bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of low‐dose ketamine on neuropathic pain: An electroencephalogram–electrooculogram/behavioral study
Authors: OGA KENTARO , KOJIMA TAKUYA , MATSUURA MASATO , NAGASHIMA MASANORI , KATO JITSU , SAEKI SHIGERU , OGAWA SETSURO
Published: March 2003

Abstract The aim of the present study was to clarify the neurophysiological changes associated with analgesic and behavioral effects of low‐dose ketamine HCl in patients suffering from chronic neuropathic pain. Ten in‐patients with neuropathic pain participated in this single‐blind, placebo‐controlled study after giving written informed consent. Following intravenous injections of a saline solution (placebo), three bolus injections of 5 mg ketamine HCl were administered at 5 min intervals. Changes in pain perception were assessed using a numerical rating scale for pain. Behavioral changes, including psychotomimetic effects, were assessed using the Brief Psychiatric Rating Scale (BPRS). Electroencephalograms (EEG) and electrooculograms (EOG) were recorded continuously throughout the testing period. One minute EEG and closed‐eye eye movements were quantified. The effects of ketamine were evaluated by comparing the neurophysiological and behavioral parameters obtained from the placebo and ketamine trials. Pain reduction was significantly correlated with ketamine‐induced changes in hallucinatory behavior and excitement as measured by the BPRS. Ketamine injections caused a significant decrease in the EEGα amplitude without an accompanying reduction in EEG frequency. The EEGα amplitude reduction at the right central electrode was significantly related to subjective pain relief. Subanesthetic doses of ketamine significantly decreased rapid eye movements, but did not initiate slow eye movements. In conclusion, the present EEG‐EOG/behavioral results indicate that ketamine‐induced failure of neural integration between cortical–subcortical regions induces psychotic symptoms and alters pain perception on neuropathic pain.
Quality of life and its correlates in a community population in a Japanese rural area
Authors: KITAMURA TOSHINORI , KAWAKAMI NORITO , SAKAMOTO SHINJI , TANIGAWA TAKESHI , ONO YUTAKA , FUJIHARA SHIGEKI
Published: March 2003

Abstract Correlations of three aspects of quality of life (QOL) (health perception, life satisfaction, and self‐confidence) with personality traits and early experiences were examined. Quality of life aspects were examined using 220 inhabitants in a rural community in Japan. Health perception was better among men than among women. Life satisfaction and self‐confidence were better in people aged 55 or over than in those under 55. Among the current predictor variables, the Eysenck Personality Questionnaire neuroticism score was correlated with poor life satisfaction in the younger women; the extraversion score with the older women's health perception, the older men's life satisfaction, and the women's self‐confidence; and the psychoticism score with the older men's life satisfaction. Among early life predictors, self‐confidence was lower among those older men who had reported early parental loss. Childhood paternal overprotection was correlated with poor health perception in younger people and with good health perception in older women. Some negative life events experienced during childhood were correlated with poorer QOL measures in some subgroups, while positive life experiences were correlated with the older women's life satisfaction. These findings suggest that the three aspects of the QOL are discrete in their psychosocial correlates and that interventions on health education and care should take into account individual's psychosocial attributes.
Characteristics of women using a mental health clinic in a gynecologic out‐patient setting
Authors: HSIAO MEI‐CHUN , LIU CHIA‐YIH , CHEN KUANG‐CHAO , HSIEH T’SANG‐T’ANG
Published: March 2003

Abstract A special mental health clinic was set up in the gynecologic out‐patient setting of a medical center. The present study examined the demographic and clinical characteristics of patients seen at the clinic and evaluated the need for mental health services in a gynecologic setting. Participants were 136 consecutive patients who visited the clinic during a 6 month period. Their ages ranged from 20 to 74 years, with a mean age of 41.5 ± 12.3 years. Twenty‐three percent of women were referred by gynecologists. All subjects were interviewed by experienced psychiatrists using the structured Mini‐International Neuropsychiatric Interview (MINI), supplemented by the DSM‐IV criteria for premenstrual dysphoric disorder (PMDD) and other diagnoses. The most common diagnosis was major depressive disorder (36.0%), followed by generalized anxiety disorder (29.4%), PMDD (16.2%), dysthymic disorder (14.7%) and others. Patients were categorized into four major diagnostic categories: depressive disorders, anxiety disorders, PMDD and others. No significant differences were found in years of education, employment status, living situations or referral pattern among the four major diagnostic groups. Most patients with anxiety disorders were married. Our results suggest that the gynecologic department may be a good setting to help women with mental disorders.
Japanese version of the Quality of Relationship Inventory: Its reliability and validity among women with recurrent spontaneous abortion
Authors: NAKANO YUMI , SUGIURA MAYUMI , AOKI KOJI , HORI SHIRO , OSHIMA MARIKO , KITAMURA TOSHINORI , FURUKAWA TOSHIAKI A
Published: March 2003

