Biomedical subjects
Publications and source records attributed to Y Higashi.
Small pancreatic tumor is difficult to be diagnosed. Two cases of pancreatic islet cell tumors were examined by ultrasonography. One case was islet cell carcinoma, the other insulinoma. In both cases, ultrasonography was useful in detecting the tumor, judging the location of tumor during surgical operation and deciding the surgical procedure.
A rare primary argyrophilic carcinoma "carcinoid tumor" of the breast in a 48-year-old woman was investigated by light and electron microscopy, and immunohistochemistry. Light microscopy showed the greater part of the tumor to have characteristic histological features of carcinoid tumor and Grimerius' stain revealed the presence of numerous argyrophilic granules in the tumor cells. Numerous neurosecretory granules and bundles of intermediate filaments were observed ultrastructurally in the cytoplasm. In addition, carcinoembryonic antigen (CEA) and neuronespecific enolase (NSE) were detected in the tumor cells using the immunoperoxidase method. From the results, it is speculated that the tumor cells have the ability to produce CEA as well as NSE in the cytoplasm. The observation of ductal spreading in parts of the tumor, and the detection of CEA, suggest the tumor cells to be derived from mammary epithelial cells.
Light microscopy of the mandibular joint tissues from fetal mice show a distribution of fibrillar structures in the articular fibrous capsule covering the condylar head. Further SEM and TEM studies were conducted on autoclaved xiphoid and mandibular condylar processes of the fetuses for observation of the elastic system fibers in these cartilaginous tissues. SEM showed that non-collaginous fibers branched and united to form a complicated network in the cartilage. A fine structure study on diameter distribution of the fibers indicated elastogenesis in the differentiating cell layer and fiber maturation in the articular surfaces and calcification layer, thus suggesting a sequential development, growth, and degeneration of the cellular and fibrillar components in the cartilage, as well as bidirectional cell differentiation in the growing mandibular joint. A further TEM study on these autoclaved connective tissues showed the elastic system fibers in the network to be composed of fine microfibrils and amorphous elastin. The elastic fibers in the condylar cartilage were a loose network having many tortuous main and oblique elastic fibers, and coiling oxytalan fibers.
Two cases of primary malignant lymphoma of the intestine were examined by ultrasonography. In the first case, the lymphoma originated from the terminal ileum and caused intussusception. The tumor was significantly hypoechoic. In the second case, the tumor showed pseudokidney sign. The echo level of the tumor was low and the size of the tumor was over 10 cm.
Squamous cell carcinoma of the renal pelvis is a relatively rare disease. Recently, we observed a case of squamous cell carcinoma of the renal pelvis with vesicoureteral reflux in a 49-year-old female patient. Her main symptom was abdominal pain on the left side. The complete duplications of uretero-pelvis on both sides, and vesicoureteral reflux in the upper left part of the kidney were recognized by means of various examinations. During the operation, a tumor was found in the upper left renal pelvis, and in the ureter belonging to the upper left renal pelvis. Pathologically, it was diagnosed as a squamous cell carcinoma. After the extraction of the left uretero-pelvis, 50 Gy of radiotherapy was administered to the patient. However, she died four months after the operation.
An SEM study on the dental hard tissue was conducted on the canines and molars removed from a fossil oreodont. The orthodentin was densely distributed with dentinal tubules measuring 2.2 microns in diameter; the tubules were filled with their related odontoblastic processes. They coursed in a parabolic fashion from the pulpal aspect towards the tooth surface. There were many fine lateral offshoots that branched from the tubules, such that the mantle dentin measuring 50 microns in thickness was mostly distributed with these terminal branches measuring 0.7 micron in diameter. However, they did not intrude into the enamel to form spindles and rods. SEM study indicated that the uneven surface of the tubular wall was due to a crisscross of the underneath dentinal matricial fibers, and the peritubular dentin was not observed. The superficial circumpulpal dentin was distributed with interglobular dentin, while the radicular dentin beneath the cementum was additionally distributed with a granular layer. We also observed concentric lamellae corresponding to incremental lines in the dentin, as well as a flat wavy dentinoenamel junction. We noticed the radicular dentin was covered with an acellular cementum except at the apical portion, where it was paved with cellular cementum.
