Takeshi Kurozumi

Dissecting aneurysm: A clinicopathologic and histopathologic study of 111 autopsied cases

One hundred eleven autopsy cases of dissecting aneurysm were collected from western Japan. The ratio of males to females was 3:2 and the sixth and seventh decades of life were most frequently affected. All 11 cases of Marfans syndrome were in patients under 40 years of age. DeBakeys type III dissections showed a male predilection and more severe atherosclerosis than in control cases. Many patients with types I and II dissections died of hemorrhage in the acute phase, while many patients with type III dissection died in the subacute or chronic phase, and half of the patients died of diseases other than hemorrhage. Hypertension was recognized in 73.7% of the 95 cases which showed no other obvious risk factors. Histologic examinations suggested that cystic medial necrosis was related to the pathogenesis of the disease in Marfans syndrome, but was not so apparent in non-Marfans syndrome. Laminar medial necrosis was found in many cases, but was considered to be a secondary ischemic change following dissection, as supported by other investigators. There were only a few cases in which dissection seemed to be directly caused by atherosclerosis.

Cerebral and aortic atherosclerosis in Hisayama, Japan

This study of autopsy cases in the general population of the town, Hisayama, describes the incidence and severity of aortic and cerebral atherosclerosis in Japan. Atherosclerosis was more severe in the aorta than in the cerebral arteries of all age groups and its disparity became more conspicuous with age. In hypertensive cases, atherosclerosis was more severe in both the aorta and the cerebral arteries from and beyond the 6th decade of age. The severity of atherosclerosis in the aorta in those with systolic hypertension was lower under the age of 79 and higher after the age of 80 than in diastolic hypertension; the cerebral arteries were afflicted similarly by the two forms of hypertension. The serum cholesterol level correlated better with the severity of aortic than cerebral atherosclerosis.

Electron microscopic study on permeability of the aorta and basilar artery of the rabbit—With special reference to the changes of permeability by hypercholesteremia

Abstract Morphological characteristies of the rabbit aorta and basilar artery, and their relationship to the permeability pattern were studied at the ultrastructural level, by using H. R. peroxidase and ferritin as the tracers. In addition, the influence of hypercholesteremia on permeability of these arteries was studied. 1. 1. Reaction product of peroxidase and ferritin particles were observed in the caveolae and vesicles of the endothelial cells of the aorta and of the basilar artery. They were also observed in the subendothelial space of the aorta, but not in the basilar artery. The endothelium of the basilar artery was closely applied to the internal elastic lamina and endothelial cells showed a small number of caveolae and vesicles and the presence of tight junction in all of the intercellular space. 2. 2. Unlike the aorta, the intima of the basilar artery showed the barrier function equivalent to the blood-brain barrier of the capillaries in the brain. 3. 3. In the rabbits fed cholesterol for 1 wk, the intima of the aorta showed a slightly enhanced junctional transport. In the rabbits fed colesterol for 16 wk, endothelium overlying the foci of foam cell accumulation in the intima of the aorta showed an enhanced junctional and vescular transport. 4. 4. The intima of the basilar artery showed neither the foci of foam cell accumulation nor altered permeability even in the rabbits fed cholesterol for 16 wk.

Hypertension-induced cerebral atherosclerosis in the cholesterol-fed rabbit

Foam cell lesions were found in cholesterol-fed rabbits with induced hypertension, particularly in intimal cushions at branching sites, where permeability to horseradish peroxidase was enhanced. Permeability to horseradish peroxidase was enhanced at the edge of intimal cushions without foam cell accumulation. This finding suggests that permeability is increased before foam cell infiltration. No foam cell lesions were observed in the intima of cerebral arteries distant from branching sites, but insudation of plasma constituents here caused endothelial cells to separate from the subendothelial matrices. Foam cell lesions were absent from the cerebral arteries in normotensive cholesterol-fed rabbits.

