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H Mashimoto

Publications and source records attributed to H Mashimoto.

18 recordsLinked to original sources

[A study of defensins in bronchoalveolar lavage fluid in patients with diffuse panbronchiolitis].

We estimated defensins, antimicrobial and cytotoxic peptides localized in azurophil granules of neutrophils, in bronchoalveolar lavage fluid (BALF) in patients with diffuse panbronchiolitis (DPB). BALF from DPB patients contained a higher concentration of defensins than those from patients with idiopathic pulmonary fibrosis and healthy volunteers. A significant correlation was observed between the concentration of defensins and the number of neutrophils, the concentration of interleukin-8 or neutrophil elastase in BALF of DPB patients. An immunohistochemical defensins in neutrophils and mucinous exudates in the airways and in the surface of bronchiolar epithelial cells. After treatment with macrolide antibiotics, significant reductions in the concentrations of defensins, IL-8 and neutrophil numbers in BALF of DPB patients were observed. These findings suggest that the lung injury in DPB could be caused by defensins released by neutrophils accumulated in the airways.

Adult

Detection of Cryptococcus neoformans in bronchial lavage cytology: report of four cases.

Four cases of pulmonary cryptococcosis were diagnosed by cytological detection of Cryptococcus neoformans in bronchial lavage. Three patients had underlying diseases, but not HIV infection. The chest X-rays showed 2 patients with nodular lesions and 2 with cavitary lesions. The cryptococcal antigen in the serum was positive in all four patients. In the cytology of bronchial lavage, Cryptococcus neoformans was detected after period-acid-Schiff (PAS) staining and was cultured in Sabouraud-dextrose agar. The cytology of bronchial lavage is useful for the rapid diagnosis of pulmonary cryptococcosis.

Adult

[A case of MRSA sepsis treated by the sequential combination therapy netilmycin and minocycline].

A sixteen year old female was feverish from June 12, 1993. Methicillin-resistant Staphylococcus aureus was isolated from the blood, the diagnosis of MRSA sepsis was established. Vancomycin (2 g/day) was administered for eighteen days, but MRSA was not eradicated in the blood culture. Then she was administered a combination therapy of arbekacin (200 mg/day) and imipenem/cilastain (1 g/day) for seven days, but MRSA in the blood was cultured continuously. The sequential combination therapy of netilmycin (200 mg/day) and minocycline (200 mg/day) was started, MRSA was eradicated from the blood culture after four days. The sequential combination therapy netilmycin and minocycline was seemed to be effective for MRSA infection.

Adolescent

[A case of brain abscess associated with enterococcal endocarditis].

Enterococcal infections involving the central nervous system are uncommon clinical entities. A 74-year-old male was admitted to our hospital on November 3, 1991 for high fever. Nuchal rigidity was observed at neurological examination. All four blood cultures yielded E. faecalis. The MIC value of ABPC against the isolated E. faecalis was 0.25 microgram/ml. Vegetation on the mitral valve and mitral regurgitation were revealed by an echocardiogram. Enhanced CT scan showed low density area with ring enhancement in the right basal ganglia and a CSF examination suggested bacterial meningitis. He became better after ABPC 8 g/day was intravenously administered. Then the vegetation on the mitral valve and the brain abscess disappeared. He was discharged with no complications. We reported a rare case of brain abscess associated with enterococcal endocarditis.

Aged

[A comparison of pathohistological findings of transbronchial lung biopsy specimens between Mycobacterium tuberculosis and mycobacteria other than Mycobacterium tuberculosis infections].

