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Biomedical subjects

A Mikata

Publications and source records attributed to A Mikata.

At least 19 recordsLinked to original sources

Islet amyloid polypeptide-derived amyloid deposition increases along with the duration of type 2 diabetes mellitus.

To investigate the involvement of islet amyloid polypeptide (IAPP) and amyloid deposits in the pathophysiology of this disease, we studied the relationship between IAPP-derived amyloid deposition and the clinical features in type 2 diabetes mellitus. We examined pancreata obtained from 37 type 2 diabetic subjects and 12 non-diabetic ones by immunohistochemical techniques using two specific antibodies to IAPP. IAPP-derived deposits occurred in 1 of the 12 (8.3%) non-diabetic subjects and 28 of the 37 (75.7%) diabetics. When diabetic patients were divided into categories according to the presence of the deposits, the duration of the disease was significantly longer in patients with amyloid than that in the patients without it. The odds ratio of type 2 diabetes mellitus of at least 14-years-duration to the deposition was significantly high, and a body weight of at least 120% maximal ideal body weight was relatively high. In conclusion, IAPP-derived amyloid deposition increases along with the duration of type 2 diabetes mellitus and obesity may further enhance these deposits, hence hypersecretion of IAPP may be involved in the progression of this disease.

Aged

Positron emission tomography using fluorine-18-fluorodeoxyglucose in malignant lymphoma: a comparison with proliferative activity.

To evaluate the relationship between PET using 18F-fluorodeoxyglucose (FDG) and pathological findings and to compare indices obtained by FDG-PET, FDG-PET was performed in 23 patients with untreated malignant lymphoma. Three indices obtained by FDG-PET, tumor-to-normal contrast ratio (TCR), distribution absorption ratio (DAR), k1k2/(k2 + k3), correlated with proliferative activity which was pathologically estimated both by mitotic count and by proportion of cells in all phases of the cell cycle. The relationship did not significantly change according to which of the three indices was chosen. FDG-PET, which shows the proliferative activity of tumors, is considered to be a useful method for managing tumors.

Adult

Prognostic factors for local control in nasopharyngeal cancer (NPC): analysis by multivariate proportional hazard models.

Despite the development of meticulous radiation therapy techniques, the local control of the nasopharyngeal cancer (NPC) remains unsatisfactory. We examined retrospectively the clinicopathologic factors which have impact upon local recurrence-free survival (LRFS) of the 67 patients with NPC who had been irradiated greater than or equal to 40 Gy with curative intent from 1975 through 1988. Three-year LRFS rate was 63%. T stage, histology, the presence of accompanying lymphocytic infiltration, and the properness of radiation therapy had influence upon LRFS with a statistical significance. Multivariate proportional hazard models showed that T stage and pathology retained significance. Radiation therapy properness emerged as a third factor when only the patients irradiated greater than or equal to 60 Gy were included in the analysis. From these results, three groups with low, moderate, and high risk of shortened LRFS could be separated. This risk classification could contribute to the stratification criteria of future study for the improvement of local control by new modalities.

Adult

Non-Hodgkin's lymphoma confined to the nasal cavity: its relationship to the polymorphic reticulosis and results of radiation therapy.

From 1975 through 1988, nine patients with locally confined nasal non-Hodgkin's lymphoma (NHL) were treated with radiation therapy in the Department of Radiology, Chiba University Hospital. Immunohistochemical study disclosed that all NHL's have T-lineage. Additionally, unique histological pictures of polymorphism, angiodestruction, and necrosis were seen in most of cases. These three findings are the histological features of polymorphic reticulosis (PMR), which is the main cause of lethal midline granuloma and has recently been shown to belong to T-cell malignancy. Therefore, it is concluded that the nasal T-cell NHL and PMR are really a single disease entity. The predominance of the T-cell lymphoma in the nasal cavity as well as its histological distinctness clearly indicate that the head and neck extranodal NHL cannot be discussed together. Although the disorder was considered to be locally limited at presentation, only 3 of the 9 patients with nasal NHL could be induced into long-term remission with involved field radiotherapy. The distant extranodal spread was the primary cause of failure. Multimodality treatment using intensive chemotherapy might improve the prognosis of nasal NHL.

Female

Multiple pulmonary hyalinizing granulomas associated with systemic idiopathic fibrosis.

