Biomedical subjects
Publications and source records attributed to M Mizoguchi.
We describe a case of herpetiform pemphigus associated with lung cancer. Only one other documented association between herpetiform pemphigus and malignancy could be found in the Japanese dermatologic literature. However, it is very difficult to determine whether such an association is coincidence or a true relationship.
The diagnostic criteria for BPD such as the DSM-III(-R) and DCR, based on polythetic format for prototypal categories, has not always been able to result in accurate clinical diagnosis of BPD. Reasons posited for this were that DSM-III(-R) criteria consist of symptom items based on descriptive phenomenology, even for Axis II personality diagnosis, and that descriptions of the criteria were vague because of the standardization of vocabulary which aimed at improved inter-rater reliability. With the polythetic "yes/no" format, diagnosis was influenced by the determination of only one item; furthermore, different combinations of items yielding a heterogeneous membership might lead to the same diagnosis. It was, therefore, considered difficult to perform an accurate diagnosis of BPD in clinical practices using the existing general diagnostic criteria, and it was realized that the development of new diagnostic criteria for BPD was necessary. For those reasons, we generated a Clinical BPD Scale (CBS) as diagnostic evaluation scale of BPD with considering advantages for clinical use. This reconstituted some features of BPD which have been reported by many researchers, synthesizing symptomatic elements and personality structural elements. CBS is composed of four clusters, Two of these four clusters are evaluated by four grade anchor points which are provided for the rating of the severity of symptoms, and that are illustrated on the radarchart for comprehensive evaluation of the severity of the disorder. CBS was confirmed to have a high degree of validity, and achieved a satisfactory degree of inter-rater reliability by ANOVA ICC, and it has been found in application of CBS to several cases in the clinical practice that the degree of severity of each symptom could be clarified and differential diagnosis was possible with this diagnostic scale. Furthermore, the outcome of treatment could be confirmed at any time during the clinical follow up. In addition, through the dimensions, it is possible to grasp the severity, and further, through spectrum and hierarchy. We considered diagnostic area of BPD and its position by CBS correlating the other closely related disorders.
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The effects of aging on the multi-organ carcinogenesis induced in rats by N-methyl-N-nitrosourea (MNU), a direct carcinogen which does not need metabolic activation to exert carcinogenicity, were examined in male F344 rats. In the first experiment, rats at 6, 52, and 98 weeks of age were treated with MNU (20 mg/kg body weight, i.p.) twice weekly for 6 weeks and then maintained without any further treatment for 24 weeks in the case of young and middle-aged rats and for 18 weeks in the case of the old rats. In young rats, malignant lymphomas, particularly thymic types, were observed at significantly high incidence. A striking result in the middle-aged rats was the significantly higher incidence of adenocarcinomas in the small intestine than in young or old animals. The induction of proliferative and neoplastic lesions of the large intestine also tended to be increased in middle-aged rats. In addition, epithelial hyperplasia of the tongue, but not the forestomach, occurred at the highest incidence in the middle-aged group. There were no differences in the induction of epithelial lesions in the urinary bladder among the groups. In a second experiment, investigation of DNA synthesis in the tongue, small and large intestines, urinary bladder and lymph nodes did reveal significant increases or tendency for increase in the MNU-treated groups, but without differences with age. In contrast, the thymus of young rats showed significantly increased incorporation of BrdU label after administration of MNU, whereas it was markedly reduced in middle-aged rats. In a third experiment, O6-methyldeoxyguanine (O6-medG) DNA adduct formation was immunohistochemically detected in various organs including the thymus, forestomach, and small intestine without any differences with age. Thus, the results demonstrated that while the target organs of MNU are modified by the age of the animals, levels of DNA synthesis and O6-medG DNA adduct formation in most cases can not explain the observed differences in carcinogenic susceptibility.
We report a case of concealed Wolff-Parkinson-White syndrome detected for the first time during spinal anaesthesia in an adult male. Episodes of tachyarrhythmia with a heart rate of approximately 115 beat.min-1, wide QRS complexes and negative T waves which lasted 30-60 s, but were unassociated with hypotension, occurred three times after spinal anaesthesia. Postoperative Holter ECG monitoring showed the frequent occurrence of supraventricular premature contractions and paroxysmal supraventricular tachycardias with the same electrophysiological characteristics as those noted during spinal anaesthesia. The patient was diagnosed as having concealed Wolff-Parkinson-White syndrome. Since this condition is asymptomatic and undetectable by routine pre-operative screening it is likely that other unsuspected cases will arise. When episodes of tachyarrhythmia occur unexpectedly during anaesthesia, as was the case in this patient, postoperative examination including Holter ECG monitoring will be necessary to determine the nature and severity of the tachyarrhythmia.
