Spinal tract degeneration confined to the bilateral posterior columns in malnutrition: Report of an autopsy case

Abstract An autopsy case of malnutrition with spinal tract degeneration confined to the bilateral posterior columns is reported. The patient had schizophrenia in adolescence, and suffered from aplastic anemia in late middle age. Subsequently, he took little food due to delusions for 18 months until his death. He had malnutrition resulting in severe hypoproteinemia. He developed gait disturbance, loss of deep tendon reflexes and paresthesia of limbs. Neuropathological examination disclosed tract degeneration confined to the bilateral spinal posterior columns, in addition to the findings of aplastic anemia and hypoxic encephalopathy in the cerebrum. The myelin and axons were severely affected throughout the spinal cord; status spongiosus with many fatty-laden macrophages was seen in these lesions. Neurons in the posterior column nuclei were intact, while the dorsal roots and their ganglia were moderately affected. The unusual distribution and extension of the degeneration of the bilateral posterior columns in the poor nutritional state is discussed.     

Adrenocorticotropic Hormone Unresponsiveness Associated with Hypertrophic Cardiomyopathy

ABSTRACT. The clinical and autopsy findings in a case of adrenocorticotropic hormone unresponsiveness associated with hypertrophic cardiomyopathy are reported. A four-month-old female with feeding difficulties and skin hyperpigmentation from two months of age was admitted with convulsions. She was hypoglycemic with normal serum electrolytes and the presence of hypertrophic cardiomyopathy was indicated by electrocardiogram and echocardiogram. Cardiac arrest occurred on the second hospital day. Low serum Cortisol, high plasma adrenocorticotropic hormone, low urinary 17-ketosteroids, and normal urinary aldosterone excretion were documented after her death. Hypoplasia of the adrenal cortex with a persistent fetal zone and concentric hypertrophy of the heart were found at autopsy. We propose that the pathogenesis of this disease lies in impaired remodelling of the fetal adrenal cortex into the permanent cortex, and postulate an effect of adrenocorticotropic hormone on the myocardium as the cause of hypertrophic cardiomyopathy.     

Expression of sialylated MUC1 in prostate cancer: Relationship to clinical stage and prognosis

Aim: MUC1 is distributed among a variety of normal epithelial tissues, and overexpression of MUC1 is detected in several human cancers. This study aimed to elucidate whether sialylated MUC1 expression correlated with: (i) clinical stage of prostate cancer; (ii) pathological grade of prostate cancer; (iii) pretreatment serum level of prostate‐specific antigen (PSA); or (iv) the disease prognosis in patients with prostate cancer who received endocrine therapy. Methods: We collected 57 biopsy specimens from prostate cancer patients treated with only endocrine therapy, and 10 specimens of normal prostates. These specimens were stained immunohistochemically by using a novel monoclonal antibody, MY.1E12, to detect sialylated MUC1. The levels of expression, clinical stages, pathological grades, pretreatment serum level of PSA and the prognoses of the patients were statistically analyzed for correlations. Results: There were statistically significant correlations between the expression of sialylated MUC1 and pathological grades (WHO grade, P < 0.01; Gleason score, P < 0.05). Expression increased according to the progression of the disease (existence of clinical metastasis, P < 0.05; clinical T‐stage, P < 0.01). Patients with high serum levels of PSA had higher expression than those with low levels (P < 0.01). The level of sialylated MUC1 significantly correlated with progression‐free survival (P < 0.01) and cause‐specific survival (P < 0.01) according to univariate analyses. Furthermore, the level significantly correlated with progression‐free survival according to multivariate analysis. Conclusions: These results suggest that sialylated MUC1 plays an important role in the progression of prostate cancer, and that its expression level in the primary lesion is a useful marker for the prognoses of patients undergoing endocrine therapy.     

Chemosensitivity Test for Human Small Cell Lung Cancer Cell Lines In Vitro

The in vitro response to seven chemotherapeutic drugs of threeestablished human small cell lung cancer (SCLC) cell lines (NCIH69, H 128, N231) was tested by a double soft agar clonogenicassay. Colony formation by the three cell lines was universallyreduced more than 50% by continuous exposure to peak plasmaconcentrations of all the drugs. However by exposure to one-tenthof the peak plasma concentrations, the colony growth of H69was reduced to 25.6% and 37.7% by etoposide and teniposide,respectively, and that of N231 was reduced to 46.7%, 39.0%,27.5% by carboplatin, etoposide and tenipo side, respectively.On the other hand colony formation by the three cell lines wasnot suppressed more than 50% by one-hour exposure to any ofthe drugs tested at one-tenth of the peak plasma concentrations.By one-hour exposure to drugs at the peak plasma concentrations,colony formation by H69, H128 and N23 I was reduced more than50% by cisplatin, etoposide, teniposide and nimustin, by adriamycin,tenoposide and ACNU, and by adriamycin, etoposide, teniposideand nimustin, respectively. It was concluded that these threecell lines have similar sensitivity to seven drugs commonlyused against small cell lung cancer.     