Intercellular communication (IC) among epithelial and/or interstitial cells of human prostate was evaluated. IC was measured by the dye transfer method. In brief, fluorescent lucifer yellow CH was microinjected into an individual cell and communication was measured by scoring the number of surrounding fluorescent cells. Cells used here were outgrowth cells from small tips of tissues of various prostatic diseases and established prostatic carcinoma cell line PC-3. To identify the epithelial cells, keratin staining was done. In prostatitis and benign prostatic hyperplasia, epithelial cells grew in five of six cases cultured and extent of maximum IC was from 18 to 46 cells (mean = 26 cells) at 4 to 6 culture days. Three specimens of separate cases cultured for more than one month had a maximum IC of more than 100 cells. In prostatic carcinoma, epithelial cells grew in 7 of 10 cases cultured and extent of maximum IC was from 6 to 38 cells (mean = 18 cells) at 3 to 6 days. The extent of IC among prostatic carcinoma cells was lower than that of benign prostatic diseases, though not significantly, this indicates the possibility that benign cells were present among the malignant cells in the specimens examined above. Prostatic carcinoma cells cultured from metastatic lesions of bone (PC-3) and lymph nodes had maximum IC of 3 to 5 cells. IC was very limited or absent between benign prostatic epithelium and PC-3 cells. No IC was present between prostatic epithelial and interstitial cells. Interstitial cells prepared from prostatic benign and malignant diseases similarly revealed a high extent of IC.(ABSTRACT TRUNCATED AT 250 WORDS)
Tokyo strain bacillus Calmette-Guerin (BCG) was instilled in a dose of 80 mg in 40 ml normal saline to the bladder of 8 patients with recurrent superficial bladder carcinoma (Ta, Tl, Tis) resistant to mitomycin C and/or adriamycin intravesical instillation chemotherapy. Instillation was performed weekly for 6 weeks and 3 to 4 weeks after the last instillation, the response was assessed by cystoscopy and urine cytology. Patients who achieved complete response underwent monthly maintenance instillation for a year and inspection with cystoscopy and urine cytology every 3 months. Of the 7 patients who underwent therapeutic instillation, 3 (43%) achieved complete response, and 2 partial response. Two patients with no response had carcinoma in situ of grade 3 anaplasia. Two of the 3 complete responders were free of disease for 11 and 12 months, but another 1 developed intravesical recurrence 13 months later. One patient underwent prophylactic instillation and remained free of disease for 23 months. Side effects included frequency, urgency and pain on urination which were tolerable with anti-analgesics. Two patients underwent total cystectomy because of tumor progression and had typical lesions of prostatic tuberculosis.
A rare case of pulmonary hypertension due to glycogen storage disease type II (Pompe's disease) was reported. An 18-year-old girl was admitted to Kawasaki Medical School Hospital because of cyanosis, dyspnea on exertion and amenorrhea. She was 149 cm in height and 29 kg in body weight. Clinical examination revealed that pulmonary artery pulse and right ventricular heave were palpable over the precordium. On auscultation, an accentuated pulmonic second heart sound, pulmonic ejection sound and diastolic decrescendo murmur (Levine III/VI) were heard in the second intercostal space at the right sternal border. Her skeletal muscles, especially her intercostal muscles were generally weak and atrophic. Her electrocardiogram showed a pulmonary P-wave and right ventricular hypertrophy. The chest X-ray revealed right ventricular enlargement and a dilated pulmonary trunk. On echocardiography, the right ventricle and the main pulmonary artery were dilated, and a systolic notch of the pulmonary valve was found. Swan-Ganz catheterization disclosed that pulmonary artery pressure, right ventricular pressure and mean pulmonary capillary wedge pressure were 76/35 (50) mmHg, 76/12 mmHg and 10 mmHg, respectively. Respiratory function tests showed severe restrictive ventilatory impairment with hypercapnea and hypoxemia. On biopsy of the left quadriceps femoris muscle, the most striking finding was numerous intracytoplasmic vacuoles. The small vacuoles were stained with PAS and acid phosphatase. Electron microscopy showed massive glycogen accumulation in the sarcoplasm and membrane bound vacuoles (glycogenosome). Alpha-1, 4-glucosidase activity in the peripheral lymphocytes was definitely decreased. Her pulmonary hypertension resulted from respiratory muscular atrophy and alveolar hypoventilation caused by Pompe's disease.
