Biomedical subjects

N Kawano

Publications and source records attributed to N Kawano.

At least 73 records · Page 4Linked to original sources

PubMed1995

Origin of ciliated craniopharyngioma: pathological relationship between Rathke cleft cyst and ciliated craniopharyngioma.

Histological study was undertaken on ciliated craniopharyngioma and Rathke cleft cyst, to know the origin of ciliated craniopharyngioma. Subjects were 7 cases with symptomatic Rathke cleft cysts and a ciliated craniopharyngioma. Light and electron microscopic observations were made on surgically resected specimens of the 8 cases. The ciliated craniopharyngioma was composed mainly of papillary type of craniopharyngioma and of dispersed ciliated columnar epithelium including goblet cells. Four cases with Rathke cleft cyst showed squamous metaplasia of which the basal cells were histologically similar to that of papillary type of craniopharyngioma. Other 3 cases of Rathke cleft cyst, basal cells were revealed to have tonofilaments and desmosomes. It seems possible that ciliated craniopharyngioma has derived from the basal cells of Rathke cleft epithelium.

Adult↗

PubMed1994

Radiological study of symptomatic Rathke's cleft cysts.

We investigated the relationship between radiological findings and the nature of the cyst fluid and histological findings of six Rathke's cleft cysts. The results show that the majority (five of six cases) of symptomatic Rathke's cleft cysts exhibit no enlargement of the sella turcica on plain x-rays, which may be helpful in differentiating cystic pituitary adenoma in the radiological diagnostic process. Three cases with large cysts showing high-intensity T1-weighted magnetic resonance images harbored abundances of cholesterol crystal and hemosiderin pigment in the cyst walls. The high signal intensity in magnetic resonance images of Rathke's cleft cysts may be explained by hemorrhage and a deposition of cholesterol crystal and may be considered in certain cases of Rathke's cleft cyst, especially when they are large.

Adult↗

PubMed1994

Development of pseudolymphoma of liver following interferon-alpha therapy for chronic hepatitis B.

A 42-year-old woman with biopsy-proven chronic hepatitis B, who had been treated with human leukocyte-derived interferon-alpha (huLe-IFN alpha) therapy for two months was found to have liver tumors on routine abdominal ultrasonography examination. She underwent laparotomy, and partial hepatectomy was performed under the clinical diagnosis of hepatocellular carcinoma. The lesions were diagnosed histologically as pseudolymphoma based on the massive infiltration of small mature lymphocytes and the presence of hyperplastic lymph follicles with germinal centers. Immunohistochemistry revealed polyclonal origin of the involved lymphocytes. The possible association between IFN alpha treatment and chronic hepatitis B with the development of pseudolymphoma is discussed.

Adult↗

PubMed1994

[Intracranial extracerebral glioma].

A case of solitary leptomeningeal extracerebral glioma is reported. A 75-year-old man was admitted to our hospital because of headache and right hemiparesis. CT scan and carotid angiography revealed a tumor in the left convexity. At operation, the tumor was located between the dura mater and the arachnoid membrane and adhered to the brain surface only in a limited area. Histological study including immunostain and electron microscopy showed the tumor as anaplastic oligo-astrocytoma. We speculate that our case may originate from a heterotopic glial nest in the dural border cell layer of dura mater. This explanation seems likely because the tumor was located mostly in the subdural space.

Aged↗

PubMed1994

[Recurrent meningioma with malignant transformation: a case which changed from meningothelial type to papillary type].

We report here a case with meningioma showing malignant transformation in its course of multiple recurrences. A 59-year-old woman developed a right-sided hemiparesis in June, 1982 and CT scan disclosed a parasagittal well-enhanced mass. The tumor was subtotally removed (Simpson grade III) by an operation in September, 1982. Histological findings of the tumor were consistent with a meningothelial meningioma but showed no malignant features, such as high cellularity, necrotic foci, high mitotic rate, or nuclear pleomorphism. However, the tumor did invade the underlying cerebral cortex. In August, 1986, a recurrent tumor was detected by CT scan and was removed (Simpson grade III). The tumor tissue at the second operation showed the same histological features as the first specimen. In September, 1990, the patient developed multiple intracranial recurrences. There were three tumor nodules, all of which were removed. Histologically, significant histological differences between the second and the third operative specimens were found. In the last tumor tissue, one nodule showed a papillary pattern. In the other tumor nodules, each tumor cell had proliferated separately instead of adhering to other tumor cells to form a syncytium. This histological pattern was consistent with an epithelial meningioma described by Cushing and Eisenhardt in 1938. The papillary portion of the tumor was stained with monoclonal antibody Ki-67 in frozen section. The labelling index was 9.7%, which was as high as malignant meningioma. Electron microscopic examination of the papillary portion of the tumor showed that the tumor cells had irregular nuclei, interdigitations between the adjacent plasma membranes and a few ill-developed desmosomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1993

Radical removal of craniopharyngioma: a long-term follow-up.

