Biomedical subjects

K Hiroshima

Publications and source records attributed to K Hiroshima.

At least 73 records · Page 4Linked to original sources

PubMed1996

Increased IL-6-production by cells isolated from the fibrous bone dysplasia tissues in patients with McCune-Albright syndrome.

McCune-Albright syndrome (MAS) is characterized by café-au-lait spot, multiple endocrine hyperfunction, and polyostotic fibrous dysplasia. A somatic point mutation of Gsalpha protein was reported to decrease GTPase activity, leading to increase in the GSalpha-associated hormone actions via cAMP. IL-6 is known to stimulate osteoclast formation and in the IL-6 promoter, a cAMP responsive element has been identified. In this paper, we investigated the role of IL-6 in the bone lesions of MAS, using the isolated fibrous cells from the polyostotic fibrous dysplasia tissues in bones of the two patients with MAS. Bone biopsy specimen revealed the increased osteoclast in number. In both patients, a GSalpha mutation (Arg201 -> His) was identified in the cultured fibrous cells. Intracellular cAMP content and IL-6 secretion by the patient cells were increased. Rp-8Br-cAMP significantly inhibited IL-6 production in the patient cells, while it had no effect on normal control. The addition of dibutyryl cAMP significantly increased the synthesis of IL-6 in normal control cells. In contrast, no effect of dibutyryl cAMP on IL-6 synthesis was observed in the cells from one of the MAS patients. These data suggest that IL-6 is, at least, one of the downstream effectors of cAMP and that the increased IL-6 synthesis has a pathogenic role in the bone lesions of MAS patients via increasing the number of osteoclasts. These results may provide a new strategy for the therapy of MAS patients.

Base Sequence↗

PubMed1996

Post-traumatic syringomyelia.

STUDY DESIGN: This study retrospectively analyzed patients who developed post-traumatic syringomyelia secondary to spinal cord injury. OBJECTIVES: To identify an indicator that would predict the outcome of surgical treatment for post-traumatic syringomyelia. SUMMARY OF BACKGROUND DATA: Syrinx-subarachnoid shunting was chosen as a surgical treatment for post-traumatic syringomyelia. No previous study has been published concerning magnetic resonance imaging findings' ability to predict surgical results before surgery. METHODS: Nine patients diagnosed by magnetic resonance imaging with post-traumatic syringomyelia were the subjects of this study. The magnetic resonance imaging findings and surgical results were analyzed. RESULTS: Neurologic deterioration was found in five patients. Ascending dissociated sensory disturbances and motor weakness were noticed to occur characteristically above the level of the spinal cord injury. The other four patients complained of a slight worsening of numbness without displaying neurologic deterioration. The five patients with neurologic deterioration were treated with a syrinx-subarachnoid shunting. Two of the five patients experienced sustained neurologic improvement after a midline myelotomy, which allowed the fluid within the syrinx to spout out and cause the expanded spinal cord to collapse. This was called a "high-pressure syrinx." In these two patients, the preoperative magnetic resonance imaging demonstrated a positive flow-void sign. On the other hand, drainage of the syrinx in the three patients with a negative flow-void sign did not collapse the expanded spinal cord, and the surgical results were considered fair. This was called a "low-pressure syrinx." CONCLUSIONS: Post-traumatic syringomyelia was classified into two types. A preoperative distinction could be made based on the presence or absence of the flow-void sign on a T2-weighted magnetic resonance image.

Adolescent↗

PubMed1996

Metastatic epidural bony tumor causing spinal cord compression: a case report.

The authors report the case of a patient with breast cancer who developed spinal cord compression due to the expansion of an epidural bony tumor from an osteoblastic vertebral metastasis into the spinal canal. Magnetic resonance imaging revealed an epidural mass that was compressing the spinal cord but that did not demonstrate the bony elements contained within the epidural mass. These bony elements were demonstrable only by computed tomography. The patient did not respond to radiotherapy but did recover after surgical decompression. Therefore, the authors recommend the use of computed tomography for patients who have osteoblastic vertebral metastases and epidural spinal cord compression diagnosed by MRI. Once an epidural bony mass expanding from a vertebral metastasis into the spinal canal is demonstrated by computed tomography, surgical decompression is indicated.

