[Two cases of Cowden's disease].
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Biomedical subjects
Publications and source records attributed to N Koike.
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The thymidylate synthase (TS) inhibition rate was measured after tegafur (FT) administration (1.5 g/day, at least 10 days) in 7 sigmoid colon cancer patients. The TS inhibition rate decreased as the interval between the time of the last administration and the time of the tumor resection increased longer. This study provides basic data for considering methods of drug administration and assessment of modification, for example, by leucovorin.
Cell proliferation kinetics of the extrahepatic bile duct were studied by flash and cumulative labelling methods and immunohistochemical techniques. We compared the cell kinetics of the epithelium of the intra- and extra-pancreatic bile ducts and of the bile duct of the ampulla in rats administered intraperitoneally with bromodeoxyuridine (BrdUrd). After a single injection of BrdUrd (flash labelling), labelled cells appeared in the lower portion of the downgrowths of the epithelium in the intra- and extra-pancreatic bile ducts. A gradual accumulation of the labelled cells at the surface epithelium was observed during the cumulative labelling. After cumulative labelling the labelled cells gradually decreased in number and were finally confined to the degenerative cell zone of the surface epithelium 30 days later. Similarly, after a single injection of BrdUrd, the labelled cells in the bile duct of the ampulla appeared at the lower half of the crypt from where they migrated to the upper portion during cumulative labelling. These findings indicate that epithelial cells of the bile duct are renewed at the lower portion of the downgrowths of the epithelium, or crypt, and shed from the surface epithelium or upper portion of the fold. The labelling indices reached 23.83 +/- 7.47% in the intra-pancreatic bile duct, 14.74 +/- 7.99% in the extra-pancreatic bile duct and 43.42 +/- 4.40% in the bile duct of the ampulla at the end of 70 h cumulative labelling. The fluctuating values of the labelling index were higher in the bile duct of the ampulla than in the intra- or extra-pancreatic bile ducts. These results indicate that the bile-duct epithelium undergoes a slower renewal rate than the other parts of the gastrointestinal tract, and that the renewal time of the epithelial cells is shorter at the bile duct of the ampulla than at the intra- or extra-pancreatic bile ducts.
A case of BK virus cystitis in a 5 year old boy is reported. This patient, who was not immunocompromised, had had acute cystitis for two weeks. Many intracytoplasmic inclusions were observed in urinary sediment smears stained by the Papanicolaou method. Electron microscopic examination showed virus particles, presumed to be human polyomavirus, in the nuclei of the degenerated urothelial cells. A DNA sequence of the BK virus was detected in 200-300 urothelial cells in Papanicolaou stained smears by the polymerase chain reaction. BK virus is an unusual cause of symptomatic cystitis in a healthy child.
The Distribution pattern and proportion of the positive cells of proliferating cell nuclear antigen (PCNA) were examined immunohistochemically to study the proliferative activities of 33 cases of carcinoma found at the confluence of the main hepatic ducts. Expressions of CEA, CA19-9 and EGF receptor (R) were further examined with serial histological sections and comparatively analyzed with the result of PCNA staining and the clinico-pathological features of the carcinoma. PCNA positive cancer cells were observed in greatest abundance at the deeply infiltrated region of the carcinoma. CEA and CA19-9 were also expressed most strongly in this region and a stromal staining pattern was predominant. However, negative or apical staining patterns of CEA and CA19-9 were more frequent in the surface or the lateral spreading regions of the carcinoma, where the PCNA positive cancer cells were fewer in number. EGFR expression was rarely observed in the present study.
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Thyroid follicles, an essential functional unit of the thyroid, exist in the extracellular matrix of the tissue in vivo. Therefore, in any monolayer culture system, the follicles cannot be reconstructed. Our previous study adopting three-dimensional collagen gel culture showed that isolated porcine follicle cells reconstructed thyroid follicles specific for the thyroid gland in vivo. To elucidate whether this culture system is also applicable to human follicle cells, and furthermore to provide a culture system for investigations of the pathogenesis of human thyroid diseases, we tried to culture isolated human follicle cells of normal thyroid tissue and of Basedow's disease in three-dimensional collagen gel. In this culture system, they apparently reconstructed thyroid follicles. The component cells of the reconstructed follicles exhibited structural polarity specific for human thyroid follicle cells and produced thyroid hormones. In addition, the cells responded to a TSH-stimulation in terms of morphological and functional differentiation, and they presented HLA-DR antigen with an interferon-gamma-stimulation. This report is a first instance of reconstruction of human thyroid follicles and HLA-DR antigen induction in three-dimensional follicle structures in vitro. This culture system provides a more physiological environment in vitro for biological and pathogenetic investigations of human thyroid follicle cells than the monolayer culture system. Further experiments using this method will probably provide new clues to the pathogenetic mechanisms of human thyroid diseases.
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The contribution of sympathetic cervical ganglion to the mechanism of action of clonidine for lowering intraocular pressure (IOP) was investigated. Pigmented rabbits were used. The animals were divided into 3 groups: normal control group (group 1), animals in which the bilateral cervical sympathetic trunks had been amputated presynaptically (group 2), animals in which the superior cervical ganglion (SCG) had been bilaterally dissected (group 3). Changes in IOP were measured after topical application of clonidine unilaterally. In group 1, IOP was significantly decreased in eye treated by clonidine and contralateral eyes compared to pretreatment values. Decrease of IOP in the contralateral eye was greater than that in the treated eye. In group 2, IOP was decreased in the contralateral eye but increased in the eye treated by clonidine. Pretreatment of yohimbine administered orally antagonized the ocular hypotensive effect of clonidine in a dose-related manner. In group 3, where SCGs were dissected, no changes in IOP were observed in both eyes by unilateral administration of clonidine. These results suggested that the bilateral ocular hypotensive effect of clonidine administered unilaterally is in part due to direct action on the SCG and that the alpha 2 receptor in the SCG plays some role in the regulation of IOP.
