Search PubMed⌕ Search

Biomedical subjects

N Kuwabara

Publications and source records attributed to N Kuwabara.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Forty-six-year-old woman with progressive external ophthalmoplegia and limb weakness].

We report a 46-year-old female who presented progressive ophthalmoplegia and limb weakness. She was well until the age of 15 years when there was an onset of bilateral deafness. She became completely deaf by 20 years of age. She noted an onset of weakness in her legs when she was 27-years-old and of ptosis at 34 years of age. She was admitted to our hospital when she was 41-years-old. Neurological examination revealed near total ophthalmoplegia, bilateral ptosis, dysphagia, generalized muscle atrophy and weakness of approximately 4/5 degree, facial grimacing, athetotic movements in four limbs. Laboratory examinations revealed increase in blood lactate and pyruvate levels and diffuse low density change in the cerebral white matter in CT scans. She was thought to have a mitochondrial encephalomyopathy. She was discharged for follow-up, but her clinical course was that of a relentless deterioration. She was readmitted to our service in December 1989. She showed further progress in her weakness and muscle atrophy. Otherwise neurological examination was essentially similar to the previous one. Her cranial CT scans showed low density changes in striatum, thalamus and midbrain in addition to the white matter. Enzyme activities of the electron transport complexes revealed a moderate decrease in the succinatecytochrome c reductase activity, and the Southern blot analysis of mtDNA revealed multiple deletions in mitochondrial genomes. Two months after her admission, she developed bronchopneumonia, and expired on March 13th, 1990. Post-mortem examination revealed diffuse pallor of myeline in the cerebral white matter in K-B staining. A marked neuronal loss and gliosis were observed in putamen bilaterally. Skeletal muscles showed typical changes of mitochondrial myopathies with ragged-red fibers in Gomori-Trichrome staining, and crystalline inclusion bodies by electron microscopic observations. Some neurogenic atrophies were also seen. Oculomotor nuclei appeared intact. It was thought that she had an incomplete form of Kearns-Sayre syndrome. The patient was discussed in a neurological CPC of the departments of Neurology and Pathology of Juntendo University School of Medicine.

Diagnosis, Differential↗
PubMed1993

[A 24-year-old man presenting Garcin syndrome and paraplegia].

We report a 24-year-old man who presented unilateral multiple cranial nerve involvements followed by progressive paraplegia. The patient expired after developing DIC and pneumonia. Post-mortem examination revealed Ewing's sarcoma originated in the pubic bone with extensive metastases including the clivus which was responsible for his cranial nerve lesions. The patient was well until 24 years of age when he noted an onset of pain and a mass in the pubic region. The histology of the biopsy specimen of the tumor suggested Ewing's sarcoma. He was treated with chemotherapy and local radiation. A year after, he noted an onset of nuchal pain, difficulty in tongue movement, dysarthria, deafness in the left ear, and diplopia. On admission to our hospital in July 1990, neurological examination revealed an alert and intelligent Japanese male in no acute distress. The olfactory to the trigeminal nerves appeared intact. He showed complete abducens nerve palsy, facial weakness, mild deafness, and weakness of the soft palate, the sternocleidomastoid muscle and the tongue, all on the left side. The remainder of the neurological examination was unremarkable except for dysesthesia along the left C8 and Th1 dermatoms. Radiological examination revealed a 10 x 10 cm sclerotic mass in the public bone and a high signal mass lesion between the clivus and the pons in the T2-weighted MRI. His clinical course was complicated by acute paraplegia with anesthesia below the Th4 dermatom, DIC, and respiratory distress due to plural effusion. Post-mortem examination revealed a necrotic and hemorrhagic tumor in the pubic bone. The histology was consistent with Ewing's sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Projections to the medial superior olive from the medial and lateral nuclei of the trapezoid body in rodents and bats.