Radical removal of craniopharyngiomas was attempted as the primary treatment in 12 adult and six child patients. No postoperative radiotherapy was given to patients undergoing total removal, while those undergoing subtotal removal received 50-60 Gy. Overall evaluation showed 15 cases of total removal and three of subtotal removal. One patient died of septicemia 2 months postoperatively and another developed a recurrent tumor which was removed totally at a second operation. The mean follow-up period was 7 years. The quality of life was "excellent" in 10 patients, "good" in five, and "fair" in two. Visual losses were minimized and endocrinological disturbances treated medically. These satisfactory results indicate that radical surgical removal is the first choice for treatment of craniopharyngioma irrespective of the age of patients.

Adolescent↗

PubMed1993

Follow-up examination schedule of postoperative HCC patients based on tumor volume doubling time.

The tumor volume doubling time of 27 recurrent hepatocellular carcinoma nodules measuring < or = 2.0 cm in diameter discovered after hepatectomy in 19 patients was analyzed by ultrasonography for 31 to 331 days. The tumor volume doubling time ranged from 39 to 420 days before specific treatment, with a mean of 112 days and a median of 80 days. It correlated with age and intrahepatic site of recurrence, which was sometimes the same lobe as that of the prior hepatocellular carcinoma, sometimes not. The tumor volume doubling time also tended to correlate with hepatitis C antibody status and initial tumor diameter. The tumor volume doubling time was, however, independent of sex, hepatitis B surface antigen status, number of recurrent tumors, initial serum alpha-fetoprotein level, interval between hepatectomy and recurrence detection, and associated liver disease. On the basis of the shortest tumor volume doubling time of the recurrent hepatocellular carcinoma nodules, we recommend that US and/or CT be performed at least every four months to screen for small recurrent carcinomas in postoperative patients.

Aged↗

PubMed1993

Invasive meningiomas in relation to high proliferating potential.

We conducted a study to investigate whether an association exists among histologic findings, labeling index determined by the labeling index (LI) of proliferating cell nuclear antigen (PCNA) and recurrence in a population of 30 meningioma patients. All of 6 patients (invasive meningioma) with brain invasion had a PCNA LI in excess of 5%. Recurrence was found in 4 of these patients. In 24 patients who did not have brain invasion, PCNA LI was 4% or less and only 1 case had recurrence. Recurrence occurred in 3 of 25 patients who underwent macroscopic total resection and all of these 3 cases had brain invasion and a PCNA LI in excess of 5%. The findings of this study indicated the existence of a close correlation between peripheral invasiveness of meningioma and its biological behavior.

Adolescent↗

PubMed1993

Origin of craniopharyngioma: an electron microscopic study.

To investigate the possibility that the two subtypes of craniopharyngioma, adamantinous type and squamous papillary type, are tumors arising from different origins, the authors conducted an electron microscopic study in 10 cases of craniopharyngioma. Light microscopic study revealed distinct differences between the two subtypes, but their ultrastructure was fundamentally similar. In this report, the authors propose an explanation of the origin of these subtypes to account for the findings.

Adolescent↗

PubMed1992

Comparison of hepatectomy and transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma: necessity for prospective randomized trial.

Transcatheter arterial chemoembolization is now widely used in cases of surgically unresectable hepatocellular carcinoma. However, it is unclear whether patients with surgically resectable hepatocellular carcinoma should always be treated with hepatectomy as opposed to transcatheter arterial chemoembolization. Sixty-six patients with hepatocellular carcinoma underwent hepatectomy, whereas 29 patients with more advanced hepatocellular carcinoma were treated with transcatheter arterial chemoembolization at our hospital from 1984 to 1990. All cases were associated with cirrhosis of Child class A or B. All of them underwent hepatectomy or transcatheter arterial chemoembolization for the first time. Their outcomes were determined on March 31, 1991. The backgrounds and survival curves for hepatectomy and transcatheter arterial chemoembolization were compared in both Child A and Child B patients. For both Child A and B patients, no significant difference was found between hepatectomy and transcatheter arterial chemoembolization with respect to age, sex, cause of underlying cirrhosis, liver function assessed by indocyanine green test and maximum diameter of the main tumor. The incidence of multiple hepatocellular carcinoma, more advanced hepatocellular carcinoma (TNM stage III or IV) or both was significantly higher in the transcatheter arterial chemoembolization group than in the hepatectomy group for both Child A and Child B patients. The survival curves of both the hepatectomy and the transcatheter arterial chemoembolization groups showed no significant difference for both Child A and Child B patients. A prospective study is therefore warranted to elucidate whether hepatectomy or transcatheter arterial chemoembolization is more effective for treating resectable hepatocellular carcinoma associated with cirrhosis.

