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Biomedical subjects

J Hanai

Publications and source records attributed to J Hanai.

At least 19 recordsLinked to original sources
PubMed1995

Myeloperoxidase-antineutrophil cytoplasmic antibody-positive crescentic glomerulonephritis complicating the course of Graves' disease: report of three adult cases.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been recently recognized in Graves' disease patients treated with propylthiouracil. We have experienced three adult cases of Graves' disease with main features being renal derangements. All three patients, who were between the ages of 22 and 82 years, had been treated with propylthiouracil for 2 to 5 years after a diagnosis of Graves' disease. After several weeks of upper respiratory tract infection or flu-like symptoms, they abruptly began to manifest proteinuria and hematuria concomitant with severe anemia. Their serum creatinine increased from normal levels to 1.2 to 3.6 mg/dL. Renal biopsy revealed crescentic glomerulonephritis without deposition of immune complexes (ie, pauci-immune type). Crescent formations were observed in 40% to 60% of the glomeruli in all three cases. The serum from the patients revealed positive perinuclear-ANCA and negative cytoplasmic-ANCA (C-ANCA) pattern, and myeloperoxidase (MPO)-ANCA titers were 120 to 502 ELISA Units/mL (normal, < 10 ELISA Units/mL). A withdrawal of propylthiouracil with or without immunosuppressive therapy ameliorated their renal derangements. Graves' disease patients should be placed under vigilant observation by monitoring their urinalysis and serum creatinine, especially when being treated with antithyroid drugs and when suffering from flu-like symptoms.

Adult↗
PubMed1992

Expression of intermediate filaments and other special markers by testicular germ cell tumors. With reference to embryogenesis.

Distribution of intermediate filament proteins (IFs) and several special markers was studied in 39 testicular germ cell tumors and 8 embryos and foetuses. The similarity and difference between development of germ cell tumor and embryogenesis were immunohistochemically investigated. Seminoma and embryonal carcinoma, as tumoral counterparts of undifferentiated germ cells, were characterized by little IF expression. This study revealed that the maturing and differentiating process in germ cell tumor is different from normal embryonal development and the tumor cells showed leaping maturing steps in tumorigenesis. Immunostaining for IFs helped to discover the further differentiation occurring in embryonal carcinoma and to demonstrate heterogeneous elements in non-seminoma germ cell tumors, which sometimes might not be apparent by light microscopical observation of H&E staining section. According to the findings, two patterns in mixed germ cell tumors are suggested; i.e., combined and diffuse types. The mechanism of tumorigenesis of the two types is supposed to be different. Clinically, the prognosis of most patients with testicular germ cell tumor is fairly good because of the improved chemotherapies that are dependent on histological diagnosis.

Adolescent↗
PubMed1992

Mass screening of neuroblastoma in Sapporo City, Japan.

In Sapporo City a mass screening program for neuroblastoma aiming at 6-month-old infants has been performed since April 1981. By March 1990, 136,001 infants were screened; 26 true-positive cases of neuroblastoma and six false-negative cases were detected. The sensitivity of the mass screening method was about 80% throughout the 9 years. During the 9-year period, a total of nine children with neuroblastoma who were not screened were also identified. Clinical stage, age at diagnosis, and survival rate for the 32 patients who were screened (26 true positives and six false negatives) were much more favorable than those for the nine patients who were not screened. A remarkable decrease in the incidence of cases of neuroblastoma with advanced clinical stages over 1 year of age, especially among children 1-4 years of age, was noted after the start of the mass screening. The mortality from this tumor in children up to 4 years of age significantly decreased after the start of the urinary screening program. Rescreening at 14 months of age was begun in April, 1991 in Sapporo City. Performing two screening examinations decreases the probability of overlooking a patient. Thus, it is expected that tumors missed on the first screening would be detected by the second screening.

Biomarkers, Tumor↗
PubMed1992

[Persistent müllerian duct syndrome with seminoma: report of a case].

A case of persistent Müllerian duct syndrome associated with seminoma is reported. A 22-year-old man was admitted with the chief complaint of left flank colicky pain. Physical examination revealed huge abdominal mass and absence of left intrascrotal contents. Right hydrothorax and left ureteral calculi were pointed out with radiography. The abdominal tumor was reduced by effective chemotherapy. Extirpation confirmed the presence of seminoma and persistent Müllerian duct structure. This case showed left testicular transverse ectopia. In our review of the Japanese literature, 16 cases of transverse testicular ectopia accompanied with testicular tumor are reported.

Adult↗
PubMed1991

Atypical lipoleiomyoma of the uterus.

A case of uterine atypical lipoleiomyoma in a 55-year-old obese woman is described. Histologically it was composed of atypical smooth muscle tissue and adipose tissue, as proved by immunohistochemical staining and ultrastructural study. Moreover, these studies revealed a transition from tumor smooth muscle cells to lipocytes. The features of this tumor suggest that at least some lipoleiomyomas result from lipomatous metaplasia of leiomyoma. Lipoleiomyoma is a rare lesion of the uterus, and the present tumor with an atypical leiomyomatous appearance is the first reported case of its kind. A review of previous case reports, together with the condition of this patient, revealed that patients with lipoleiomyoma are often overweight and menopausal, and have a high incidence of gallbladder disease.

