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Biomedical subjects

K Kakudo

Publications and source records attributed to K Kakudo.

At least 73 records · Page 4Linked to original sources
PubMed1998

Pulmonary capillary hemangiomatosis: a unique feature of congestive vasculopathy associated with hypertrophic cardiomyopathy.

A 34-year-old man with an 18-year history of hypertrophic cardiomyopathy died of worsening right-sided heart failure. Central venous pressure was greatly increased to 25 cm H2O before death. Postmortem examination revealed features of severe congestive vasculopathy, including those of pulmonary capillary hemangiomatosis in the lungs. Marked proliferation of capillaries was seen chiefly in alveolar septa and extending into pulmonary veins and arteries, causing severe luminal occlusion with recanalization. Diffusely distributed intra-alveolar edema and hemorrhage with collections of hemosiderin-laden macrophages were also seen, which suggested that the pulmonary capillary hemangiomatosis was associated with longstanding chronic passive congestion of the lung. It is possible that severe pulmonary passive congestion may be one of the causes of development of idiopathic pulmonary capillary hemangiomatosis.

Adult↗
PubMed1998

[Quality control in aspiration biopsy cytology].

Comparison and quality control of our experience of thyroid cytology (784 samples) and breast cytology (1,202 samples) were reported. False positive rate and other parameters were superior in breast cytology than thyroid. It may be due to the fact that cytological diagnostic criteria for follicular thyroid carcinoma from follicular adenoma is not established yet. More suspicious diagnosis in thyroid than breast also give low incidence of malignancy in thyroid suspicious diagnosis. As recommended by a guideline for both thyroid and breast cytology from the Papanicolaou society et al, conservative handling and protective diagnosis may help to reduce false positive and false negative rates.

Breast Diseases↗
PubMed1998

Somatic mutations of multiple endocrine neoplasia type 1 gene in the sporadic endocrine tumors.

Endocrine tumors of the parathyroid and pancreas are encountered either as sporadic type or as part of multiple endocrine neoplasia type 1 (MEN 1). A high frequency of the loss of heterozygosity (LOH) has been observed in tumors of the sporadic type in the locus of the MEN 1 gene, which has recently been cloned and designated the menin gene. It would be of great interest to determine whether somatic mutations in the menin gene are responsible for the sporadic endocrine tumors. For this purpose, we have investigated the menin gene mutations in 21 sporadic parathyroid adenomas, 2 parathyroid carcinomas, 4 sporadic insulinomas, and 1 malignant VIP (vasoactive intestinal polypeptide)oma with WDHA (watery diarrhea, hypokalemia, and achlorhydria) syndrome, using PCR-single strand conformation polymorphism analysis and DNA sequencing. In none of these cases did the patient have a family history or other possible association with MEN 1. We have discovered somatic point mutations in two parathyroid adenomas (A340T and A541T), in one insulinoma (T429K), and in the malignant VIPoma (W198X). In addition, we have found two polymorphisms (D418D and V367V) in two parathyroid carcinomas and two parathyroid adenomas. Of these mutations and polymorphisms, three (A340T, T429K, and V367V) are first reported here, in the present article. Our results indicate that somatic mutations of the menin gene are responsible for a proportion of the sporadic parathyroid adenomas and pancreatic islet cell tumors.

Adenoma↗
PubMed1998

Pulmonary hypertension associated with systemic lupus erythematosus: predominantly thrombotic arteriopathy accompanied by plexiform lesions.

