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Kenji Kashima

Publications and source records attributed to Kenji Kashima.

50 records · Page 3Linked to original sources
PubMed2004

Regression of liver fibrosis in cases of chronic liver disease type C: quantitative evaluation by using computed image analysis.

OBJECT: It was reported that the liver fibrosis is reduced in patients with chronic liver disease type C after eradication of HCV. Degree of fibrosis was expressed by the classical fibrosis scoring system (F0-F4) at present. However a change of subtle reduction of fibrosis cannot be expressed in its fibrosis score and thus we measured an area of fibrosis and compared detailed change of the fibrosis area in paired liver biopsy. METHODS: For quantitative assessment of liver fibrosis, we measured an area of fibrosis using computed digital image analysis and pursued the rate of a fibrosis area for whole biopsied liver tissue of 25 patients with HCV infection (20 complete response patients to IFN therapy who showed viral eradication: CR and 5 non-treated ones with IFN but had conservative therapy: CT). RESULTS: In CR group, fibrosis rate was 7.2 +/- 1.5% before therapy, 2.7 +/- 0.5% after the therapy and they were significantly regressed. In CT group, fibrosis rate was 8.4 +/- 4.3% at the first biopsy, 15.9 +/- 7.7% at the second biopsy. CONCLUSIONS: Regression of liver fibrosis could be confirmed in patients with virologic response to IFN even in patients with liver cirrhosis. Our quantitative evaluation provided information superior to that obtained by the classical fibrosis staging score system.

Adult↗
PubMed2003

Biofeedback rehabilitation for prevention of synkinesis after facial palsy.

OBJECTIVE: We developed a new training method of biofeedback rehabilitation for the prevention of synkinesis after facial palsy and evaluated the efficacy of the training. METHODS: Twenty-seven patients with complete facial palsy were divided randomly into 2 groups. Twelve of the patients were treated with the training method, and the other 15 patients served as controls. Patients were instructed to keep their eyes open symmetrically during mouth movements using a mirror. Thirty minutes of daily training was continued for a period of 10 months. The degree of synkinesis was evaluated by computing the percent asymmetry of eye opening width. RESULTS: The percent asymmetry of eye opening width was significantly greater in the training group than in the control group (P < 0.05). The results indicate that the degree of synkinesis is much less in the training group than in the control group. CONCLUSION: Our new training method is very effective for preventing the development of synkinesis after facial palsy.

Adolescent↗
PubMed2003

Multiple spindle cell lipomas of the tongue: report of a case.

Spindle cell lipoma (SCL) is a relatively uncommon benign lipomatous tumor characterized by a mixture of mature adipocytes and bland spindle cells on a fibromyxoid background. These lipomas usually arise as solitary nodules in the subcutaneous tissue of the posterior neck, shoulder and back in adult men. Multiple SCLs account for 0.5% to 3% of all SCLs. In the literature, there have been 15 cases of intraoral SCL, including 6 cases of SCL in the tongue. We report a case of multiple SCLs on the bilateral margins of the tongue of a 75-year-old Japanese man. The tumors were removed surgically, and they exhibited the classic histopathological features of SCL, being well-circumscribed masses composed of a mixture of adipocytes and fibroblast-like spindle cells within a fibromyxoid stroma. Immunohistochemical analysis revealed that the spindle cells were strongly positive for CD 34 and bcl-2. To our knowledge, this is the first report of a case of multiple SCLs of the tongue.

Adipocytes↗
PubMed2003

Phlebosclerotic colitis coincident with carcinoma in adenoma.

Phlebosclerosis of the colon is a rare disease characterized by a thickening of the wall of the colon with fibrosis, hyalinization and calcification to the affected veins. These symptoms result in a type of ischemic colitis known as phlebosclerotic colitis. A case of phlebosclerotic colitis coincident with carcinoma in adenoma is reported. A 74-year-old Japanese woman was admitted to hospital because of a mass in her right lower abdomen. Abdominal computed tomography examination revealed linear calcifications in the wall of the cecum and the ascending colon. Colonoscopy revealed dark purple mucosa with multiple ulcers in the cecum and the ascending colon. Biopsy specimens showed a marked hyalinous thickening of the wall of small blood vessels in the mucosa. Phlebosclerotic colitis was suspected because of negative results with amyloid stain. Alternative ileocolic angiography showed the serpentine of the peripheral nature blood vessels and pooling at the late venous phase. Microscopic examination of the surgically resected colon revealed mucosal and submucosal fibrosis, and a thickening of the venous wall with fibrosis, hyalinization and calcification from the mucosa to the serosa, which caused a marked luminal narrowing. A small polypoid lesion was also found in the affected region and was diagnosed histologically as carcinoma in adenoma. To our knowledge, this is the first reported case of phlebosclerotic colitis complicated by carcinoma.

