Biomedical subjects
Publications and source records attributed to H Yamase.
In this brief article we report on two HIV-negative patients with documented oral hairy leukoplakia who had no known risk factors for HIV infection nor any evidence of other forms of immune suppression. Therefore we conclude that in some instances hairy leukoplakia can represent an isolated and innocuous Epstein-Barr virus infection.
The present study investigates a possible source of inflammatory mediators involved in the pathogenesis of bladder inflammation characteristics of interstitial cystitis disease. Our tested hypothesis is that in response to injury, tissues of the urinary bladder participate in the initiation of bladder inflammation by releasing inflammatory mediators such as neutrophil chemotactic factors. Bladders of anesthetized rabbits (n = 7) were instilled with an acidic solution (pH 4.5) for 15 minutes, then washed with saline and instilled with sterile phosphate buffered saline (PBS) (pH 7.2) for an additional 45 minutes prior to sacrificing the rabbits. Control rabbits (n = 7) were instilled with sterile PBS (pH 7.2) for 15 minutes, then 45 minutes. The levels of neutrophil chemotactic factors were measured using modified Boyden chambers and rabbit peritoneal neutrophils as indicator cells. Results indicated the release of high levels of neutrophil chemotactic factors (via a checkerboard analysis) from acid-treated bladders after 15 minutes (70 +/- 4% of standard) and 45 minutes (80 +/- 7%). Electron microscopy analysis of these acid-treated bladders revealed the infiltration of a large number of neutrophils, which correlates with the recovery of neutrophil chemotactic factors. Control rabbits, on the other hand, showed low levels of chemotactic activity (less than 10 percent) and exhibited normal bladder morphology with absence of neutrophils. The glycosaminoglycan (GAG) layer was intact in both acid-treated and control bladders. High levels of neutrophil chemotactic factors were also detected in urine samples from eleven patients with interstitial cystitis (113 +/- 25%) (not due to interleukin-1 or leukotriene B4) which were not detected in urine samples from healthy volunteers (n = 9) or from thirteen control patients with bladder diseases other than interstitial cystitis. These preliminary studies indicate the capability of injured bladder tissues to release neutrophil chemotactic factors which contribute to the initiation of bladder inflammation. The presence of neutrophil chemotactic factors in urine samples of interstitial cystitis patients suggests a possible role of these mediators in the pathogenesis of the disease.
Renal parenchymal malacoplakia is a rare cause of renal failure. Patients presenting with renal failure carry a poor prognosis, the majority either dying or requiring chronic dialysis. In this report, we describe an alcoholic man who presented with renal failure due to bilateral renal parenchymal malacoplakia and papillary necrosis. The patient, who initially required dialysis, partially recovered renal function following prolonged antibiotic treatment with a fluoroquinolone antibiotic.
We report a case of Sjögren's syndrome characterized by keratoconjunctivitis sicca, parotid swelling, reduced salivary flow, and abnormalities on nuclear scanning. Two labial gland biopsies showed complete atrophy. Biopsy of an enlarged submandibular gland revealed lymphoid follicles and glandular replacement consistent with the diagnosis of Sjögren's syndrome. This case supports the concept that a negative finding on labial biopsy does not rule out a diagnosis of Sjögren's syndrome.
We studied the clinicopathological characteristics of the proximal border of bile duct cancer among 46 cases. In both the superficial and the superficially spreading type, cancer was located within the mucosa and the mucous membrane at its verge was more hypertrophic than the proximal noncancerous mucosa, but they didn't differ from each other in thickness at the fibromuscular and Glisson's fibrous layer. In bile duct cancer without superficial spread, on the other hand, the tumor involve the fibromuscular or Glisson's fibrous layer and fibromuscular or Glisson's fibrous layer at their verge was more hypertrophic than the proximal noncancerous bile duct, which resulted in the narrowing bile duct at the lesion. Percutaneous transhepatic cholangioscopy (PTCS) facilitates the preoperative diagnosis of the extent of the bile duct cancer, which shows a granular change of the mucosa and tumor vessels. The wall irregularity and narrowing of the bile duct demonstrated by the selective cholangiography are also referred to its extent.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 1.95-kg fetus delivered at 33 weeks' gestational age survived less than 1 hour. Physical examination and autopsy disclosed an enormous, protuberant primary malignant melanoma of the skin, enveloping most of the back. A rim of surrounding hyperpigmented skin proved to be a giant congenital melanocytic nevus (GCMN), from which the cutaneous melanoma had arisen. Autopsy demonstrated metastatic melanoma in the lungs, liver, spinal cord, leptomeninges, and placenta. Radiography and dissection confirmed that the melanoma had minimal connection to spinal or neural structures. The mother was clinically free of tumor 8 months after she was delivered of the infant. Pathologic, radiographic, histologic, immunohistochemical, and ultrastructural investigations of this unique case are presented.
Explore the source record for details and available documents.
A case of Wegener's granulomatosis is reported which manifested episcleritis followed by scleritis, and followed in turn by separate episodes of right and left orbital pseudotumor spanning 15 years prior to respiratory tract disease. The unusually protracted progression of symptoms in this case may be explained on the basis of the histopathological findings. Areas of fibrinoid necrosis of connective tissue occurred alone or alternated with areas of nongranulomatous fibrinoid necrosis of blood vessel walls. Granulomatours vasculitis was not observed. This histopathological picture is pathognomic of early cases of Wegener's granulomatosis which run especially protracted courses.