Until now most of the research on social support has concentrated on general support in relationship to the whole group of people around each individual. In contrast, only a few studies have dealt with individual‐specific support (i.e. social support from a particular individual relationship). The Quality of Relationship Inventory (QRI) is a recently developed questionnaire to measure individual‐specific social support. We developed the Japanese version by means of back translation and ascertained its reliability and validity among the Japanese women who had had two recurrent spontaneous abortions without known organic etiologies. Factor analysis revealed that the Japanese QRI had a two‐factor structure, representing supportive and conflictual aspects of a particular relationship (named Factor‐S and Factor‐C, respectively). Each factor showed satisfactory reliability with Cronbach's alphas of 0.95 and 0.89. When the QRI scores were compared with the scales from the Social Support Questionnaire, a measure of general social support, the Factor‐C of the former with respect to the mother correlated negatively with the Social Support Satisfaction of the latter (r = – 0.40; 95% confidence interval (CI) – 0.64 to – 0.09). Childhood experiences with parents also showed expected correlations with the QRI: care received from the parent before age 16 years strongly predicted Factor‐S with that parent (r = 0.50, 95% CI 0.21–0.71 in the case of the mother; r = 0.54, 95% CI 0.27–0.73 in the case of the father). Although we still need to examine the Japanese QRI with different populations, it appears to be a promising measure of individual‐specific relationship for the Japanese population.
Factors of good outcome after discharge from support house (engoryou) for schizophrenia
Authors: SAKIYAMA SHINOBU , IIDA JUNZO , MINAMI YOSHITAKE , KISHIMOTO TOSHIHUMI
Published: March 2003

To restore mentally disabled persons to social activities, it is necessary to establish an appropriate facility and support system according to the severity of disorder. In the present study, in an attempt to obtain a guide to identifying conditions on which the use of the support house (engoryou) is effective, patients who had been discharged from the support house were divided into different groups by evaluation at discharge. The first group consisted of 30 patients who underwent continued social rehabilitation (recovery group); the second group consisted of 25 patients with discontinued social rehabilitation (the re‐hospitalization group), and their demographic factors were compared. The findings are summarized as follows: (i) the recovery group had a significantly shorter total hospitalization period and a smaller number of hospitalizations before entry into the facility, as compared to the re‐hospitalization group; (ii) the recovery group was significantly better than the re‐hospitalization group in terms of the score of ‘thought disorder’, although there was no difference in total Brief Psychiatric Rating Scale (BPRS) score, at the time of entry into the facility; (iii) the recovery group was better than the re‐hospitalization group in terms of the Rehabilitation Evaluation Hall and Baker (REHAB) items ‘speech skills’ and ‘self‐care’ at the time of entry into the facility; (iv) the re‐hospitalization group experienced relapse of symptoms, mainly positive ones, at the time of the discontinuation of the use of the facility or re‐admission. These findings suggest that to make good use of the support house, the improvement of thought disturbance and self‐care must be managed appropriately and the prolongation of hospital stay must be prevented before entry into the facility.
Sjögren’s syndrome in mice carrying the lprcg gene and the therapeutic efficacy of an immunosuppressive agent FK506
Authors: Yang Jihong , Shikata Nobuaki , Yasuda Takuwa , Matsuzawa Akio , Tsubura Airo
Published: March 2003

The influence of the lprcg gene on the development of Sjögren’s syndrome was followed up to 5 months of age in male and female mice of MRL, CBA and C3H strains. In MRL‐lprcg mice, focal mononuclear cell infiltration started at 2 months and became conspicuous after 3 months of age in the lacrimal and submandibular glands but was minimal in the parotid and sublingual glands, even at 5 months of age, without any apparent sex effects found. In CBA and C3H mice carrying the lprcg gene, this manifestation of Sjögren’s syndrome was much less prominent, indicating that the participation of some genes of the MRL strain may be indispensable for the development of Sjögren’s syndrome in mice carrying this gene. In MRL‐lprcg mice, an immunosuppressive agent, FK506, improved the serological abnormalities (decreased levels of anti‐double‐stranded DNA antibody of IgG2a and IgG3 subclasses) and proteinuria. It also reduced the manifestations of Sjögren’s syndrome when it was intraperitoneally administered three times weekly at a dose of 2 mg/kg from 6 weeks (before disease onset) until 5 months of age (the termination of the experiment). Although Vβ8.2+ T cells have been demonstrated to be responsible for causing several autoimmune diseases, the selective deletion of Vβ8.2+ T cells with the superantigen encoded by mouse mammary tumor virus did not affect the disease severity at all, suggesting that this T cell repertoire may not play a crucial role in induction of Sjögren’s syndrome.
A retroperitoneal bronchogenic cyst with malignant change
Authors: Sullivan Seth M. , Okada Shinya , Kudo Motoshige , Ebihara Yoshiro
Published: March 2003

A unique case of adenocarcinoma arising in a retroperitoneal bronchogenic cyst is presented. A 55‐year‐old woman presented with lower abdominal discomfort. Computed tomography revealed a retroperitoneal cystic mass attached to the ascending colon. The resected cyst was unilocular and filled with milky white mucus and hemorrhagic debris. Histologically, most of the cyst wall was of well‐differentiated papillary adenocarcinoma with no cyst wall invasion. Other small areas of the cyst were lined with variably atypical dysplastic/metaplastic cuboidal to pseudostratified columnar epithelium. The cyst wall was mostly hyalinized, but there was apparent thickened subepithelial basement membrane, elastosis, and a single layer of smooth muscle that suggested bronchial wall structures. A mucin staining study with O‐acylated sialic acid, which is used for the demonstration of gastrointestinal, cholecystic and uterine cervical mucins, was negative for the mucin‐producing epithelial cells of the cyst. Thus, to our knowledge, this is the first reported case of adenocarcinoma arising in a retroperitoneal bronchogenic cyst.
Immunohistochemical analysis of pericryptal fibroblast sheath and proliferating epithelial cells in human colorectal adenomas and carcinomas with adenoma components
Authors: Li Aihua , Hasui Kazuhisa , Yonezawa Suguru , Tanaka Sadao , Sato Eiichi
Published: March 2003

