Biomedical subjects
Publications and source records attributed to R Chiba.
We reported two cases of primary sclerosing lipogranuloma in the scrotum. We performed tumor resection in both cases, but in one of the two cases tumor recurrence was observed 7 days after the removal. Sixty-three cases have been reported in our country, and we discuss the diagnosis and treatment with reference to previous reports.
To establish an adequate statistical classification of epithelial atypia in the pancreatic duct, a total of 78 areas of duct epithelia with varying grades of atypia were subjected to nine-parameter morphometry and nine-dimensional multivariate cluster analysis. The material was derived from 53 pancreases resected for various epithelial tumors or acute or chronic pancreatitis. The result was correlated with immunohistochemical findings in which the pattern of intraepithelial distribution of carcinoembryonic antigen changed with the degree of ductal atypia. Finally, atypical cells classified by cluster analysis and immunohistochemistry were subjected to computer-aided three-dimensional mapping to visualize their distribution in the ductal tree. Cluster analysis demonstrated that the various epithelial forms were classifiable into Clusters 1, 2, and 3, representing ordinary epithelia and mild and severe dysplasias, respectively. The last category was created so as to include not only in situ and invasive carcinoma but the so-called borderline atypical lesions. The reproducibility of this classification was proved by two sorts of discriminant analyses. Also, the grades of atypia shown by the clustering proved to correlate with the reaction patterns for carcinoembryonic antigen. In the computer-aided three-dimensional mapping, severely dysplastic areas were shown surrounded by zones of mild dysplasia, justifying the assumption of a stepwise carcinogenesis in the pancreatic ducts.
BACKGROUND: Atypical adenomatous hyperplasia (AAH) of the human lung is considered to be an important lesion preceding adenocarcinoma, but its difference from well-differentiated adenocarcinomas is so subtle as to cause diagnostic uncertainty. In view of this, the authors undertook to establish reproducible microscopic criteria for AAH, Type II pneumocyte type, and Clara cell type adenocarcinomas. METHODS: Twelve-parameter morphometry of atypical cells was performed on 97 lesions selected from 303 surgical specimens of lung by routine microscopic examination: all were considered by premorphometry examination to correspond to one of the above three diseases. Measurements were performed on photomicrographs using a digital image analyzer. The data of morphometry were subjected to 12-variate cluster analysis using a mainframe computer. RESULTS: It was demonstrated that the lesions were classifiable into three groups: Cluster 1 (Type II cell adenocarcinoma and AAH), Cluster 2 (AAH), and Cluster 3 (Clara cell adenocarcinoma). Whereas the latter two were created as homogeneous clusters, Cluster 1 was a mixture of Type II tumors and AAH. CONCLUSIONS: AAH in the strict sense of the word is definable by the features of those classified into Cluster 2, with atypia milder than overt adenocarcinomas. These AAH are likely to correspond to one of the steps of carcinogenesis forgoing the final one. The lesions, diagnosed as AAH before morphometry and being assigned to Cluster 1 and therefore not separable from Type II carcinoma, are considered to have been Type II carcinoma from the very beginning, which were however underdiagnosed in routine microscopic examination.
The adenocarcinoma sequence of the human colon is usually divided into three separate steps according to the grade of epithelial dysplasia, i.e., adenomas with mild, moderate and severe dysplasia. In an attempt to re-examine whether or not this sequence can be morphologically separable as usually assumed, a total of 192 epithelial lesions including adenomas with various grades of dysplasia were analyzed, relying on morphometrical and multivariate-statistical techniques. Histologic features of epithelial lesions were characterized by 10 quantitative parameters and subjected to 10-variate cluster analysis. In the result of computations, separation of neoplastic lesions into different groups proved to be rather ambiguous, not justifying the classification into three groups as generally expected. It was concluded that adenocarcinoma can develop from adenoma as a seemingly continuous process which may involve more steps than usually assumed.
In morphologically diagnosing cancer, pathologists' attention is focussed on the presence or absence of atypia, i.e., the form of cells and tissues deviated from the norm, and if it is present, on its grade. However, due to retarded development of techniques for the objective evaluation of its grade, separation of cancer from premalignant lesions still meets great ambiguity. Particularly, the boundaries of "dysplasia" with cancer and noncancerous lesions are not defined in clear morphological terms and are susceptible to a strong between-observers fluctuation. In this paper we outlined our recent efforts to establish in various organs a statistically most adequate, and therefore reproducible, classification of atypical lesions, resorting to morphometry and multivariate analysis. Two examples were given: atypia of the pancreatic duct epithelia as an object for the study of purely cellular abnormalities, and hepatocellular carcinoma, which required also to quantify the atypia of tissue structures, The classifications thus established proved to be the most adequate, in that, they closely reflected the grade of malignancy in a clinical as well as biological sense, as shown by the clear between-categorier differences in oncogene mutation, DNA ploidy pattern, the patients' prognoses, and so on.
From 1979 to 1983, surgical reconstruction of the buried penis was performed on 16 boys. They have been followed up for at least 5 years. In 15 boys, satisfactory appearance of the penis was gotten after the operation. In this paper, we introduced our surgical technique and reviewed the records.