The repeated administration of mercuric chloride to BN rats induces the production of anti-GBM. In the present paper, we describe the immunohistopathology and histopathology of the kidneys from mercuricchloride-treated rats. Direct immunofluorescence demonstrated bright linear deposits of immunoglobulins at the level of the GBM of the kidney. Light microscopy failed to reveal substantial glomerular changes, but electron microscopy demonstrated a spectrum of ultrastructural alterations of the glomeruli (including the detachment of endothelial cells from the GBM and the presence of electron-opaque deposits). In the aggregate, these findings are suggestive of membranous glomerulonephritis. We also investigated whether treatment with low doses of PG had any effect on the course of this experimental model of autoimmune renal disease. Two groups of mercuric-chloride-treated BN rats received different doses of DMPGE2. This resulted in significantly lower levels of circulating autoantibodies to the GBM, as well as a decrease in the amounts of rat immunoglobulins bound to the kidneys and an increase in proteinuria. On the other hand, there were no major differences in renal histopathology between rats treated with DMPGE2 and controls.
A case of resected renal cell carcinoma with massive pancreatic metastases is reported. A 72-year-old man was diagnosed as suffering from obstructive jaundice. Massive pancreatic tumor and left renal tumor were shown by several kinds of radiological examination. Total pancreatectomy and left nephrectomy were performed. Postoperatively this case was histologically diagnosed as renal cell carcinoma with massive pancreatic metastases. Very few cases of resected renal cell carcinoma with pancreatic metastasis have been reported in the world. In such cases, there is no useful treatment except for resection of both the primary and metastatic lesions.
Explore the source record for details and available documents.
A mass in a woman's neck, with no sequestration by Tc-99m imaging, was accompanied by an elevated serum calcitonin on one occasion. Light microscopy of a biopsy was consistent with medullary thyroid carcinoma. Electron microscopy showed secretory granules similar to those found in normal C-cells and in medullary carcinoma of the thyroid. The neck mass (and pulmonary and hepatic metastases likely from the principal mass) concentrated radioiodide (I-131). Subsequent immunoperoxidase examination of the tissues showed them to contain thyroglobulin but not calcitonin. The tumor was thus likely of follicular-cell origin. Reports of radioiodide uptake in medullary thyroid carcinoma may be correct, but each case will have to be re-examined with attention to tissue markers such as thyroglobulin and calcitonin. These markers might more correctly classify the origin of the tumor. The possibilities of cell interconversion and of dual origin are also discussed. Whole-body turnover of radioiodide was quantified as well as that in the pulmonary lesions. Rapid removal of radioactivity was present, suggesting that agents reducing iodide turnover might have therapeutic value in these cases. At five days after radioiodide administration, a biopsy specimen showed that the tumor-to-blood ratio (per gram) was greater than 1.
Explore the source record for details and available documents.
The present study was designed to produce the experimental carcinoma of the biliary tract in dogs. Tube cholecystostomy was constructed in 8 mongrel dogs and 5-10 ml of 0.7-1.0 mg/ml solution of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was administered through the tube every day for the maximum period of 180 days. As the results: The experiment had to be cut off in 7 dogs (5 dogs: The tube was inadvertently pulled out. 2 dogs: died of general weakness). Pathological changes were observed in one dog given ENNG for 180 days and sacrificed at 372 days after the beginning of the experiment. Macroscopically, scattered foci of flat elevation of the mucosa were observed in the entire mucosal surface of common bile duct and a tiny polypoid lesion at the terminal protion. A tiny polypoid projection was adenocarcinoma confined to the mucosa, and areas of flat elevation showed marked hyperplasia of mucosa with partial atypical proliferation. No remarkable findings were noted in other organs.
The gastric acid output was studied in the 11 patients of hyperparathyroidism before and after parathyroidectomy. The gastric acid output before operation was almost equal to the normal control in our hospital. After the correction of serum calcium by parathyroidectomy, the gastric acid output and serum gastrin were decreased. The decreased gastric acid output was recovered as the days passed since operation and approached to the preoperative level. The acid output in hyperparathyroidism was less in the case whose activity of alkaline phosphatase was more, which suggested that the calcium deposition on gastric mucosa might damage the parietal cell as the result of long lasting hypercalcemia.
Caerulein was applied to oral cholecystography and the opacity of the common bile duct was evaluated at intervals. To 127 subjects whose gallbladder had been visualized by cholecystography was administered caerulein by intramuscular route in a dose of 0.2 mug per kg of body weight. As a result: 1. The visualization of the common bile duct reached its maximum 15 minutes after administration of caerulein (52% of the subjects); in total, 62.2% of the subjects responded to this cholecystography. 2. The visualization by caerulein was superior to that by the yolk both in its rate and intensity. 3. The cholangiogram taken after administration of caerulein was preferably available for diagnosis of bile duct lesions. Caerulein used for a pretreatment of drip infusion cholangiography (DIC) remarkably improved the picture in 3 of the 10 subjects in whom DIC alone had failed to show the bile duct. Thus, the application of caerulein to cholangiography facilitated diagnosis of bile duct lesions.