In order to examine stromal–epithelial interaction during the oncogenic progression of large bowel tumors, the association between pericryptal fibroblast sheath (PCFS) and expression of Ki‐67 antigen was evaluated in 87 cases of colorectal adenoma and 95 cases of carcinoma with an adenoma component (CWA). For the immunohistochemistry, anti‐α‐smooth muscle actin antibody (α‐SMA) and anti‐Ki‐67 antigen antibody (MIB‐1) were used. In adenomas and adenoma components of CWA, the quantity of neoplastic glands with PCFS was reduced relative to the progression of histological atypia. Pericryptal fibroblast sheath was virtually absent from invasive carcinoma areas of CWA. Increased expression of Ki‐67 correlated with the degree of histological atypia of adenomas. A significant reverse correlation was also seen between Ki‐67 expression and PCFS‐positive glands in adenoma components of CWA. These findings suggest that the prevalence of PCFS and Ki‐67 expression are important indicators of colorectal neoplasia progression. The significant reduction of PCFS in colorectal epithelial neoplasms reflects progression in the adenoma–carcinoma sequence.
Diffuse large B cell lymphoma expressing the natural killer cell marker CD56
Authors: Sekita Toru , Tamaru Jun‐ichi , Isobe Kouichi , Harigaya Kenichi , Masuoka Syu‐ichi , Katayama Toshio , Kobayashi Masayuki , Mikata Atsuo
Published: March 2003

The expression of the natural killer (NK) cell antigen, CD56, in hematological malignancies is rare. However, there are several reports that some hematological malignancies, such as T/NK cell lymphoma, multiple myeloma (MM) and acute myeloid leukemia (AML), express this molecule. In B cell non‐Hodgkin’s lymphomas (NHL), however, very limited number of cases have been reported to express CD56 molecule. Although one study has recently described that half of microvillous B cell lymphoma (MVL), an uncommon subset of large cell lymphoma, expressed CD56, there have been no reports about most common type of B‐NHL, diffuse large B cell lymphoma (DLBL) other than a mention of weak CD56 expression in one of 83 DLBL. We herein presented the first case of diffuse large B cell lymphoma expressing CD56 clearly. The immunophenotype determined by immunostaining and flow cytometric analysis was CD10+, CD19+, CD20+, CD45RO−, CD3− and CD56+. On immunohistochemical study, neither bcl‐2 nor TIA‐1 was positive for tumor cell. Monoclonal immunoglobulin heavy chain (IgH) gene rearrangement was detected, and the sequence analysis of the variable region of IgH (VH) suggested that this tumor was derived from antigen selected post germinal center B cell. Conventional combination chemotherapy (CHOP) was administered, and the patient has still been in complete remission for 10 months.
An immunohistochemical and clinicopathological study of gastrointestinal stromal tumors
Authors: Tazawa Kenichi , Tsukada Kazuhiro , Makuuchi Hiroyasu , Tsutsumi Yutaka
Published: March 2003

Immunohistochemical and clinicopathological features of 58 gastrointestinal stromal tumors (GIST) were studied. One occurred in the esophagus, 41 in the stomach, nine in the small intestine, and seven in the large intestine. By using indirect immunoperoxidase staining for Cajal cell markers (c‐kit protein and CD34), smooth muscle markers (α‐smooth muscle actin, desmin, heavy caldesmon and calponin) and Schwann cell markers (S‐100 protein and Leu 7), GIST were classified into five groups, such as Cajal cell type (n = 9), myogenic type (n = 5), Schwann cell type (n = 2), mixed cell type (n = 40) and undifferentiated type (n = 2). c‐kit Protein (42/58; 72%) and CD34 (45/58; 78%) were commonly and diffusely expressed in GIST. Novel smooth muscle markers, caldesmon (29/58; 50%) and calponin (18/58; 31%), were useful in detecting myogenic characters of GIST. S‐100 protein was expressed in 16 (28%) tumors, two of which were also reactive with Leu 7 (CD57). Three small bowel tumors with skeinoid fibers expressed the Cajal cell markers, and were categorizable in GIST. Clinicopathological analyses using aggressive (n = 21) and non‐aggressive (n = 21) GIST indicated that the malignant potential was correlated with the intestinal location, large tumor size, high cellularity, necrosis, solid (non‐interlacing bundled) pattern of growth, negativity of c‐kit protein and/or CD34, high mitotic count, and high MIB‐1 labeling.
Infectious etiology of xanthogranulomatous cholecystitis: Immunohistochemical identification of bacterial antigens in the xanthogranulomatous lesions
Authors: Mori Mitsuo , Watanabe Mamori , Sakuma Masaki , Tsutsumi Yutaka
Published: March 2003

The clinicopathologic features of 31 surgical patients with xanthogranulomatous cholecystitis were analysed in relation to the immunohistochemical demonstration of bacterial antigens using a polyclonal anti‐E. coli antibody. The time period after the initial clinical manifestation was critical for identifying the bacterial antigens in the cytoplasm of foamy macrophages. Of 12 lesions removed within 4 weeks of the onset (subacute group), 7 lesions showed positive staining. No positivity was seen in 19 gall‐bladder specimens with a clinical course of more than 4 weeks (chronic group). Abscess formation was seen in 7 cases in the subacute group, 5 of which were positive for the bacterial antigens. Gram‐negative bacteria were cultured from the bile in four in the subacute group and three in the chronic group. All the four culture‐positive subacute lesions were immunoreactive for the bacterial antigens. Accumulation of ceroid pigment in the cytoplasm of foamy macrophages was characteristically seen in 16 of 20 chronic lesions. Three subacute lesions with ceroid pigmentation was negative for the bacterial antigens. In conclusion, xanthogranulomatous cholecystitis can be divided into two forms: subacute and chronic, and the subacute form is closely related to bacterial infection.
Hepatocellular carcinoma with spontaneous regression of multiple lung metastases
Authors: Toyoda Hiroshi , Sugimura Satoru , Fukuda Kousei , Mabuchi Tateo
Published: March 2003

