Biomedical subjects

K Kashima

Publications and source records attributed to K Kashima.

331 records · Page 19Linked to original sources

PubMedDate not supplied

A case of polymyositis associated with chronic thyroiditis presenting as hyperthyroidism.

We describe a case of polymyositis associated with hyperthyroidism (Graves' disease). Clinical findings and thyroid function tests revealed hyperthyroidism. On histological examination, it was found that the thyroid gland was involved in chronic thyroiditis, and no appearance of Graves' disease was noted. This case suggested that the patient's muscle weakness might have been related to a disturbance of thyroid function, that is, coexistence of subclinical thyrotoxic myopathy. There were fluctuations in the levels of various antibodies during the clinical course of this overlap syndrome.

Female↗

PubMedDate not supplied

Movement disorder with abnormal copper metabolism--a case report and review of the literature.

We describe a neurological disease, seen in the elder sister of identical twins, with dysarthria, involuntary movements, spastic gait, slightly low serum copper, borderline low to normal serum ceruloplasmin, normal urinary copper, and a high hair copper concentration. This neurological disorder appears to differ from others associated with abnormal copper metabolism such as Wilson's or Menkes' kinky hair disease.

Adult↗

PubMedDate not supplied

A case of neurogenic orthostatic hypertension.

A patient with orthostatic hypertension of neurogenic origin is reported. The Schellong and head-up tilt tests produced a sudden moderate to marked increase of the blood pressure, but the plasma renin activity and plasma aldosterone level showed a normal response. The cold pressor test also produced a moderate to marked increase in the blood pressure. Pharmacological cardiovascular autonomic nervous function tests showed a decrease of parasympathetic tone and denervation hypersensitivity of the sympathetic nerve terminals. These findings suggest that the orthostatic hypertension in this patient was mainly due to sympathetic denervation hypersensitivity.

Adrenal Glands↗

PubMedDate not supplied

Langerhans cell histiocytosis of an adult with tumors in liver and spleen.

We describe a 58-year-old male with multiple histiocytic tumors in the liver and spleen. Multiple tumors in the liver and spleen were seen by image analysis, and splenectomy showed a large splenic tumor with a small nodule and a swelling lymph node in the hilus. Histological features of the tumors in the liver and spleen revealed proliferation of histiocytic cells with large and clear cytoplasm and a horseshoe-shaped nucleus. Immunohistochemical studies revealed the presence of S-100 protein and CD1a antigen in the tumor cells, and neither lymphocytic marker nor lysozyme was detected. No definite Birbeck granules were seen ultrastructurally, thus the tumor cells could be classified into Langerhans cell type without Birbeck granules. Administration of adriamycin, vincristine, cyclophosphamide and prednisolone reduced size and number of the liver tumors, and the histiocytic cells could not be detected in repeatedly biopsied tissue from liver tumor. We present the clinical, immunohistological and cytological features in a visceral type of adult Langerhans cell histiocytosis, which responded well to chemotherapy.

Antigens, CD1↗

PubMedDate not supplied

Primary and metaplastic choriocarcinoma of the bladder. A report of two cases.

Two cases of primary choriocarcinoma arose in the urinary bladder in males aged 72 and 70 years. Human chorionic gonadotropin (hCG) in serum and urine was significantly elevated in both cases. Cytologic features consisted of bizarre mononucleate and multinucleate giant cells with numerous erythrocytes, necrotic cells and neutrophils, indicating the possibility of choriocarcinoma. Histologically, one tumor consisted of an admixture of choriocarcinomatous areas and transitional cell carcinoma (TCC) with or without syncytiotrophoblastic differentiation, and the other was composed of pure choriocarcinoma. Immunohistochemical examination revealed that syncytiotrophoblasts and a small number of TCC cells were intensely positive for hCG in their cytoplasm. The histogenesis of choriocarcinoma arising in the bladder is considered to be metaplasia or retro-differentiation from TCC to trophoblasts because of TCC's differentiating to hCG-positive trophoblasts, as seen in one of the present cases.

Aged↗

PubMedDate not supplied

Pulmonary blastoma. A case report.

Pulmonary blastoma occurred in a 71-year-old man. Bronchial brushing specimens showed numerous epithelial cells and only a few mesenchymal cell clusters. The epithelial cells were round to oval, more uniform and smaller than ordinary adenocarcinoma cells. The nuclear:cytoplasmic ratio of these cells was increased, with an even chromatin distribution, and nucleoli were inconspicuous. Mesenchymal cell clusters were markedly hypercellular and consisted of small and short spindle-shaped cells with hyperchromatic nuclei. Although it is very difficult to diagnose pulmonary blastoma correctly by cytology, the possibility of pulmonary blastoma should be considered when small, nonsquamous neoplastic cells are observed, particularly in association with small and short spindle-shaped cells reminiscent of mesenchymal origin.

Aged↗

PubMedDate not supplied

Clinical features, image analysis, and laparoscopic and histological liver findings in Budd-Chiari syndrome.

BACKGROUND/AIMS: Clinical manifestations and histological features of the liver in Budd-Chiari syndrome (BCS), with or without idiopathic membranous obstruction of the inferior vena cava (MOVC), vary according to whether BCS is acute, subacute or chronic. We clarified the diagnostic features in 6 patients with MOVC and in 1 without MOVC. METHODOLOGY: Five patients with subacute or chronic type BCS with MOVC complaining of epigastric pain, hematemesis and encephalopathy, and signs of portal hypertension or collateral circulation were seen. There was 1 asymptomatic patient with MOVC. One patient with acute type BCS without MOVC revealed hepatic and multi-organ failure. Liver function tests in BCS with MOVC were similar to those in liver cirrhosis, and laboratory data in acute type without MOVC were quite the same as those seen in fulminant hepatitis. Non-invasive image analysis by US, CT and MRI showed thrombi and obstruction of the IVC, and extrahepatic vasculature or communication between hepatic veins and IVC. Vena cavography showed the length of obstruction in IVC and collateral circulation in the extrahepatic or intrahepatic veins. Liver biopsy demonstrated massive hemorrhagic necrosis in acute type without MOVC, and laparoscopy with liver biopsy in asymptomatic, subacute and chronic type with MOVC showed subcapsular hemorrhage, congestion, fibrosis, and cirrhotic features. CONCLUSIONS: The non-invasive image analysis was complementary to vena cavography, and liver biopsy with or without laparoscopy was essential not only for diagnosis of acute, subacute, and chronic BCS, but also for therapeutic decision-making.

Adult↗