Anaplastic Carcinoma of the Thyroid: Report of Nine Cases

Nine cases of anaplastic carcinoma of the thyroid were reviewed,with focus on the therapy adopted and the prognosis. Surgeryand chemotherapy were considered to have no therapeutic effect.Irradiation therapy, although it was used in only one case,was thought to be effective. Except for one patient with smallcell carcinoma, all of the patients died within six months aftera diagnosis was established. One of the factors which may affectthe prognosis seems to be the histologic figure. Four patientswere found to have other differentiated thyroid carcinomas.Differences in the constituents of the tumor seem to have noinfluence on its biological behavior. The poor prognosis foranaplastic carcinoma of the thyroid is confirmed although thenumber of cases is too small for a definite conclusion to bedrawn.     

Acute fulminant ulcerative colitis with toxic megacolon

An 11-year-old boy with acute fulminant ulcerative colitis (UC) is presented. He had systemic deterioration with frequent diarrhea and lethargy. Acute fulminant UC associated with toxic megacolon was diagnosed by rectal endoscopy and biopsied specimen. He was treated with intensive intravenous administration of prednisolone and total parenteral nutrition. He recovered completely without any surgical intervention.     

Reversibility of organic anion-induced cholestasis: Association with compensatory hypersecretion of biliary phospholipid and protein in the dog

Abstract The effect of a concomitant infusion of organic anions, structurally related phthaleins, on bile flow was studied in anaesthetized dogs. A combination of rose bengal and sulfobromophthalein was found to uniquely and synergistically produce an acute, reversible form of intrahepatic cholestasis (< 10% of control level). This phenomenon was not observed with the administration of those individual organic anions at concentrations previously associated with the induction of intrahepatic cholestasis. The infusion of either a micelle forming bile salt, sodium taurocholate, or a non-micelle forming bile salt, sodium dehydrocholate, rapidly reversed the intrahepatic cholestasis (within 20 min after bile salt infusion). During the choleretic phase immediately following the bile salt infusion, a transient but marked hypersecretion, a disproportionately increased output in relation to that of bile acids, of biliary phospholipid (176% of control level by taurocholate and 138% of control level by dehydrocholate), and an even more striking amount of biliary protein hypersecretion were observed (392% of control level by taurocholate and 357% of control leverl by dehydrocholate). Although the significance of these new post-cholestatic observations requires clarification, it is suggested that the intrahepatic cholestasis induced by organic anions reflects a reversible defect in the mechanism(s) involved in transcellular transport.     

Bladder smooth muscle cell phenotypic changes and implication of expression of contractile proteins (especially caldesmon) in rats after partial outlet obstruction

BACKGROUND: The purpose of the present study was to investigate morphological changes in bladder smooth muscle of rats with partial outlet obstruction. We investigated smooth muscle cell phenotypic changes and implication of synthetic phenotype in contractility decrease and bladder compliance after bladder outlet obstruction. METHODS: Partial bladder outlet obstruction was introduced in female rats. Bladder were removed at 1, 3, 6, 10 and 20 weeks after the obstruction. Temporal pattern of changes in bladder mass, light microscopic pathogenesis and phenotypic expression of the bladder smooth muscle cells in the electron micrographs were investigated. Expression of contractile protein was also investigated by the immunoblotting method. RESULTS: Marked increase in bladder mass with marked thickening of smooth muscle layer was observed at 1 week after obstruction. The ratio of myocytes exhibiting contractile and synthetic phenotypes was almost constant until 6 weeks after the obstruction, but thereafter, synthetic phenotypes gradually increased and the ratio (synthetic/contractile phenotype) was 1.5-fold at 20 weeks after the obstruction. Caldesmon was most markedly expressed after the obstruction among contractile proteins examined by the immunoblotting method. CONCLUSION: Phenotypic changes were confirmed in bladder smooth muscle, and the decrease of the ratio of contractile phenotype was observed after long-term obstruction of the bladder outlet. Among the contractile proteins in the bladder smooth muscle cell, caldesmon was considered a reliable marker for predicting the pathogenetic conditions of the bladder.     

Primary carcinoid tumor of the testis with teratoma metastatic to the para-aortic lymph node

A primary testicular carcinoid tumor with teratoma metastasized to the para-aortic lymph node. After inguinal orchiectomy, serum and urinary levels of 5-hydroxyindoleacetic acid (5-HIAA) were found to be elevated. Chemotherapy consisting of cisplatin, etoposide and bleomycin was not effective on the metastatic lesions. Retroperitoneal lymphadenectomy normalized the levels of 5-HIAA. The patient is alive without recurrence 25 months after the retroperitoneal lymphadenectomy.