Spontaneously regressed lung metastasis of hepatocellular carcinoma (HCC) in a 82‐year‐old Japanese man with liver cirrhosis was recorded. Multiple nodular lesions of both lungs, up to 1 cm across, were shown on chest X‐ray when the clinical diagnosis of HCC was made because of the presence of a liver mass on abdominal computed tomography (CT) scan and high serum α‐fetoprotein (AFP) value. The lung lesions which were regarded clinically as metastasis of HCC decreased in number and size 7 months later, and subsequenly disappeared a further 7 months radiographically. However, the liver mass revealed no reduction on abdominal CT, despite normalization of the serum AFP value, and the patient died 7 months after the disappearance of the lung lesions. The patient refused biopsy for the liver mass and anticancerous treatment during the course of the disease. At autopsy, the liver mass, 13 cm in diameter, histologically featured moderately differentiated HCC. Only one metastasis, 0.5 cm across, was obvious in the left lower lung lobe. In addition, there were 14 minute lesions in both lungs, up to 0.2 cm across, including three with complete necrosis and 11 with histocytic reaction and fibrosis. The necrotic tissue was filled with large ghostly cells that appeared to be debris from a neoplastic tissue, regardless of no viable tumor cells among them. The clinical and autopsy findings highly suggested that the patient developed spontaneous regression of multiple lung metastases of HCC and subsequently left the very small lesions as the vestige. Thus, the histology of these lesions may exhibit a process of the regression as the sequence of events, i.e., a transition from necrosis of the metastatic HCC to its fibrosis. Presence of an effective factor(s) in relation to the regression was unclarified. There has been no reported cases with regression of the only metastasis of HCC in the literature to date.
Pulmonary carcinosarcoma: Immunohistochemical and ultrastructural studies
Authors: Haraguchi Shuji , Fukuda Yuh , Sugisaki Yuichi , Yamanaka Nobuaki
Published: March 2003

A case of pulmonary carcinosarcoma in a 68‐year‐old male patient is reported. The tumor in the resected left upper lobe extended mainly endobronchially, invading the normal bronchial lumina and mucosa. The carcinomatous component consisted of poorly differentiated squamous cell carcinoma and was mainly located in the periphery of the tumor nests. The sarcomatous component consisted of chondrosarcoma and was mainly located in the center of the tumor nests. Tumor cells in the sarcomatous component reacted with anti‐S‐100 protein antibody and were surrounded with abundant homogeneous extracellular matrix staining positively with Alcian blue. The transition from the carcinomatous component to the sarcomatous component appeared to be very smooth. The tumor cells in both the carcinomatous and sarcomatous components reacted with anti‐epithelial membrane antigen antibody. Ultrastructurally, the tumor cells with tonofibrils in the carcinomatous component were apposed and connected to each other by desmosomes. By contrast, in the sarcomatous component, the tumor cells had well‐developed and dilated rough endoplasmic reticulum and were arranged loosely in a myxomatous matrix. Some tumor cells in the sarcomatous component had occasional tonofibrils, and were apposed and connected to each other by desmosome‐like structures. It is shown for the first time, ultrastructurally and immunohistochemically, that the tumor cells in the sarcomatous component of pulmonary carcinosarcomas have features of both epithelial and mesenchymal cells. It is suggested that the sarcomatous component in the present case is derived from the carcinomatous component.
Sebaceous carcinoma of the breast
Authors: Varga Zsuzsanna , Kolb Stefan A. , Flury Renata , Burkhard Roger , Caduff Rosmarie
Published: March 2003

We report on a rare distinctive variant of infiltrating ductal carcinoma characterized by sebaceous differentiation of tumor cells. The neoplasm was identified in a lumpectomy specimen from a 45‐year‐old woman with extensive metastatic disease. In addition to conventional in situ and invasive ductal components, approximately half of the tumor cells exhibited a phenotype resembling tumors of the sebaceous skin appendage with coarsely vacuolated cytoplasm and peripherally displaced nuclei. The sebaceous moiety was also present in the distant metastatic deposits. There was no evidence of mucin production by tumor cells. Ultrastructurally, empty‐appearing non‐membrane bound vacuoles attested to the sebaceous cells’ lipid content. The immunoprofile of the lesion included positivity for cytokeratin and epithelial membrane antigen. Vimentin, S100 protein and carcinoembryonic antigen were not expressed. Most tumor cell nuclei reacted with antibodies to oestrogen and progesterone receptors but failed to show overexpression of the HER2/neu protein. The MIB‐1 labeling index averaged 16%. At variance with sebaceous breast carcinomas on record, the present case is notable for its prolonged clinical course.
Ovarian leiomyosarcoma: An autopsy case report
Authors: Nasu Michiyo , Inoue Jun , Matsui Mitsuaki , Minoura Shigeki , Matsubara Osamu
Published: March 2003