Breast Neoplasms↗

PubMed1996

Nodular pulmonary amyloidosis associated with asbestos exposure.

A 71 year old man was admitted for the purpose of diagnosis of a right solitary pulmonary nodule. The size of the nodule was 18 x 18 mm in diameter 2 years ago, but it has become large, 25 x 25 mm in diameter. The nodule was resected by thoracotomy. Microscopically, eosinophilic amorphous, acellular substances were surrounded by inflammatory infiltrates. It stained with Congo red stain and showed green birefringence with polarizing microscopy. Amyloid fibrils were observed electron microscopically. Asbestos bodies were observed in the lung parenchyma around the nodule. This case shows that a nodule in nodular pulmonary amyloidosis can grow gradually and suggests the possibility of asbestos fibers as one of the etiologic factors in nodular pulmonary amyloidosis.

Aged↗

PubMed1996

Factors influencing survival following pulmonary resection for metastatic colorectal carcinoma.

The results of pulmonary resection and clinical factors relating to long-term survival were evaluated in 29 patients with histologically proven pulmonary metastasis from colorectal carcinoma. The patients were followed up from 4 months to 120 months, with an average of 43.7 months. Overall 5- and 10-year survival rates were 41% and 34% respectively. The 5- and 10-year survival rates in patients with metastatic nodules 30 cm or less in diameter were 77% and 58%, respectively, a significantly better result than in those with metastatic nodules over 30 mm in diameter. Survival in patients without nodal involvement was significantly better than that in patients with lymph node metastases. Multivariate analysis according to Cox proportional hazards model demonstrated that the size of the metastasis was an independent prognostic factor.

Adult↗

PubMed1996

The cervical spine in athetoid cerebral palsy. A radiological study of 180 patients.

We have reviewed the cervical spine radiographs of 180 patients with athetoid cerebral palsy and compared them with those of 417 control subjects. Disc degeneration occurred earlier and progressed more rapidly in the patients, with advanced disc degeneration in 51%, eight times the frequency in normal subjects. At the C3/4 and C4/5 levels, there was listhetic instability in 17% and 27% of the patients, respectively, again six and eight times more frequently than in the control subjects. Angular instability was seen, particularly at the C3/4, C4/5 and C5/6 levels. We found a significantly higher incidence of narrowing of the cervical canal in the patients, notably at the C4 and C5 levels, where the average was 14.4 mm in the patients and 16.4 mm in normal subjects. The combination of disc degeneration and listhetic instability with a narrow canal predisposes these patients to relatively rapid progression to a devastating neurological deficit.

Adolescent↗

PubMed1996

[Malignant mediastinal schwannoma associated with von Recklinghausen's disease--a resected case].

A case of malignant mediastinal schwannoma associated with von Recklinghausen's disease is reported. A 44-year-old woman was admitted to Chiba University Hospital because of an abnormal shadow on chest X-ray film. CT scan showed a cystic tumor in upper mediastinum and then tumor extirpation was performed. This cystic tumor was related to the sympathetic trunk and 60 x 35 x 33 mm in diameter. Its cut surface showed a thick irregular capsule and multilocular. Microscopic examination disclosed malignant cells with mitosis associated with neurofibroma. An immunohistochemical staining of these malignant cells with anti S-100 protein showed positive reaction. From these findings this tumor was diagnosed as malignant schwannoma. There is no evidence of recurrence two year after the operation. This is the first case of malignant schwannoma with cystic formation in Japan.

Adult↗

PubMed1995

Blood and lymphatic vessel invasion as prognostic factors for patients with primary resected nonsmall cell carcinoma of the lung with intrapulmonary metastases.

