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Biomedical subjects

K Hiroshima

Publications and source records attributed to K Hiroshima.

At least 91 records · Page 5Linked to original sources
PubMed1992

A case of primary sarcoma of the pulmonary artery.

A 39-year-old male was admitted complaining of nonproductive cough and dyspnea on exertion. Death occurred eight months after onset of the symptoms. Autopsy examination showed that the pulmonary trunk and left main pulmonary artery were markedly dilated and completely occluded by a tumor. The tumor had infiltrated into the left upper lobe and mediastinal lymph nodes, and metastatic nodules were found in both lungs and in the left adrenal gland. Small foci of infarction were noted in the lower lobes of both lungs. The tumor cells were of two types; pleomorphic spindle cells and bizarre multinucleated giant cells. Immunohistochemically, they were positive for vimentin, myosin, and lysozyme, but negative for desmin and muscle-specific actin. The cytoplasm of the tumor cells was showed by electron microscopy to contain microfilaments, dense bodies, and pinocytotic vesicles. We diagnosed this case as undifferentiated sarcoma of the pulmonary artery. Approximately 100 cases of pulmonary artery sarcoma have been reported. Histopathologically, almost all of the reported cases showed both spindle cells and pleomorphic giant cells, indicating a biologically anaplastic neoplasm.

Adult↗
PubMed1992

Ehlers-Danlos syndrome with soft-tissue contractures.

We report four patients with a form of Ehlers-Danlos syndrome associated with soft-tissue contractures from birth and skin hyperalgesia. In early infancy, these cases were thought to be forms of arthrogryposis multiplex congenita, Larsen's syndrome or Marfan's syndrome. The characteristic triad of signs of Ehlers-Danlos disease gradually appeared from four to six years of age, allowing us to establish the correct diagnosis. We discuss the differential diagnosis of these connective-tissue disorders and the problems of the orthopaedic treatment of the associated joint deformities. Ehlers-Danlos syndrome is a heterogeneous group of metabolic diseases of collagen and our cases constitute a group which is distinct from the conventional types.

Adult↗
PubMed1992

[A case of new type scrub typhus (tsutsugamushi disease) presenting with acute respiratory failure and hemophagocytic syndrome].

A 47-year-old male was referred to our hospital with persistent high fever. He had received antibiotics (ASPC) for the diagnosis of acute infectious disease, which failed to respond, and subsequently developed marked lymphocytopenia and thrombocytopenia. During his hospitalization, hypoxic respiratory failure rapidly developed. A bone marrow aspiration revealed marked hemophagocytosis, leading to the tentative diagnosis of opportunistic respiratory infection associated with malignant histiocytosis. Treatment for suspected malignancy and Pneumocystis carinii pneumonia was commenced. However, because of the initial lack of response to ASPC, generalized skin rashes without an ordinary stick wound which had diminished before the hospitalization, and a history of working outdoors in a nearby mountain area, the possibility of new type tsutsugamushi disease was strongly suggested. Intravenous administration of minocycline promptly improved his symptoms and laboratory data. The diagnosis was confirmed by a significant increase in the titer of antibody to Rickettsia tsutsugamushi. The thrombocytopenia was considered to have been caused by co-existent hemophagocytic syndrome.

Acute Disease↗
PubMed1991

[A case of Kartagener's syndrome with bilateral superior vena cava and absent inferior vena cava].

A 39-year-old man with a history of repeated attacks of acute bronchitis and pneumonia since childhood was admitted complaining of cough, sputum, and a high fever. A diagnosis of Kartagener's syndrome was made because of the presence of mirror-image dextrocardia with complete situs inversus, bronchiectasis in right B6 and B10, and chronic sinusitis. Examination of the ciliary ultrastructure of the bronchial epithelium showed defective inner dynein arms and impaired nasal clearance was suggested by the saccharin particle method. Contrast venography of great veins revealed a McCotter type II bilateral superior vena cava and an absent inferior vena cava with (hemi-) azygos continuation. A search to find a similar case in the literature failed. Abnormal ciliary movement from the embryonic period was implicated as a causative factor in Kartagener's triad and the morphological abnormalities of the great veins.

Adult↗
PubMed1990

Physical therapeutic and surgical management in spastic diplegia. A Japanese experience.

With the development of intensive neonatal care, spastic diplegia associated with prematurity has become the most common type of cerebral palsy. The principles of the present authors' treatment for children with the disease are physical therapy (involving neurodevelopmental treatment) and surgical treatment for contractures and deformities. The authors studied the long-term results of physical therapy and its effect on the necessity for surgery and the improvement of locomotor function. From 1973 to 1988, 355 children with spastic diplegia were treated at the authors' facility. From this group, the authors selected and studied 71 children who received systematic treatment for a minimum of one year and who could be followed at the age of six years or older. At the follow-up examination, 41 of these children were free ambulators, 28 were crutch ambulators, and two were not ambulatory. Of the 41 freely ambulatory children, four achieved free ambulation after the age of seven years. Of the 28 crutch ambulators, relatively small hip-flexion contractures were found in 11 children who had received the early developmental treatment program.