Primary non‐specific sarcoma of the ovary is extremely rare, and only 22 reported cases of pure leiomyosarcoma (LMS) are known to the authors. We present an autopsy case of a primary ovarian leiomyosarcoma in a 73‐year‐old woman. She had noticed an abdominal mass after difficulty in defecating for several months. The excision of tumor with bilateral salpingo‐oophorectomy and hysterectomy was carried out. A diagnosis of pure leiomyosarcoma of the left ovary was made on pathological examination with immunohistochemistry. Adjuvant radio–chemotherapy was not given. At 18 months’ follow up, abdomino‐pelvic sonography revealed an abdominal tumor and hepatic metastasis. The patient died 3.5 years after the initial surgery. The post‐mortem examination revealed a peritoneal recurrent tumor and extensive distant metastases of the liver, lungs, pancreas, gastric mucosa, muscle and skin. The prognosis of the ovarian LMS is poor from the pertinent literature. Several prognostic indicators on histology including mitotic activity, proliferative activity and p53 status of the tumor are discussed.
Adenomyosis with a sex cord‐like stromal element
Authors: Fukunaga Masaharu
Published: March 2003

A case of adenomyosis with a sex cord‐like stromal element is described. The element was an incidental, solitary, microscopic finding in a focus of adenomyosis. It was characterized by cord and trabecular arrangements of round to polygonal shaped cells in the endometrioid stroma. The cells were immunohistochemically positive for desmin and alpha‐smooth muscle actin but negative for sex cord markers (alpha‐inhibin and O13). The element appears to originate from the endometrial stromal cells through smooth muscle metaplasia.
Periosteal osteoblastoma: A case report and a review of the literature
Authors: Sulzbacher Irene , Puig Stefan , Trieb Klemens , Lang Susanna
Published: March 2003

Osteoblastomas located on the surface of cortical bone, so‐called periosteal (juxtacortical) osteoblastomas, are extremely rare. A 24‐year‐old man complained of pain and swelling in the left knee. The clinical and radiological investigation showed a tumor located in the posterior portion of the distal shaft of the femur. The radiological differential diagnosis included parosteal osteosarcoma, periosteal chondroma and periostitis ossificans. A frozen section was obtained and histology revealed an osteoblastoma with large epithelioid‐appearing osteoblasts consistent with an aggressive osteoblastoma. An en bloc resection of the tumor was performed and the definitive histology of the whole specimen revealed a typical osteoblastoma. The authors draw attention to the fact that periosteal osteoblastoma is a rare tumor that could be mistaken clinically and histologically for other and more common tumors at this location.
Characterization of hyperplastic foci observed in surgical specimens of hepatocellular carcinoma
Authors: Kato Kazuki , Ozaki Daisuke , Zheng Kefei , Kondo Fukuo , Urashima Tetsuro , Asano Takehide , Ochiai Takenori , Suzuki Yoshio , Ebara Masaaki , Saisho Hiromitsu , Kondo Yoichiro
Published: March 2003

By reviewing previous surgical specimens of hepatocellular carcinoma, 17 cases with hyperplastic foci (HPF) characterized by discernible increase in nuclear densities, could be histologically selected. Nuclear densities of HPF and control hepatic parenchyma were assessed quantitatively by counting the nuclear number of hepatic cells, and proliferating cell nuclear antigen labeling index was measured. HPF occurred multifocally, confined within a lobular unit, smoothly merging into surrounding hepatic parenchyma. Nuclear densities of HPF were 1.71 times greater than those of control hepatic parenchyma. The hepatocytes of HPF also showed significantly higher proliferative activities than those of control parenchyma. In addition, noticeable structural distortions, such as focal trabecular thickening or microacinar formation of hepatocytes, were sometimes observed in HPF. However, these HPF seemed to be distinguished from minute de novo hepatocellular carcinoma (HCC) or intrahepatic HCC metastasis, because of paucity of distinctive atypical changes, and intimate correlation with neighboring hepatocytes. Several adjacent HPF were aggregated to form a much larger unit of a hyperplastic area with loss of fibrous septa of liver cirrhosis. It was suggested that grossly detectable large regenerative nodules are produced via fusion of several adjacent HPF.
Hamartomatous endocervical polyp with heterologous mesenchymal tissue
Authors: Ilhan Rıdvan , Yavuz Ekrem , Iplikçi Altan , Tuzlalı Sıtkı
Published: March 2003

We present an endocervical polyp with heterologous elements. Although a few neoplastic cervical lesions with cartilaginous and adipocytic heterologous tissue have been reported, an endocervical polyp with heterologous cartilage and adipose tissue has not been reported before our case. The patient was a 33‐year‐old woman who presented with abnormal uterine bleeding. On physical examination, there were no remarkable findings other than a cervical polyp protruding into the cervical canal. The polyp was removed. Pathological examination revealed an endocervical polyp with typical epithelial features. The stroma of the polyp contained mature cartilage islands and adipose tissue. There were also many thick‐walled vascular structures. Neither stromal periglandular condensation nor atypia was found. Mitotic figures were not observed. Arteriolar structures did not contain internal elastic lamina. In our opinion, these pathological findings are all consistent with a hamartomatous lesion rather than with a true neoplasm.
Thyrocyte integration, and thyroid folliculogenesis and tissue regeneration: Perspective for thyroid tissue engineering
Authors: Toda Shuji , Koike Norimasa , Sugihara Hajime
Published: March 2003

