Smallest angiomyolipoma of the liver in the oldest patient.
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Aged↗
Biomedical subjects
Y Mizukami
Publications and source records attributed to Y Mizukami.
Histological changes of the liver in experimental graft-versus-host disease across minor histocompatibility barriers. VII. A light and electron microscopic study of the large bile duct.
Although morphologic changes of the intrahepatic bile ducts in graft-versus-host disease (GVHD) have been well studied, those of the large extrahepatic bile ducts in the porta hepatis or common bile ducts have not been so well elucidated. In the present study, pathologic changes of the extrahepatic bile ducts in experimental mouse GVHD across minor histocompatibilty barriers were examined up to 14 months after transplantation. Mononuclear cell infiltration was most striking around 2 weeks after transplantation. Although it gradually decreased, infiltration persisted during the entire period of observation. Fibrous thickening and sclerosis of the bile duct wall continued over time following transplantation, especially 3 months after transplantation. The appearance was similar to sclerosing cholangitis, but obliteration of the lumen was not demonstrated. Electron microscopically, the bile duct epithelial layer was frequently infiltrated by lymphocytes, and often accompanied by polymorphonuclear leukocytes, monocytes, and rarely by plasma cells. The epithelial cells in close contact with and in the vicinity of these cells showed a variety of degenerative changes. These results suggest that not only the interlobular and/or small bile ducts but also the large hilar and extrahepatic bile ducts are involved in hepatic GVHD, and thus bile duct injury in GVHD may occur along the full length of the biliary tree.
Animals↗
[A study on the bactericidal activity of povidone-iodine in the synthetic mediums].
To evaluate the bactericidal activity of povidone-iodine (PVI), synthetic mediums without the protein components were prepared. The stability of the available iodine in the synthetic mediums was compared with that in heart infusion broth (HIB; natural broth). The available iodine was remarkably decreased soon after addition of PVI in the HIB, but it was stable for 24 hr in the synthetic mediums. The growth of Escherichia coli and Salmonella enteritidis were found to be normal in the synthetic mediums. Minimal inhibitory concentrations (MICs) of PVI in the synthetic mediums were about one thousandth of that in HIB, and the phenol coefficients (PCs) of PVI in the synthetic mediums were about 30 times lower than that in the HIB.
Bacteria↗
Iodine-induced hypothyroidism: a clinical and histological study of 28 patients.
Thirty-three thyroid specimens obtained from 28 patients with clinically and laboratory-proven iodine-induced hypothyroidism were examined clinically, histologically, immunohistochemically, and ultrastructurally. Twenty-eight specimens obtained during the hypothyroid phase showed common histological changes in the thyroid thought to be specific for this disease; hyperplastic change in the follicles with some papillary folding, cuboidal to columnar change of follicular cells with clear and vesicular cytoplasm, scanty or absent colloid material in the large distended follicles, and occasional dilatation of capillary vessels. Lymphocytic infiltration was present in about half of the specimens. No specimens showed either stromal fibrosis or parenchymal atrophy. Immunohistochemical and electron microscopic examination revealed that severe interference with thyroid hormone biosynthesis occurs in the follicular cells. In two patients who had a follow-up biopsy in the recovery (euthyroid) phase after iodine restriction, the histological involvement seen in the hypothyroid phase was no longer present. The histological changes in the thyroid gland seen in patients with iodine-induced hypothyroidism are characteristic. This disease can be diagnosed from laboratory tests, but thyroid biopsy is also a useful tool to differentiate this condition from other diseases causing hypothyroidism. Not only clinicians, but also pathologists, must pay attention to this type of hypothyroidism, because thyroid function may revert to normal by iodine restriction alone.
Adult↗
Malignant lymphoma with myxoid change and sarcomatous features.
We report a case of unusual B-cell malignant lymphoma of the kidney and mediastinum. Renal biopsy showed prominent myxoid changes and sarcomatous features, leading to considerable difficulty in histologic diagnosis on routinely stained histologic sections. However, immunohistochemical staining for lymphocyte markers led to the final histologic diagnosis of B-cell malignant lymphoma. Although myxoid change is not generally found in malignant lymphoma, malignant lymphoma should not be excluded from consideration when one encounters a small round cell sarcoma with myxoid stroma, especially in extranodal soft tissue tumors.
Adolescent↗
Alcoholic hypertriglyceridemia with decreased activity of lipoprotein lipase and hepatic triglyceride lipase.