Adenoma↗
PubMed2003

Aberrant intranuclear localization of biotin, biotin-binding enzymes, and beta-catenin in pregnancy-related endometrium and morule-associated neoplastic lesions.

Biotin-rich intranuclear inclusions, also known as optically clear nuclei, have been observed in various neoplastic and non-neoplastic lesions. They look like nuclei of herpesvirus-infected cells and cause a false-positive immunohistochemical result by avidin-biotin-complex (ABC) method. In the literature, all types of neoplastic lesions with intranuclear inclusions, with one exception, have been characteristically associated with squamoid structures known as morules. By contrast, all reported non-neoplastic lesions with such inclusions lacked morules and were confined to pregnancy-related endometrium. In the present study, adding unreported types of morule-associated neoplastic lesions, we investigated the distribution of biotin, biotin-binding enzymes, and beta-catenin in these lesions by immunohistochemical staining. We detected the intranuclear localization of biotin and of two mitochondrial biotin-binding enzymes (pyruvic acid carboxylase and propionyl CoA carboxylase) in all lesions examined, regardless of whether they were neoplastic or non-neoplastic and irrespective of the presence or absence of morules. The intranuclear localization of beta-catenin was detected in all neoplastic lesions with morules and in ovarian endometrioid adenocarcinoma without morules, but not in non-neoplastic endometrial lesions. These results suggest the following conclusions: (1) lesions with biotin-rich intranuclear inclusions can be classified as non-neoplastic/pregnancy-related endometrial and as neoplastic/pregnancy-unrelated or morular category; (2) the intranuclear biotin in both types of lesion is found in conjunction with biotin-binding enzymes. However, the role of beta-catenin in morule-associated neoplastic lesions, the relationship between beta-catenin and biotin/biotin-binding enzymes, and the mechanism of migration of biotin and biotin-binding enzymes from the cytoplasm to the nucleus remain unclear.

Biotin↗
PubMed2003

An antigen retrieval method using an alkaline solution allows immunoelectron microscopic identification of secretory granules in conventional epoxy-embedded tissue sections.

Immunoelectron microscopy using chromogranin A-specific antibodies has been proposed as an efficient technique for identification of secretory granules (SGs) in tumor cells with evidence of apparent neuroendocrine differentiation. Using an antigen retrieval (AR) method, we succeeded in immunolabeling SGs with antibodies in ultrathin sections of routinely processed epoxy-embedded blocks of tissue. Samples of an insulinoma were fixed in 2% glutaraldehyde, postfixed in 1% OsO(4), and embedded in epoxy resin. Ultrathin sections were immunostained with chromogranin A-specific antibodies and gold-conjugated second antibodies. There was no significant labeling in the absence of AR. Neither etching with sodium metaperiodate nor microwave irradiation of ultrathin sections in citrate buffer (pH 6.0) or in EDTA buffer (pH 8.0) was effective in improving the efficiency of immunolabeling. However, ultrathin epoxy-embedded sections that were microwaved in alkaline solution (pH 10) were adequately labeled (5.2 +/- 0.34 particles per SG). Moreover, considerably improved efficiency of immunostaining was achieved by microwaving sections in alkaline solution (pH 10) with subsequent immunostaining at 60C (12.2 +/- 0.51 particles per SG). This method can also be applied to epoxy-embedded sections obtained from formalin-fixed, paraffin-embedded blocks of tissue and was even valid for an old epoxy-embedded block of tissue prepared 15 years previously.

Acrylic Resins↗
PubMed2002

The ectopic expression of gastric mucin in extramammary and mammary Paget's disease.