Cerebral Palsy↗
PubMed1989

Morphological study of the effects of ozone on rat lung. II. Long-term exposure.

To evaluate the morphological changes observed in animals after prolonged ozone exposure, 56 male rats were exposed to a high ambient level of ozone (0.5 ppm) 6 hr a day, 6 days a week, for 2, 3, 5, and 12 months and examined by light and electron microscopy. Bronchitis and peribronchitis were observed throughout the exposure periods, and connective tissue around the bronchi thickened as a result of fibrosis. Some bronchiolar ciliated cells were in a degenerated condition and others in a reparative phase. Hyperplastic nodules were not found in the bronchioles, but hyperplasia of the bronchiolar epithelium was observed. Hyperplasia of lymphoid nodules around small vessels was prominent after 2 months of exposure. After 3 months of exposure, alveolar ducts were lined by type 2 cells, and after 12 months, by the bronchiolar epithelium consisting of both ciliated and nonciliated cells. Alveolar macrophages accumulated in the centriacinar alveoli. Fibrous strands were seen to be deposited in alveolar ducts after 3 months, and in bronchioles after 5 months. This fibrosis was due to an increment in collagen fibers. The degree of fibrosis increased with the length of ozone exposure.

Animals↗
PubMed1989

Unstable cervical spine in athetoid cerebral palsy.

The manifestations and pathomechanism of cervical instability of the athetoid neck in cerebral palsy (CP) patients was clarified in this study by means of static and dynamic x-ray analysis. Instability was defined as follows: 1) listhesis indicating anterior or posterior slip of more than 3 mm and/or 2) sagittal rotation between two vertebrae beyond the normal range measured by Penning. Cervical instability fitting this definition mainly took place in the upper and middle cervical disc levels, such as C3-4, C4-5, and/or occasionally C5-6. These coincide with the disc levels adjacent to the apex of the lordotic curve and/or those around the transitional vertebrae between the two reversed curves that render the cervical spine S-shaped in athetoid CP. A large facet angle at the apex vertebra facilitated anterior and/or posterior listhesis of the vertebrae. Conversely, a sudden decrease in the facet angle around the transitional vertebra in S-shaped curves precipitated deflection of the spine and increased sagittal rotation at this level. In addition to these structural abnormalities, rapid and repetitious neck movements seemed to accelerate the progression of cervical instability in athetoid CP patients.

Athetosis↗
PubMed1988

Morphometry of the cervical spinal cord and its relation to pathology in cases with compression myelopathy.

The purpose of this study was to determine whether or not computerized tomography myelography (CTM) gave an actual size and shape of the cervical spinal cord, and whether such dimensions reflected pathology of the spinal cord in cases suffering from compression myelopathy. Spinal cord transverse area and compression ratio (sagittal diameter divided by transverse diameter) were measured as indicators of spinal cord morphology. As a basis for this study, we first performed CTM of cadaveric cervical columns and compared the actual dimensions of the spinal cord of the cadaveric specimens with the CTM image. Second, the correlations between these dimensions and pathology of the affected spinal cord were investigated. The results showed that CTM provided a precise image of the actual cross-section of the spinal cord. In 12 cadaveric specimens of cervical myelopathy examined, the transverse area and compression ratio were in good correlation with the severity of observed pathological changes.

Aged↗
PubMed1987

A morphological study of the effects of ozone on rat lung. I. Short-term exposure.

In order to determine the effects of ozone on lungs and the course of cell renewal after damage, young male rats were exposed to 3 ppm of ozone for 4 hr. They were killed at 1, 6, 12, and 18 hr and 1, 2, 3, 4, 7, and 14 days after exposure. One hour before the killing, dividing cells were labeled with tritiated thymidine. Type 1 cells of centriacinar location and bronchiolar cells were severely damaged after exposure. Labeling indices of type 2 cells and bronchiolar nonciliated cells increased 1 day after exposure. Hyperplasia of type 2 cells and bronchiolar nonciliated cells was observed 2 and 3 days after exposure. Ciligenesis of bronchiolar ciliated cells occurred 4 days after exposure. Our study shows that injured type 1 cells are repaired by proliferation of type 2 cells and that injured bronchiolar ciliated and Clara cells are repaired by proliferation of bronchiolar nonciliated cells. These undifferentiated cells are probably progenitors of ciliated cells and Clara cells, and some nonciliated cells are in a transitional form between nonciliated and type 2 cells.