In this study we present direct evidence of axonal projections from both the medial and lateral nuclei of the trapezoid body to the medial superior olive. Projections were traced by intracellularly labeling cells and axons in a tissue slice preparation of two rodent species, Mus musculus and Meriones unguiculatus and two bat species, Eptesicus fuscus and Pteronotus parnellii. The main axon of most principal cells in the medial nucleus of the trapezoid body gives off one or more collateral branches which arborize within the medial superior olive. These collateral axons form small bouton-like swellings which primarily contact somata within the central cell column in the medial superior olive. Likewise, labeled elongate and multipolar cells of the lateral nucleus of the trapezoid body send axons to both the medial and lateral superior olives. These axons also form perisomatic contacts in both target nuclei. These two sets of projections may relay ascending input to the medial superior olive and the lateral superior olive; the medial nucleus of the trapezoid body is known to relay input from the contralateral ventral cochlear nucleus, and the lateral nucleus of the trapezoid body may relay input from the ipsilateral ventral cochlear nucleus. These projections offer two routes for indirect, possibly inhibitory input to reach the medial superior olive from both cochlear nuclei. These indirect, inhibitory pathways may parallel the direct excitatory projections the medial superior olive receives from each cochlear nucleus.

Animals↗
PubMed1992

Split notochord syndrome in an adult presenting with colonic duplication. Report of a case.

A case of tubular colonic duplication, sigmoid colon diverticulum, and lumbar anterior spina bifida in a 28-year-old man was diagnosed as split notochord syndrome. After subtotal colectomy, including the duplicated colon, the patient recovered. Histologic study of the duplicated colon revealed multifocal, ectopic gastric fundic mucosa in a mosaic pattern. Since bleeding and perforation occur most frequently in conjunction with ectopic gastric mucosa within the duplication, we believe that complete resection of the duplicated bowel is the best procedure. Split notochord syndrome is a rare congenital anomaly. It is usually discovered in the first year of life, and the majority of reported cases have involved the cervical or thoracic region. Our patient is exceptional in having reached the age of 28 years without complaints and in that his case involved lumbar anterior spina bifida and tubular colonic duplication.

Adult↗
PubMed1992

The liver in systemic lupus erythematosus: pathologic analysis of 52 cases and review of Japanese Autopsy Registry Data.

We present pathologic findings for 52 livers (51 autopsy specimens and one wedge biopsy specimen) from patients with systemic lupus erythematosus (SLE). Hepatic congestion was the most common disease (40 livers), followed by fatty liver (38), arteritis (11), cholestasis (nine), peliosis hepatis (six), chronic persistent hepatitis (six), nonspecific reactive hepatitis (five), cholangiolitis (four), nodular regenerative hyperplasia of the liver (three), and hemangioma (three). The data obtained here suggest that arteritis of the SLE liver is more common than has been recognized previously. One patient had hepatic infarction complications induced by arteritis. On the basis of the findings in the present study and a review of the literature, we suggest that hepatic infarction resulting from arteritis is rare in SLE. On the other hand, while occurrence of nodular regenerative hyperplasia of the liver in SLE patients has been considered to be rare, our findings suggest that it may be more common than has been recognized previously. Although congestion and cholestasis may be acute terminal illnesses, fatty change is considered to be specific to the SLE liver. Statistical analysis indicates that exposure to a large dosage of glucocorticoids is a significant factor in the etiology of severe fatty liver. In addition, our review of Japanese autopsy registry data for 1,468 patients with SLE indicates that the incidence of chronic liver diseases in SLE autopsy cases is as follows: chronic hepatitis, 2.4%; cirrhosis, 1.1%; and liver fibrosis, 0.8%.

Adolescent↗
PubMed1992

Common variable immunodeficiency with increased surface IgM-positive double-bearing B cells.