A new type of high sharpness, high speed film was evaluated in combination with rare-earth screens for modulation transfer function, root-mean-square granularity and characteristic curve, and compared with currently available film-screen combinations. The clinical applicability of the new system was also compared on the basis of resolution and the discrimination of anatomical features on radiographs of a skull phantom. The results indicated that the new type film provided a radiograph of higher image quality while at the same time reducing patient dose by about 20% compared with the present rare-earth screen systems, or with no loss of image quality while reducing patient dose by about 50% compared with the present calcium tungstate system.
Under the assumption that the more hyperreactive the bronchial muscles are, the greater their work hypertrophy, we analyzed the distribution of hypertrophic smooth muscles along airways to see where in the bronchial tree asthmatic constrictions mainly occur. Autopsy lungs from 16 patients with bronchial asthma, 13 with other COPDs, and 20 controls were submitted to morphometry of the bronchial muscles. In microscopic slides, cross sections of airways were taken from the segmental bronchi to the terminal bronchioles. The perimeter length L of the basement membrane and the area S of muscles were measured, and the anatomic radius R and the muscular thickness D were calculated in a standardized circular state, in which the basement membrane was stretched into a circle without changing L or S. On bilogarithmic coordinates of D and R on which data from the asthmatics were pooled, it was shown that hypertrophy of muscles was the most pronounced in larger bronchi where constriction was most likely to occur. Closer analysis of patients, however, revealed that besides this typical pattern, which we designated Type I asthma, there was a group of patients (Type II) in whom hypertrophy involved the entire range of airways, including the bronchioles, suggesting that the site of asthmatic response varies among patients. In nonasthmatic patients with COPD, only mild hypertrophy of muscles was found in the large airways, despite the presence of obstructive lesions mainly in the small airways.
An automated method for determination of yohimbine (Yoh) in the serum was developed by means of column switching high performance liquid chromatography (HPLC). TSK-precolumn BSA-ODS and TSK-gel ODS-120T were used as a precolumn and analytical column, respectively. The wavelengths of detection were used at 280 nm (excitation) and 360 nm (emission). A 100 microliter serum sample is directly injected onto the precolumn. Yoh is then eluted within 30 min with an methanol-potassium phosphate buffer mixture. The analytical recoveries (99.3-110.4%), reproducibilities (within-run, C.V. less than 2.27%), and detection limit (0.80 ng/ml, S/N = 3) indicate that this system is suited for determination of Yoh. The five healthy volunteers received a single oral dose 10 mg of HYoh powder. The average of the maximal serum concentration and the area under the curve (AUC) from 0 to 4 h were 10.3 +/- 0.88 ng/ml and 19.70 +/- 0.87 ng.h.ml-1, respectively. The elimination rate constant (Kc1) was 0.52 +/- 0.03 h, and biological half-life (t1/2el) was 1.32 +/- 0.12 h.
To clarify features of late vitamin K deficiency hemorrhagic disease in Japanese infants, seventeen of 1,687 infants screened by normotests were examined for signs and symptoms suggesting hepatobiliary diseases. Clinical observations disclosed findings suggesting hepatobiliary diseases in 7 of the 17 selected infants with normotest values of less than 40%, and 11 infants had abnormal results in one or more liver function tests. Taken together, 14 of the 17 infants had findings suggesting hepatobiliary diseases. Upon vitamin K supplementation normotest values improved in various degrees in all infants, whether or not they had signs or symptoms of hepatobiliary diseases. Late vitamin K deficiency hemorrhagic disease of infancy may be related to subclinical hepatobiliary diseases.
We administered intracavernous injections of 20 micrograms. prostaglandin E1 to 135 patients with impotence, and evaluated the effects and side effects. Among 135 patients who underwent intracavernous injection of prostaglandin E1 complete erection was observed in 83 (62 per cent), while incomplete erection was noted in 33 (24 per cent). In both groups the erection was sufficient for sexual intercourse. Tumescence without rigidity was noted in 12 patients and no response was obtained in 7. Poor response was seen frequently in patients with disorders of the vascular system and/or damage to the cavernous body of the penis. Priapism after the injection was not observed. Moreover, we never observed any other severe side effects. Intracavernous injection of prostaglandin E1 could be applicable to the therapy of impotence, especially that due to neurogenic disturbance. Since prostaglandin E1 acts quickly and loses its validity rapidly it is considered to be a more suitable agent than other vasoactive drugs.
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To determine a participation of cytomegalovirus (CMV) infection in acute respiratory tract disease (ARTD) of low-birth-weight (LBW) infants, specific antibodies against CMV antigens, IgG antibodies against early antigens of CMV (IgG EA) and IgM antibodies against membrane antigens of CMV (IgG MA) were analyzed. The frequency of IgG EA in patients with ARTD was higher than that in controls (46% vs. 32%), and the geometrical mean titer (GMT) of IgG EA in the patients was also higher than that in controls (50.2 vs. 20.1). Five of 15 ARTD patients had IgM MA, and the frequency was significantly higher than that of controls (33% vs. 1.3%, p less than 0.01). Eleven of 15 LBW patients with ARTD had a history of blood transfusions during the neonatal period, and 5 of them had significant IgM MA indicating active CMV infection. All 4 LBW patients without blood transfusion were negative for IgM MA. These results suggest a close relationship of CMV infection to ARTD of LBW infants, but it remains for further studies whether blood transfusion is a primary source of CMV infection in LBW infants.
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