The pathohistological findings of transbronchial lung biopsy (TBLB) were compared between Mycobacterium tuberculosis infection (group A) and Mycobacteria other than Mycobacterium tuberculosis (MOTT) infections (group B). The number of positive pathological findings in TBLB were 14 (70%) in group A and 2 (16%) in group B, respectively. Eleven cases (55%) in group A were positive for acid-fast bacilli in TBLB by Ziehl-Neelsen stain, and 3 cases of group A showed granulomatous lesion in TBLB. In pathohistological findings of group B, 2 cases (16%) were granulomatous lesion, 4 cases (33%) were fibrosis, and 3 cases (25%) were inflammatory changes. The pathohistological examination of TBLB was more useful for the diagnosis of pulmonary tuberculosis than for MOTT infection.

Adult

[Thymic cyst].

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Diagnosis, Differential

[An autopsy case of urinary bladder carcinoma with pulmonary infarction and subacute cor pulmonale caused by tumor embolization].

Pulmonary tumor embolism is a common finding at autopsy but is difficult to diagnose clinically antemortem. We report an autopsy case of urinary bladder carcinoma associated with tumor emboli of the pulmonary arteries and subsequent pulmonary infarctions. An eighty-six-year-old man with bloody sputum showed multiple infiltrates on chest X-ray and multiple pleural based parenchymal lesions with truncated apex on computed tomography. The patient had a history of radiation therapy against urinary bladder carcinoma two years earlier. Transitional type carcinoma cells were identified from a urine sample obtained on admission. Three weeks later, the patient developed subacute cor pulmonale and died in severe respiratory distress. Postmortem examination revealed primary carcinoma of the urinary bladder. Multiple tumor emboli of pulmonary arteries and subsequent pulmonary infarctions were visible microscopically. There was a large amount of effusion in both the pleural and the abdominal space. The heart contained focal scarring and mild right ventricular hypertrophy and there was congestion of the lungs, liver, kidneys and spleen. Pulmonary tumor embolization may present at any stage of the patient's illness but rarely causes subsequent pulmonary infarctions. Cytologic examination of blood samples obtained from Swan-Ganz catheters may be useful in the diagnosis of tumor embolization.

Aged

[A case of pulmonary asbestosis with slightly increased serum IgE concentration and histopathological changes resembling DIP].

A 68-year-old male presented with cough and sputum. He had suffered from these symptoms for ten years prior to admission. Chest roentgenogram revealed reticulonodular shadows in the lower fields of both lungs. CT scan of the chest revealed an interstitial pattern in the lower field of both lungs. Honeycombing and bullous pattern were also present in the subpleural area. The patient had a history of dust and asbestos inhalation while working as an electrician. Eosinophilia of the peripheral blood and BALF, and a slightly increased serum IgE concentration were noted. Open lung biopsy revealed interstitial fibrosis with intra-alveolar macrophage accumulation and asbestos bodies. The histopathological features resembled UIP and DIP, although DIP is uncommon in pulmonary asbestosis. The slightly increased serum IgE concentration was considered to be an additional effect of asbestos. This is a case of pulmonary asbestosis with intriguing immunological and histopathological features.

Aged

[A case of mediastinitis and bilateral pyothorax, following acute epiglottitis with concurrent Aspergillus infection].

Life threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.

Acute Disease

[A case of interstitial pneumonitis with hemoptysis, BOOP (bronchiolitis obliterans organizing pneumonia) pattern, granulomas and foreign body giant cells in lung biopsy].

A 66-year-old male presented to our hospital in January 1990 with chief complaints of hemoptysis and cough. These symptoms had developed 10 months previously and had gradually increased. Fine crepitations were audible over the right lower lung field. There were no results suggesting an inflammatory process such as leucocytosis, elevation of ESR or positive CRP reaction. Chest X-ray film on the first visit showed fine nodular shadows in the right lower lung field, and chest CT revealed fine nodular shadows and mild dilatation of the right lower lobe bronchus. Transbronchial lung biopsy specimens showed granulomas with multinucleated giant cells, alveolitis and Masson bodies. The open lung biopsy specimens showed numerous macrophages and foreign body giant cells, and extensive organizing exudates in the bronchioles and alveolar spaces. Proliferation of smooth muscle and fibrosis around the dilated bronchioles were also seen. Thus, this patient demonstrated BOOP pattern, with granulomas and foreign body giant cells. His hemoptysis appeared to have resulted from inflammation of dilated bronchioles. His symptoms and abnormal shadows on chest X-ray improved without any therapy after admission. After treatment with corticosteroid, the diffuse fine nodular shadows disappeared. There has been no recurrence of symptoms to date, although this patient has continued living in the same environment as prior to admission. BAL findings during his prolonged follow-up revealed decrease in lymphocytes and elevation of CD4/CD8 ratio. Although the presence of granulomas suggests the possibility of an allergic reaction, no antigenic material could be identified in this case.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[Clinical and pathological investigation of opportunistic pulmonary mycoses in autopsy cases].