We report an autopsy case of pulmonary hypertension associated with systemic lupus erythematosus in a 48-year-old woman. After 8-year follow-up under a definite diagnosis of systemic lupus erythematosus, she experienced gradually developing exertional dyspnea with palpitation. Her chest x-ray showed clear lung fields with marked cardiac enlargement. A right cardiac catheterization revealed a pulmonary arterial pressure of 74/30 mm Hg (mean: 47). She was treated with repeated plasmapheresis, oral corticosteroid, and immunosuppressant without improvement, and she died suddenly, 23 days after admission. Pathological examination revealed that small pulmonary arteries and arterioles were diffusely involved by florid thrombotic lesions, which were characterized by intimal eccentric fibrous thickening, luminal occlusion with recanalization, and occasional fresh thrombi. In addition, some arteries showed plexiform lesions coexistent with intimal thrombotic lesions. Concentric laminar intimal fibrosis was not seen. No significant parenchymal change was seen. Our study not only adds a rare case of thrombotic pulmonary hypertension associated with systemic lupus erythematosus, but also suggests that plexiform lesions can occur in association with thrombotic arteriopathy.

Fatal Outcome↗
PubMed1998

Objective evaluation of Papanicolaou staining.

OBJECTIVE: To evaluate the color of cytoplasm stained by Papanicolaou staining quantitatively. STUDY DESIGN: Cytoplasm photographed under the same conditions was measured for spectral reflection by colorimetry, and the color of the cytoplasm was shown by the L*a*b* color specification. RESULTS: This method enabled us to specify the color of cytoplasm, which was classified in light green, eosin and orangeophilic. CONCLUSION: The variation in the color of cytoplasm by different staining methods was quantified and related to the dyes absorbed by the cytoplasm.

Colorimetry↗
PubMed1997

Comparative analysis of clonality and pathology in primary and secondary hyperparathyroidism.

Parathyroid adenoma and hyperplasia are the most common causes for hyperparathyroidism, and distinction between them is controversial based on the current criteria for pathological diagnosis. We studied the clonality of hyperparathyroidism and its correlation with the pathological features, analysing 39 female patients with hyperparathyroidism. Clonality was successfully detected in 12 heterozygous cases by PCR amplification of PGK-1 gene. The 12 cases yielded 14 hypercellular glands, 8 affected by primary and 6 by secondary hyperparathyroidism. The results revealed that 7 of the 8 glands with primary hyperparathyroidism showed monoclonal proliferation. Only 1 gland pathologically diagnosed as adenoma showed a polyclonal pattern. In the 4 cases with secondary hyperparathyroidism, at least one monoclonal tumour was detected in each case. Our data indicate that monoclonal tumours are more common than expected in both primary and secondary hyperparathyroidism. Monoclonal tumours and polyclonal hyperplasia can co-exist in the same patient. Comparative study of the clonality and the pathological features showed that the clonality was consistent with the diagnosis of parathyroid adenoma, whereas it was in conflict with the diagnosis of hyperplasia with multigland involvement. One of the reasons for this is that we are ignorant of the true natures of hyperparathyroidism with multigland involvement.

Cell Line↗
PubMed1997

Allelic variants of human calcitonin receptor in the Japanese population.

Evidence from cDNA cloning has shown that calcitonin receptors (CTRs) have seven potential transmembrane domains. In this study, structural analysis of CTRs from ten cultured human tumor cell lines and 117 human blood samples demonstrated allelic variants at the 1377th nucleotide in intracellular domain 4, expressing either proline or leucine as the 463rd amino acid. It was found that the variant with proline at this site was the more prevalent type of CTR among the Japanese population.

Alleles↗
PubMed1997

A case of sarcoid reaction associated with papillary thyroid carcinoma.

Sarcoid reaction, a granulomatous lesion similar to those seen in sarcoidosis, has been reported to be associated with various disorders. Here we describe a 54-year-old woman, who was diagnosed with sarcoid reaction associated with papillary carcinoma of the thyroid. Her history included total thyroidectomy with radical neck dissection for a papillary carcinoma of the thyroid. She was found to have a right subclavian mass. Dissection of the mass was performed for the diagnosis of metastatic papillary carcinoma to the lymph node, but the pathological examination showed granuloma without caseation as well as metastasis to the lymph node. Polymerase chain reaction (PCR) of the specimen excluded a possibility of Mycobacterium infection. There was no supporting evidence for systemic sarcoidosis in this patient; the patient showed no skin, eye, or lung lesions, or bilateral hilar lymphadenopathy, and she did not show increase in serum gamma-globulin or in plasma angiotensin-converting enzyme (ACE) levels, or increased CD4/CD8 ratio of lymphocytes obtained from bronchoalveolar lavage. These findings suggest that the present case had sarcoid reaction associated with papillary carcinoma. Although sarcoid reaction has been reported to be associated with various malignancies, only five cases, to our knowledge, are reported in the literature, which were associated with papillary carcinoma.

