefore, further studies on MRL/Ipr mice, with respect to pathogenesis of primary biliary cirrhosis, are warranted.
Regulatory effects of senescence marker protein 30 on the proliferation of hepatocytes
Authors: Ishigami Terunobu , Fujita Toshiko , Simbula Gabriella , Columbano Amedeo , Kikuchi Kazunori , Ishigami Akihito , Shimosawa Tatsuo , Arakawa Yasuyuki , Maruyama Naoki
Published: March 2003

Senescence marker protein 30 (SMP 30) is preferentially expressed in the liver. One of its remarkable functions is the protection of cells against various injuries by enhancement of membrane calcium‐pump activity. We analyzed the role of SMP 30 in hepatocyte proliferation. SMP 30 expression was decreased initially, then increased along with hepatic regeneration, after carbon tetrachloride (CCl4) administration. SMP 30 expression was decreased in the necrotic phase and then gradually increased. Its increase was slightly delayed just after the mitotic phase. These results lead us to speculate that mitoses of hepatic cells induce enhanced SMP 30 expression. In contrast, administration of lead nitrate (LN) as a hepatic mitogen induced a more stable increase of SMP 30 expression. To estimate the effect of SMP 30 on cell proliferation, we evaluated hepatic mitosis in wild‐type and SMP 30‐deficient knockout (KO) mice after CCl4 administration. We found an increase in mitotic numbers in hepatocytes of KO mice. This result suggests that SMP 30 has a suppressive effect on cell proliferation. Suppressive activity of SMP 30 cDNA was shown in cultured hepatoblastic cells. Our results suggest that SMP 30 performs a regulatory function in liver regeneration.
Primary low‐grade MALT lymphoma of the gallbladder
Authors: Tsuchiya Tomoshi , Shimokawa Isao , Higami Yoshikazu , Ohtani Hiroshi , Shigeoka Yuji , Ohshima Koichi , Tanaka Kenji , Ayabe Hiroyoshi
Published: March 2003

We report a case of primary low‐grade B‐cell lymphoma of the mucosa‐associated lymphoid tissue (low‐grade MALT lymphoma) in the gallbladder. A 58‐year‐old woman suspected of gallbladder carcinoma underwent laparoscopic cholecystectomy. Microscopic examination of the gallbladder demonstrated lymphoid cell infiltration forming lymphoid follicles with hyperplastic secondary follicles. The surrounding monocytoid B cells and centrocyte‐like cells selectively infiltrated the crypt epithelium forming lympho‐epithelial lesions. Plasma cells were also noted beneath the mucosal epithelium. Bile culture revealed the Gram‐negative bacilli Enterococcus faecalis and Morganella
morganii. Immunoglobulin heavy chain gene rearrangement was confirmed using polymerase chain reaction (PCR) and oligoclonal lymphoid proliferations was detected. Because autoimmune diseases, or chronic inflammatory disorders, seem to correlate with the occurrence of MALT lymphoma, Gram‐negative bacterial infection could also be considered as a prodrome of MALT lymphoma of the gallbladder.
Mechanism of intramedullary high intensity area on T2‐weighted magnetic resonance imaging in osteoid osteoma: A possible role of COX‐2 expression
Authors: Kawaguchi Yoji , Hasegawa Tadashi , Oka Shiro , Sato Chubun , Arima Nobuo , Norimatsu Hiromichi
Published: March 2003

To study the mechanism and pathophysiology of the development of intramedullary high intensity areas on T2‐weighted magnetic resonance images (MRI) in cases of osteoid osteoma, we examined the expression of cyclooxygenase‐2 (COX‐2) in the nidus and surrounding bone tissues. In all six cases showing a marked intramedullary high intensity area adjacent to the nidus before surgery, neoplastic osteoblasts inside the nidus showed strong and diffuse COX‐2 immunoreactivity. On the other hand, the osteoblasts rimming the surrounding reactive bone were COX‐2 negative. In two cases examined by reverse transcription–polymerase chain reaction (RT–PCR), COX‐2 mRNA was detected in abundance in the nidus. Histologically, vascular dilatation together with intramedullary edema was observed in all cases, which was probably reflected as a high intensity area on T2‐weighted MRI. From our study, a high level of COX‐2 expression in neoplastic osteoblasts in the nidus of osteoid osteomas may cause the secondary changes depicted by MRI.
Perivascular myoma: Case report with immunohistochemical and ultrastructural studies
Authors: Mikami Yoshiki , Shiomi Tatsushi , Manabe Toshiaki
Published: March 2003