We report a case of common variable immunodeficiency (CVI) that shows low levels of IgG and IgA, but a normal quantitative or qualitative level of IgM. T-cell functions were not disturbed. Increased numbers of surface IgM (sIgM) and sIgD, sIgM and sIgG, sIgM and sIgA double-bearing B cells were observed as compared with a control. No IgG and IgA induction upon stimulation with Staphylococcus aureus Cowan I (SAC) and recombinant interleukin-2 (rIL-2), or pokeweed mitogen (PWM) and rIL-4 or rIL-6 was observed, although there was proliferation. Although mu mRNA was expressed as much as in a healthy control, transcription of gamma mRNA and alpha mRNA was very low. Furthermore, no enhanced effects of gamma mRNA and alpha mRNA were recognized upon stimulation with rIL-4 and rIL-6. These results suggest that the patient's B cells might be defective at the switching process from mu, mu and delta, mu and gamma to gamma or mu and alpha to alpha.

Antibody Formation↗
PubMed1992

Incidence of Paneth cells in minute tubular adenomas and adenocarcinomas of the large bowel.

This study attempted to demonstrate the incidence of Paneth cells within large bowel tubular adenoma and adenocarcinoma according to location and macroscopic appearance using minute tumors (up to 5 mm in size). We have shown that Paneth cells were sometimes seen in the early stage of the development of large bowel epithelial neoplasia. According to the macroscopic appearance (elevated or depressed type), in large bowel epithelial neoplasia, there was a statistical difference between the depressed type (32.5%, 14 of 40 cases) and the elevated type (16.6%, 24 of 145 cases) (Chi square analysis, p < 0.05) in the incidence of Paneth cells. Paneth cells were seen more frequently in adenocarcinoma (45.8%, 11 of 24 cases) than in tubular adenoma (16.8%, 27 of 161 cases), with a significant statistical difference (Chi square analysis, p < 0.01). According to location, in both tubular adenoma and adenocarcinoma, Paneth cells were more frequently observed in the proximal colon (tubular adenoma: p < 0.01, adenocarcinoma: p < 0.05, Chi square analysis).

Adenocarcinoma↗
PubMed1992

Long-term study of the immunodeficiency of Bloom's syndrome.

The immune state was evaluated over a 10-year period in two individuals with Bloom's syndrome. In both patients, serum concentrations of IgM were markedly low. Mildly decreased serum concentrations of IgG and IgA increased significantly with age, whereas the IgM levels remained low. From assessments of B-cell and T-cell functions in pokeweed mitogen-induced immunoglobulin production, the IgM deficiencies were thought to result from B-cell dysfunction. T-cell function appeared intact. Moreover, although the percentages of surface IgM-bearing cells were not reduced, the numbers of IgM-secreting cells were reduced. These findings suggest that the IgM deficiency is due to an abnormality in the maturation of surface IgM-bearing B cells into IgM-secreting cells.

Adolescent↗
PubMed1992

[Electron-microscopic observations on rat lungs after long term inhalation of diesel emissions--non-neoplastic lesions].

Non-neoplastic lesions in the respiratory organs of rats (F344) were investigated after exposure to heavy and light duty diesel emissions for 30 months. Pathological examinations of the lungs after every 6 months of exposure were performed by light and electron microscopy. Anthracosis caused by the inhaled diesel soot was the main morphological change observed in the lung. Foci of alveoli filled with alveolar macrophages engorged with diesel particles were scattered in the lung parenchyma. Marked changes observed in these areas consisted of intake of diesel particles by type 1 epithelium, hypertrophy and glandular proliferation of type 2 epithelium with many extended microvilli and increased number and size of lamellar inclusion bodies, focal increase of collagen fibers in the interstitium, and infiltration of particle-laden macrophages, neutrophils, mast cells and plasma cells into the interstitium of alveolar septa. Within the alveolar lumina there was marked accumulation of particle-laden macrophages or neutrophils and their debris, as well as laminated or scrolled materials discharged from the type 2 epithelium. The most marked changes observed in the airways were focal shortening of cilia and protrusions of non-ciliated cells, which were attributable mainly to the effects of gaseous components in the diesel exhaust. These morphological changes appeared in all the groups exposed to particle concentrations greater than 1 mg/m3 after 6 months' exposure, and were more marked with increase in particle concentration and with time.

