Junko Suzuki

ASYMMETRICAL HEAD‐TURNING OF PRETERM INFANTS: SOME EFFECTS ON LATER POSTURAL AND FUNCTIONAL LATERALITIES

Asymmetrical head‐turning and its effects on subsequent functional lateralities and postural asymmetries were examined in 44 relatively low‐risk preterm and 53 fullterm infants. Persisting head‐turning to the right was observed more often among preterm infants, as was an asymmetrical skull with flattened right occiput and head‐turning to the right. Asymmetrical trunk posture was present in 20 preterm and four fullterm infants. At nine months right‐hand preference was more marked in preterm infants, and hand preference was well coincident with head‐turning. Changes in hand preference occurred more often among fullterm infants. Asymmetrical gait seemed to correlate with head‐turning in preterm infants.

Temporal and Spatial Expression of a Muscle Actin Gene during Embryogenesis of the Ascidian Halocynthia roretzi

Screening a cDNA library from tailbud embryos of the ascidian Halocynthia roretzi with a Styela plicata mantle actin probe yielded several muscle‐type actin clones. These clones differed from each other in the nucleotide sequences of their 3′non‐coding regions, although the sequences of the coding region were almost identical. One of the clones, HrcMA4, was selected and characterized. HrcMA4 contains an open reading frame of 1137 bp and a 100 bp 3′non‐coding region followed by a poly(A) tail. An antisense probe consisting of a small segment of 3′coding region and a large portion of 3′non‐coding region of the clone was constructed. In situ hybridization analysis with this probe demonstrated that expression of HrMA4 mRNAs was restricted to differentiating muscle cells in tailbud embryos. Signal was not detectable in other regions of the embryo. Northern blot analysis showed that HrMA4 mRNA was undetectable in unfertilized eggs, zygotes and cleavage‐stage embryos. A single band of the HrMA4 transcripts about 1.5 kb in length was first observed in gastrulae. The amount of HrMA4 mRNAs increased rapidly as development progressed. The mRNA was evident in tadpole larvae and newly metamorphosed juveniles. The amount of transcripts, however, decreased after metamorphosis and became undetectable by a week after metamorphosis. Thus, the HrMA4 gene showed strict zygotic expression restricted to the muscle lineage cells.

Nonsurgical management of epidural hematoma in neonates

We successfully treated 4 neonates with epidural hematoma by nonsurgical methods. In 3 of these infants, epidural hematoma was complicated by cephalohematoma and skull fracture; however, the epidural hematoma disappeared after aspiration of the dark red blood in the cephalohematoma, resulting in complete recovery without sequelae. In the remaining infant, epidural hematoma was complicated by intraventricular and subarachnoid hemorrhage and disseminated intravascular coagulation; the patient was successfully treated by conservative therapy, including exchange transfusion and repeated lumbar puncture with only mild motor difficulties remaining. Some patients with neonatal epidural hematomas can be managed by nonsurgical, conservative procedures, including cephalohematoma aspiration.

Carcinosarcoma of the Submandibular Gland

We present a rare case of submandibular gland carcinosarcoma occurring in a 45 year old male patient. His clinical history revealed that the carcinosarcoma had developed from a carcinoma ex mixed tumor in three years. In spite of repeated resection, intensive chemotherapy and irradiation, the tumor recurred and grew rapidly, and the patient died of hemothorax caused by rupture of a pulmonary metastatic tumor. The fourth recurrent tumor and autopsy specimens showed features of carcinosarcoma consisting of three tumor components, i.e., undifferentiated carcinoma, and chondrosarcomatous and osteosar‐comatous growth. The metastatic nodules in both lungs and pulmonary hilar lymph nodes showed the same pattern. Immunohistochemically, the chondrosarcomatous cells were positive for vimentin and S 100 protein, and for epithelial markers such as epithelial membrane antigen (EMA) and cytokeratin (MA 902). Undifferentiated carcinoma cells, on the other hand, were partially positive for muscle actin other than cytokeratin (KL 1). Ultrastructur‐ally, desmosome like structures were seen in the chondrosarcomatous cells. These findings suggest that the sarcomatous lesions might have originated from epithelial cells. Acta Pathol Jpn 40: 827 831, 1990.

67Ga-labeled human fibrinogen: A new promising thrombus imaging agent

Gallium-67 labeled fibrinogen was prepared as a new deep-vein thrombus imaging agent, using deferoxamine (DF) as a bifunctional chelating agent. Excellent physicochemical and biological properties of 67Ga-DF-fibrinogen were obtained. The isotopic clottability was 85.3%. High stability in vivo as well as in vitro was observed. Studies carried out in rabbits with induced thrombi in the femoral vein showed thrombus to blood radioactivity ratio of 11.7, comparable to the value estimated with conventional 131I-fibrinogen 24 h after injection. Remarkable visualization of these thrombi with a scintillation camera provided good evidence for the selective mechanism of this new radiopharmaceutical.