A subcutaneous myopericytoma‐type perivascular myoma arising in the elbow of a 61‐year‐old woman is described. The tumor was well demarcated and consisted microscopically of small ovoid and spindle cells arranged in a concentric fashion, surrounding small to medium‐sized vessels and imparting a superficial resemblance to hemangiopericytoma. In some areas, the cellular whorls were separated by myxoid stroma. Cells located between cellular whorls appeared immature with scant cytoplasm but did not show distinct nuclear anaplasia, increased mitoses or foci of necrosis. Immunohistochemistry showed that constituent cells were positive for α‐smooth muscle actin and desmin. Electron microscopy disclosed that the immature‐looking cells, as well as the ovoid and spindle‐shaped cells, possessed focal densities along with thin filaments, subplasmalemmal densities, pinocytotic vesicles and an external lamina. These ultrastructural and immunohistochemical features indicate a myoid nature of pericytic cells and justify this type of neoplasm being categorized as perivascular myoid tumor.
Ductal adenoma of the breast with chondromyxoid change
Authors: Kato Noriko , Ohe Sinya , Motoyama Teiichi
Published: March 2003

A case of ductal adenoma of the breast in a 66‐year‐old woman is reported. The lesion was a small, firm nodule present in the periareolar area of the left breast. It showed extensive hyalinization with tubular structures and spotty calcifications. In spite of such a regressive and relatively well‐circumscript appearance, focal eccentric peripheral sclerosis with distorted ductal structures suggested malignancy. However, immunohistochemical examination demonstrated a preserved myoepithelial layer surrounding the ducts. The tumor also showed focal chondromyxoid change and adipocytic differentiation. The myxoid change started exclusively around the ductal structures within the hyalinized acellular stroma and coalesced to form larger chondromyxoid areas. Myoepithelial cells constituting the ductal elements may have been responsible for the aberrant mesenchymal differentiation of this tumor.
Expression of MUC1 and MUC2 mucins in extrahepatic bile duct carcinomas: Its relationship with tumor progression and prognosis
Authors: Tamada Shugo , Goto Masamichi , Nomoto Mitsuharu , Nagata Koji , Shimizu Takeshi , Tanaka Sadao , Sakoda Koro , Imai Kohzo , Yonezawa Suguru
Published: March 2003

Our previous immunohistochemical studies in the pancreas, intrahepatic bile duct, and ampulla of Vater demonstrated that an invasive carcinoma with a poor outcome showed a pattern of MUC1 (membrane‐bound mucin) positive and MUC2 (intestinal‐type secretory mucin) negative, whereas many of the non‐invasive tumors with favorable outcome showed a pattern of MUC1 negative and MUC2 positive. The aim of this study is to compare the expression profiles of MUC1 and MUC2 mucins in extrahepatic bile duct carcinomas to gain insight into the relationship between the biological nature of the carcinomas and the role of mucins. We examined the expression profiles of MUC1 of different glycoforms and MUC2 in 60 extrahepatic bile duct carcinomas using immunohistochemistry. The expression of MUC1/CORE (core peptide of MUC1), MUC1/DF3 (core peptide of MUC1 with sialyl oligosaccharides) and MUC1/MY.1E12 (sialylated MUC1) showed a significant relationship with tumor progression factors such as poor differentiation, deep invasion, lymph node metastasis, lymphatic invasion or perineural invasion. In contrast, the expression of MUC1/HMFG‐1 (fully glycosylated MUC1) did not show a significant relationship with the tumor progression factors. In the different glycoforms of MUC1 examined, the expression of MUC1/DF3 and MUC1/MY.1E12 was related with the poor outcome of the patients. In contrast, the expression of MUC2 was inversely related with the tumor progression factors and poor outcome. In the 52 patients with advanced tumors, only MUC1/DF3 high expression correlated with poor prognosis. In conclusion, MUC1/DF3 was the most useful prognosis indicator among the various glycoforms of MUC1 mucins.
Control of the plant pathogenic fungus Macrophomina phaseolina in mung bean by a microalgal extract
Authors: Mahakhant Aparat , Padungwong Patcharee , Arunpairojana Vullapa , Atthasampunna Poonsook
Published: March 2003