Monocrotaline-induced renal lesions

Monocrotaline, an alkaloid obtained from Crotalaria spectabilis, provides an experimental model for studies of mesangiolysis as seen in Habu venom poisoning and hemolytic-uremic syndrome. Renal lesions induced in rats by a single intraperitoneal administration of monocrotaline were examined by light and electron microscopy. Two weeks after the injection glomerular capillaries showed focal endothelial cell detachment and adhesion of platelets to the basal lamina. At 3 weeks there was no endothelial denudation but the mesangium was severely edematous. Mesangiolysis occurred at 4 weeks, accompanied by dilatation or obliteration of capillaries and necrosis and hemorrhage in the mesangium. Insudation of plasma constituents facilitated by the endothelial injury appeared important in the pathogenesis of mesangiolysis. Fusion of capillaries seemed to lead to capillary aneurysmata and necrosis of the mesangium. These glomerular lesions induced by monocrotaline were similar to those of Habu venom poisoning or hemolytic-uremic syndrome.

CARCINOSARCOMA OF THE PROSTATE

The present report describes a rare prostatic tumor occurring in a 78‐year‐old Japanese male. The histological features were those of carcinosarcoma involving an adenocarcinoma and a chondrosarcoma, with metastasis to the liver. The carcinomatous component stained positively for prostatic acid phosphatase (PAP) by an immunoperoxidase technique. The literature is reviewed. ACTA PATHOL. JPN. 35 : 481–487, 1985.

Effects of hypertension and hypercholesteremia on the permeability of fibrinogen and low density lipoprotein in the coronary artery of rabbits: Immunoelectron-microscopic study

In an attempt to elucidate the effects of hypertension and/or hypercholesteremia on atherogenesis, with special reference to permeation and deposition of fibrinogen and low density lipoprotein (LDL) in the coronary artery, we studied electron-microscopically the localization of fibrinogen and LDL. In the untreated control rabbits, fibrinogen was localized in the caveolae and vesicles of the endothelial cells and in very small amounts in the subendothelial spaces of the coronary artery. Hypertension or hypercholesteremia was related to an enhanced insudation of fibrinogen into the subendothelial spaces of the coronary artery. The insudation of fibrinogen seemed to have occurred by way of vesicular transport and, to some extent, by junctional transport. LDL was localized only in the caveolae and vesicles of the endothelial cells of the coronary artery in the untreated control rabbits. LDL was deposited in the subendothelial space of the hypercholesteremic rabbits, with or without hypertension. Despite the lack of clear-cut and direct evidence, the insudation of LDL into the intima appeared to be enhanced by way of vesicular transport.

Buerger's Disease: Histology and Pathogenesis

The average age of the patients who underwent operations was 41. Among them, 107 were resected surgically, 12 from upper and 95 from lower extremities. The arterial trees of 6 patients resected from amputated lower extremities were examined systematically from proximal to distal arteries. Surgically resected arterial segments from 7 patients were cut longitudinally. Fibrinolytic activity of the arterial segments was examined in 3 patients by Todd’s fibrinolysis autography.

Intestinal-type mucinous adenocarcinoma arising from the prostatic duct

Abstract  We present a case of mucinous adenocarcinoma of intestinal type arising from the prostatic duct in a 72‐year‐old Japanese man. The patient presented with macroscopic hematuria. Cystourethroscopy exibited a mucus deposit at the 5 o’clock position of the verumontanum portion. A transurethral biopsy specimen revealed mucinous adenocarcinoma. A radical retropubic prostatectomy was performed. In the prostatectomy specimen, the cancer lesion mainly showed intraductal growth in the prostatic ducts with scattered mucin lakes in the prostatic stroma. There were no abnormalities in the urethral epithelium. The cancer cells resembled the intestinal epithelium rather than either the prostatic duct or the acinar epithelium, which showed diffusely positive immunohistochemical staining for carcinoembryonic antigen, but showed negative staining for prostate‐specific antigen. Therefore, these findings suggest mucinous adenocarcinoma of intestinal type arising from the prostatic duct. A number of cases with mucinous adenocarcinoma arising from the prostatic urethra resembling the present case have been reported, but this is the first known case of carcinoma arising from the prostatic duct.

ULTRASTRUCTURAL STUDY OF EXPERIMENTAL THROMBOSIS IN PULMONARY MUSCULAR ARTERIES OF RABBITS

In order to clarify the ultrastructural change of initial phase of thrombosis, an autologous clot Injection or one shot of thrombin was performed via an auricular vein of each rabbit.