Matrigel is a solubilized tissue basement membrane gel extracted from the mouse Engelbreth-Holm-Swarm sarcoma. Cultures of human endothelial cells could be induced to undergo extremely rapid morphological differentiation into capillary-like structures by Matrigel. The present study demonstrates the following: (a) Matrigel-induced tube formation by endothelial cells is laminin-dependent and, particularly, the YIGSR peptide site in the B1 chain of laminin may be necessary for endothelial cell differentiation resulting in capillary formation; (b) endothelial cells may be preprogrammed for rapid differentiation into blood vessels and do not require DNA, RNA or protein synthesis in order to undergo tube formation on Matrigel; and (c) microfilament assembly and function is important for Matrigel-induced tube formation.
Two patients with an infarct limited to the thalamus developed auditory and visual experiential hallucinations. Neuropathological studies in one patient showed a small cavity in the right intralaminar nuclei surrounded by focal spongiform change, partly involving the right dorsomedial nucleus. Neuroradiological data in another patient indicated that the same nuclei in the left thalamus were also affected. It was concluded that a unilateral thalamic lesion could cause experiential hallucinations and the intralaminar and dorsomedial nuclei might be important structures to explain the phenomenon.
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A child's head-sized tumor on the upper back developed in a 43-year-old man. In spite of an extensive operation for the tumor, he died of multiple metastasis 15 months after the operation. Histologically, tumor cells proliferated throughout the dermal and subcutaneous regions, and a boxed-in appearance was noted with silver staining. Because electron microscopic observations strongly suggested a smooth muscle origin, we diagnosed this case as cutaneous and subcutaneous leiomyosarcoma.
Neutrophilic dermatoses (ND), with or without accompanying myelodysplastic syndrome (MDS), were examined in terms of nuclear abnormality like pelgeroid anomaly of infiltrating cells into skin lesions. Six ND accompanying MDS showed 1.0 to 13.5% of such anomalous cells among infiltrating cells. In contrast, ND without accompanying myeloproliferative disorders rarely had such anomalous cells. Our findings suggest that pelgeroid-like anomalous cells infiltrating into ND are probably a good marker of underlying MDS.
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We report a case of lambda-AL amyloidosis which manifested prominent hepatic cholestasis. The patient was a 71-year-old Japanese male who was admitted to our hospital because of abdominal distension and jaundice. Laboratory examination revealed a marked deterioration of liver function with cholestasis. Gastric biopsy revealed amyloid deposition. Under a diagnosis of primary amyloidosis he was treated with corticosteroid and dimethylsulfoxide. However, jaundice progressed, renal function deteriorated rapidly, and he died two weeks after admission. Autopsy revealed a profound deposition of lambda-AL amyloid not only in the liver but also in the kidneys, spleen, lungs, heart and intestine.
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A 31-year-old pregnant woman had eruptions on her wrist, face and neck. We diagnosed her as having Sweet's syndrome from clinical symptoms, histopathological and laboratory findings. We successfully treated her with prednisolone and there are no relapses after delivery. We studied her polymorphonuclear leukocyte activity by the polarization assay with N-formyl-methionyl-leucyl-phenylalanine as a chemoattractant and it is higher than that of control. It is known that Sweet's syndrome is accompanied with collagen diseases and malignant diseases or others as underlying diseases or conditions. Three cases of Sweet's syndrome associated with pregnancy have been reported before and this is the first one in Japan.
Erythematous papulonodules that resembled a malignant lymphoma developed in a 62-year-old man. Further examination revealed that he had primary myelofibrosis with cutaneous extramedullary hematopoiesis. All three marrow elements (myeloid, erythroid, and megakaryocytic series) were present in the skin lesions. Although extramedullary hematopoiesis of the skin is a rare complication of myelofibrosis, 13 similar cases have been reported. In nine cases, including ours, all three marrow elements were present in the cutaneous lesions.
The clinical and pathological findings in a patient with monocytic aleukemic leukemia presenting initially as multiple monoblastic tumors of the skin is described. The patient was a 35-year-old Japanese woman, who had first noticed multiple, asymptomatic, reddish-brown papules on her trunk. Asymptomatic enlargements of several lymph nodes were present in the bilateral cervical and axillary areas. There was no hepatosplenomegaly, sternal tenderness, bruising, or bleeding. The skin and lymph node biopsies were originally interpreted as malignant lymphoma. The diagnosis of acute monocytic leukemia was established when bone marrow involvement was detected. Immunohistochemical observation of the skin eruptions revealed the following: Positive staining with lysozyme was noted in almost half of the infiltrating atypical cells. Most of the infiltrating cells reacted positively with antisera to Leu-M5 and some of them reacted to Leu-M1. The helper T cell antibody, Leu-3a+3b, showed weak positive staining of most infiltrating cells. However, there were no reactions with antisera to Leu-6, Leu-7, Leu-14, CALLA, OKT 6, OKT 8, OKT 16, OKB 19, OKM 14, beta F1, or delta TCS1. OKM 5-positive keratinocytes were observed in some parts of the upper epidermis, although no OKM 5 expression could be detected on any tumor cells. Cytochemistry, immunohistochemistry, and electron microscopy can aid in the diagnosis of monocytic leukemia. This case illustrates the importance of using an expanded panel of monoclonal antisera in certain hematopoietic tumors.