Animals↗
PubMed1992

Zahn infarct of the liver resulting from occlusive phlebitis in portal vein radicles.

A 56-yr-old man had a solitary nodular mass in the right hepatic lobe. The nodule was clinically diagnosed as hepatocellular carcinoma, and a right hepatic lobectomy was performed. The nodule had a previously undescribed histological appearance, and was finally diagnosed as a Zahn infarct with the additional feature of fibrosis. We think that the mass was produced by occlusive phlebitis in a medium-size portal vein radicle and its smaller radicles. This is the case of a very unique Zahn infarct in two respects: 1) the histological appearance (fibrosis), and 2) the fact that it was due to occlusive phlebitis in portal vein radicles. The data obtained here indicate that a special type of Zahn infarct, as represented by this case, may present with clinical information (nodular mass and neovascularity) suggestive of hepatocellular carcinoma.

Diagnosis, Differential↗
PubMed1992

Papillary renal cell carcinoma. Report of two cases.

Papillary renal cell carcinoma is an uncommon variant of renal cell carcinoma which has unique features including hypovascularity or avascularity, extensive stromal macrophage infiltration and better prognosis than that for nonpapillary renal cell carcinoma. Two cases of papillary renal cell carcinoma presenting hypovascular or avascular angiology are presented. Histologically, the two tumors had a purely papillary structure. Papillae were lined by a layer of epithelial cells which lacked prominent cellular atypia, and there were numerous macrophages in the stroma. In addition, in one patient, extensive calcification of the tumor capsule was present. Furthermore, our experience in the present study with imprint cytology indicates that it offers corroborative information for the intraoperative diagnosis made on the basis of frozen section examination.

Adult↗
PubMed1991

Afferents to the medial nucleus of the trapezoid body and their collateral projections.

Cells and axons that supply direct afferent input to the medial nucleus of the trapezoid body are described. Afferents were intracellularly labeled in brainstem tissue slices of two rodent and two bat species. The main afferents are calyciferous axons from globular bushy cells of the ventral cochlear nucleus. Calyciferous axons were highly consistent across species, projecting directly from the cochlear nucleus, across the midline in the trapezoid body, to the contralateral medial nucleus of the trapezoid body. Within the target nucleus, a typical axon turned sharply away from horizontal to form a large ending, the calyx of Held, around the soma of a single principal cell. Three groups of calyciferous axons were classified based on the path taken from bend to calyx. In subjects younger than four weeks, single axons often formed two calyces, each on a different cell. These calyx pairs were often found on adjacent or vertically aligned cells. In older animals, calyx pairs were more closely aligned, but fewer double calyx axons were seen. A secondary focus of this study was the system of thin collateral branches that characterizes calyciferous axons in all species. The projection patterns of these collaterals suggest that calyciferous axons may provide ascending input to periolivary cell groups with descending projections. In addition to calyciferous afferents, labeled cells that provide input to the medial nucleus of the trapezoid body from adjacent periolivary cell groups are described. Also described is a type of afferent that descends from the level of the lateral lemniscus to the medial nucleus of the trapezoid body.

Afferent Pathways↗
PubMed1991

Classification of the principal cells of the medial nucleus of the trapezoid body.

Cells in the medial nucleus of the trapezoid body were intracellularly labeled in brainstem tissue slices of two bat and two rodent species. The main cell type found in this nucleus, the principal cell, is an important link in the relay of ascending projections from the contralateral cochlear nucleus to the lateral superior olive, completing an essential pathway for sound localization. Principal cells are often viewed as a highly homogeneous group with a consistent morphology as well as a common function. Intracellular labeling has revealed a number of new axonal and dendritic features of principal cells. Some of these features vary widely from cell to cell, suggesting that the population of principal cells contains several morphologically distinct subgroups. Similar subsets of principal cells were recognized in all species examined. Five subgroups were distinguished on the basis of the position of dendritic fields. Although the dendrites of most labeled cells were confined to the medial nucleus of the trapezoid body, some principal cells had dendrites that spread outside the nucleus to one of several adjacent periolivary cell groups. Cells were also found that had dendrites that spread medially across the midline and into the contralateral medial nucleus of the trapezoid body. Axonal projections were used to distinguish two additional subgroups of principal cells. All principal cells project to the lateral superior olive and virtually all have one or more secondary projections. There are two subgroups with unusual collateral projections: one with collaterals that extended to the lateral lemniscus and one with recurrent collateral axons.