Clinical and pathological investigations were performed in 58 cases of opportunistic pulmonary mycoses diagnosed at autopsy during the 10 years between 1979 and 1988 at Sasebo General City Hospital. The following findings were obtained. 1) The incidence of opportunistic pulmonary mycoses during the 10 years was 7.7%, with a significant increase in the incidence of fungal infections during the last 5 years of the study. The incidence of pulmonary mycoses was higher in patients with blood dyscrasia than in those with solid tumor or benign disease (p less than 0.001). 2) Administration of steroid hormone and anticancer drugs were suspected to be causative factors in the development of pulmonary aspergillosis and cryptococcosis, but not in candidiasis. 3) Characteristic radiographic patterns and clinical symptoms were absent in cases of pulmonary candidiasis due to the small size of the lesions and the high incidence of other complicating pulmonary infections and edema. 4) The most common initial roentgenographic pattern in opportunistic pulmonary aspergillosis was localized infiltrate, subsequently progressing to either multifocal infiltrates or cavitation. 5) The initial symptom in opportunistic pulmonary aspergillosis was usually high fever, and the radiographic abnormalities appeared later. The median duration between onset and death in 19 patients with pulmonary aspergillosis was 23.1 days. 6) Pulmonary aspergillosis should be suspected in the compromised host with high fever refractory to antibiotics and pulmonary infiltrates. Empiric antifungal therapy should be initiated at an early stage for the best chance for survival.

Aged

A sequential ultrastructural and histoautoradiographic study of early neoplastic lesions in ethylnitrosourea-induced rat glioma.

A sequential study of the early stage of development of ethylnitrosourea (ENU)-induced glioma in the rat was performed by electron microscopy and [3H]thymidine histoautoradiography. Hyperplasia, the earliest neoplastic change that was detectable morphologically, consisted of a few or several immature oligodendroglia-like cells which were connected with one another or with preexisting neural tissue by junctional apparatus, and showed no reactive changes in the astrocytes or microglia. The labelling index of hyperplastic cells was 2.6%. Foci of early neoplastic proliferation (ENP) showed mild destructive changes in the neighboring neural tissue, and their major constituent cells had characteristics of immature oligodendroglias. The labelling index of cells showing ENP was 3.3%. The intercellular spaces exhibited slight enlargement with accumulation of extracellular matrix and a decrease in the number of junctional apparatus on the neoplastic cells. Microtumors showed apparent destruction of the preexisting neural tissue to form a tumor mass with an increase in the extracellular matrix. Constituent cells of the microtumors were similar to those of the ENP, although reactive astrocytes and microglias occurred more frequently. The labelling index was 9.6% in the central area of microtumors and 5.3% in the peripheral area. These findings suggest that in the initial or very early stages of glial cell neoplastic proliferation, it is necessary for the neoplastic cells to maintain contact with the neurons for metabolic purposes, and that after losing contact, these cells can proliferate autonomously with the accumulation of extracellular matrix.

Animals

[A case of thymic cyst with elevated CEA in the cystic fluid].

