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Biomedical subjects

Y Mitsuhashi

Publications and source records attributed to Y Mitsuhashi.

At least 55 records · Page 3Linked to original sources

A case of infantile digital fibromatosis with spontaneous regression.

We reported a fourteen-month-old boy with infantile digital fibromatosis. At the age of seven months, a nodule appeared on the back of the left third toe, and developed into a slight red tumor divided into five hemispherical nodules. Histopathologically, spindle-shaped tumor cells with an eosinophilic inclusion body in the cytoplasm were seen in the dermis. Electron microscopy showed a dense body in the cytoplasm of the tumor cells. One year and two months after the first visit, the tumor regressed without any aggressive treatment. Japanese cases of infantile digital fibromatosis were reviewed. The literature review and our case suggest that the tumor should be observed without any aggressive treatment unless it causes mobile dysfunction of the affected finger or toe.

Diagnosis, Differential↗

Eccrine syringofibroadenoma: report of a case and analysis of cytokeratin expression.

Eccrine syringofibroadenoma (ESFA) is a rare disorder which shows differentiation toward the eccrine sweat apparatus. There is a controversy concerning the pathogenesis and precise differentiation of this tumor. We report a case of ESFA and its differentiation pattern by an analysis of cytokeratin expression. Using paraffin-embedded materials, histopathological and immunohistochemical studies were performed. Staining patterns of the luminal, peripheral, and inner cells of the tumor strands closely matched or mimicked those of the luminal, outer and intermediate cells of the normal eccrine dermal duct, respectively. The case of ESFA reported revealed a pattern of differentiation suggestive of an eccrine duct origin.

Adenoma, Sweat Gland↗

Basal cell carcinoma within vulvar Paget's disease.

An 85-year-old Japanese woman had noticed erythema on her vulvar region 3 years before. The erythema gradually increased in size and followed erosion and ulceration with pigmentation on the edge of the erythema. A skin biopsy from the pigmented area showed large round cells with ample cytoplasm, which formed nests or glandular structures. In the dermis there was mass formation of basophilic cells and peripheral cells in a palisade arrangement. The tumor cells in the epidermis showed positive immunoreactivity for carcinoembryonic antigen; on the other hand, the dermal tumor was negative. We diagnosed that the tumor in the epidermis was vulvar Paget's disease, and the dermal tumor was a solid type of basal cell carcinoma. We speculate that the vulvar Paget's disease preceded and then the basal cell carcinoma developed in the area of Paget's disease. This is the first report in which basal cell carcinoma in the area of Paget's disease was documented.

Aged↗

Lipodystrophia centrifugalis abdominalis infantilis.

AIM: To describe the clinical features of lipodystrophia centrifugalis abdominalis infantilis (LCAI) with special attention to the erythema which is seen around the depressed lesion. BACKGROUND: LCAI is a rare disorder which occurs mainly in Asian people, particularly in Japanese; it usually begins as an erythematous macule which subsequently expands centrifugally and leaves a central depression. However, the erythema has been seldom documented in detail. We here report a case of LCAI observed from its early stage and review the literature. CASE REPORT: A 2-year-old Japanese girl was brought to our out-patient clinic. Clinical examination revealed a slight depression surrounded by faint erythema that mimicked morphea on her left inguinum, but there was no hardening of the skin. The erythema disappeared 5 months after onset. Thereafter, the lipodystrophy expanded irrespective of the treatment to her right inguinum and lower abdomen. CONCLUSIONS: The depression continues to grow without the erythema in most patients. This suggests that the erythema is not necessary for enlargement of the depression although it precedes the depression in most patients.

Anti-Inflammatory Agents↗

Enzymic method for the spectrophotometric determination of benzoic acid in soy sauce and pickles.

A simple spectrophotometric method for the determination of benzoic acid is described. Benzoic acid is measured enzymically through its reaction with benzoate 4-hydroxylase coupled with NADPH and O2. The entire enzymic procedure required 20 min to complete. The method greatly simplifies the procedure for benzoic acid determination and permits the routine inspection of a number of samples with very little laboratory equipment. The method was compared with HPLC and satisfactory agreement was achieved.

Benzoates↗

Toxic epidermal necrolysis possibly linked to hyperacute graft-versus-host disease after allogeneic bone marrow transplantation.

Toxic epidermal necrolysis (TEN) is a severe blistering skin disease of high mortality. TEN may occur after bone marrow transplantation (BMT). In such cases, TEN have been attributed to graft-versus-host disease (GVHD) or an adverse drug reaction. It is very difficult to distinguish the causes of TEN after BMT. We report a 21-year-old Japanese man who developed TEN eight days after BMT, evaluate the differential diagnosis of hyperacute GVHD and an adverse drug reaction, and deduce that hyperacute GVHD was the more likely pathogenesis of TEN in this patient.

Acute Disease↗

Sister Joseph's nodule: a case report and review of the Japanese literature.

We report a case of metastatic carcinoma on the umbilicus, which is known as Sister Joseph's nodule. A 65-year-old man with the chief complaint of a painful nodule on the umbilicus was referred to our hospital. Histopathological examination revealed moderately differentiated tubular adenocarcinoma in the dermis. Endoscopic examination found gastric cancer of Borrmann type IV. The umbilical lesion represented a metastasis from the gastric cancer. We reviewed 80 cases of metastatic carcinomas to the umbilicus that have been reported in the Japanese literature.