Animals↗
PubMed1991

Necrotizing sialometaplasia in the mouth floor secondary to reconstructive surgery for tongue carcinoma.

Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63-year-old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the occurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap.

Biopsy↗
PubMed1991

[A three-dimensional computerized reconstruction of the rectum, anus and surrounding muscles of the rat fetus at the 20th gestation day].

Using fetuses of Wistar/I rats on the 20th gestation day. We designed a three-dimensional computerized reconstruction of the rectum, anus and the surrounding muscles. The tissues were fixed in Bouin's solution sagittally sectioned serially were stained with hematoxylin-eosin. Light microscopic pictures at 40 x magnification were subjected to the analysis using a three-dimensional image processing system, consisting of a drum-scanner, a general purpose computer (Micro VAX II), and a color image processor. The results showed that this system clearly reconstructed the three-dimensional image of the rectum, anus and the surrounding muscles and suggested the presence of the puborectal muscle sling.

Anal Canal↗
PubMed1991

[A case of diffuse panbronchiolitis, performed an open lung biopsy after improvement with 6 years medication].

A 51-year-old male was hospitalized in June 1983, complaining of productive cough and dyspnea. Diffuse panbronchiolitis (DPB) was diagnosed on the basis of the physical examination, chest roentgenogram, chest CT and transbronchial lung biopsy (TBLB). The patient underwent surgery for chronic sinusitis and deviated nasal septum, and received Pseudomonas aeruginosa vaccine, ampicillin and erythromycin. He revealed a posterior mediastinal tumor in March 1989. The clinical findings of DPB improved but open lung biopsy was performed on the occasion of surgery for the posterior mediastinal tumor. Pathologically, fibrosis and mild infiltration of mononuclear cells localized in the walls of respiratory bronchioli and in surrounding areas was recognized in addition to slight accumulation of foamy macrophages in interstitial spaces. These morphological findings, as well as the clinical findings, might suggest repair of DPB lesions.

Bronchiolitis↗
PubMed1991

[A study on BrdU labelling index of gastric cancer using in vitro labelling method].

In order to reveal the effect of environmental factors to BromodeoxyUridine labelling index (BrdU L.I.) and its usefulness as clinicopathological information, 522 specimens obtained from 121 lesions of gastric cancer were studied. Five hundred twenty two specimens in which BrdU had been incorporated using an in vitro labelling method were divided into 3 groups according to their degree of necrosis and cell infiltration. The average L.I. of the specimens with no or slight necrosis was 23.3 +/- 8.7%, medium, 14.2 +/- 10.0%, and severe necrosis, 6.6 +/- 3.8%, with no or slight cell infiltration, 25.3 +/- 9.5%, medium, 21.0 +/- 7.1%, and severe cell infiltration, 21.2 +/- 6.1%, therefore L.I. correlated to necrosis and cell infiltration. Representative values for each lesion were adopted and compared using 3 methods. In method A, a representative value of the L.I. for each lesion was chosen using all biopsy specimens, method B using specimens without necrosis, and method C, specimens without necrosis and cell infiltration. L.I. correlated to stage and the lymphnode metastasis only using methods, B and C and more strictly using method C. Necrosis and cell infiltration should be considered in adopting a representative value of the L.I. for each lesion. Method C is considered to be a best among the three studied, and the L.I. of gastric cancer may be considered a clinicopathological marker.

Biopsy↗