A 41-year-old man with progressive nodular infiltration of the lung of about 2 years' duration died of cardiac and respiratory failure. Autopsy revealed bilateral multiple pulmonary hyalinizing granulomas (PHGs) diagnosed on the basis of the characteristic dense hyaline collagen bundles with nonspecific inflammatory infiltration. Constrictive pericarditis, retroperitoneal fibrosis, mediastinal fibrosis, fibrous thickening of the peritoneal and pleural surfaces, and fibrosis of soft tissue of the neck, flank, and hepatic hilar region were present, therefore, a diagnosis of systemic idiopathic fibrosis was made. The patient had anti-thyroglobulin and anti-thyroid microsomal antibodies and lymphocytic thyroiditis. The inflammatory process of PHG of the present case was active and the clinical course was progressive. PHG seems to be a lesion belonging to the systemic idiopathic fibrosis complex. Immunologic abnormalities may be related to PHG and systemic idiopathic fibrosis.

Adult

Amyloid protein in somatostatinoma differs from human islet amyloid polypeptide.

Amyloid deposits in somatostatinomas are rare observations. To examine the characteristics of this amyloid, we compared amyloid deposits in a somatostatinoma to those found in pancreatic tissue in patients with Type II diabetes mellitus and in insulinomas, using immunohistochemical techniques and specific antibodies to islet amyloid polypeptide or other pancreatic hormones, as well as electron-microscopy. Antibodies to islet amyloid polypeptide regions 8-17 or 25-37 were confirmed to be specific. Amyloid deposits in patients with Type II diabetes mellitus and in insulinomas, but not those in the somatostatinoma strongly reacted with these antibodies, or to an antibody to amyloid P component. Amyloid deposits in the somatostatinoma were not reactive with antibodies to somatostatin or to other pancreatic hormones. Electron-microscopic examinations revealed that amyloid fibrils in the somatostatinoma were thinner and more randomly distributed than were those in islets from patients with Type II diabetes mellitus. As amyloid in somatostatinomas is unlike that consisting of islet amyloid polypeptide or other mature pancreatic hormones, it may be a novel type of local amyloid in pancreatic islets.

Adult

Expression of functional molecules in non-Hodgkin's lymphoma. Correlation with bone marrow involvement and serum LDH value.

It is well known that non-Hodgkin's lymphoma (NHL) cells express various antigens which are normally involved in a variety of functions. In addition, NHL is diverse in its proliferative capacity. To investigate the relation between these factors and the clinical picture, 45 cases of NHL were studied by immunohistochemistry using snap-frozen materials obtained before therapy. Reactivities with 27 monoclonal antibodies were examined and the results were correlated with clinical findings. The expression of surface mu and ICAM-1 in B-NHLs and CD25 in T-NHLs were significantly associated with bone marrow involvement. B-NHLs without expression of CD21(B2) and T-NHLs with CD25 were seen more frequently in cases with a LDH value of over 500 units/ml. The positivity rate of Ki-67 on B-NHLs was correlated with serum LDH value, NHL histologic classification, and overall survival. These data indicate that immunophenotyping and determination of the proliferative capacity of NHL are of value not only for confirmation of the histopathologic classification of the tumor but also for assessment of clinical behavior.

Adult

Reciprocal/dichotomic expression of vimentin and B cell differentiation antigens in Reed-Sternberg's cells.

An immunohistochemical study of 63 cases of Hodgkin's disease was undertaken using formalin-fixed paraffin embedded tissue sections. The antibodies used were against L26, LN-1, LN-2, EMA (epithelial membrane antigen), Leu-M1, Vimentin, UCHL-1, S-100, and lysozyme. Hodgkin's disease could be divided into three groups: the first group was LN-1+/L26+/vimentin-, the second LN-1-/L26+/vimentin+, and the third LN-1-/L26-/vimentin+). Sixteen cases of follicular lymphomas were also examined and were all positive for LN-1 and L26 and negative for vimentin. Thus the vimentin negativity of the first group, including 7 nodular lymphocyte-predominant cases, gives further evidence of their germinal center B-cell origin. Since vimentin is expressed mainly in the immature stage of B-lymphocytes, the second group of Hodgkin's disease may represent immature B-cell Hodgkin's disease. In the third group, vimentin was present in Reed-Sternberg's (RS) and Hodgkin's (H) cells in 45 of the 48 cases (92.5%). In none of 48 cases were these cells positive for S-100 or lysozyme, but strong vimentin-positivity still suggested monocytic or histiocytic origin. The results of our study suggest, at least, divergent origin of RS's and H's cells.