Adenocarcinoma↗

A case of triple extramammary Paget's disease.

We report a 74-year-old Japanese man with triple extramammary Paget's disease; the genital and both of the axillar regions were simultaneously involved. Literature review revealed that 27 cases of triple extramammary Paget's disease have been reported in Japan, but there are no reports of triple extramammary Paget's disease from countries other than Japan, although 2 cases of double extramammary Paget's disease are reported. In all 28 cases, including our case, the genital lesion preceded the axillary lesions. All cases except one were male and only the exceptional female case was reported to have an the invasive tumor in the dermis. We speculate that extramammary Paget's disease may appear multi-centrically.

Aged↗

Tubal endometriosis diagnosed within one month after menarche: a case report.

A 13-year-old nulligravida girl, 158.5 cm in height and 76.0 kg in body weight, came to our department complaining of continuous right lower abdominal pain. One month earlier, an ovarian cyst in the right ovary, about 3 cm in diameter, was found when she underwent appendectomy at another hospital, but was left untreated. Menarche occurred at the age of 13 years and 1 month, which was after the appendectomy and 24 days before the present operation. Right hematosalpinx with peripheral obstruction and a para-ovarian serous cyst on the same side were diagnosed, and therefore right salpingectomy with para-ovarian cyst resection was performed. The bilateral ovaries and uterus were completely normal by inspection. The post operative histological examination confirmed hematosalpinx and revealed tubal endometriosis.

Adolescent↗

[An experiment in a new method of nursing education--the problem-based learning for prenatal nursing].

At the opening of lectures in 1995 on the Science of maternity Nursing in the Special Subjects of Nursing, a problem-based learning was tried as a new educating method in the unit of "Prenatal Nursing." In the present paper, reviewing the introduction/implementation of the method, subjects in the future are described. This process contained two major flows, one was the training of tutors in problem-based learning, including participating the workshop held at McMaster University, and the other was the preparation for the class at the introduction of the new educational method, such as the overall subject composition and the development of teaching materials of prenatal nursing and resources, etc. according to the procedures of the problem-based learning. As the results of the actual implementation, various different reactions in comparison with the lecture method were observed both in tutors and students. As the subjects hereafter, the following three points have been clearly elucidated, that is, in order to proceed the problem-based learning under the present condition that it is not in the comprehensive curriculum, to prevent the overload and conflict in the student learning, considering and adjusting the relationship with contents and methods of concurrent subjects and units, to establish the system for tutorial assessment and evaluation, and to insure tutors and fulfill their training system.

Curriculum↗

Lichen striatus in an adult.

A 58-year-old Japanese woman with lichen striatus had asymptomatic multiple erythemato-papular plaques in arranged linear or band-like patterns over the right half side of her chest, back, and the right upper and lower extremities, following Blaschko's lines. A biopsy specimen demonstrated a dermoepidermal interface inflammation with a lichenoid lymphoid cell infiltrate into the upper and middle dermis. All lesions spontaneously cleared within 2 months. Lichen striatus in an adult should be differentiated from other acquired erythemato-papular dermatoses which may follow Blaschko's lines. Its histopathological features may mimic those of lichen planus, but it can be distinguished because of its consistent distribution on Blaschko's lines, not only in children but also in adults.

Arm↗

Scleroedema in a child.

A 3-year-old Japanese girl with scleroedema was reported. She had had no signs of diabetes but did have a preceding bacterial infection in the tonsils three weeks before the skin lesion appeared. The skin on the face, shoulders, extensor aspect of the upper arms, and proximal half of the forearms was indurated. The skin lesions expanded from the middle part of the forearms to the wrists during the observation period. Thereafter, the induration gradually disappeared. A literature review revealed there were only six reports of scleroedema in children under 15 years old before 1996 in Japan; a total of 166 cases of the disease was reported in the same period. Five out of these six cases were not diabetes-associated. All but one of these six patients were female. Juvenile scleroedema seems to be rare in Japan.

Bacterial Infections↗

[A case of leiomyomatosis in pelvic lymph nodes].

We report a rare case of leiomyomatosis in iliac lymph nodes, which was found in a woman operated with a diagnosis as keratinizing epidermoid carcinoma of the cervix. A 39-year-old Japanese female, married, who had received hormonal therapy in her past history, visited the Department of Obstetrics and Gynecology at Kinki University Hospital, with a chief complaint of bloody discharge. Colposcopy and biopsy suggested a diagnosis of keratinizing epidermoid carcinoma of the cervix. A radical hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph nodes dissection was performed. Histopathological examination showed a keratinizing epidermoid carcinoma of the cervix. An intramural leiomyoma nodule (0.5cm in diameter) was detected in the fundus of the uterus. Histopathologically, this was a typical benign leiomyoma. The lymph nodes were free of neoplasms. But bilateral iliac lymph nodes were enlarged up to soybean size. Microscopically, the iliac lymph nodes contained a large amount of well differentiated smooth muscle tissue (11/30). Immunohistochemical investigation showed a positive reaction for smooth muscle actin and desmins in the spindle cells proliferated in the lymph nodes; no cytokeratin positivity was detected. Leiomyomatosis of lymph node may rise through metaplasia of intranodal decidua or endometriosis by myofibroblasts or smooth muscle cells, reflecting the multipotentiality of the pelvic subcoelomic mesenchyme that can be found in the peripheral sinus of lymph nodes.

Adenocarcinoma, Papillary↗