The thyroid gland is composed of many ball‐like structures called thyroid follicles, which are supported by the interfollicular extracellular matrix (ECM) and a capillary network. The component thyrocytes are highly integrated in their specific structural and functional polarization. In conventional monolayer and floating culture systems, thyrocytes cannot organize themselves into follicles with normal polarity. In contrast, in 3‐D collagen gel culture, thyrocytes easily form stable follicles with physiological polarity. Integration of thyrocyte growth and differentiation results ultimately in thyroid folliculogenesis. This culture method and subacute thyroiditis are two promising models for addressing mechanisms of folliculogenesis, because thyroid‐follicle formation actively occurs both in the culture system and at the regenerative phase of the disorder. The understanding of the mechanistic basis of folliculogenesis is prerequisite for generation of artificial thyroid tissue, which would enable a more physiological strategy to the treatment of hypothyroidism caused by various diseases and surgical processes than conventional hormone replacement therapy. We review here thyrocyte integration, and thyroid folliculogenesis and tissue regeneration. We also briefly discuss a perspective for thyroid tissue regeneration and engineering.
Methylation of the hMLH1 promoter in multiple gastric carcinomas with microsatellite instability
Authors: Jung Hwoon‐Yong , Jung Kyeong Cheon , Shim Yhong Hee , Ro Jae Y. , Kang Gyeong Hoon
Published: March 2003

Hypermethylation of the hMLH1 promoter is observed in the majority of sporadic gastric carcinomas with high frequency microsatellite instability (MSI), and it contributes to the genesis of MSI‐positive gastric carcinoma. Multiple gastric carcinoma is known to have a higher frequency of MSI positivity than single gastric carcinoma. However, the molecular basis of MSI in these tumors remains obscure. We investigated the role of hMLH1 promoter hypermethylation in the genesis of multiple gastric carcinoma with MSI. We analyzed 33 tumors from 15 patients with multiple gastric carcinoma (12 double tumors and three triple tumors) for MSI, expression of hMLH1 and hMSH2, and hypermethylation of hMLH1 and hMSH2 promoters. High frequency MSI was found in seven out of 33 tumors (21%) in five out of 15 patients (33%). All of the tumors with high frequency MSI had a lack of hMLH1 expression, with the presence of hMSH2 expression, while all the tumors with no MSI or low frequency MSI were positive for both hMLH1 and hMSH2. All of the tumors with no expression of hMLH1 had hMLH1 hypermethylation, whereas hMLH1 hypermethylation was observed in two out of 26 (8%) tumors with no or low frequency MSI. None of the tumors showed hMSH2 hypermethylation. These results suggest that epigenetic changes in the hMLH1 promoter account for the genesis of multiple gastric carcinoma with high frequency MSI.
β‐Catenin gene mutation in human hair follicle‐related tumors
Authors: Kajino Yuri , Yamaguchi Akihiro , Hashimoto Naoko , Matsuura Akihiro , Sato Noriyuki , Kikuchi Kokichi
Published: March 2003

β‐Catenin, a multifunctional protein related to the adherens junction and to signal transduction, is a key molecule of cell proliferation, and it is central to epithelial architecture, regulating the polarity of cells and tissues. β‐Catenin stabilization may play a key role in epidermal signaling leading to hair development, and its aberrant activation may be implicated in formation of hair tumors. Several investigators have shown that pilomatricomas are frequently associated with β‐catenin mutation. In this study, we confirmed β‐catenin gene (CTNNB1) mutation in human pilomatricomas (100% frequency) from which adequate DNA could be obtained for gene analysis. A novel mutation, D32N, was found in one case of pilomatricoma. A preliminary immunohistological study revealed prominent β‐catenin staining in basophilic cells of pilomatricomas, especially in nuclei. Benign tumors which were considered to be derived from hair matrix or hair follicles, and other benign skin tumors, were also investigated. β‐Catenin mutations were not detected in any of the these tumors. These results seem to indicate that hair matrix cells are key players in hair development. Investigation into gene abnormalities of hair‐follicle tumors may elucidate the cause of their neoplastic transformation, and may provide a suggestion for the mechanism of hair development.
Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients
Authors: Nakamura Etsuko , Shimizu Michio , Itoh Tomoo , Manabe Toshiaki
Published: March 2003

To investigate the clinicopathological features of patients with secondary tumors of the pancreas, we reviewed autopsy records and pathological features of 103 cases with pancreatic secondary tumors from 690 cases of malignant tumors (excluding cases of primary pancreatic cancer) over a 10‐year period. There were 67 men and 36 women in the study, ranging in age from 2 to 94 years (mean: 61 years). The incidence of pancreatic secondary tumors was 15% in the autopsy cases of malignant tumors, and the majority of the secondary tumors were carcinomas. The stomach was the most common primary tumor site (20%), followed by the lung (18%) and extrahepatic bile duct (13%). Because the total number of each primary carcinoma differed, we paid specific attention to the incidence of pancreatic metastasis in each primary carcinoma. We found that carcinoma of the papilla of Vater showed the highest rate of incidence (75%) of pancreatic metastasis in each type of primary carcinoma. Approximately half of the metastatic lesions were solitary, but the metastatic lesions in the pancreas could not be identified macroscopically in 34 cases (33%). Histologically, the most common carcinoma was adenocarcinoma, followed by large cell carcinoma, small cell carcinoma and neuroendocrine carcinoma. The most common non‐epithelial tumor was leukemia, followed by malignant lymphoma. Undifferentiated carcinoma and neuroendocrine carcinoma were often found in cases of extrahepatic bile duct or urinary bladder carcinoma with pancreatic metastasis. As for the microscopic infiltration patterns of tumor cells, 73% of cases showed an interlobular and intralobular infiltration. Fat necrosis was most frequently seen as an associated pathological finding (19%). Our study indicates that secondary tumors of the pancreas can be found in approximately one out of six to seven autopsy cases of malignant tumors, and in Japan, the most common of these is adenocarcinoma of the stomach.
Acceleration of murine AA amyloidosis by oral administration of amyloid fibrils extracted from different species
Authors: Cui Dan , Kawano Hiroo , Takahashi Mutsuo , Hoshii Yoshinobu , Setoguchi Mihoko , Gondo Toshikazu , Ishihara Tokuhiro
Published: March 2003

