[Two autopsy cases of Cronkhite-Canada syndrome (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Fujii.
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The thoracic duct of Wistar strain rats was cannulated during 5 days for studying the effect of selective lymphocyte depletion on the lymphoid tissue. A technique for the continuous infusion of cell-free lymph, whole lymph of Eagle's medium to the rat with the thoracic duct fistula is described in detail. The prolonged drainage of lymph from rats was followed by lymphopenia, sever atrophy of lymphoid tissues and the depletion of small lymphocytes in the thymus-dependent areas of spleen and lymph nodes. The infusion of cell-free lymph into the drained rat resulted in the recovery of the weight of lymphoid tissues and in the massive proliferation and accumulation of large cells with prominent nucleoli and intensely pyroninophilic cytoplasm in the lymphocyte depleted areas of the peripheral lymphoid tissues and thymic cortex. There was histological evidence that the large pyroninophilic cells developed well in the spleen and tended to localize preferentially around the periarteriolar region through the marginal zone bridging channels to the red pulp. The infusion of Eagle's medium was found ineffective in restoring the weight of the lymphoid tissues and in bringing about the proliferation of lymphoid cells. The rats infused with whole lymph showed almost similar findings biologically and histologically to those of sham-operated rats.
Two cases of Ewing's sarcoma and two neuroblastoma, rosette forming and round cell type, were studied electron microscopically and their fine structures were compared. The neoplastic cells of Ewing's sarcoma were characterized by aggregated glycogen particles in the cytoplasm. They had pseudopod-like cytoplasmic processes having tight junctions, which never contained microtubules or mitochondria. Ewing's sarcoma cells exhibited several stages of cell maturation and some mature cells possessed a large amount of smooth and rough endoplasmic reticulum, large Golgi complexes and numerous phagosomes containing glycogen particles as well as cytoplasmic organelles. The neoplastic cells of neuroblastoma, rosette forming type, were characterized by synaptic junctions and numerous cytoplasmic processes with production of neurites containing microtubules, neurofibrils, mitochondria and a few catecholamine granules. A few cytoplasmic processes containing mitochondria were observed even in the round cell type.
The effects of arterial PCO2 on plasma activity was studied in chloralose anesthetized dogs undergoing carefully controlled respiratory acidosis. Plasma renin activity, measured by radioimmunoassay, was enhanced (P less than 0.001) during inhalation of CO2 despite insignificant changes in renal blood flow and arterial pressure. Although underlying mechanism remained to be investigated, activation of sympathetic nervous system and intrarenal effects of CO2 seemed to be involved in this enchancement.
A case of Cushing's syndrome due to huge adrenocortial multinodular hyperplasia who was shown to be hyperresponsive to ACTH administration, unresponsive to metyrapone administration and resistant to dexamethasone high dose suppression was reported. After two years' duration of his symptoms, the multinodular adrenals weighing 161 g in total were removed by bilateral adrenalectomy which abolished his symptoms. Postoperatively, plasma ACTH rose gradually to above normal levels, suggesting the presence of primary disorder in the hypothalamus-pituitary axis.
High doses of testosterone were subcutaneously given to B mice, neonatally thymectomized, lethally irradiated and reconstituted with syngeneic bone marrow cells. Histological observations of the peripheral lymphoid tissues revealed that testosterone inhibited the regeneration of the thymus-independent areas which were considered to be composed mainly of B lymphocytes. This result suggests that testosterone would inhibit the differentiation of B lymphocytes.
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MIC of amoxicillin (AMPC), ampicillin (ABPC) and cephalexin (CEX) against bacteria detected from the patients suffering from urinary infections was determined and the clinical efficacy of AMPC was examined. As the result of determining MIC of AMPC against the detected Escherichia coli, 85.4% showed the value of less than 6.25 mcg/ml. AMPC and ABPC seem to be well correlated with each other regarding MIC, and AMPC showed 1 approximately to 2 stage lower concentration than CEX. In connection to clinical efficacy of AMPC, the oral administration at a daily dose of 750 mg gave the effectiveness rate of 92.5%. Few side effects were caused by administering AMPC and this is an excellent drug for healing acute simple urinary infections.
Two autopsy cases of Cronkhite-Canada syndrome were reported. The caused of hypoproteinemia, electrolyte imbalance and ectodermal changes were discussed with reference to previously reported cases. The mechanism of protein loss was probably due to outflow into the intestinal lumen of the mucous substance in the cystically dilated glands, directly and/or indirectly followed by loss of mucosal surface. Electrolyte imbalance probably developed from gastrointestinal loss as well as poor substitution. The ectodermal changes were probably not a subsequent part of the emaciation or hypoproteinemis, but an inherent part of this disease. Therapy, whether substitution or surgical procedure, should be selected in order to control the general condition of the patient.
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Plasma Lps of the patients on maintenance hemodialysis and the patients with other specific renal diseases have been studied. The patients on hemodialysis frequently showed gross abnormality in their plasma Lps, which was differentiated from the abnormalities demonstrated in other renal diseases or clinical entities. An exception was type-III hyperlipoproteinemia; i.e. Lp electrophoretograms of the hemodialysis patients resembled those ultracentrifugal fractions had been made had VLDL of beta-migration in paper electrophoresis and another had VLDL or pre-beta-migration. During hemodialysis, intravascular lipolysis, accelerated by heparin infusion, affected all plasma Lps, producing an increase of alpha-Lps and cholestrol ester-rich-beta-Lp. The accelerated triglyceride hydrolysis under circumstances of high glucose availability may stimulate resynthesis of endogenous triglyceriderich Lps, which characterizes the plasma Lp abnormality in more than half of the hemodialysis patients. The abnormality may not be attribuate to the predisposing renal disease but due to an accumlation of the characteristic Lp during the course of maintenace hemodialysis. A possible cause of accelerated atherosclerosis in the hemodialysis patients may be the accumulation of remnants of plasma Lp catabolism and the stimulated synthesis of triglycerdie-rich plasma Lp.
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