The immunohistochemical analysis of the ectopic expression of gastric mucin has been used as a valuable tool for the identification of several neoplasms. We performed an immunohistochemical examination of the expression of gastric, intestinal, and mammary-type mucins in 25 lesions from patients with extramammary Paget's disease (ExMPD) and in 10 lesions from patients with mammary Paget's disease (MPD). All ExMPD lesions were immunopositive for HGM-45, a marker of gastric surface mucous cells, whereas only 40% of MPD lesions were weakly immunopositive. No markers for gastric-gland mucous cells were found in almost all ExMPD and MPD lesions, and markers for intestinal mucin were recognized in only a few lesions. Antibodies specific for MUC1, a marker of mammary-type mucin, gave positive results in both ExMPD and MPD lesions at a higher frequency than antibodies specific for gross cystic disease fluid protein-15. Our analysis indicates that Paget's cells contain gastric surface-type mucin in ExMPD and they contain mammary-type mucin in both ExMPD and MPD. The ectopic localization of mucosubstances may be a further step in the understanding of these lesions. Moreover, antibodies against MUC1 seem to be a useful tool for the diagnosis of both ExMPD and MPD.

Aged↗
PubMed2002

Immunohistochemical localization of pyruvate carboxylase and carbamyl-phosphate synthetase I in normal and neoplastic human pancreatic tissues.

INTRODUCTION: It has been suggested that pyruvate carboxylase (PC) and carbamyl-phosphate synthetase I (CPS I) might be colocalized with carbonic anhydrase V (CA V), which is generally considered to provide HCO3- ions for PC and CPS I. AIM: To examine the immunohistochemical staining of endogenous biotin; of three mitochondrial biotin-binding enzymes (namely, PC, CPS I, and propionyl CoA-carboxylase); and of cytosolic acetyl CoA-carboxylase in pancreatic tissues. METHODOLOGY: Immunohistochemical analysis was performed on 23 samples of normal pancreas and 63 samples of neoplastic pancreatic tissues. RESULTS: It was found that the distribution of PC, CPS I, and endogenous biotin was not related to that of CA V but was similar to that of CA II in normal centroacinar cells, intercalated duct cells, and intralobular duct cells. In addition, PC was detected unexpectedly in delta-cells of islets. CONCLUSION: It seems likely that CA II plays a major role in the secretion of NaHCO3 into the pancreatic juice. Hence, it is possible that PC and CPS I in the centroacinar cells, intercalated duct cells, and intralobular duct cells are strongly activated and might use HCO3- ions provided by CA II and not by CA V. Among the pancreatic neoplasms examined, ductal adenocarcinomas exhibited significantly elevated immunoreactivity specific for the four biotin-binding enzymes.

Acetyl-CoA Carboxylase↗
PubMed2002

[A case of suspected lung metastasis of pancreatic carcinoma with bronchorrhea similar to bronchioloalveolar carcinoma].

There have been only a few reports of bronchorrhea in patients with metastatic pulmonary carcinoma. We report a case of suspected lung metastasis of pancreatic carcinoma with bronchorrhea, which was radiologically similar to bronchioloalveolar carcinoma. A 67-year-old man who had previously undergone surgical resection of pancreatic carcinoma was admitted because of a progressive cough producing copious amounts of serous sputum. A chest radiograph on admission revealed an infiltrative shadow with air bronchograms and ground glass opacities in the left middle and lower lung fields. A chest CT scan revealed a consolidative shadow with air bronchograms and bubble-like lucencies similar to bronchioloalveolar carcinoma in the left lower lobe. The histopathological features of the specimen obtained by transbronchial biopsy revealed adenocarcinoma with a pattern identical to that of the pancreatic carcinoma. Immunohistochemical staining with anti-SP-A antibody was entirely negative but those with anti-CA 19-9, Dupan 2 and CA 50 were positive in both lung and pancreatic tumors. These results strongly suggest that the pulmonary carcinoma was a metastasis of cystic adenocarcinoma of the pancreas. In summary, for a definitive diagnosis of bronchioloalveolar carcinoma, extrapulmonary adenocarcinoma as a primary site should first be ruled out.

Adenocarcinoma↗
PubMedDate not supplied

Ultrastructure and chromogranin A immunogold labelling of ECL cell carcinoids.

