Biomedical subjects
Publications and source records attributed to Y Fujioka.
A 3-year-old boy developed idiopathic thrombocytopenic purpura (ITP) and Perthes' disease concurrently. Antiphospholipid antibodies were detected in the serum of the patient. Therefore, it is possible that Perthes' disease in this patient might be one of the manifestations of ITP-associated antiphospholipid syndrome.
Hepatocyte growth factor (HGF)/c-Met expression is known to be correlated with poor prognosis in several cancers. We investigated HGF/c-Met immunoreactivity and its correlation with clinical features in 51 patients with curatively resected extrahepatic biliary tract carcinoma. c-Met showed significant correlations with tumor location, T category, stage, perineural invasion and local recurrence. Overall survival in patients with HGF and c-Met immunopositivity was significantly worse than in those who were negative. Our findings suggest that HGF/c-Met play some roles in tumor development and that HGF/c-Met immunoreactivity could be a predictor of the mode of recurrence and poor prognosis.
BACKGROUND: Vascular endothelial growth factor (VEGF) is one of the most important factors for angiogenesis in various tumors. However, its clinical significance in extrahepatic biliary tract carcinoma remains unclear. MATERIALS AND METHODS: To clarify the association of VEGF expression with the clinicopathological features of the disease, surgical specimens from 51 patients were examined for VEGF expression by immunohistochemistry. RESULTS: Sixteen of 51 (31.4%) cases were positive for VEGF. VEGF immunoreactivity showed a tendency toward association with lymph node metastasis, M category and peritoneal recurrence (p = 0.059, 0.086 and 0.069, respectively). Overall survival in patients with VEGF positivity was significantly worse than in those with negativity (p = 0.033 by log-rank test). Multivariate Cox regression analysis revealed that VEGF expression was an independent negative predictor (p = 0.025). CONCLUSION: VEGF immunoreactivity is an independent negative predictor in extrahepatic biliary tract carcinomas.
BACKGROUND/AIMS: In this study we investigated the expressions of molecular biologic factors, p53, rasp21, bcl-2, c-erbB-2, and Ki-67 by immunohistochemical method in intraductal papillary-mucinous tumor of the pancreas to identify their diagnostic values and to determine their relations to the degree of histopathologic abnormalities. METHODOLOGY: Thirty-eight different histologic lesions from 28 patients of intraductal papillary-mucinous tumor of the pancreas, comprising normal pancreatic duct (n = 6), intraductal papillary hyperplasia (n = 6), intraductal adenoma (n = 15), and intraductal carcinoma (n = 11) were immunostained by the avidin-biotin peroxidase conjugate method. RESULTS: p53 and Ki-67 expressions were significantly greater in malignant intraductal papillary-mucinous tumor than in their benign counterpart (p = < 0.0001), while rasp21 showed gradual increase in the frequency of expression from normal pancreatic duct (0%), to intraductal hyperplasia (16.7%), to intraductal adenoma (26.7%), and ultimately to intraductal carcinoma (63.6%). bcl-2 and c-erbB-2 were not expressed in any lesions. CONCLUSIONS: These results suggest that p53 and Ki-67 expressions have significant diagnostic values in differentiating benign intraductal papillary-mucinous tumors from malignant ones and thus can facilitate in the pre-operative planning of treatment in individual cases. Secondly, gradual stepwise increase in the frequency of rasp21 expression with increasing degree of cellular atypia supports the presence of adenoma-carcinoma sequence in the carcinogenesis of this tumor.
BACKGROUND/AIMS: Multiple genetic alterations are involved in the development of pancreatic neoplasm. Here we investigated the incidence of p53, ras, bcl-2 and c-erbB-2 gene alterations in intraductal papillary-mucinous tumors and invasive ductal adenocarcinoma of the pancreas by immunohistochemical method to identify and analyze their relationship in terms of these genetic alterations. METHODOLOGY: Fifty-four pancreatic lesions, including 18 benign (hyperplasia (3) and intraductal papillary adenoma (15)), and 16 malignant (carcinoma in situ (2) and intraductal papillary adenocarcinoma (14)) cases of intraductal papillary-mucinous tumor; and 20 cases of invasive ductal adenocarcinoma, were immunostained by avidin-biotin peroxidase conjugate method. RESULTS: p53 and rasp21 expressions were significantly greater in malignant intraductal (P < 0.01, P < 0.05) and invasive ductal (P < 0.01, P < 0.01) tumors than in benign intraductal papillary-mucinous tumors; while bcl-2 and c-erbB-2 expressions were significantly greater in invasive ductal adenocarcinoma than both benign (P < 0.01, P < 0.05) and malignant (P < 0.05, P < 0.05) intraductal papillary-mucinous tumors. CONCLUSIONS: Different groups of genetic alterations are involved in different phases of pancreatic tumorigenesis. p53 and ras gene alterations occur at an early stage during the development of intraductal papillary-mucinous tumor, while additional alterations of bcl-2 and c-erbB-2 occur during the development of invasive ductal adenocarcinoma of the pancreas.
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An autopsy case of stiff-man syndrome is presented. The patient was a 54-year-old man who had suffered from fluctuating rigidity and tonic spasm of the trunk and leg muscles for three years. These symptoms were induced by emotional stress, strain at voiding and other external stimuli. Physical examination revealed stiffness of the neck, trunk and legs without obvious muscle weakness or atrophy. Deep tendon reflexes were hyperactive, while sensation was normal. EMG showed the stiffened muscles to have continuous motor unit activity which was decreased by myoneural block, spinal anesthesia, diazepam or sleep. Administration of diazepam (60 mg daily) gave some relief of the stiffness for several days. However, respiratory arrest suddenly occurred. Although the patient was resuscitated, he died nine days after this episode. Examination of the spinal cord revealed loss and degeneration of nerve cells with marked gliosis in the medial motor nuclei of the anterior horns. A symmetric degeneration in the bilateral anterior columns which has never been described as a spinal cord lesion in the stiff-man syndrome was also seen.
The clinical, radiologic, and histologic features of ossification and calcification of the ligamentum flavum were studied in 18 patients. Ossification (15 patients) usually occurred in the lower thoracic spine in men of various ages, while calcification (three patients) was found exclusively in the cervical region of older women. Histologic examinations of ossification showed mature lamellar bone associated with proliferated cartilage replacing the ligamentum flavum (endochondral ossification). This corresponded well with radiographic and computed tomographic (CT) appearances. In the cases with calcification of the ligamentum flavum, calcification within the degenerated ligamentous fibers was observed on histologic examination, and correlated well with an oval nodular density on radiographs and CT. The two conditions differ in clinical, radiologic, and histologic considerations. Pathomechanisms in the development of these lesions and clinical significance are also discussed.