An anti‐fungal antibiotic was characterized from an extract of Calothrix sp. TISTR 8906 with respect to an inhibition effect on plant pathogenic fungi. Optimal medium for anti‐fungal compound production was modified from nitrogen‐free BGA medium by the addition of NaN03 at the concentration of 1.5gL‐1, increasing K2HP04 concentration to 1.5 g L‐1 and decreasing NaCl concentration to 0.03 g L‐1 with an initial pH of 7.0. Algal growth, anti‐fungal activity and anti‐fungal compound production could be increased 2.6‐fold, four‐fold and 10‐fold, respectively. Crude algal extract formulated with surfactant applied to Macrophomina phaseolina at a concentration of 250 μg seed‐1 showed the same efficiency at inhibition as the commercial fungicide, mancozeb, at the recommended dose of 200 μg seed‐1, both in laboratory and pot experiments.
Phototactic responses of four marine dinoflagellates with different types of eyespot and chloroplast
Authors: Horiguchi Takeo , Kawai Hiroshi , Kubota Mamoru , Takahashi Tetsuo , Watanabe Masakatsu
Published: March 2003

Great structural variety is seen in the eyespot of dinoflagellates, a structure involved in phototaxis. Although there are several works on the phototactic responses in some species of dinoflagellates, none of the dinoflagellates used in these studies possessed an eyespot and, therefore, we have no knowledge of the relationship between eyespot type and phototactic response. In this study, we determined wavelength dependency curves for phototaxis in four marine dinoflagellates that possess a different type of either eyespot or chloroplast. These include: (i) a dinoflagellate possessing a peridinin‐containing ohioroplast with an eyespot (Scrippsiella hexapraecingula Horiguchi et Chihara); (ii) a dinoflagellate containing a diatom endosymbiont and with the type B eyespot sensu Dodge (1984; (Peridinium foli‐aceum (Stein) Biecheler); (iii) a dinoflagellate with peri‐dinin‐containing chloroplasts, but lacking an eyespot (Atexandrium hiranoi Kita et Fukuyo); and (iv) a dinoflagellate with fucoxanthin, 19′‐hexanoyloxyfucoxanthin and 19′‐butanoyloxyfucoxanthin, but lacking an eyespot (Gymnodinium mikimotoi Miyabe et Kominami ex Oda), Regardless of the eyespot or the chloroplast type, all four dinoflagellates showed similar wavelength dependency curves for phototaxis, with sensitivity between 380 and 520 nm, the highest peak at approximately 440 or 460 nm and smaller peaks or shoulders at 400–420 nm and 480–500 nm. Substantial peaks have also been noted in the ultraviolet range (260–280 nm). The ultrastructural study of the eye‐spot of Scrippsiella hexapraecingula revealed that the eyespot consists of two layers of lipid globules and probably acts as a quarter‐wave stack antenna.
Salinity tolerances of 62 strains of Pflesteria and Pfiesteria‐like heterotrophic flagellates (Dinophyceae)
Authors: Sullivan Barbara E. , Andersen Robert A.
Published: March 2003

The salinity tolerance of 62 strains of Pfiesteria and Pfiesteria‐like heterotrophic dinoflagellates was measured. All strains were acclimated at 12 psu for at least 1 year before experimentation. Strains isolated from the Chesapeake Bay and Neuse River systems tolerated lower salinities than strains isolated from the Wilmington River system (P< 0.005). Swimming cells were still observed after 5 days at 0.5 psu for one strain, and at 1 psu for most other Chesapeake Bay and Neuse River strains. Swimming cells for the Wilmington River were still observed after 5 days at 3–5 psu, but no swimming cells were observed at ≤ 2 psu. With regard to the upper salinity tolerance, the Wilmington River strains tolerated higher salinities than the Chesapeake Bay and Neuse River systems (P< 0.005). Most Wilmington River strains were swimming after 5 days at salinities ≥ 50 psu, whereas the Chesapeake Bay and Neuse River system strains rarely had swimming cells at salinities exceeding 35–45 psu. For all three water systems and for both lower and higher salinities, cells apparently encysted in many instances. However, when salinities were returned to 12 psu, swimming cells often re‐appeared. Statistically significant geographic differences in salinity tolerance suggest a geographic adaptation has occurred and that salinity tolerance is under genetic control. The results also suggest there is diversity among the strains.
Community acquired parapneumonic thoracic empyema: Predictors of outcome
Authors: Lindstrom Steven , Kolbe John
Published: March 2003