Adult↗

PubMed1992

Primary intraosseous meningioma: case report.

A case of 72-year-old Japanese woman with a rare intraosseous meningioma is presented. The tumor was located in the right frontoparietal region, involving the coronal suture. The tumor was excised totally and the pathological diagnosis was meningioma. Similar cases reported in the past literature are reviewed and the possible histogenetic mechanism of the tumor is discussed.

Aged↗

PubMed1992

Marked and prolonged depression of factor XIII after esophageal resection.

Anastomotic leakage is one of the most common complications of esophagectomy and, since Factor XIII is required for normal wound healing, we investigated the temporal changes in plasma Factor XIII following esophagectomy and hepatectomy. A control group of patients undergoing other abdominal operations was also studied. Factor XIII activity was determined before surgery and on postoperative days (POD) 1, 3, 7 and 14. The plasma levels of acute phase protein were also measured. The plasma Factor XIII activity decreased significantly in both the hepatectomy and control groups until POD 7, reaching the lowest level on POD 3. In contrast, the esophagectomy group showed significant decreases in Factor XIII levels throughout the postoperative study period, with a nadir with an average activity of 56 per cent on POD 7. Preoperative transferrin levels had a positive correlation with Factor XIII levels measured on POD 3 and there was also a positive significant correlation between Factor XIII activity and alpha 2-macroglobulin levels on POD 3. These results suggest that there is a marked and prolonged depression of plasma Factor XIII activity following esophagectomy which may be attributed to accelerated tissue demands, inadequate synthesis or increased degradation. Moreover, the severe and sustained decrease in Factor XIII activity may be related to poor wound healing after esophagectomy.

Abdomen↗

PubMed1992

Hepatic resection for minute hepatocellular carcinoma.

Twenty-three patients with minute hepatocellular carcinoma, defined as a solitary lesion less than or equal to 2 cm, underwent hepatectomy at our institute during the 10 years between January, 1979 and December, 1988. Hepatitis B surface antigen was positive in 4 patients and the preoperative serum alpha-fetoprotein level was within the normal range in 7 patients and slightly elevated (20-200 ng/mL) in 14 patients. Liver cirrhosis was present in 16 patients and chronic hepatitis in 6 patients. The diagnosis was first suspected from the results of periodic examinations, including echography and the measurement of alpha-fetoprotein, in all except one patient. Minor hepatic resection was performed in 22 patients, and lobectomy in one patient in whom the tumor was located centrally in the liver. Three patients died of hepatic failure in hospital following surgery, and the survival rates of the other 20 patients at 1, 3, and 5 years were 90, 79, and 61 percent, respectively. The prognostic factors that influenced long-term survival were investigated by comparing the survival curves. The only factor associated with a significant difference in survival was the severity of concomitant liver disease. Thus, severe cirrhosis is the main obstacle against the long-term survival of patients with minute hepatocellular carcinoma.

Adult↗

PubMed1992

A continuous cell line (KK-2) from a supratentorial primitive neuroectodermal tumor.

Tumor tissue located in the occipital lobe with hemorrhage was obtained from a 19-year-old patient. Histological examination indicated it to consist of undifferentiated small, round cells without neuronal or glial differentiation, and possibly to be a type of primitive neuroectodermal tumor. The tumor cells were cultured for 3 years and a continuous cell line (KK-2) was established. KK-2 was transplantable to nude mice. With immunocytochemistry, neuron-specific enolase, protein gene product 9.5, vimentin, TUJ1 (a monoclonal antibody specific for neuron-associated class III beta-tubulin isotype) and 6H7 (a monoclonal antibody to NCAM produced by us) were detected. None of the following could be found: glial fibrillary acidic protein, S-100 protein, neurofilament and synaptophysin, calcitonin gene-related peptide, gastrin releasing peptide corticotropin-releasing factor, substance P, somatostatin, chromogranin, aromatic L-amino acid decarboxylase and tyrosine hydroxylase. The original tumor and KK-2 cells obtained after 3 years of culture and transplants in nude mice displayed essentially the same ultrastructural and immunohistochemical characteristics. KK-2 cells showed no differentiation to mature neuronal, glial or ependymal cells. This cell line may possibly serve as a useful model for studying cellular differentiation of human neuroectodermal tumors and normal neuronal development.

Adult↗

PubMed1992

Periodicity of insulin secretion comprises multiple cycles with different duration in perfused rat islets.