A case of miliary tuberculosis with intracranial tuberculoma was reported. Homogenous or ring-like enhancing lesions surrounded with edema were seen after administration of contrast material on CT examination. However, CT is considered very useful method of evaluating the effect of antituberculous therapy.
Twelve patients with stage D2 adenocarcinoma of the prostate were treated with the combination chemotherapy of ifosfamide (2 g/body, i.v., day 1-3), 5-fluorouracil (250 mg/body, i.v., day 1-5) and cisplatin (20-30 mg/body, i.v., day 1-5). The averaged age was 62 years (from 52 to 73 years) with mean performance status of 70% (from 40 to 90%). Six patients were refractory to prior hormone therapy or chemotherapy and the other six had received no prior treatment for prostatic cancer. Based on criteria of National Prostatic Cancer Project, 4 patients achieved partial response (PR) which was maintained from 11 to 23 months with the mean of 17.8 months. Two patients achieved objectively stable stage (NC). Response rate (PR + NC) was 50%. Response rate of patients without prior therapy was 80%, whereas that of hormone-resistant group was 30%. There was a trend toward unfavorable response in patients with prior therapy. Adverse effects were mild to moderate gastric problems and myelosuppression except in one case Adverse effects were mild to moderate gastric problems and myelosuppression except in one case with low performance status under 60%. IFP combination chemotherapy achieved favorable responses and toxicities were tolerable. Therefore, it appears worth while to study whether IFP combination chemotherapy could extend the life of patients with advanced prostatic cancer.
In April, 1987, we treated a 33-year-old male patient who presented a painless swelling of the right scrotal content of 6 months duration. After surgery, the resected testis weighed 130 g, and the cut surface showed an edematous, white-yellow, homogenous tumor. A histopathological examination revealed a typical spermatocytic seminoma composed of three types of tumor cells. The small cells had pyknotic nuclei and an eosinophilic cytoplasm while the medium-sized cells and most of the giant cells had nuclei containing granular chromatins. Some of giant cells contained a filamentous, chromatin-like spireme of primary spermatocytes. A chest X-ray, CT scanning and lymphography revealed no metastatic lesions, and the patient is still alive with no evidence of disease 10 months after the orchiectomy.
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The chronic effect of cAMP-dependent regulation on adrenocortical steroidogenesis is known to be revealed in the stimulation of the biosynthesis of steroidogenic enzymes. P-450(SCC), one of the enzymes, catalyzes the first and the rate-limiting reaction in steroidogenesis from cholesterol and its synthesis is regulated by cAMP. In order to investigate cis-acting DNA elements of this gene in response to cAMP-dependent regulation, we have constructed a fusion gene (pSCC5.4k) by ligating the 5'-flanking and the upstream untranslated region (5.4 kb) of the human P-450(SCC) gene to the structural gene for chloramphenicol acetyltransferase (CAT) and transfected it into various culture cells including Y-1 (mouse adrenal tumor), L929 (mouse fibroblast), HTC (rat hepatoma) and Hepa-1 (mouse hepatoma). Only Y-1 cells transfected with pSCC5.4k were found to express transiently the enhanced CAT activity in response to the cAMP analogue, cyclic dibutyryl-AMP (Bt2cAMP). Primer-extension analysis of RNA prepared from the cells treated with or without Bt2cAMP showed that the enhanced CAT activity was due to an increase in the CAT mRNA and that the transcription start site, determined here with the human P-450 gene in the adrenal cortex, was correctly utilized with the fusion gene in the transient expression system. Forskolin and cholera toxin, activators of adenylate cyclase, also increased the expression of the CAT activity in the Y-1 cells. It has been demonstrated, therefore, that the cAMP-dependent regulation of the P-450(SCC) gene in adrenal cortex is faithfully reflected in the transient expression system using Y-1 cells and the fusion gene and that a cis-acting DNA element(s) in response to cAMP is present within the 5'-flanking sequence (5.4 kb) of the P-450(SCC) gene.
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