We herein report that experimental murine amyloid A (AA) deposition is accelerated by oral administration of semipurified amyloid fibrils extracted from different species. Three groups of mice were treated with semipurified murine AA amyloid fibrils, semipurified bovine AA amyloid fibrils or semipurified human light chain‐derived (Aλ) amyloid fibrils for 10 days. After 3 weeks, each mouse was subjected to inflammatory stimulation by subcutaneous injection with a mixture of complete Freund’s adjuvant supplemented with Mycobacterium butyricum. The mice were killed on the third day after the inflammatory stimulation, and the spleen, liver, kidney and gastrointestinal tract were examined for amyloid deposits. Amyloid deposits were detected in 14 out of 15 mice treated with murine AA amyloid fibrils, 12 out of 15 mice treated with bovine AA amyloid fibrils and 11 out of 15 mice treated with human Aλ amyloid fibrils. No amyloid deposits were detected in control mice receiving the inflammatory stimulant alone or in amyloid fibril‐treated mice without inflammatory stimulation. Our results suggest that AA amyloid deposition is accelerated by oral administration of semipurified amyloid fibrils when there is a concurrent inflammatory stimulation.
Analysis of cell damage in Helicobacter pylori‐associated gastritis
Authors: Noguchi Kenji , Kato Katsuaki , Moriya Takuya , Suzuki Takashi , Saito Michiya , Kikuchi Tohru , Yang Jing , Imatani Akira , Sekine Hitoshi , Ohara Syuichi , Toyota Takayoshi , Shimosegawa Tooru , Sasano Hironobu
Published: March 2003

Helicobacter pylori infection is currently considered to be a major cause of acute and chronic gastritis, and of gastric and duodenal ulcers. Superoxide dismutase (SOD) is well known for scavenging superoxide radicals such as reactive oxygen species (ROS), subsequently protecting cells from oxidative injury, and for maintaining tissue homeostasis. In this study, we therefore evaluated the level of SOD activity and protein expression, as well as various factors associated with oxidative injury, in H. pylori‐positive (n = 46) and ‐negative (n = 28) gastric mucosa obtained from endoscopy, in order to elucidate the possible biological significance of SOD in these mucosa. Overall SOD activity was significantly higher in H. pylori‐positive mucosa (15.5 ± 7.0 U/mg protein) than in negative mucosa (9.2 ± 10.6 U/mg protein), and decreased markedly following H. pylori eradication (8.2 ± 4.2 U/mg protein). Enzyme‐linked immunosorbent assay (ELISA) analysis of SOD revealed that the manganese SOD (Mn‐SOD) level in H. pylori‐positive mucosa (1166.7 ± 435.2 ng/mg protein) was significantly higher than in control tissues (446.3 ± 435.3 ng/mg protein) and in mucosa obtained following eradication therapy (431.9 ± 189.9 ng/mg protein). The level of Mn‐SOD protein showed a significant correlation with degree of inflammation in the gastric mucosa. Moreover, Mn‐SOD immunolocalization patterns were well correlated with the activity and protein levels evaluated by ELISA. Factors presumably associated with oxidative injury in human gastric mucosa, including terminal deoxynucleotidyl transferase‐mediated dUTP‐biotin nick‐end labeling, Ki‐67, 8‐hydroxydeoxyguanosine and single‐stranded DNA, were all significantly higher in H. pylori‐positive gastric mucosa than in control tissue and in tissue following eradication. These results all suggest that Mn‐SOD, but not cytoplasmic copper–zinc SOD, plays an important role as an anti‐oxidant against ROS generated in H. pylori‐infected gastric mucosa and, sub­sequently, in the maintenance of cell turnover in gastric mucosa.
Peritoneal endometriosis in the broad ligament presenting as a large tumor
Authors: Itoga Tomoko , Matsumoto Toshiharu , Suzuki Chikako , Miyazaki Ryoichiro , Kurosaki Yoshihisa , Suda Koichi , Kinoshita Katsuyuki
Published: March 2003

Peritoneal endometriosis presenting as a tumor is very rare. A case of peritoneal endometriosis in the broad ligament presenting as a large tumor is reported. A 39‐year‐old woman had a solid and cystic tumor with many microcysts, measuring 17 × 13 × 3.5 cm, mainly located in the right posterior broad ligament. Histologically, the tumor consisted of many endometrial glands associated with various amounts of endometrial stroma. Neither the glands nor the stromal cells had cellular atypia. We diagnosed peritoneal endometriosis presenting as a tumor. Among the six cases (five previously reported cases and our case) of tumor‐like endometriosis in the peritoneum, two cases (33%) had received tamoxifen therapy and four cases (67%) had cystic or solid and cystic tumor. Among them, the tumor size ranged from 3 to 17 cm in diameter, and our case was the largest. In conclusion, this case is rare, but it is important for pathologists to be aware of the phenomenon (that extensive peritoneal endometriosis produces a large tumor) in the histological diagnosis of a tumor in the peritoneum.
Expression of mucin core proteins in extramammary Paget's disease
Authors: Yoshii Noriko , Kitajima Shinichi , Yonezawa Suguru , Matsukita Sumika , Setoyama Mitsuru , Kanzaki Tamotsu
Published: March 2003