Poorly differentiated neuroendocrine cells can be difficult to recognise. Sensitive methods are needed to label cells that have lost their ultrastructural features and have reduced concentrations of neuroendocrine markers. In gastric neoplasms, enterochromaffin-like cells might dedifferentiate and lose their characteristic granules and secretory vesicles, making detection of such cells increasingly difficult. However, chromogranin A (CgA) immunogold labelling could provide sensitive and specific detection of gastric neuroendocrine cells. We present ultrastructural findings, CgA immunogold labelling as well as conventional immunohistochemical findings of two human enterochromaffin-like cell carcinoids. Electron-dense granules of poorly differentiated cells were less intensely labelled than granules in well-differentiated cells. Granules with atypical shape as well as punctuate granules previously found in neuroendocrine neoplasms were also CgA labelled. The CgA labelling efficacy after antigen retrieval in an alkaline solution was higher after heating in an autoclave at 135 degrees C compared to a microwave at 100 degrees C for both granules and secretory vesicles without significant deterioration of the ultrastructure. In conclusion, the use of CgA immunogold labelling could ensure a specific classification of cells with neuroendocrine granules and be a supplement to immunohistochemical examination of poorly differentiated tumours.

Aged↗
PubMedDate not supplied

Detection of the HTLV-I gene on cytologic smear slides.

OBJECTIVE: To apply the polymerase chain reaction (PCR) for detection of the HTLV-I gene from cytologic smear slides. STUDY DESIGN: Samples were from seven cases of serum anti-ATL antibody (ATLA)-positive T-cell lymphoma and three from ATLA-negative T-cell lymphoma. Six of the seven ATLA-positive cases were confirmed to be ATLL by Southern blotting. From the seventh case a fresh sample for blotting could not obtained. DNA was extracted from the cytologic smear slides of all 10 cases; they had been stained with Papanicolaou or May-Giemsa stain, digested with proteinase K and precipitated with phenol and ethanol. The target sequence in the pX region of the HTLV-I gene was amplified by PCR. RESULTS: All seven ATLA-positive cases, including one that had not yet been confirmed by Southern blotting, showed a single band, as predicted, while the three ATLA-negative cases showed no band. CONCLUSION: If cytologic smear slides are available but a fresh sample is not, the PCR method should provide evidence that the virus is present since in our study sufficient DNA templates were successfully extracted from the stained cytologic smear slides for detection of the virus.

Biopsy, Needle↗
PubMedDate not supplied

Biological analysis of gastrointestinal stromal tumors.

The biological behaviour of a gastrointestinal stromal tumor (GIST) cannot be easily predicted from preoperative clinical examination alone. As a result, there is little standardization in the surgical treatment of GIST. In this study, we analyzed the clinicopathology and immunohistochemistry of 20 cases of GIST to clarify factors associated with tumors showing malignant potential. Immunohistochemical analysis of KIT, CD34, vimentin, alpha-smooth muscle actin (SMA), s-100, p53, ki-67, bcl-2 and bax expression was performed on 20 surgically resected GIST. An apoptotic index (AI) was calculated for each sample using a TdT-mediated dUTP-biotin nick end-labeling method. With regard to bcl-2, t(14;18) translocations were also investigated using a polymerase chain reaction based method. Finally, the relationship between these biological results and clinicopathological data was analyzed. Of the 20 cases studied, two patients died due to lung or liver metastasis. All cases stained positive for vimentin, nine cases were positive for alpha-SMA and three cases positive for s-100. All cases were stained for both KIT and CD34, which tended to correlate with malignant potential. There was significant difference in frequency of bcl-2 overexpression (p<0.05) and trend in Ki-67 labeling index (p=0.098) between benign and malignant cases. However, with regard to bcl-2, no chromosomal t(14;18) translocations were detected in four analyzed cases. In GIST, overexpression of bcl-2 may play an important role in increasing malignant potential. Furthermore, Ki-67 L.I. and bcl-2 overexpression may be useful in predicting malignant potential, and therefore help to determine the surgical treatment, follow-up manner, and the necessity of adjuvant therapy.

Adult↗
PubMedDate not supplied

Gastrointestinal stromal tumor with diffuse mesenteric metastases.

Although malignant gastrointestinal stromal tumors (GISTs) sometimes show peritoneal dissemination, diffuse metastasis to only the mesentery is rare. We describe the unusual case of GIST in a 69-year-old woman who showed multiple nodules restricted only to the mesentery except the surface of the small and large bowel, omentum, and abdominal wall. These small nodules were similar to those seen in leiomyomatosis peritonealis disseminata. Histological and immunohistochemical findings were consistent with GIST. This case of GIST shows an apparently unique and rare spreading pattern.

Aged↗