BACKGROUND: The new classification of intrapulmonary metastases of lung cancer was proposed by the American Joint Committee on Cancer; however, the prognostic factors are heterogeneous and not yet fully clarified. In this study, the authors evaluated the prognostic factors for and the possible routes of intrapulmonary metastases. METHODS: The factors influencing the prognosis of primary resected nonsmall cell lung carcinomas with intrapulmonary metastasis in the resected specimens were evaluated according to the Cox proportional hazards model using a total of 66 nonsmall cell lung carcinomas. The possible routes of tumor spread via the blood or lymphatic vessels also were evaluated. RESULTS: The overall 5-year survival rate was 26.1%, and the statistical analysis of survival curves revealed a significant difference with regard to N classification (P = 0.042), site of intrapulmonary metastasis (P = 0.012), blood vessel invasion (P = 0.0046), and lymphatic vessel invasion (P = 0.0267); there were no significant differences in relation to age, sex, histology, differentiation, T classification, tumor size, stage, number of intrapulmonary metastases, or size of intrapulmonary metastasis. Multivariate analysis according to the Cox proportional hazards model identified a significant correlation between survival and blood vessel invasion (P = 0.044) and lymphatic vessel invasion (P = 0.042), suggesting independent prognostic significance. The correlation between site of intrapulmonary metastasis and the ratio of blood or lymphatic vessel invasion showed a significantly lower ratio of blood vessel invasion in cases with intrapulmonary metastases at sites central to the primary lesion or in different segment(s) compared with those in cases with intrapulmonary metastases at sites peripheral to the primary lesion or in ipsilateral different lobe(s), suggesting a possible lymphatic vessel route of tumor spread. CONCLUSION: Blood vessel and lymphatic vessel invasion are important clinical factors in evaluating prognosis and the route of tumor spread in primary resected nonsmall cell carcinoma with intrapulmonary metastasis.

Adult↗

PubMed1995

Idiopathic spinal epidural lipomatosis. Case report and review of literature.

Idiopathic spinal epidural lipomatosis rarely is found (8 reported cases) in the absence of steroid treatment or obvious endocrinopathy. One additional symptomatic case with gait difficulty is described here. The only common etiologic factor for all cases is their obesity. Magnetic resonance imaging is the most helpful diagnostic means and should be used initially. In a patient with radicular pain or progressive paralysis who is obese, spinal epidural lipomatosis may be the etiologic factor involved.

Adolescent↗

PubMed1994

Gadolinium-DTPA--enhanced magnetic resonance imaging of a sequestered lumbar intervertebral disc and its correlation with pathologic findings.

A 37-year-old man developed spinal nerve root compression caused by a sequestered lumbar intervertebral disc that migrated caudally away from the L5-S1 interspace of origin. Magnetic resonance imaging (MRI) scans of the lumbosacral spine after administration of gadolinium-DTPA (Gd-DTPA) revealed intense peripheral, but not entire, enhancement of an extradural defect. The result of examination using Gd-DTPA-enhanced MRI increased the certainty of preoperative diagnosis of sequestered disc. Pathologic examination of the resected specimen showed that the extradural defect was sequestered disc material covered with vascularized granulation tissue, and indicated that the intense peripheral enhancement of the extradural defect in Gd-DTPA-enhanced MRI was related to the accumulation of contrast material within the vascularized granulation tissue surrounding the avascular sequestered disc material.

Adult↗

PubMed1994

Serial change of sliding in intertrochanteric femoral fractures treated with sliding screw system.

We investigated the serial change of the extent of sliding of the compression screw in 42 intertrochanteric femoral fractures fixed with a sliding screw system. Neither age, gender, bone density, fracture type nor quality of fracture reduction could accurately predict healing time. There was a significant correlation between the extent of sliding at union and healing time (correlation coefficient r = 0.505). The average healing time in group B (the extent of sliding at union of 8 mm or greater) was 13.8 weeks postoperatively, and that in group A (the extent of sliding at union of less than 8 mm) was 8.9 weeks. There was a significant difference in the average healing time between groups A and B (P = 0.0004). The extent of sliding at union had a influence on the healing time. The phenomenon of sliding progressed mainly during the first 2 weeks postoperatively. There was a significant positive correlation between the extent of sliding at union and the extent of sliding at 2 weeks postoperatively (r = 0.977). An assessment using the extent of sliding at 2 weeks postoperatively can accurately predict the extent of sliding at union and the healing time. It is important to examine the phenomenon of sliding during the early postoperative course, especially until 2 weeks postoperatively, in order to predict fracture repair.