Carcinoma, Papillary↗
PubMed1997

Detection of Epstein-Barr virus DNA in gastric carcinoma with lymphoid stroma.

Gastric carcinoma with lymphoid stroma (GCLS) was considered to be one of the virus-associated neoplasms. However, the precise mechanism of Epstein-Barr virus (EBV) oncogenesis for GCLS remains unclear. We used polymerase chain reaction (PCR) and DNA in situ hybridization (ISH) methods to detect the presence of EBV DNA in 14 cases of gastric carcinoma, including 8 cases of GCLS. Epstein-Barr virus DNA was detected by both PCR and ISH in 3 of the 8 GCLS cases (37.5%) and was negative in the other 6 cases of non-GCLS. In situ DNA hybridization showed that the EBV DNA was in the carcinoma cells in all cases that were positive by PCR. Among the positive cases, one early gastric carcinoma showed that EBV DNA was not only in the carcinoma cells, but also in the normal epithelium. This study provides the interpretation of the finding of EBV DNA in nonneoplastic gastric epithelium. Some genetic changes may be initiated in the EBV-infected nonneoplastic cells, which would lead to oncogenesis.

DNA, Viral↗
PubMed1997

Synchronous and metachronous multicentric squamous cell carcinomas in the upper aerodigestive tract.

A rare case is presented of a 57-year-old Japanese male with synchronous and metachronous multicentric squamous cell carcinomas (SCC) in the upper aerodigestive tract. During a 9-year-period from the appearance of first primary SCC to autopsy, 14 foci of primary SCC and one severe dysplasia developed in succession in the thoracic esophagus, oral floor, soft palate, uvula, lingual radix, piriform recess, hypopharynx, cervical esophagus, trachea and lingual body. The patient died of severe bronchopneumonia due to Gram-negative bacterial infection that developed as a result of recurrent nerve paralysis. Human papilloma virus and Epstein-Barr virus, which are risk factors, were not detected by immunohistochemistry or by the polymerase chain reaction method. Genetic analysis revealed the absence of point mutations in K-ras codon 12. Heavy consumption of alcohol and excessive smoking may have been responsible for the multicentric carcinogenesis. This is the first case report in the literature of the development of so many primary SCC lesions in the upper aerodigestive tract during such a short period.

Carcinoma, Squamous Cell↗
PubMed1997

Chondroitin sulfate isomers in synovial fluid of healthy and diseased human temporomandibular joints.

Synovial fluid was collected from the superior articular cavity of the temporomandibular joint in patients with unilateral internal derangement and joint pain whose contralateral joint was healthy. Glycosaminoglycans were liberated by digestion with pronase E, and precipitated with cetylpyridinium chloride and ethanol. Unsaturated disaccharide isomers of chondroitin sulfate, obtained following chondroitinase ACII digestion, were analyzed by high-performance liquid chromatography. Analytic data indicated that deltaDi-0S and deltaDi-6S were often found in chondroitin sulfate from the fluid of the diseased joints. The amounts of deltaDi-0S and deltaDi-6S differed significantly between synovial fluid samples from the diseased and healthy joints. Comparison of the relative proportions of the unsaturated disaccharides in the synovial fluid with previously reported values for several tissues, indicated that the chondroitin sulfate originated from articular cartilage, with possibly some contributions from soft connective tissues and serum present in the synovial fluid. These results suggest that chondroitin sulfate in the synovial fluid provides a useful indicator of the degree of internal derangement of the temporomandibular joint.