Extramammary Paget's disease (EPD) is a relatively common skin cancer wherein tumor cells have mucin in their cytoplasm. However, little is known about mucin expression in EPD. We examined immunohistochemically the expression of mucin core proteins (MUC1, MUC2, MUC5AC and MUC6) in 36 cases of EPD and found different patterns of expression in intraepithelial (n = 36), microinvasive (n = 13) and invasive lesions (n = 6). In normal skin, MUC1 was expressed in the sebaceous, eccrine and apocrine glands. MUC2, MUC5AC and MUC6 were not expressed in any of these. In the 36 intraepithelial lesions, MUC1 and MUC5AC were expressed in 35 and 36 lesions, respectively. MUC1 expression was also observed in all 13 microinvasive lesions and in all six invasive lesions. In contrast to the intraepithelial lesions, a decrease or loss of MUC5AC expression was observed in five out of 13 microinvasive lesions and in all six invasive lesions. MUC2 and MUC6 were not expressed in any of the EPD lesions examined. The combination of immunohistochemical staining for MUC1 and MUC5AC was useful for identifying invasive Paget cells. The decrease or loss of MUC5AC expression may have an important role in the invasive growth of Paget cells.
Malacoplakia of the ovary, fallopian tube and uterus: A case associated with diabetes mellitus
Authors: Chou Shih‐Cheng , Wang Jyh‐Seng , Tseng Hui‐Hwa
Published: March 2003

Malacoplakia is a chronic xanthogranulomatous inflammation that most commonly affects the urinary tract and the gastrointestinal system of middle‐aged women. It is rarely encountered in a female genital tract, and only a handful of cases of malacoplakia of the ovary have been described. We report an unusual case of malacoplakia extensively involving the ovary, fallopian tube and uterus of a 47‐year‐old woman with poorly controlled diabetes mellitus. Escherichia coli was cultured from the ovarian lesion. To our knowledge, such an extensive female genital malacoplakia associated with diabetes mellitus has not been reported before. Widespread or atypical site malacoplakia occurring in a patient with systemic disease may result from a diminution of macrophagocytic function, either under the influence of the systemic illness or related to corticosteroid excess. We propose that diabetes mellitus without appropriate medical control may have resulted in impaired leukocyte function which, when combined with E. coli infection, led to the development of extensive malacoplakia in the genital tract of this patient.
Case of postradiation osteosarcoma with a short latency period of 3 years
Authors: Matsuyama Atsuji , Yonemitsu Nobuhisa , Hayashida Seiichiro , Watanabe Keiko , Sugihara Hajime , Inokuchi Akira
Published: March 2003

Osteosarcoma is one of the neoplasms that may occur following exposure to radiation. A case of osteosarcoma arising in the craniofacial bone with a short latency period of 3 years after radiotherapy for maxillary squamous cell carcinoma is described. A 64‐year‐old‐man underwent right partial maxillectomy and chemoradiotherapy due to squamous cell carcinoma of his right maxillary sinus. Histologically, the tumor was composed of moderately differentiated squamous cell carcinoma with a component of spindle cell carcinoma. Three years later, osteosarcoma developed in the craniofacial bone within the irradiation field of the first tumor. Detailed histological examination demonstrated that there was no component of osteosarcoma in the first tumor or squamous cell carcinoma in the second tumor. Radiation‐induced osteosarcoma usually occurs after a long latency period of more than 10 years after the radiotherapy. In this case, osteosarcoma was possibly a radiation‐induced osteosarcoma with a short latency period of 3 years.
Adenomyoma of the small intestine: Report of two cases and review of the literature
Authors: Park Ho‐Sung , Lee Seong Ok , Lee Jeong Min , Kang Myoung‐Jae , Lee Dong‐Geun , Chung Myoung‐Ja
Published: March 2003

Adenomyoma of the small intestine is a rare tumor‐like lesion composed of exocrine‐type ducts and hypertrophic smooth muscle. We describe two cases of adenomyoma of the small intestine. One was an ileal adenomyoma that presented with intussusception occurring in a 7‐month‐old boy. The other was a jejunal adenomyoma found incidentally in a 63‐year‐old man with colon cancer. Histologically, the lesions composed of benign ducts and bundles of smooth muscle. The second case was detected on contrast‐enhanced computed tomography scan as a small enhancing polypoid mass. We review the previous literature of adenomyoma of the small intestine.
Lipomatous pseudohypertrophy of the pancreas: Further evidence of advanced hepatic lesion as the pathogenesis
Authors: Kuroda Naoto , Okada Mitsuo , Toi Makoto , Hiroi Makoto , Enzan Hideaki
Published: March 2003

An 80‐year‐old Japanese man with liver cirrhosis was suspected of having lipomatous pseudohypertrophy of the pancreas on the basis of results of ultrasonography and a computed tomography scan. He eventually died of hepatic failure. He had no obesity, diabetes mellitus or pancreatic symptoms during his entire clinical course. Autopsy results confirmed lipomatous pseudohypertrophy of the pancreas, cholecystolithiasis, and postnecrotic liver cirrhosis associated with submassive hepatic necrosis was suspected. Although the pathogenesis of lipomatous pseudohypertrophy of the pancreas is not clear, the findings in the present case provide further evidence to support the hypothesis that advanced hepatic lesions cause this lesion.