A case report of inflammatory pseudotumor of the lung: rapid recurrence appearing as multiple lung nodules.

An inflammatory pseudotumor (IPT), known as a plasma cell granuloma, is a relatively uncommon neoplasm with an unidentified etiology. To our knowledge, an early relapse with multiple lung nodules following lung resection and occurrences in multiple organs is extremely rare. The patient was a 49-year-old man who presented with left chest pain and fever. A chest film demonstrated an 8x8 cm mass in the left lower lobe. During thoracotomy in April 2001, a mass was seen to have invaded the diaphragm with remarkable pleural adhesion. The intraoperative pathological diagnosis was infiltration of inflammatory cells with no malignancy. Therefore, a partial resection of the left lower lobe was performed. Three months after the thoracotomy, a chest CT scan disclosed multiple nodular opacities bilaterally, and an open lung-biopsy of the right lung was performed in January 2002. His past history included an excision of a mass on the penis in another hospital in 1994 and a subcutaneous mass that appeared on the right thigh and disappeared spontaneously following a needle biopsy in 1999. Pathologically there was no fundamental difference among his present lesion and the former two. The pathological diagnosis at each occurrence was inflammatory pseudotumor (IPT). In immunohistochemical study, the staining with smooth muscle actin cells was positive, but was negative for the staining with anaplastic lymphoma kinase (ALK). With no evidence of a neoplastic process, these histopathological and immunohistochemical findings could imply that this case may be a postinflammatory reparative reaction, although his condition exhibited the clinically aggressive behavior of suspected lung metastasis.     

A Case of Infantile Febrile Psoriasiform Dermatitis

Abstract: An infant suffered from psoriasiform dermatitis complicated by severe constitutional symptoms. During his 12 months of hospitalization, the symptoms exacerbated periodically despite numerous therapeutic trials. Histologie findings revealed lichenoid psoriasiform dermatitis with striking eosinophilic necrosis of epidermal cells and satellite cell necrosis. Immunohisfochemically, CD1 + Langerhans cells had almost disappeared, and CD8+ cytotoxic-suppressor T cells were predominant over CD4+ helper-inducer T cells in the epidermis. These findings in the skin biopsy specimens suggested some similarity to graft-versus-host disease but no known cause of that disorder was proved. Finally, methotrexate was effective. The patient became afebrile, and his skin lesions Improved, leaving almost no scarring. This patient seems to have had specific clinical features that do not correspond with any of the known dermatitites. Clinical, histoiogic, and laboratory findings did not uncover any etiologic factors.     

Gastric pneumatosis and portal venous gas in superior mesenteric artery syndrome.

Superior mesenteric artery (SMA) syndrome is a condition where compression of the duodenum between the root of the SMA and the aorta results in intermittent obstruction of the third part of duodenum. Portal venous gas associated with nonischemic bowel is uncommon. We report an 81-year-old man who developed gastric pneumatosis and hepatoportal venous gas due to SMA syndrome, which healed without any sequelae.     

Nucleolar organizer regions in vascular and neoplastic cells of human gliomas.

The number of nucleolar organizer regions in vascular cells and neoplastic cells of human gliomas was counted by a combined staining technique: one-step silver colloid method for nucleolar organizer region-associated argyrophilic protein (AgNOR) and periodic acid-Schiff staining for basement membrane of vascular components. The number of AgNORs (mean +/- SD) in the vascular and neoplastic cells of various tumors tested was as follows: benign astrocytoma (Grade 2, n = 4), 1.52 +/- 0.07 and 1.80 +/- 0.13, respectively; anaplastic astrocytoma (Grade 3, n = 7), 1.98 +/- 0.23 and 2.87 +/- 0.50; and glioblastoma multiforme (Grade 4, n = 11), 2.05 +/- 0.29 and 3.13 +/- 1.13. AgNOR scores in vascular cells of benign astrocytomas, anaplastic astrocytomas, and glioblastomas were significantly higher than those of vascular cells in normal brain tissue without neoplastic alteration (1.26 +/- 0.05; n = 3; P less than 0.01, P less than 0.001, and P less than 0.001, respectively). Moreover, the AgNOR scores of vascular cells in high-grade gliomas (Grades 3 and 4) were significantly higher than those in low-grade gliomas (Grade 2) (P less than 0.01). These results indicate that the proliferative activity of both vascular and neoplastic cells in gliomas increased as histological malignancy advanced, and that the quantification of AgNORs was useful in evaluating proliferative activity in vascular cells as well as in assessing the malignancy of neoplastic tissues.     