A 66 year-old male was admitted on October 31, 1987 because his chest X-ray film revealed a well-defined round shadow in the right inferior mediastinum. Chest CT showed a large homogenous mass in the right anterior mediastinum. The mass was identified as a cyst on echogram. Surgical removal of the cyst was done with right thoracotomy. The cyst was 15 cm in size and contained about 500 ml of grayish white fluid. Pathological examination showed a thymic cyst and no malignancy. Biochemical analysis of the cystic fluid revealed increased CEA value of 223.2 ng/dl in spite of normal CEA level in serum. CEA was demonstrated in the epithelium of the surface and Hassall's corpuscles by PAP stain. It is conceivable that this elevated CEA observed in the cystic fluid might be correlated with CEA-like antigens such as NCA, NFA and BGP.

Aged

[A case of HTLV-1 associated myelopathy with pulmonary involvement].

A 70-year-old woman was admitted complaining of gait disturbance and difficulty in urination. Neurological examination showed myelopathy and both serum and CSF anti ATLA antibodies were positive. A diagnosis of HTLV-associated myelopathy (HAM) was made and steroid therapy was initiated. Chest X-ray film on admission showed no abnormality, but three months later, diffuse fine nodular and reticular shadows appeared in both lung fields. The patients had no respiratory symptom. The results of pulmonary function tests were normal, aside from a mild obstructive defect as indicated by reduced V25. Arterial blood gas was also normal. Bronchoalveolar lavage studies showed increased total cell counts and an increased proportion of T-cells. The histological findings of the transbronchial lung biopsy specimen were bronchiolitis and alveolitis. Subsequently, within the next eight months the abnormal shadows on chest X-ray cleared gradually on maintenance dosage of prednisolone, 10 mg/day. Possible relationships between HAM and the pulmonary lesions were discussed.

Aged

[The nature of immunohistochemically defined astrocytic cells in rat gliomas].

The nature of astrocytic cells in rat gliomas induced by ethylnitrosourea (ENU) was studied by means of immunohistochemically demonstrating glial fibrillary acidic protein (GFAP), vimentin and beta-subunit of S 100 protein (S 100 beta) on paraffin sections. A special attention was paid to elucidating whether astrocytic cells would be neoplastic or not. The astrocytic cells in tumors were compared with astrocytes in normal rat brains and reactive astrocytes around a stab wound for their morphology, distribution and immunohistochemical characteristics. GFAP positive astrocytic cells in tumors were roughly divided into astrocytic cells and hypertrophic cells that showed morphologically similar appearance to fibrous astrocytes and hypertrophic reactive astrocytes around a stab wound respectively. A few multi-nucleated pleomorphic cells regarded as a kind of hypertrophic cells were also noted in gross tumors. GFAP positive cells were diffusely distributed in early neoplastic proliferations and microtumors, while in gross tumors they tended to be localized at the periphery. The GFAP positive cells were scattered among negative cells of tumors, forming no tumor mass. These findings suggest that the GFAP positive cells show no neoplastic growth, even though histopathologically they exhibit atypism or pleomorphism. The quantitative analysis of GFAP positive cells in tumors indicated more than 8% in most tumors in the white matter, whereas less than 8% in tumors in the gray matter and approximately 5% in gross tumors. The predominance of GFAP positive cells in the white matter was also observed in lesions induced by a stab wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Leiomyoblastoma of the greater omentum. A case report and review of literature.

A case of leiomyoblastoma of the greater omentum, occurring in a 36-year-old man was described. Leiomyoblastoma of the omentum is extremely rare and only 6 cases have been reported in the Japanese and English literature up to date. According to the review of these cases, including the present case, 1) females were affected more frequently than males, and the age ranged from 36 to 76 years; 2) leiomyoblastoma was usually a large tumor which caused abdominal fullness and pain, and occasionally complicated with anemia and bloody ascites; 3) mitosis was rare, and there was no sign of metastasis and recurrence. Finally the morphological criteria and clinical parameters of malignancy in leiomyoblastoma were discussed.

Adult