Adult↗
PubMed1997

Immunoelectron microscopic demonstration of regulated pathway for calcitonin and constitutive pathway for carcinoembryonic antigen in the same cells of human medullary carcinomas of thyroid glands.

The human medullary carcinomas are well known to secrete calcitonin (CT) as a neuroendocrine peptide and carcinoembryonic antigen (CEA) as a serum protein that is integrated into the cell membrane. This ultrastructural study is designed to elucidate whether CT and CEA are secreted via two different intracellular secretory pathways, a regulated pathway and a constitutive pathway. The immunoelectron microscopic postembedding method, performed on four cases of the human medullary carcinomas of the thyroid using plastic embedding material, disclosed two distinct different localization patterns for CT and CEA. CT was localized exclusively in dense cored secretory granules. CEA was present in the cell membrane and in the secretory vesicles. The secretory granules were completely negative for CEA. The trans-Golgi networks were also positive for CT and CEA. Electron microscopic double staining confirmed these localization in the same carcinoma cells. These observations suggest the presence of two distinct pathways in the endocrine cancer cells, i.e., the regulated pathway for CT and the constitutive pathway for CEA.

Biological Transport↗
PubMed1997

A simple approach to single-cell microdissection and molecular analysis.

OBJECTIVE: To develop a simple approach to single-cell microdissection from Papanicolaou-stained smears and to determine its usefulness in molecular diagnosis using archival cytologic material. STUDY DESIGN: Culture cells from three cell lines (TT, A549 and Lu65) were used to prepare Papanicolaou-stained smears. Mount-Quick, a mounting medium, was used to establish the method of sorting target single cells from smear slides under direct microscopic observation. Calcitonin receptor gene and codon 12 of the K-ras oncogene were amplified to check the application of single-cell genetic analysis in cytology. RESULTS: The target single cell could be simply sorted from Papanicolaou-stained smears using the Mount-Quick microdissection technique. Boiling in water was more suitable for preparing DNA from a single cell or from fewer than five cells versus other methods. Analysis of calcitonin receptor gene and K-ras codon 12 demonstrated that molecular analysis was applicable to a single cell or a few cells from archival Papanicolaou-stained smears. CONCLUSION: This approach has significant implications for cytology: (1) it circumvents the limitations of molecular analysis in cytology and makes the combination of molecular analysis and morphologic diagnosis possible in cases with limited materials; (2) the remaining part of the smear is still preserved well for additional analysis; and (3) the approach is simple, economical and practical for cytology as well as histology.

DNA, Neoplasm↗
PubMed1996

Nodular lymphoid hyperplasia of the terminal ileum: report of a case and the findings of an immunological analysis.

The immunological and immunohistochemical characteristics of a patient with nodular lymphoid hyperplasia (NLH) of the terminal ileum were investigated pre- and post-operatively. The patient presented with diarrhea, lower abdominal pain, and weight loss, and an abdominal X-ray following barium enema revealed multiple small nodules in the terminal ileum which were subsequently confirmed to be NLH by histological examination. Preoperatively, although the serum immunoglobulin levels were normal, the T-cell responses in the peripheral blood, including the phytohemagglutinin (PHA)-blastogenesis and the T4/T8 ratio, were impaired. However, following an ileocecal resection, the PHA-blastogenesis became augmented and the T4/T8 ratio recovered to within the normal range. The immunohistochemical findings revealed a more marked accumulation of T cells in the interstitium around the hyperplastic follicles than in the interstitium of the normal intestine.

CD4-CD8 Ratio↗
PubMed1996

Post-bullous milia.

A 65-year-old woman with bullous pemphigoid responded rapidly to treatment with systemic and topical corticosteroids, but subsequently developed multiple milia where the bullae had been.

Adrenal Cortex Hormones↗