Age Factors↗

PubMed1994

Progressive migration in bipolar arthroplasty for osteoarthritis of the hip secondary to congenital dislocation.

Seventy-one hips with osteoarthritis secondary to congenital dislocation underwent bipolar arthroplasty with autologous bone grafting (grafted group) or without bone grafting (ungrafted group). Clinical and radiographic followup was performed; the average followup was 5.7 years (range, 3-11.3 years). At followup, the mean Merle d'Aubigné and Postel score was 14.3 points. Excellent or good results were achieved in only 50% of all cases. The mean extent of prosthetic head migration was 6.5 mm in the grafted group and 4.7 mm in the ungrafted group. Progressive migration occurred in 68% of the grafted group and in 43% of the ungrafted group. There was a significant negative correlation between the extent of migration of the outer head and the coverage of the outer head by the original acetabulum (R = 0.53). In the grafted group, the revision rate for failure of the outer head of the prosthesis was 60% at 6 years postoperatively. In the grafted group, progressive migration was more extensive and more frequently than in the ungrafted group. Extensive migration was also observed when there was adequate coverage of the outer head by host bone in the ungrafted group. In conclusion, bipolar arthroplasty is not recommended for osteoarthritis secondary to congenital hip dislocation because of the poor clinical outcome, high risk of significant progressive migration, and high revision rate.

Adult↗

PubMed1993

Characterization of asbestos fibers in lungs and mesotheliomatous tissues of baboons following long-term inhalation.

Changes in the dimensions of inhaled asbestos fibers in the lung and translocation of intrapulmonary asbestos fibers into mesothelial tissues were investigated in 17 baboons (5 exposed to amosite, 4 to chrysotile, 5 to crocidolite, and 3 unexposed). The animals received different cumulative doses of asbestos by inhalation, followed by varying recovery periods (0-69 months). All asbestos types induced pulmonary asbestosis with severity directly related to the cumulative dose. There were a larger number of asbestos bodies in the lung of the amphibole-exposed animals than in those exposed to chrysotile. A tissue burden study, using transmission electron microscopy on 25-microns paraffin sections, ashed in a low-temperature asher, was performed. Intrapulmonary amosite fibers were shorter in geometric mean length compared with a standard amosite sample (UICC) (3.3 microns). In explanation, it was considered that long fibers might not be able to reach the lower respiratory tract and/or long fibers might be fragmented into shorter fibers. Further, in the amosite-exposed group, the mean length of intrapulmonary fibers increased with the extension of recovery period, suggesting that shorter fibers had been cleared from the lung. The chrysotile standard sample (UICC) had a shorter geometric mean length (1.1 microns) than amosite. The mean length of intrapulmonary chrysotile did not noticeably change with the extension of inhalation and recovery periods; however, the mean width decreased with the extension of these periods. This finding strongly suggested that separation of thick chrysotile fibers had occurred in the lung. The crocidolite standard sample (Transvaal) had a shorter geometric mean length (1.4 microns) than amosite.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

The lumbar spine in spastic diplegia. A radiographic study.

Some radiological features of the lumbar spine of 84 patients with spastic diplegia were compared with 50 control subjects. The average age of the patients was 20.1 years (3 to 39). Spondylolysis of the fifth lumbar vertebra was found in 21%, four times more frequently than in normal subjects. No patient under nine years of age had spondylolysis and the frequency increased with age. The average angle of lumbar lordosis in spastic patients in the standing position was greater than in normal subjects, and increased with age. The patients had a decreased sacrofemoral angle which caused an increase in Ferguson's angle and explained the increased angle of lumbar lordosis.

Adolescent↗

PubMed1993

[A case of polypoid bronchial neurofibroma originating from right B2b successfully treated by bronchoscopic snaring forceps and Nd-YAG laser therapy].