A 35-year-old male with alcoholic hypertriglyceridemia due to decreased lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) activities is reported. The patient had been drinking about 180 ml of whiskey (equivalent to 80 g of 100% ethanol) every day for the last 17 years, and the highest levels of serum triglyceride (TG) and cholesterol were 5,120 mg/dl and 506 mg/dl, respectively. Serum TG level returned to normal levels after complete alcohol abstinence. Further intake of ethanol resulted in an increase in serum TG to 326 mg/dl with a concomitant decrease in the serum levels of LPL and HTGL activities.
Adult↗
Abscessing bronchioloectasia with elements of plasma cell granuloma.
A 79-year-old male was admitted to the hospital with the complaint of bloody sputum. Chest X-ray revealed an abnormal shadow in the right upper lobe. Macroscopically, the lesion measured about 3.5 x 2.5 x 2.0 cm with a central cavity containing pus. Histologically, the lesion was composed of interlacing fibroblastic proliferation with abundant plasma cell infiltration and central cavitation. The inner surface of the cavity wall was partially covered by bronchial epithelial cells; there was no cartilage found, suggesting that the lesion had developed from chronic inflammatory processes in relation to ectatic bronchioles. Since the pathogenesis of plasma cell granuloma (PCG) has not been well established, it is probable that this case represents one stage in the development of classic PCG.
Aged↗
[The surgical management of breast cancer, especially breast conserving treatment].
The management of breast cancer is highly controversial. Various operations have been performed at different hospitals. Herein, we reviewed the results of randomized clinical trials regarding breast conserving treatment, and axillary and internal mammary lymph node dissections. Variations in local-regional therapy may not substantially affect survival, but the incidence of local-regional failure is inversely related to the extent of operation and/or radiotherapy. At present, surgeons are highly recommended to perform adequate surgery which provides the ultimate local control, does not compromise the chance for cure and gives the best cosmetic and aesthetic results. Therefore, quadrantectomy with or without immediate reconstruction, axillary dissection and internal mammary biopsy and breast irradiation are more preferably recommended for ensuring local control and for providing a better cosmetic and psychological impact.
Breast Neoplasms↗
[Evaluation of type IV collagen in patients with various thyroid disease].
Serum level of type IV collagen was measured in 104 patients with various thyroid disease, and the relationship between its level and thyroid hormone level was examined. The type IV collagen was measured by the method of one step sandwich enzyme immunoassay (EIA) using two distinct monoclonal antibodies recognized triple-helical (TH) domain and 7-S domain, respectively. The serum level of type IV collagen was significantly high in the hyperthyroid patients compared with that in normal controls, and a significant positive correlation was found between its value and thyroid hormone levels (T3, T4, FT3, FT4). The elevated level of type IV collagen in hyperthyroid patients was decreased to normal level, when they became to euthyroid after antithyroid drug therapy for hyperthyroidism. The serum level of type IV collagen was in normal range in hypothyroid patients, but the value was increased to high normal range after T4-replacement therapy for hypothyroidism. This evidence indicates that the serum level of type IV collagen is closely related to thyroid hormone level in patient with various thyroid disease. Type IV collagen concentration might be one of the useful variables for evaluating the thyroid function, although its mechanism is not elucidated.
Adult↗
Identification of the binding site of 55kDa tumor necrosis factor receptor by synthetic peptides.
We have synthesized a series of peptides, which cover almost the whole range of the N-terminal extracellular domain of human 55kDa TNF receptor (55kDa TNF-R). The peptides were examined for the binding activity to TNF by solid phase binding assay and for the inhibition of TNF cytotoxicity to mouse L-M cells. The peptide 159-178 exhibited remarkably higher binding activity to TNF than other peptides did. The specificity of the TNF binding to the peptides was confirmed by their inability to bind other cytokines. The peptide 159-178 also inhibited TNF cytotoxicity. These results indicate that the specific binding site of 55kDa TNF-R to TNF might reside within the peptide segment of amino acid numbers 159 to 178 in the N-terminal extracellular domain.
Amino Acid Sequence↗
Ectopic expression of the floral homeotic gene AGAMOUS in transgenic Arabidopsis plants alters floral organ identity.
