Renal function in patients with yusho

Renal functions were examined in 102 patients with yusho in 1988, Frequencies of proteinuria, microhematuria and history of renal diseases were not different from 20 age-matched controls. The means of blood urea nitrogen, serum creatinine and serum uric acid levels of yusho patients did not differ from those of controls. The levels of serum beta 2-microglobulin and its urinary excretion showed no difference between two groups. Serum concentrations of sodium, potassium, chloride, calcium and phosphorus revealed no abnormality in all patients except for one who had hypophosphatemia. Urinary excretions of phosphorus, however, were significantly higher in yusho patients than in controls. Serum PCB levels, which were still higher in yusho patients, did not correlate with urinary excretions of phosphorus. The mechanism and the clinical significance of this phenomenon remain to be elucidated.     

Hepatic squamous cell carcinoma with hypercalcemia in liver cirrhosis

Primary squamous cell carcinoma of the liver is exceedingly rare and has previously been reported in association with hepatic teratoma, hepatic cyst or hepatolithiasis. This paper describes an autopsy case of squamous cell carcinoma which developed with hypercalcemia in a cirrhotic liver. This cancer was characterized histologically, immunohistologically and ultrastructurally, and was found to exhibit immunofluorescence positivity for anti-epidermal keratin monoclonal antibody, together with the presence of tonofilaments scattered sparsely in the cytoplasm of the cancer cells.     

Analysis of PCB- and PCT-methylsulfones in the blood in yusho patients

Polychlorinated biphenyl (PCB)- and terphenyl (PCT)-methylsulfones were isolated from the blood of yusho patients sampled in 1987 and characterized by gas chromatography with mass spectrometry (GC/MS), electron capture detection (GC/ECD) and flame photometric detection (GC/FPD). GC/MS analysis for PCB-methylsulfones showed that all the blood tested (nine samples) contained the tri- and tetrachloro congeners. The concentrations of PCB-methylsulfones were estimated to be 15-120 ppb. PCT-methylsulfones detected in the same fraction, which were confirmed by GC/MS comparison with authentic samples as well as by GC/ECD and GC/FPD, consisted of tetra-, penta- and hexachloroterphenyl methylsulfone congeners. The levels of PCT-methylsulfones in six samples detected were preliminarily estimated to be 10-270 ppb, on the basis of a PCB-methylsulfone standard. Their origins and biological effects are unclear at present.     

Polychlorinated dibenzo-p-dioxins in the subcutaneous adipose tissue of yusho patients

The abdominal subcutaneous adipose tissues, the mother milk, and the blood samples of yusho patients were collected between 1986 and 1988, and analyzed for polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) by high resolution gas chromatography/high resolution mass spectrometry in selected ion monitoring mode. PCDDs and PCDFs were found all of the samples examined.: 1,2,3,7,8-Pentachlorodibenzo-p-dioxin (pentaCDD), 1,2,3,6,7,8-hexaCDD, octaCDD, 2,3,4,7,8-pentachlorodibenzofuran (pentaCDF), and 1,2,3,4,7,8- and 1,2,3,6,7,8-hexaCDF were detected. The levels of PCDDs was several times lower than those of PCDFs in all samples. The concentrations of PCDDs and PCDFs found in the fat of the mother milk were similar to those of the adipose tissues. On the other hand, the levels of PCDDs and PCDFs in the blood samples were several hundred times less than those of the adipose tissues.     

Hepatic giant cell carcinoma. An ultrastructural and immunohistochemical study

Hepatocellular carcinoma with osteoclast-like giant cells (hepatic giant cell carcinoma [HGCC]) is a rare entity, with only three cases reported. The tumor is histologically similar to giant cell tumor (GCT) of bone, and the origin of the multinucleated giant cells and mononuclear stromal cells has not been determined. The purpose of this report is to present a case of this rare tumor and compare its ultrastructural and immunohistochemical features with those of a conventional GCT of bone. Histologically, the HGCC consists of sheets of osteoclast-like giant cells with a background of mononuclear cells. The giant cells lack the pleomorphism seen in hepatocellular carcinomas with anaplastic giant cells. At the light microscopic level, most of this tumor was nearly identical to a GCT of bone, but several microscopic fields (less than 5% of the tumor) had the histologic appearance of a "usual" hepatocellular carcinoma. The hepatic tumor was negative for HAM 56, epithelial cytokeratins, muramidase, and alpha-1-antitrypsin, with only focal positivity for chymotrypsin in mononuclear and giant cells. The GCT was strongly positive for alpha-1-antitrypsin and chymotrypsin in both the mononuclear and giant cells and showed focal, weak staining for AE1 and AE3 in the mononuclear stromal cells. Ultrastructurally, both mononuclear and giant cells of the HGCC showed features typical of hepatocellular carcinoma. Although the patient presented in this report died, the pattern of growth was different from most hepatocellular carcinomas. The overall histologic features of this tumor are distinctive and appear to justify separating this variant from other types of hepatocellular carcinoma.     

Polychlorinated dibenzofurans (PCDFs) in the subcutaneous adipose tissue of yusho patients and normal controls

Polychlorinated dibenzofurans (PCDFs) are well known to be the toxic chemicals in both animal experiments and human studies. It is, therefore, important to determine the level of PCDFs still retained in patients for understanding relationship between the concentration of PCDFs and present symptoms of the disease. In this study, the abdominal subcutaneous adipose tissue of 18 yusho patients and those of 11 normal controls who were all of volunteers were collected, and their levels were determined by high resolution gas chromatography/high resolution mass spectrometry. Results obtained were as follows: The principal compounds detected in the adipose tissue of yusho patients were 2,3,4,7,8-pentachlorodibenzofuran (PenCDF), 1,2,3,4,7,8- and 1,2,3,6,7,8-hexachlorodibenzofuran (HCDF). The concentration of the compounds in 7 patients, wearing typical symptoms, from 160 to 3,000 ppt for 2,3,4,7,8-PenCDF, from 51 to 1,000 ppt for 1,2,3,4,7,8-HCDF, and from 16 to 220 ppt for 1,2,3,6,7,8-HCDF. In normal controls, 2,3,4,7,8-PenCDF was detected only in five samples at the low level of from 16 to 38 ppt. On an average, PCDF levels in in the typical 7 yusho patients and 11 normal controls were 1,900 ppt and 16 ppt, respectively. On the basis of the results, the concentrations of PCDF congeners in the adipose tissues of the typical 7 patients was 100 times higher than that of the normal controls. Hence, we consider that the present levels of PCDFs in the patients probably play an important role for the symptoms of the yusho.