A 34-year-old man with persistent cough was admitted to our hospital. Bronchoscopic examination revealed a polypoid tumor with smooth surface which almost completely obstructed the right main bronchus. The tumor was removed by transbronchial snaring forceps and histologically confirmed as neurofibroma. Residual tumor was excised by biopsy forceps and further endoscopic Nd-YAG laser vaporization was performed. This is the first case in our country in which bronchoscopic treatment was performed for bronchial neurofibroma. Bronchoscopic removal might be the preferred treatment in the present case, although long-term follow-up is also required.

Adult↗

PubMed1993

[A case of primary pulmonary artery sarcoma].

A 39-year-old male was admitted with persistent cough, palpitations and dyspnea on exertion. Chest X-ray showed cardiomegaly, left pleural effusion and left hilar mass shadow. Echocardiogram revealed dilatation and hypertrophy of the right atrium and ventricle. Perfusion lung scintigram disclosed a complete defect of the left lung and a partial defect of the right upper lobe. CT scan showed an intravascular tumor mass in the bilateral main pulmonary arteries. Digital subtraction angiography of the pulmonary artery revealed complete obstruction of the left pulmonary artery and stenosis of the right pulmonary artery. MR image showed intravascular tumor infiltrating the mediastinum and surrounding tissue. Sarcoma was highly suspected, but a histopathological diagnosis could not be made. The patient died of heart failure two months after admission to our hospital. Postmortem examination showed that the pulmonary trunk and left main pulmonary artery were markedly dilated and completely occluded by the tumor. Tumor infiltrated into the left upper lobe and mediastinal lymph nodes. The tumor was histologically diagnosed as undifferentiated sarcoma.

Adult↗

PubMed1993

Characterization of asbestos bodies and uncoated fibers in lungs of hamsters.

Dimensional changes of asbestos bodies and uncoated fibers and the leaching of magnesium from the surface of chrysotile after a single intratracheal injection (1 mg) were investigated in male hamsters. The animals were sacrificed at 1 day, 6 months, 1 and 2 years later. In addition to histopathological observation, asbestos tissue burdens were investigated in 25 microns thick sections of the lungs. The sections were ashed in a low-temperature asher to be extracted with carbon film. The carbon extracted ashed sections were investigated by high resolution analytical electron microscopy to characterize asbestos fibers and asbestos bodies. Pulmonary interstitial and pleural fibrosis were observed after 6 months and later on. Light microscopically, asbestos bodies were observed after 6 months; their incidence subsequently increased with the lapse of time after the injection. Asbestos bodies measured on light micrographs became longer with the lapse of time. This suggested that the coating of chrysotile fibers had been continuously progressing in the lung. Geometric means of length and width of uncoated chrysotile fibers seen by transmission electron microscopy in animals at 1 year (length: 1.4 microns; width: 0.057 micron) or 2 years (1.2 microns, 0.047 micron) were greater compared with those of animals at 1 day (0.9 micron, 0.041 micron) or 6 months (0.9 micron, 0.037 micron) after instillation. These findings suggested that short and thin chrysotile fibers were cleared from the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

A case of adenocarcinoma of the lung with a spindle cell component.

We report a 60-year-old man, who was admitted to the hospital with complaints of cough and sputum. His chest x-ray showed an abnormal mass in the right upper lobe. After admission he noticed the painful gingival tumor. Right upper lobectomy and resection of the gingival tumor were performed. Their histological features showed that the tumor consisted of a papillary and tubular adenocarcinoma mixed with a component of spindle cells. Immunohistochemical study demonstrated a positive reaction in the epithelial component for keratin and epithelial membrane antigen, and not only these epithelial markers but also vimentin were expressed in some spindle tumor cells. Electron microscopic study confirmed the biphasic pattern, showing gland formation and undifferentiated cells. We diagnose this case as adenocarcinoma of the lung with a spindle cell component and the gingival tumor was metastatic. Autopsy showed that metastatic lesions were found in the left adrenal gland and in the left kidney. The tumor cells in the left adrenal gland were composed of spindle cells and the tumor in the left kidney showed gland formation. Immunohistochemical and electron microscopic findings of surgical and autopsy specimen suggest that this tumor is of epithelial origin, and the spindle cells are derived from immature mesenchymal cell transformation of epithelial cells.

Adenocarcinoma↗