The objective of this study was to determine those factors which are predictive of outcome in cases of thoracic empyema that are solely community acquired. All patients admitted with a diagnosis of thoracic empyema in the Auckland region between 1993 and 1995 were reviewed retrospectively. Both clinical and radiological outcomes were determined at 3–6 month follow up. Radiological outcomes were scored on admission, discharge and follow up by blinded chest radiograph review based on lung field opacification, extent and thickness of pleura. Forty‐six cases fulfilled inclusion criteria. Mean age was 56 ± 21 years, 67% were male and there was no ethnic preponderance. Forty‐six per cent of cases had specific underlying risk factors. Multi‐loculated cases of empyema occurred in 63%, pleural aspirate was culture positive in 59% and Streptococcus milleri represented 42% of all positive cultures. Delay in appropriate management was 5.2 ± 4.2 days. Fifty‐six per cent of total procedures incorporated intrapleural streptokinase as an adjunct to drainage. The cure rate was 93.3% without requirement for surgical intervention. Two patients died early giving a 4.3% mortality rate. Radiological scores were 8.6 ± 0.6 on admission, 6.3 ± 1.5 on discharge and 2.5 ± 2.5 at follow up. Improvement in radiological scores was statistically significant from admission to discharge and follow up (P<0.001). The total duration of hospitalization was 22 ± 10 days and by univariate analysis was predicted by: pleural sepsis not involving S. milleri (P = 0.001), specific predisposing factors (P = 0.02), and frank pus on pleural aspiration (P = 0.03). Total delay in management was suggestive in prolonging the duration of hospitalization (P = 0.07). Parapneumonic thoracic empyema is an important source of morbidity which is determined by both patient and management factors. Good results can be obtained by prompt medical therapy including tube drainage and intrapleural streptokinase without need for surgical intervention.
Giant cell interstitial pneumonia in two hard metal workers: The role of bronchoalveolar lavage in diagnosis
Authors: Kinoshita Masaharu , Sueyasu Yoshiko , Watanabe Hisashi , Tanoue Sachiko , Okubo Yo , Koga Takeharu , Kawahara Masao , Nagata Eisuke , Oizumi Kotaro
Published: March 2003

Two cases of hard metal lung disease and pathological findings of giant cell interstitial pneumonia are reported. The cases worked in different factories manufacturing hard metal parts from tungsten carbide and cobalt. Pathological specimens were obtained by percutaneous thoracoscopy and transbronchial lung biopsy. X‐ray microanalysis detected only tungsten carbide in the lung specimen of one case. Bronchoalveolar lavage showed diagnostic bizarre macrophages in the lavage fluid.
Prehospital management of exacerbations of asthma: Relation to patient and disease characteristics
Authors: Marks Guy B. , Heslop Wendy , Yates Deborah H.
Published: March 2003

Objective:

Admission to hospital due to an exacerbation of asthma may represent a failure of prehospital management to prevent an attack or bring about its remission. We aim to describe the steps taken prior to hospital attendance in patients with asthma and to identify patient or disease characteristics that were associated with failure to take appropriate actions.

Methodology: Patients aged over 15 years who were discharged from hospital or the Emergency Department with a primary diagnosis of asthma completed a questionnaire about the impact of asthma and its management prior to the onset of the recent exacerbation. The impact of asthma on quality of life was measured using our Asthma Quality of Life Questionnaire (AQLQ).

Results: Seventy‐eight subjects completed the questionnaire including 49 who had been in‐patients and 29 who had been discharged from the Emergency Department. They included many subjects with severe asthma: 41% had nocturnal symptoms three or more times per week and 41% had been admitted to hospital with asthma in the 12 months prior to this episode. Their AQLQ scores were high (severe) (mean 4.5 ± 2.2). Most subjects described their presenting exacerbation as slow in onset and moderate or severe in intensity. During this exacerbation and prior to hospital attendance, only 27% of subjects had measured their peak expiratory flow rate, 19% had commenced or increased the dose of inhaled steroids, and 22% had commenced oral steroids. These actions were not related to the self‐perceived speed of onset of the attack. Patients with lower levels of asthma‐related concerns for health and more severe mood disturbance associated with asthma were less likely to take these appropriate self‐management steps.

Conclusions: This study shows that the failure of prehospital management to prevent the necessity of hospital attendance in most cases stems from a failure to implement currently recommended actions or treatments for exacerbations. Addressing this problem should result in a reduction in rates of hospitalization for asthma.
Cytokines enhance airway smooth muscle contractility in response to acetylcholine and neurokinin A
Authors: Reynolds Ann M. , Holmes Mark D. , Scicchitano Raffaele D.
Published: March 2003

Objective:

In vivo airway hyperresponsiveness has been demonstrated following inhalation of specific cytokines in normal individuals. Whether this airway hyperresponsiveness results from a direct effect of cytokines on airway smooth muscle contractility, or via changes in airway wall structure is not known. The aim of the present study was to determine the effect of the pro‐inflammatory cytokines interleukin‐1β (IL‐1β) and tumour necrosis factor‐α (TNF‐α) on airway smooth muscle contractility in vitro.