Insulin secretion from pancreatic islets has been found to be periodic by in vivo and in vitro experiments. The pacemaker which regulates the periodicity may be localized in the central nervous system or in the pancreas, though the precise location and the mechanisms of generating pacing have not been determined. In order to solve these problems, we examined the period of secretory cycles of insulin in isolated islets using a prolonged perfusion system, and investigated the effects of glucose and other agents on these periods. Isolated islets from male Wistar rats were enclosed in a millipore holder and were perfused with MEM containing 1 mg/ml glucose at a flow rate of 0.3 ml/min for 240 min. The effluent was collected at 1-min intervals to measure insulin secretion. The results were analyzed by the maximum entropy method to demonstrate the periodicity of insulin secretion. When islets were perfused with 1 mg/ml glucose, the periodicity comprised five cycles with different duration: 71.5 +/- 14.6 min, 29.8 +/- 3.4 min, 19.2 +/- 1.5 min, 11.6 +/- 2.1 min and 4.3 +/- 0.4 min. This indicates the presence of a pacemaker within the islets, although, in vivo, participation of a higher center to control periodicity has to be taken into account. Further, the presence of a long cycle (71.5 +/- 14.6 min) of insulin secretion which previously has only been observed in vivo was first demonstrated in this in vitro study. The cycles were consistent even in islets which were desensitized to glucose by cultivating in a high glucose medium for 5 days before perfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Activity Cycles↗

PubMed1992

[A case of granulomatous hypophysitis].

The patient was an unmarried, 25-year-old woman who presented herself with amenorrhea and lactation as her chief complaints. Radiography revealed a tumor in the sella turcica. Upon neurological examination at the time of admission, there were no abnormal findings affecting the field of vision or visual acuity, and no abnormalities were seen in the fundus oculi. In endocrinological tests, the basal plasma values of pituitary hormones were normal except for that of prolactin, which was 69.1 ng/ml. The preoperative diagnosis was nonfunctioning pituitary adenoma, and this neoplasm was resected by the transsphenoidal approach. Postoperative histological investigation showed vermiculous destruction of the anterior lobe of the pituitary gland, and also scattered lymph follicles accompanying infiltration by numerous lymphocytes and multinucleated foreign-body giant cells, and deposition of calcium. These findings, together with the epithelioid cells gathered around them, pointed to a diagnosis of granulomatous hypophysitis. The causes of granulomatous hypophysitis are known to include syphilis, tuberculosis, sarcoidosis, mycotic granuloma, and foreign-body granuloma due to the rupturing of a Rathke's cleft cyst, but no evidence of any of these was found in this patient. Another known source of inflammatory lesions in the hypophysis is lymphocytic hypophysitis, which resembles Hashimoto's autoimmune disease of the thyroid gland, and which is characterized both by the formation of lymph follicles and by extensive lymphocyte infiltration. In relation to the cause of granulomatous hypophysitis, thinking that it might possibly be an autoimmune disease, we conducted an immunological investigation, and also made a serological study of autoantibodies, but obtained no positive results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[A case of dural sarcoidosis].

A 26 year-old man, who was treated for meningitis in our hospital previously, was rehospitalized 1 year later because he developed disturbance of consciousness, gait disturbance and urinary incontinence. Blood examination revealed accelerated ESR, elevated GPT, slight elevation of serum Ca, strong positive CRP, and a decrease in PHA and Con A. ACE was within normal range and tuberculin reaction was negative. Lumbar puncture revealed that the initial pressure was 310 mmH2O, cells were 152/3, and protein was 343 mg/dl. Bilateral hilar lymphadenopathy was absent in chest X ray film. Head CT revealed enlarged lateral ventricles and irregularly enhancing nodular lesions in the anterior half of the falx cerebri, and abnormally strong enhancement of the choroid plexus. Ventriculoperitoneal shunt was performed. As a diagnosis was difficult to obtain from the clinical data, biopsy of the nodular lesions was performed. The histopathologic diagnosis was sarcoidosis. Steroid hormone was administered thereafter, and the nodular lesions of the falx disappeared in the follow-up. In the literature, only 8 cases of sarcoidosis of the dura mater have been reported. Since intracranial sarcoidosis is a part of systemic sarcoidosis, its diagnosis is not difficult in most cases. However, in cases difficult to diagnose as in our case, biopsy may be necessary. When nodular lesion occurs in the dura mater, sarcoidosis must be included as a possibility in the differential diagnosis in addition to the usual meningioma, lymphoma, and metastatic brain tumor.

Adult↗

PubMed1991

Homer Wright rosettes in ependymoma.

A brain tumor in the fourth ventricle of a 26-year-old woman displayed numerous Homer Wright rosettes by conventional histology, but immunostaining and electron microscopy revealed the tumor an ependymoma. Since the presence of Homer Wright rosettes in ependymoma has not been well appreciated in the past, the diagnostic importance of this finding is discussed.

Adult↗