We reported a resected case of thymolipoma, which has been hardly experienced. The patient was 21-year-old female and consulted a doctor for general fatigue. Chest roentgenogram revealed a mass-like shadow at the right lower mediastinum, which was suspected mediastinal tumor. The mass of right anteroinferior mediastinum, which was clearly shown by chest CT scan and MRI, was continued to the right lobe of the thymus. Under a diagnosis of anterior mediastinal tumor, operation was carried out. The tumor, which was 10 x 8 x 7 cm in diameter and 160 g in weight, was removed together with right lobe of the thymus. Histological diagnosis of thymolipoma was obtained from the resected specimen.
Holter ECG recordings obtained form 11 hyperthyroid patients (mean age 29.2 +/- 11.4 years) before and after surgical treatment were analyzed regarding heart rate (HR) and arrhythmias. The mean 24-hour HR significantly decreased form 104 +/- 8.8 bpm before to 76.8 +/- 8.9 bpm after the treatment (p less than 0.001), with the most pronounced reduction while asleep form 0:00 AM to 6:00 AM. HR variability also significantly decreased (p less than 0.02), but the circadian rhythm of HR did not change before and after the treatment. Serum T3 level correlated with the mean HR (r = 0.63, p less than 0.05) in hyperthyroid state. The percent changes in T3 (% delta T3) best correlated with the percent changes in the mean HR (% delta mean HR) (r = 0.84, p less than 0.01). The frequencies of supraventricular and ventricular premature contractions significantly decreased after the surgical treatment (p less than 0.01). Normal circadian pattern of hourly HR before the treatment highly suggests that normal adrenergic responsiveness is maintained in hyperthyroidism.
A case of early gastric plasmacytoma in a 51-year-old woman is reported. The demonstration of monotypic IgM-kappa immunoglobulin in biopsy specimens by an immunoperoxidase technique contributed to the histological diagnosis. The patient had non-ulcerative lesions (of approximately 15 x 16 cm) of a superficially spreading type of gastric plasmacytoma. Extensive histological analysis of the resected stomach showed the IgM-kappa monoclonal proliferation of plasmacytic tumor cells to infiltrate merely into the lamina propria of the gastric mucosa and not to extend deeply into the submucosa, proper muscle and serosa of the stomach.
During the last 10 years, 162 aged cases (60 yrs. to 96 yrs., average 75.7 yrs.) that had positive effusion cytology were confirmed to have malignancy on autopsy. The effusion cytology of samples from aged patients made the first clinical diagnosis of malignancy in 46% of the cases studied, and this frequency increased with increasing age. The effusion cytology results from aged patients with malignancy were observed to have the following characteristic pathology profiles; (a). In pleural effusion: The primary organ of cancer was mostly the lung. However the histological cell types varied from predominantly adenocarcinoma to small cell carcinomas, squamous cell carcinomas etc. (b). In ascitic effusion: The primary organ of cancer varied and included the stomach, gallbladder, pancreas and ovaries. In these cases, however, the histological cell type was predominantly adenocarcinoma.
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Adherence ability to catheter materials for intravenous use of coagulase-negative staphylococci (CNS) which is frequently isolated from prosthetic implants and medical devices inserted into the body was studied, and the mechanism of catheter-associated infections and the prevention against that were discussed. Difference of the adherence ability of CNS to various kinds of catheter materials was found, and adherence ability to the catheter materials was correlated with that of human epithelial cells in culture. CNS isolated from intravenous catheters had higher adherence ability to the human epithelial cell cultures than isolates from other clinical sources. Among 4 kinds of catheter materials, including ethylene vinyl acetate (EVA), polyvinyl chloride (PVC), silicone (Sil) and polyurethane (PUR), the adherence ability of CNS on the EVA containing barium was highest, and Sil treated with tungsten showed the lowest. The physicochemical properties of both the bacteria and the catheter materials, hydrophobicity of the bacterial cultures and the catheter materials, negative charges on surface of the bacteria, surface structure of the catheter materials, additives to the catheter materials, and coating the catheter surface gave great effects on the adherence of CNS to the catheter materials. In addition, as biofactors, fibronectin and PROTEAMIN-HICALIQ solutions enhanced the adherence of CNS. These results suggested that catheter materials having a smooth surface and higher hydrophobicity, treated with tungsten and coated with urokinase were effective on the suppression of the adherence to catheter materials. In addition to the improvement of catheter materials, aseptic procedures in catheterization were thought to be critical for the prevention of catheter-associated infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Mutagenicity of five benzene metabolites was examined by a fluctuation test modified by Gatehouse. The test was performed by using Salmonella typhimurium TA100 with or without a metabolic activation system. Catechol showed mutagenic activity with and without a metabolic activation system in the fluctuation test. Hydroxyhydroquinone, phenol, hydroquinone and p-benzoquinone were positive only with a metabolic activation system in this test. The Ames' plate method and preincubation method are widely used as a screening test for the mutagenic compounds. However, the fluctuation test is very useful in detecting mutagenic activity of chemicals which are negative in the Ames test though being a mutagen or carcinogen.