Methodology: Ovine tracheal smooth muscle strips were incubated for 18 h at room temperature in Dulbecco’s modified Eagle’s medium, supplemented with antibiotics, with IL‐1β (10 ng/mL) and TNF‐α (100 ng/mL), in an atmosphere of 5%CO2 : 95%O2. Following incubation cumulative concentration–response curves to acetylcholine (ACh) and neurokinin A (NKA) were obtained. Antagonist affinity studies were performed to determine whether the cytokine‐induced enhanced contractility to ACh and NKA resulted from a functional alteration to specific M3 and NK2 receptors. Cumulative concentration–response curves to NKA were performed in the presence of phosphoramidon to determine if the enhanced contractility to NKA following cytokine exposure was due to a reduction in endogenous neutral endopeptidase activity. To assess the calcium dependence of the hyperresponsiveness, cumulative concentration–responses to ACh were conducted in calcium‐free Krebs’–Henseleit solution.

Results: Pre‐incubation with TNF‐α and IL‐1β caused a significant leftward shift, and an increase in the magnitude, of the concentration–response curves to both ACh and NKA. No difference in M3 and NK2 receptor antagonist affinity (pA2) values between the control and cytokine‐treated tissue was observed. Neurokinin A contractility in the presence of phosphoramidon indicated that the enhanced contractility following cytokine exposure was not due to a reduction in endogenous neutral endopeptidase activity. Removal of extracellular calcium ions attenuated the contractile response to low concentrations of ACh in the control and cytokine‐pretreated tissue. However, enhanced contractility following TNF‐α and IL‐1β pretreatment was still present.

Conclusion: Pro‐inflammatory cytokines induce in vitro hyperresponsiveness in normal airway smooth muscle via a mechanism involving intracellular calcium mobilization.
Chylothorax occurring 23 years post‐irradiation: Literature review and management strategies
Authors: McWilliams Annette , Gabbay Eli
Published: March 2003

Chylothorax is an uncommon condition rarely seen outside the clinical scenario of trauma or malignancy, and management may be difficult. We report the case of a 52‐year‐old man with a right chylothorax occurring 23 years after mantle irradiation for Hodgkin's disease. In addition, a Medline literature search was performed. Chylothorax occurring post‐irradiation is rare and the aetiology is uncertain. Recurrent malignancy must be excluded. There are a number of management options and our patient was successfully treated with a combination of thoracocentesis, medium chain triglyceride diet and thoracoscopy with talc pleurodesis. There was no evidence of recurrent chylothorax at 2 years follow up. Prompt assessment and treatment is required. Surgical measures need to be considered early if medical treatment is unsuccessful.
Molecular mechanisms underlying human β‐defensin‐2 gene expression in a human airway cell line (LC2/ad)
Authors: TOMITA Tetsuji , NAGASE Takahide , OHGA Eijiro , YAMAGUCHI Yasuhiro , YOSHIZUMI Masao , OUCHI Yasuyoshi
Published: March 2003

Objective: Recently, human β‐defensin‐2 (hBD‐2), an inducible defensin, has been reported to be involved in innate immunity and host defence. To examine the exact roles of hBD‐2 in the respiratory system, we examined the molecular mechanisms of hBD‐2 gene expression in vitro.

Methodology: Using a human airway cell line (LC‐2/ad), lipopolysaccharide (LPS)‐induced gene expression of hBD‐2 was studied in the absence or the presence of (i) dexamethasone, (ii) inhibition of NF‐κB and AP‐1, (iii) intracellular calcium chelator, and (iv) cyclooxygenase (COX) inhibitors.

Results: Lipopolysaccharide‐induced gene expression of hBD‐2 was down‐regulated by (i) dexamethasone, (ii) inhibition of NF‐κB and AP‐1, and (iii) intracellular calcium chelator. However, COX inhibitors had no effect on LPS‐induced mRNA expression of hBD‐2.

Conclusion: These findings suggest that glucocorticoids (GC), but not COX inhibitors, reduce hBD‐2 gene expression, while NF‐κB, AP‐1 and intracellular calcium are essential for hBD‐2 expression. Glucocorticoid‐induced down‐regulation of hBD‐2 might be involved in the GC‐induced suppression of respiratory host defence associated with hBD‐2.