Animals↗
PubMed1986

[Ehlers-Danlos syndrome--clinico-pathology and orthopedic treatment].

Eight cases of Ehlers-Danlos syndrome (EDS) were surveyed for clinical manifestations and orthopaedic treatment. Cases of EDS were clinically subdivided into three groups. The first group was characterized by multiple congenital contractures in the extremities, so that it was very difficult to distinguish it from arthrogryposis multiplex congenita in early infancy. Since laxity of the soft tissue coexists with contracture in this group, over-correction of deformity caused much more disability than under-correction, especially in clubfoot. Care should therefore be taken to avoid this. The third group was characterized by marked laxity of the soft tissue from birth. Diagnosis in this group was easily made by the obvious triad of EDS. Lengthy immobilization in an appropriate position was necessary to maintain a corrected position for the treatment of any deformity in the hip, foot or hand. In the second group, deformity and disability were clinically so mild that no orthopaedic management was generally required.

Child, Preschool↗
PubMed1984

Ball-and-socket ankle joint: anatomical and kinematic analysis of the hindfoot.

Ten feet in eight children with ball-and-socket ankle joint (BSA-J) are reported with discussion of associated anomalies, kinematic analysis of the hindfoot motion, and talocalcaneal malalignment in the apparent valgus deformities. BSA-J is considered to be a common congenital condition associated with other anomalies in the foot or lower extremities. Even though BSA-J seems to have unusual side-to-side motion at the ankle joint, it does not occur in patients without subtalar fusion. Moreover, apparently valgus feet are responsible for talocalcaneal malalignment, not for lateral unstable motion at the ankle.

Ankle Joint↗
PubMed1983

[Histopathological changes of the human spinal cord--with special reference to latent lesions found in spinal cords of the aged].

The fifty-six spinal cords, which were randomly removed from the patients at the First Department of Pathology, National Defence Medical College, were histopathologically examined, to detect masked spinal lesions and some age-related changes. Pathological lesions were found in 55.4% of the cases, about half of which were opportunistic findings and had not caused any clinical symptoms. In these opportunistic lesions, benign neurogenic tumors (one cellular ependymoma from the central canal and ten schwannomas arose from anterior or/and posterior rootlets in 7 cases) were found predominantly in the higher age-group (17.9% of the cases above the age of 60 year had these tumors). Other opportunistic lesions were paraneoplastic syndrome, arachnoiditis ossificans, minimum-sized infarction in the spinal gray-matter, demyelination of the posterior white column, ganglio-radiculopathy and so on. As the basic changes of the cord related with aging process, attention was focused on the dystrophic axonal swelling and perivascular schwannosis. The incidence of dystrophic axonal swelling and of perivascular schwannosis were relatively correlated with patient's age. Hyalinization of arterioles in the spinal cord and the cauda equina were also observed in the higher age. It could be suggested that these vascular hyalinization would unfavorably influence the vulnerability of the spinal cord.

Adolescent↗
PubMed1983

Primary leiomyosarcoma of bone. An immunohistochemical and ultrastructural study.

Primary leiomyosarcoma of bone is extremely rare. A 60-year-old woman had a mass in the right femur that was studied immunohistochemically and by electron microscopy. Human smooth-muscle actomyosin was detected in tumor cells, but human skeletal-muscle myoglobin and lysozyme (muramidase) were not. Electron microscopy of the tumor showed findings suggestive of a smooth-muscle origin, such as myofilaments, dense bodies, pinocytotic vesicles, and basement membrane. The results were diagnostic of leiomyosarcoma rather than rhabdomyosarcoma, fibrosarcoma, or malignant fibrous histiocytoma, which are similar neoplasms. We believe that ours is the first case of primary leiomyosarcoma of the bone proved by immunohistochemistry.

Actomyosin↗
PubMed1980

Anterior transfer of the toe flexors for equinovarus deformity of the foot.

Anterior transfer of the long toe flexors was carried out for the treatment of spastic equinovarus foot deformity in both adults and children. Adults included those with hemiplegia subsequent to a stroke, spastic hemiplegia due to cerebral palsy and spastic spinal paraplegia. Most of the children had cerebral palsy. The transfer was indicated for an equinovarus foot with persistent activity of the toe flexors, which produced curling of the toes in the swing phase of the gait or a fixed hammer toe deformity. Fifty six patients were followed up for more than four years. In all cases correction of the equinovarus deformity was achieved and maintained. With satisfactory correction stability of the ankle improved, postural abnormalities during gait decreased and bracing was not required. This study demonstrates the advantage of the long toe flexors for muscle transfer in these patients. The length of tendon available permitted easy transfer to the metatarsal. The defunctioning of the spastic muscles allowed gait improvement and function of the tibialis posterior and tibialis anterior was preserved.

Adolescent↗