Concentrating human sperm before cryopreservation

To improve the quality of cryo-preserved sperm, ejaculated semen was concentrated prior to freezing by means of continuous-step density gradient centrifugation. Freezing was simplified by employing liquid nitrogen vapor with KS-II cryo-medium. The original semen (n = 32, 41 +/- 13 x 10(6)/ml, 17 +/- 11% motility) was improved by the processing to be 68 +/- 29 x 10(6)/ml, 55 +/- 19% motility. Even after the specimens were thawed, sperm concentrations were similar to those of the original semen and 39 +/- 18% motility remained with a mean survival rate of 74 +/- 7.7%. The improved sperm motility and higher survival rate resulted in better post-thaw sperm quality than those of the original semen.     

Gonadotroph adenoma of the pituitary mimicking a prolactinoma

In a 41-year-old woman with mild hyperprolactinemia and amenorrhea, preoperative hormonal and neuroradiological findings suggested the diagnosis of a macroprolactinoma. She underwent transsphenoidal surgery since the tumor size had not changed in spite of bromocriptine administration for 5 months. Consequently, this case was diagnosed as a female-type gonadotroph adenoma on the basis of its characteristic ultrastructural features including a honeycomb Golgi complex, even though endocrinological and immunohistochemical findings were not those of a typical gonadotroph adenoma.     

Evaluation of modern therapy for neuroblastoma

The clinical results were evaluated periodically in 50 cases of neuroblastoma, 4 survived cases out of 15 from 1965 to 1971, 6 survived of 16 (38%) from 1972 to 1982 and 11 survived of 19 (58%) after 1983. In the early period, before 1971, our systemic wide resection was not performed. From 1972, we operated on by our wide resection's technique which based on to preserve main vessels from tumor and lymph nodes. To separate the vessels from the lymph nodes was begun from both iliaca vessels to caeliac vessels. The systemic wide resection might contribute to improve survival rate from 1972 to 1982, however, all of 7 cases in stage IV did not survive. The best result after 1983, 58% survival rate, depends on new intensive chemotherapy accompanying with autologous bone marrow transplantation. All of 3 cases in stage III and 5 of 11 cases in stage IVA survived and better survival rates. Five alive cases in stage IVA received delayed wide resection after 3 or 4 cycles of new regimen A1, and then underwent bone marrow transplantation preconditioned by Melphalan .     

Structural and biochemical basis for the UVB-induced alterations in epidermal barrier function

Ultraviolet light (UVR) induces a myriad of cutaneous changes, including delayed disruption of the permeability barrier with higher doses. To investigate the basis for the UVB-induced barrier alteration, we assessed the epidermal lamellar body secretory system at various time points before and after barrier disruption with a single high dose of UVB (7.5 MED) to murine epidermis. Morphological data were correlated with changes in epidermal proliferation and lipid synthesis, indicative of lamellar body generation. Twenty-four hours following UVB, the stratum corneum (SC) is normal, but a layer of abnormal, vacuolated, and lamellar body (LB)-deficient cells is present, immediately beneath the stratum granulosum (SG)/SC interface. Immediately subjacent to this band of damaged cells, normal keratinocytes that contain intact LBs are present. By 72 h, concomitant with the appearance of a barrier abnormality, extensively damaged cells persist at the SC/SG interface, and abnormal lamellar membrane structures appear in the lower SC. Upper stratum spinosum (SS) and lower SG cells appear normal, with increased numbers of LBs. A barrier abnormality is still present at 96 h, in association with membrane abnormalities in the lower SC interstices, but up to four normal-appearing, subjacent SG cell layers are present. By 120 h, accelerated LB formation and precocious LB extrusion occur throughout the thickened SG; normal lamellar membranes are present in the lower SC; and barrier recovery is almost complete. Whereas, epidermal synthesis of the major barrier lipid species (i.e., cholesterol, fatty acids, and ceramides, including acylceramides) is reduced or unchanged at 24 and 48 h, it increases significantly 72 h after exposure to UVB. Therefore, the delayed disruption of the permeability barrier following acute UVB exposure results from the arrival of a band of lamellar body-incompetent (i.e., damaged) cells at the SG/SC interface. The subsequent, rapid recovery of the barrier, in turn, results from compensatory hyperplasia of subjacent, undamaged SS/SG cells, generating increased numbers and contents of LB. These results underscore the critical role of the stratum compactum in mediating barrier function, and suggest that beneficial therapeutic effects of UV exposure may be due to enhanced lipid production and barrier regeneration.