The Arabidopsis floral homeotic gene AGAMOUS (AG) is required for development of the reproductive organs (stamens and carpels). In ag mutants, the loss of AG function leads to the conversion of these organs to the perianth organs (petals and sepals). In contrast, mutations in another floral homeotic gene, APETALA2 (AP2), result in the replacement of the perianth organs by the reproductive organs. On the basis of these observations, it has been proposed that AG and AP2 act in an antagonistic fashion. To test this hypothesis, we have studied the effects of ectopically expressed AG in transgenic Arabidopsis plants. The flowers of the transgenic plants exhibit a range of phenotypes mirroring those of ap2 mutants. These experiments provide direct evidence of the proposed antagonism between AG and AP2 functions, and the results strongly suggest that AG does indeed inhibit AP2 function.
Arabidopsis↗
[Evaluation of the internal mammary nodes by lymphoscintigraphy and ultrasonography in patients with breast cancer].
The efficacy of lymphoscintigraphy and ultrasonography was evaluated in the detection of internal mammary lymph node (IMN) metastases in patients with breast cancer. On histological examination of IMN, 10 patients had metastases (positive group) and 47 did not (negative group). On lymphoscintigraphy, lack of uptake in the parasternal region of the affected side was classified as abnormal. The frequency of this abnormal finding was not significantly different between both groups. On sonography, the thickness of the sonolucent internal mammary area was measured. The thickness of the affected side was 6 mm or more in two patients of the positive group and only one of the negative group. A thickness of over 6 mm on the affected side was statistically significant (p less than 0.05). The difference in thickness between the affected side and the healthy side was 3 mm or more in four patients of the positive group, and was less than 3 mm in all patients of the negative group. A difference in thickness of more than 3 mm between the two sides was extremely significant (p less than 0.001). In conclusion, sonography is valuable in detecting IMN metastases, while lymphoscintigraphy is not useful. Sonography is recommended as an efficient diagnostic modality for IMN metastases.
Adult↗
C-erbB-2 oncoprotein expression versus internal mammary lymph node metastases as additional prognostic factors in patients with axillary lymph node-positive breast cancer.
The relationship was assessed between c-erbB-2 oncoprotein expression and other prognostic factors in breast cancer, such as axillary and internal mammary node metastases. The value of these indicators was analyzed in estimating prognosis, especially in patients with axillary node-positive breast cancer. These results showed that c-erbB-2 is significantly related to clinical stage and axillary node metastases. A univariate study revealed that disease-free and overall survival were correlated significantly with clinical stage, tumor size, axillary and internal mammary node metastases, and 21N status. Among the patients with axillary node involvement, however, 21N status did not appear to be a significant additional prognostic factor. Internal mammary node metastases were significant. In a multivariate study, only axillary and internal mammary node metastases were significant prognostic factors for either the entire group of patients or those with positive axillary nodes. Therefore, axillary node dissection and biopsy of the internal mammary nodes may provide important prognostic information for patients with breast cancer.
Adult↗
Papillary thyroid cancer and its surgical management.
The surgical management in papillary thyroid cancer has been highly controversial. In the Department of Surgery (II), Kanazawa University Hospital, the surgical management especially for cervical lymph node metastases has changed since 1973 from a conservative approach to an aggressive one. In order to determine whether an aggressive approach is warranted, a retrospective multivariate analysis was carried out on 106 cases of papillary thyroid cancer. The patients have been followed for 10-28 years. Multivariate analysis was conducted following Cox's model. By this analysis, aggressive management appeared to have no impact on survival or relapse-free survival. However, age, sex, tumor size, and cervical lymphadenopathy were confirmed to be important prognostic factors in survival and/or relapse-free survival.
Adult↗
Alpha-fetoprotein production by hepatocellular carcinoma is prognostic of poor patient survival.
Immunohistochemistry using the avidin-biotin-peroxidase complex method was performed to study the production of alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC) tissue specimens which were obtained surgically. The relationship between staining for AFP and serum AFP levels or pathological findings was examined. The prognosis of the patients with HCC who underwent curative hepatic resections was studied with respect to the staining for AFP in their tumors. The mean serum AFP level in patients with positive AFP staining was significantly higher than in those with negative AFP staining. No significant relationship was found between AFP positivity and tumor size, tumor encapsulation, degree of vascular invasion, or the histological differentiation grade of the tumor. The patients with AFP-positive carcinomas had a poorer prognosis than did those with AFP-negative carcinomas (5-year survival rate of AFP-positive and negative groups were 26.7% and 56.5%, respectively.