Lipoma of the corpus callosum: A case report with a review

Abstract A case of lipoma of the corpus callosum with developmental delay is reported. No other symptoms of the intracranial mass were noticed. Electroencephalography and plain skull radiography were normal. CT revealed a very low density area with a Hounsfield number of between −40 and −60 in the corpus callosum consistent with fat. The literature was reviewed. Among the collected 87 cases, epileptic seizures are reported in 49, developmental delay and/or mental retardation in 18, and no symptoms in 17.

Clinicopathological studies on pulmonary hypoplasia in very low birth weight infants.

Seven VLBW infants with pulmonary hypoplasia (P.H.) were studied retrospectively and their necropsied lungs were analyzed morphologically and histometrically in an attempt to entablish the clinical and pathological criteria of P.H. Clinically they had various features as follows; 1) causes with oligohydramnios due to amniotic fluid leakage, 2) bell‐shaped chest and/or small lung radiographically, 3) severe respiratory distress Immediately after birth, 4) frequent complications with air leaks, lethal within several hours after birth. Pathologically they showed a series of changes; 1) remarkably decreased LW: BW ratios, less than 0.015, 2) decreased number of alveoli per alveolar duct, less than 3 or 4 alveoli/duct compared with 6.5 of normal controls at 28 weeks gestation, 3) immature duct system and increased interstitium which suggested delay in growth and structural maturation of the lungs. It is suggested that the tendency to develop pulmonary air leaks is not only due to high pressure ventilation but also to histological immaturity of the lungs.

Clinical and Angiographic Characteristics of 35 Patients With Cryptogenic Hemoptysis

BACKGROUND: Hemoptysis can cause a life‐threatening condition and often needs to be treated urgently. Nearly 20% of hemoptysis cases are diagnosed as cryptogenic after clinical investigation. The purpose of this study was to clarify the clinical and angiographic characteristics of cryptogenic hemoptysis. METHODS: We retrospectively reviewed medical records of 35 patients admitted to our hospital with cryptogenic hemoptysis from October 2010 to September 2014. RESULTS: In the 35 cases, bronchial artery embolization was successfully performed in 33 patients (94.3%), whereas bronchoscopic hemostatic therapy was added in one patient (2.8%), and embolization was not performed in one patient (2.8%) because the bronchial artery was too narrow. In the successful embolization group, the non‐rebleeding rate was 97.0% for 20 months. The angiographic findings revealed that the diameter of the bronchial arteries was < 2 mm in 13 patients, 2 to 3 mm in 17 patients, and > 3 mm in five patients. Hypervascularization was detected in 29 patients (82.9%) and small bronchial aneurysms in eight patients (22.9%). The amount of hemoptysis was slight (< 50 mL/d) in 12, mild (50–100 mL/d) in 11, moderate (100–200 mL/d) in eight, and massive (> 200 mL/d) in four patients. No obvious relationship was found between the diameter of bronchial arteries and the amount of hemoptysis. CONCLUSIONS: BAE was highly effective for the management of cryptogenic hemoptysis. Most cases of cryptogenic hemoptysis have angiographic abnormalities, including small or microaneurysms, which were suspected as the cause in some cases.

Relationship Between Lung Cancer and Mycobacterium Avium Complex Isolated Using Bronchoscopy

Introduction: The incidence of Mycobacterium avium complex (MAC)-positive respiratory specimen cultures and MAC lung disease (MACLD) is increasing worldwide. This retrospective study aimed to assess the association between MAC culture-positive bronchoscopy specimens and lung cancer. Materials and Methods: The medical records of 1382 untreated lung cancer patients between 2003 and 2011 were collected using our hospital database. Of them, records for 1258 that had undergone bronchoscopy together with sampling for mycobacterial culture were reviewed. Patient characteristics were compared between those with MAC-positive/other nontuberculous mycobacteria (NTM)-negative bronchial washings and those with MAC-negative/other NTM-negative bronchial washings. Patients with MAC-positive lung cancer were cross-sectionally divided into MACLD and non-MACLD groups, and their features were assessed. Follow-up data for patients with lung cancer but without MACLD were reviewed for subsequent development of MACLD. Results: Of the 1258 patients with lung cancer, 25 (2.0%) had MAC-positive/other NTM-negative bronchial washings. The proportion of women (52% vs 30%; P = 0.0274) and patient age (72 years vs 69 years; P = 0.0380) were significantly higher in the MAC-positive/other NTM-negative lung cancer group (n = 25) than in the MAC-negative/other NTM-negative lung cancer group (n = 1223). There were 10 patients with lung cancer and MACLD and 15 without MACLD; significant differences in patient characteristics were not found between the two groups, and none of the 15 patients without MACLD subsequently developed MACLD. Conclusion: MAC culture-positive bronchial washing is positively associated with lung cancer. Female sex and advanced age, but not lung cancer characteristics, were found to be associated with MAC infection in patients with lung cancer.

An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids

A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS). The administration of corticosteroids resolved the obstructive jaundice without surgical treatment or endoscopic drainage. Obstructive jaundice caused by IRIS should first be treated with corticosteroids before invasive treatment.