Desmin↗
PubMed1991

Can a patient with neuroblastoma be diagnosed by a single urine sample collected randomly?

We have observed that a fairly large amount of vanillylmandelic acid and homovanillic acid in urine samples taken randomly from patients with a tumor of about 10 g was less than the cutoff values and overlapped with the respective ranges of normal infants. Consequently, with only a single random urine sample there is a risk of overlooking a patient, especially in cases where the tumor is small. However, according to theoretical calculation, several random urine samples may enable us to discriminate a patient from a normal infant and can replace the 24-hour urine accumulation for 3 days which is currently performed for final judgement in the mass screening of neuroblastoma.

Homovanillic Acid↗
PubMed1991

Argyrophilia in ovarian serous tumors. A comparative study in 127 epithelial ovarian tumors.

The distribution of argyrophil cells in epithelial ovarian tumors was studied in 127 cases. The results showed that not only mucinous tumors and endometrioid tumors contained argyrophil cells, but also some serous tumors expressed argyrophilia. 31% of serous tumors including 40% of serous adenocarcinomas contained variable numbers of argyrophil cells. Argyrophilia has been demonstrated in mucinous tumors, endometrioid tumors and Brenner tumors before. However, this is the first time the presence of argyrophilia in serous tumors has been noticed. Moreover, the argyrophil cells in 5 serous carcinomas showed reactivity with Neuroendocrine (chromogranin A) antibody but not with serotonin. The expression pattern of argyrophilia in the serous tumors was different from that of the mucinous tumors; in the former, argyrophil granules appeared in apical portions or throughout the cytoplasm of single or clustered cells. In addition, the argyrophilia in some serous tumors and endometrioid tumors decreased after diastase digestion. Ultrastructurally, no typical neurosecretory granule was found in the argyrophilic serous tumors. The findings in this study suggest that argyrophilia could be quite frequently found in ovarian epithelial tumors and in itself is not a very specific differential characteristic of carcinoid tumors. The argyrophilia found in a variety of epithelial ovarian tumors might lend additional support to the histogenesis and close relationship between the common epithelial tumors of the ovary.

Antibodies, Monoclonal↗
PubMed1991

S-100 protein in ovarian tumors. A comparative immunohistochemical study of 135 cases.

The distribution of S-100 protein in 135 ovarian tumors, of which 127 were epithelial, was investigated using the immunoperoxidase method. S-100 protein has been demonstrated previously in tumors of various origins. The present study further revealed its characteristic distribution in common epithelial tumors of the ovary. S-100 protein was present in 69% of serous tumors (benign, 50%; borderline, 100%; malignant, 71%), as well as in the serous elements of serous & mucinous mixed tumors (30%). S-100 protein was also demonstrated in 25% of clear cell carcinomas and 29% of endometrioid carcinomas. Interestingly, none of the mucinous tumors were positive for S-100 protein. In addition, the expression of S-100 protein by epithelial ovarian tumors was compared with that of CA 125 and carcinoembryonic antigen (CEA). The distribution of S-100 protein was similar to that of CA 125, since both antigens were frequently present in serous tumors, although their expression patterns were different. On the other hand, S-100 protein-positive cases were almost negative for CEA or vice versa. Our observations indicate that demonstration of S-100 protein in common epithelial tumors of the ovary and comparison of S-100 protein distribution with that of CA 125 and CEA may further clarify the characteristics of common epithelial tumors of the ovary.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

Fluctuation in the concentrations of vanillylmandelic acid and homovanillic acid in mass screening for neuroblastoma.

Fluctuations in the amount of vanillylmandelic acid (VMA) and homovanillic acid (HVA) were studied in random urine samples from 13 infants with neuroblastoma. In patients with a small tumour, many samples contained amounts below the cut off values, suggesting that detection of a patient with neuroblastoma depended on mathematical probability. Using high performance liquid chromatography a patient with a tumour of about 10 g may well be overlooked, whereas a patient whose tumour weighs over 30 g would probably be detected. With qualitative screening, although more likely to miss a patient with low VMA excretion, a patient with a tumour weighing over 50 g would be detected. In a thorough hospital examination care should be exercised in interpreting borderline values of VMA and HVA; excretion information suggesting the existence of a tumour may aid localization by radiological imaging procedures.

Adrenal Gland Neoplasms↗
PubMed1990

Incidence of neuroblastoma in Sapporo city.

The incidence of neuroblastoma in Sapporo City for the period before the enforcement of the mass screening of neuroblastoma (1974 to 1980) was compared with the period after it (1981 to 1987). No large difference was found in incidence between them. In 1981 to 1987 the occurrence cluster at 2 to 4 years of age found in the prescreening period disappeared and an accumulation of patients at 0 year of age was noted. The sensitivity of the mass screening was almost stable (76.9% to 80.0%) throughout the 7 years. By the mass screening system of Sapporo City, early detection will be expected in 60% to 70% of all the neuroblastoma patients, the deficiency of which is due to the patients who neglected the mass screening.