Carcinoma, Hepatocellular↗
The relationship between lymph node metastases and DNA-ploidy status as prognostic factors in invasive breast cancer.
We evaluated the relationship between the regional lymph node metastases and the DNA ploidy status in 207 patients with invasive breast cancer, as well as their prognostic values in estimating the prognosis of breast cancer. A significantly higher incidence of aneuploidy was found in patients with a large T3 or T4 tumor, a positive axillary lymph node status, more than 4 positive axillary lymph nodes or positive internal mammary lymph nodes. In a univariate study, the overall survival was significantly correlated with tumor size, axillary lymph node status, axillary and internal mammary lymph node metastases, and DNA ploidy status. In the multivariate analysis, however, only axillary and internal mammary lymph node metastases were recognized as important independent prognostic factors on survival. In this series, the DNA ploidy status did not appear to be an independent prognostic factor either in the entire series or in negative axillary node patients, since it was closely correlated with the axillary or internal mammary lymph node metastases, and the axillary node negative patients had an extremely favorable prognosis.
Adult↗
Clinicopathologic study of alcohol-like liver disease in non-alcoholics; non-alcoholic steatohepatitis and fibrosis.
Alcohol-like liver injury (ALLI) in non-alcoholics has not been elucidated in Japan. The present study attempted to characterize the clinicopathologic features of ALLI in routine liver biopsies. ALLI was found in 1% of 561 biopsy cases obtained from 1988 to May, 1991 at Kanazawa University Hospital. Laboratory data characteristically showed only a mild to moderate degree of dysfunction, and none of the cases exhibited jaundice. Hepatic histology showed a mild to moderate degree of perivenular, pericellular and/or portal stellate fibrosis with a varying degree of fatty change and inflammatory cell infiltration. Portal stellate fibrosis with a varying degree of cell infiltration was more severe than the centrilobular or pericellular fibrosis in all cases. Intralobular inflammatory cell infiltration was associated with spotty or single hepatocyte necrosis, but extensive hepatocyte necrosis was not observed. Neutrophil infiltration was absent or minimal, and lymphocytes predominated in all cases. Mallory bodies were rare and were found in a few hepatocytes of only one of the 7 cases. The above histologic findings in ALLI were very similar to those seen in liver disease in Japanese alcoholics, and were somewhat different from ALLI reported in Western countries. In cases in which hepatic fibrosis, characterized by pericellular, perivenular or portal stellate fibrosis dominated without apparent hepatic necrosis and inflammation, the term "non-alcoholic steatofibrosis" is more suitable to depict its liver histology, being very similar to the alcoholic fibrosis frequently seen in Japanese alcoholics.
Adult↗
Chronic thyroiditis: thyroid function and histologic correlations in 601 cases.
Six hundred one patients with histologically proven "chronic thyroiditis" were assessed for the correlation of thyroid function to histologic findings. The histology of chronic thyroiditis was classified into four groups (oxyphilic, mixed, focal, and hyperplastic), and the thyroid function of patients was divided into hyperthyroid, euthyroid, latent hypothyroid, and overt hypothyroid, based on the laboratory data of serum triiodothyronine (T3), thyroxine (T4), and thyrotropin (TSH) levels, as well as thyrotropin-releasing hormone (TRH) tests. In the oxyphilic group (137 cases), 116 (85%) of the patients were classified as hypothyroid: 52 (38%) as latent hypothyroid and 64 (47%) as overt hypothyroid. In the mixed group (161 cases), the thyroid function of the patients varied. Thirty-seven (23%) of the patients were classified as hyperthyroid, 61 (39%) as euthyroid, 54 (33%) as latent hypothyroid, and nine (5%) as overt hypothyroid. In this group thyroid function was intimately related to the ratio of replacement by hyperplastic-changed follicles and oxyphilic-changed follicles. In the focal group (149 cases), 123 (83%) of the patients were classified as euthyroid, while 22 (14%) were classified as latent hypothyroid. The frequency of latent hypothyroid patients increased in parallel with the severity of cell infiltration. In the hyperplastic group (154 cases), 130 (85%) of the patients were classified as hyperthyroid. In this series 19 patients under 10 years of age were included, and no difference in the distribution of histologic varieties was observed between juvenile and adult patients. Thyroid needle biopsy is a useful and safe tool, not only for the histologic diagnosis of chronic thyroiditis, but also for the evaluation of thyroid function and the identification of causes for hyperthyroidism or hypothyroidism.
Adult↗