Antigens, Differentiation, B-Lymphocyte

Class II major histocompatibility antigen expression on coronary arterial endothelium in a patient with Kawasaki disease.

To investigate the class II major histocompatibility antigen expression on coronary arterial endothelium of Kawasaki disease and immunophenotypes of the infiltrating cells in the coronary vascular lesions, myocardial sections from a patient who died during the acute stage of Kawasaki disease were studied using an immunoperoxidase technique. The mononuclear cells in the lesions mainly consisted of macrophages and T cells, whereas B cells and NK/K cells were not seen. The majority of T cells reacted with Leu-3a antibodies, and only a few reacted with Leu-2a antibodies. Cells bearing the interleukin-2 receptor, indicative of activated T cells, were also found in the lesions. To determine the distribution of class II antigen, we used anti-HLA-DR antibodies. The massive expression of HLA-DR antigen on mononuclear cells was found in the lesions. In addition, the HLA-DR activation antigen was expressed on the coronary arterial endothelium at the infiltrates in which macrophages and T cells coexisted. In contrast, coronary arterial endothelium did not express HLA-DR antigens in the myocardial tissues of controls (n = 4). HLA-DR+ endothelial cells may play an important role in the development of Kawasaki vasculitis.

Coronary Vessels

Increased activity on radiocolloid scintigraphy in splenic hamartoma.

A higher uptake of radiocolloid in a splenic tumor than in the rest of the spleen was observed in a 17-year-old boy. The pathologic diagnosis of the surgically resected tumor was hamartoma composed of anomalous mixtures of splenic elements, and radiocolloid was considered to be distributed to reticuloendothelial cells in the tumor. Radiocolloid scintigraphy, which can demonstrate the function of the reticuloendothelial system, is helpful in the diagnosis of splenic hamartoma.

Adolescent

Immunoglobulin deposits in diabetic microangiopathy. Observations in autopsy materials.

Non-enzymatic glycosylation of vascular wall collagen is considered to be most important in the pathogenesis of diabetic microangiopathy, and glycosylated collagens are reported to bind immunoglobulins in vivo. We investigated the occurrence of IgG or IgM deposits in the microvasculature of certain organs of diabetics using routine autopsy materials. Glomerular capillary basement membrane/endothelium was often positive for IgM in diabetics. Endothelial cells of glomerular capillaries were positive for HLA-DR in 6 of 16 diabetics and in 2 of 11 controls. This was associated with IgM or IgG deposits in 5 cases. In the esophagus and/or tongue of diabetics, IgG was frequently deposited in the microvasculature. In total, IgG deposits were found in 13 of 16 diabetics, either in the esophagus or the tongue, but in only 3 of 16 controls. The difference was significant at p less than 0.005. These observations suggest that deposition of immunoglobulins is a component of diabetic microangiopathy. Differences in expression of HLA-DR in glomeruli between diabetics and non-diabetics remain to be explored.

Adult

Study of vimentin expression in non-Hodgkin's lymphoma using paraffin sections.

Human non-Hodgkin's lymphomas were studied by means of an avidin-biotin complex immunoperoxidase method using several monoclonal antibodies against the intermediate filament protein, vimentin. The study cases were 61 B-cell lymphomas (including 2 plasmacytomas) and 30 T-cell lymphomas (including 8 cases of mycosis fungoides). Twelve of the 61 B-cell lymphomas were positive for vimentin, and were composed of extrafollicular-center cells such as immunoblastic and plasmacytoid cells. On the other hand, lymphomas of follicular center cell origin were negative for vimentin. All cases of T-cell lymphoma except for 14 (all of 9 AILD-type lymphomas, all of 4 lymphoblastic lymphomas and one diffuse mixed small/large lymphoma) were positive for vimentin. Although vimentin expression appeared to be influenced by various conditions such as the proportion of T- and B-cell subsets, or B-cell proliferation rate, follicular center cells were constantly negative for vimentin.

Histological Techniques

A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma.

A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma of the mediastinum is reported in a 14-year-old boy. Computed tomographic scan of the chest showed a mass of the anterior mediastinum and conspicuous swelling of the lymph nodes in the upper and lower mediastinum. They were grossly resected. The tumor of the anterior mediastinum was histologically diagnosed as true thymic hyperplasia. All of the mediastinal lymph nodes were diagnosed as non-Hodgkin's lymphoma, diffuse, mixed small and large cell type.

Adolescent

[M-BACOD in advanced case of non-Hodgkin's lymphoma].