Adolescent↗
PubMed1990

Primary adenocarcinoma of the female urethra with three histologic patterns and partial AFP positivity.

A rare case of adenocarcinoma of the female urethra with alpha-fetoprotein (AFP) positivity in a 52-year-old woman is reported. The tumor was papillary polypoid, localized in the posterior wall of the mid-urethra and microscopically showed three histologic components. Upon immunostaining and histochemical staining, the tumor was characterized by intestinal-type cells positive for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), EMA-negative and AFP-positive columnar vacuolated cells and mainly EMA-positive clear cells. On the basis of these features together with the known embryogenesis of the urethra, an endodermal origin of the tumor is suggested, possibly arising from the reserve or stem cells in the urethral mucosa. This case and its immunohistochemical features are quite unique and the histologic combination is meaningful when considering the oncogenesis and histogenesis of urethral tumors.

Adenocarcinoma↗
PubMed1990

Urinary vanillylmandelic acid and homovanillic acid levels in randomly-sampled urine for the mass screening of neuroblastoma.

Employing 421 urine samples taken randomly from normal infants and 294 samples from infants with neuroblastoma, we investigated the application of values of vanillylmandelic acid (VMA), homovanillic acid (HVA) and square root of VMA2 + HVA2 to discriminate between patients and normal infants. The establishment of an HVA cut-off level is virtually impossible because of its low sensitivity. In contrast, VMA sensitivity is high, and that of square root of VMA2 + HVA2 is very similar to that of VMA although it includes HVA. Although VMA appears to be able to discriminate well, discrimination employing VMA alone would be dangerous because cases with normal VMA and abnormal HVA would be missed, especially in the first screening for which a mechanical discrimination is performed. Overlooking such cases can be avoided by the adoption of the function square root of VMA2 + HVA2. The present study suggests that the combined use of variables can be more effective than using them separately.

Homovanillic Acid↗
PubMed1989

Japanese experience of screening.

In Sapporo City, the mass-screening for neuroblastoma concerning the urine of infants at about 6 months of age, started in 1981. After 1984, the quantitative determination of VMA, HVA in the urine was carried out using high performance liquid chromatography from the first step. About 104,000 babies have received the screening during the last 7 years, and 19 patients were found (incidence of detection 1:5,500). Except for one, who died of the duodenal perforation shortly after the surgery, all other patients are surviving free from disease. Among 10,000 neonates, we determined urinary concentration of VMA, HVA, and no positive cases were found. However, from this group, 2 patients we detected by the mass-screening at 6 months of age (1:5,000). After the start of mass-screening, the number of the patients with this tumor in much earlier stages and younger ages increased, clarifying that the main cause for improvement of the survival rates of neuroblastoma in Sapporo.

Chromatography, High Pressure Liquid↗
PubMed1989

Mother's attitudes towards the mass screening of neuroblastoma.

Two hundred and two mothers whose infants participated in mass screening of neuroblastoma in Sapporo City, and 200 mothers whose infants did not, were interviewed about their attitudes towards the mass screening. Only a few non-participants (3.5%) thought the mass screening was unnecessary. More than half of non-participations (56.0%) were due to mothers' forgetfulness or to loss of the "Neuroblastoma Screening Examination Set" during the two months' interval between the delivery of the set and the sample submission. Mailing of the set at six months for the purpose of eliminating this interval would greatly reduce such neglect of the mass screening. On the other hand, not many infants would participate in re-screening for detection of false negative cases, since the percentage of mothers who were willing to make their children take part in re-screening for a fee of 1,000 yen (about 7 U.S. dollars, which would be administratively necessary) was less than 60%.

Attitude to Health↗
PubMed1989

Cases of neuroblastoma missed by the mass screening programs.

Twenty-two reported cases of neuroblastoma missed by the mass screening programs were reviewed (six cases in Sapporo City where a quantitative measurement for both vanillylmandelic acid (VMA) and homovanillic acid (HVA) is used and 16 cases in the districts of qualitative judgment only for VMA), and some potential factors for missing a patient were discussed. Most of the 22 patients were diagnosed over 12 mo and had advanced clinical stages at diagnosis (III or IV). Of the 17 cases whose outcome in prognosis was available, nine cases were dead and only three cases were alive without any trace of tumor. Fluctuation in the amounts of urinary VMA and HVA seemed to be one of the causes for missing a patient, especially with a small tumor. The comparison about tumor wt, VMA and HVA amounts, and clinical stage between the 22 true positive cases in Sapporo City and 46 ones in the districts of qualitative methods, and the difference in detection rate between the two groups suggested that the qualitative methods missed more patients with a small tumor. The patients who had abnormally high amounts of HVA with low amounts of VMA accounted for a fairly large part of the missed cases in Sapporo City as well as in the districts of qualitative methods. To the contrary, no patient of this type was found even among the 22 true positive cases in Sapporo City.

Child, Preschool↗