Biomedical subjects
Publications and source records attributed to N Sasano.
A case of hepatic alveolor echinococcosis with contiguous invasion of the pancreas, vertebrae, and spinal cord and intrathecal metastases to the brain stem is reported. The long course after a hemihepatectomy may be a factor in the modification of the natural course of the disease and in the induction of this unusual mode of spread.
A case of tertiary hyperparathyroidism with a parathyroid adenoma and hyperplasia was described as the first report in Japan. A 24-year-old man manifesting hypercalcemia had been treated with hemodialysis for 9 years. On admission, clubbed fingers richitic rosaries and a palpable node in the neck were the major physical findings. Laboratory examinations revealed hypercalcemia had elevated levels of plasma parathyroid hormone (PTH) in a c-terminal assay. Nevertheless the levels of PTH found by a n-terminal assay disclosed an only small increase. The PTH levels were scarcely decreased after a bolus injection of calcium gluconate. A large tumor corresponding to the palpable node was resected. Histologically, the tumor was an adenoma with thick fibrous capsule and interparenchymal bands. Other parathyroid glands showed secondary clear cell hyperplasia without signs of cellular hyperactivity.
Morphological and functional properties of dispersed cells of human adenomatous goiter and those of the thyroid tissue adjacent to and distant from the nodular lesion (normal control) were investigated. In the presence of TSH, reconstructive arrangement of adenomatous goiter cells into a three-dimensional follicular structure occurred in a similar manner to that of normal controls. An addition of thyrotropin (TSH) to culture resulted in the secretion of thyroid hormones in control cells, but adenomatous goiter cells showed no response to TSH. It was found that the ratio of rT3, T3, the ratio of an inactive to an active form, was about three times higher in adenomatous goiter than in normal control. These findings suggested that conversion from T4 to rT3 is increased in adenomatous goiter.
A little more than 20,000 examinees of x-ray mass survey of gastric cancer and the controls were followed up from 1960 to 1977. Cumulative doses of x-rays were calculated for each examinee, and a collective dose in person-year-rads was constructed. Incidence of leukemia was ascertained from Miyagi Prefectural Cancer Registry. Seven cases of leukemia were found out of 242,689 person-year-rads in the irradiated population, and 9 cases out of 273,344 person-years in the controls. Incidence rate in the two groups was identical. Therefore, the risk of this mass survey was disproved.
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ACTH, beta-lipotropin (beta-LPH) and beta-endorphin concentrations were determined in pituitary adenomas of the patients with Cushing's disease. Immunoreactive ACTH and beta-endorphin were present in high concentrations and essentially equimolar amounts in pituitary adenomas. beta-LPH conversion to beta-endorphin was activated in pituitaries associated with ACTH/beta-LPH producing adenomas. Immunoreactive ACTH and beta-endorphin concentrations were markedly suppressed in the surrounding tissues.
A patient with steroid hormones or androgen producing bronchogenic adenocarcinoma was presented. Clinically he had a mediastinal mass and bilateral multiple pulmonary nodules which showed a rapid growth despite cancer chemotherapy. At postmortem examination, radioimmunoassay of the tumor tissue revealed androgen and their precursors. The mitochondria of the tumor cells resembled those of cells in the zona reticularis of the adrenal cortex.
Myofibroblasts were observed in the stroma of breast tumors in all cases examined by electron microscopy; 1 intraductal papillomatosis, 1 papillary carcinoma and 7 infiltrating duct carcinomas. The tubule- or duct-like structure in the tumor tissue were frequently surrounded by myofibroblasts which corresponded to delimiting fibroblasts in the normal breast tissue. In infiltrating duct carcinomas without tubule-like structures, myofibroblasts occurred dispersely in the stroma and they might correspond to fibroblasts in normal connective tissue. A possible role of these myofibroblasts as mesenchymal cells activated in a tumorous condition was discussed.
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Since the relationship between steroidogenic activity and morphological differentiation is not necessarily clear in the human adrenal cortex, aldosterone (Al), cortisol (F) and corticosterone (b) from the adrenal tissues cut into four small pieces (capsule and glomerulosa, outer fascicular, inner fascicular, and reticular zones) on a cryostat immediately after their removal at surgery were estimated by radioimmunoassay in 15 patients with adrenal diseases (8 primary aldosteronism, 1 idiopathic aldosteronism, 4 Cushing's syndrome and 2 pheochromocytoma) and 8 control subjects with other diseases. A larger amount of Al was contained in the outer fascicular zone than in other zones in control subjects. Al showed a high value of 0.16 approximately 7.40 ng/mg tissue in adenomas of primary aldosteronism and a low value of 0 approximately 0.25 ng/mg tissue in adenomas of Cushing's syndrome. A high value of Al was detected in idiopathic aldosteronism but not in the remaining adrenal of primary aldosteronism. In Cushing's syndrome, F showed a high value of 2.58 approximately 12.3 ng/mg tissue in adenoma and a relatively low level of 0.77 ng/mg tissue in carcinoma. A larger amount of F and B was found in the inner fascicular zone than in other zones in the control subjects. These results indicate that the corticosteroid content in each adrenal zone correlates with the morphological findings.
In order to grade objectively and characterize dysplastic and precancerous esophageal epithelium its DNA content was measured by cytofluormetric methods and compared to normal and cancerous esophageal epithelium. This yielded the following results. With transition of the esophageal eipthelium from mild dysplasia to severe dysplasia and finally to in situ carcinoma, Feulgen-DNA values showed patterns characteristic of a tetraploid population. They lacked prominent peaks which were usually observed with invasive carcinomas. Dominant near-tetraploid population and definite tetraploid-octoploid populations were characteristic of severe dysplasia or carcinoma. The mean Feulgen-DNA values were significantly larger in severe dysplasia than in the lesser grade of dysplasia as well as the normal epithelium. However, this was not the rule in the full blown carcinomas. It would appear that the esophageal cytophotometric patterns are analogous to those previously observed in the skin and uterine cervix.
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Subserial examinations of the noncancerous esophagus from 86 autopsy materials (male 47, female 39) in Kagoshima Prefecture revealed epithelial dysplasia in 54 instances (63%); 32 males (68%) and 22 females (57%). Higher grades of dysplasia were shown in 17 males (36%) and 3 females (8%). Histologically a formation of the rete ridge-like elongation of basal epithelium was characteristically conspicuous in these materials. Tabacco and alcohol intakes were regarded as promoting factors of dysplasia. Distribution and severity of dysplasia around carcinoma were histologically examined on semiserial blocks in 100 surgical materials under the consideration of preoperative treatment. A coexistence of carcinoma with extensive dysplasia was found in 24 instances and that with multifocal dysplasia in 46. Multicentric in situ carcinoma was found in 19 patients. These in situ carcinomas were frequently surrounded by severe dysplasia and occasionally showed gradual transition to the latter. The lesion of invasive carcinoma sometimes did not show sharp demarcation from the surrounding mucosa, especially in cases of well differentiated squamous cell carcinoma. The results indicate that dysplasia plays a significant role on carcinogenesis of the esophagus as a precursor lesion.