A M-BACOD regimen using an increased dose of Adriyamycin has been administered to 18 patients with non-Hodgkin's lymphoma. Sixty-three percent of the patients who had been previously untreated obtained a complete remission and the 2-year survival rate of those who evidenced a complete response reached 71%. The stage of the lymphoma was found to be a prognostic factor for a complete remission, while LDH and tumor response had an influence upon survival.

Adult

Herpes simplex lymphadenitis. Report of two cases with review of the literature.

We report two cases of herpes simplex lymphadenitis without widespread organ involvement in a 60-year-old man and a 67-year-old woman. Their complaints were high fever and generalized erythema followed after few days by generalized lymphadenopathy. This report describes the findings obtained by light and electron microscopy, immunohistochemistry, and in situ hybridization. In both instances, Cowdry's type A intranuclear inclusion bodies were found in T-immunoblasts in the background of T-zone hyperplasia with focal necrosis. Electron microscopic investigation revealed intranuclear and cytoplasmic virus particles with characteristics of the herpes group. Immunohistochemical staining utilizing anti-herpes simplex virus (HSV) antibody was positive and in situ hybridization with HSV-DNA probe revealed positive signals in the nucleus and in the cytoplasm of T-immunoblasts. Although rare, HSV lymphadenitis in the absence of generalized infection can occur.

Aged

[Effect of ethanol injection in tracheal large cell carcinoma--a case report].

A 66-year-old woman was admitted with dyspnea. A tracheal tumor was found by bronchofiberscopy, and histological examination revealed large cell carcinoma. The tumor obstructed nearly 90% of her tracheal lumen, so we performed intratumoral ethanol injection. The tumor became almost completely necrotic, and obstruction of her airway markedly improved. No serious complication was found. Intratumoral ethanol injection was very effective and safe in this case. This is the fifth report of undifferentiated carcinoma of the trachea in Japan.

Aged

Evolution and progression in malignant lymphoma of Waldeyer's ring: histopathological and immunohistochemical studies of three cases of total tonsillectomy.

Histopathological and immunohistochemical studies were performed in three patients with malignant lymphoma of Waldeyer's ring (ML-WR) who underwent total tonsillectomies. Residual reactive follicles mixed with neoplastic follicles were present beneath the surface epithelium of the crypts at the base of the tonsils. The neoplastic follicles were growing expansively and fusing with each other until finally, the process resulted in a diffuse proliferation pattern. Both of the tumor and follicular center cells (FCCs) in the reactive follicles were positive for LN-1; accordingly, the ML-WR tumor cells were considered to originate from FCCs. Anti-S-100 positive follicular dendritic cells (FDCs) were much scarcer in the neoplastic follicles of the tonsils than in the neoplastic follicles of the lymph nodes. FDCs may have a role to play in regulating the proliferation pattern of tumor cells in ML-WR.

Adult

[Follicular lymphoma in Japan: retrospective study on natural history and therapeutic results in 50 cases collected from 4 institutions].

Clinical data of the 50 patients with nodal follicular lymphoma were collected from 4 institutions in Japan and were analysed retrospectively. A frequency of follicular lymphoma was 9.3% in the 364 patients with nodal lymphoma registered between 1981-1986. Twenty-one patients (42%) were classified as follicular medium-sized cell type (F-medium; identical with follicular small cleaved cell type by Working Formulation criteria), 12 (24%) as follicular mixed (F-mixed), and 17 (34%) as follicular large (F-large). There were 31 (62%) patients with Stage III-IV disease involving bone marrow in 6 patients, liver in 2, bone marrow and liver in 2, stomach in 1. Overall five- and ten-year survival rates were 65% and 32%, respectively, in the 49 patients whose median follow-up period was 3 years, ranging from 2 to 11 years. Adriamycin-based combination chemotherapy [ADM(+) therapy] produced 10 (100%) complete response (CR) of 10 patients with F-large lymphoma and 8 (80%) of them were free from relapse. But, in the patients with F-medium lymphoma, ADM(+) therapy produced one (17%) CR of 6 patients and their survivals were not superior to those treated with ADM(-) therapy, single agents or radiotherapy alone. There was no difference in the natural history or therapeutic results between the patients in Japan and United States, although the frequency of follicular lymphoma was extremely lower in Japan. ADM(+) therapy can be accepted as the first-line chemotherapy for the patients with F-large lymphoma, but the best modality of treatment should be investigated for the patients with F-medium lymphoma.

Adult